Transcript for Mark Hyman, James Gordon, and Penny George — The Evolution of Medicine

December 3, 2015

Dr. Mark Hyman: I think one of the biggest scientific discoveries of the last 30 years is that food isn’t just energy, that it’s actually information that actually provides instructions in a literally minute-to-minute, bite-by-bite basis to everything that’s going on in your body.

Ms. Krista Tippett, host: A transformation of medicine is underway — a transition from a science of treating disease to a science of health. Dr. Mark Hyman is a pioneer in the new discipline of functional medicine. He’s best known, perhaps, as Bill Clinton’s transformative personal physician. I joined him with two other visionaries helping to align medicine with a 21st-century grasp of human wholeness. James Gordon is an expert in using mind-body medicine to heal depression, anxiety, and psychological trauma. Penny George became a philanthropist of integrative medicine after she experienced cancer in mid life.

Dr. Penny George: The standard of care really looked at me as a body part, and a disease, and it was clear to me even then that I was so much more than that. And what I found was it was the experience of taking charge of my own return to well-being, more than just health. And I ended up at a place that was so much better than where I had been before I started that I thought, everybody should have access to this.

Dr. James Gordon: We’re looking to create the opportunity for people to heal themselves and to create that environment. And that’s what we do, whether we’re working in the middle of a war, or after a natural disaster, or with a hospital system, or with a corporation. It’s all the same.

Ms. Tippett: I’m Krista Tippett, and this is On Being.

[music: “Seven League Boots” by Zoe Keating]

Ms. Tippett: Penny Pilgrim George is the board chair of the Penny George Institute Foundation, which supports the work of the largest hospital-based integrative medicine program in the U.S., in the Allina Health System of Minneapolis. James Gordon is executive director of the Center for Mind-Body Medicine and a clinical professor in the departments of psychiatry and family medicine at Georgetown Medical School. And Mark Hyman is a practicing family physician and director of the Cleveland Clinic Center for Functional Medicine. I spoke with them before a live audience full of health care practitioners at the University of Minnesota.

Ms. Tippett: Part of the integrity and depth of all of your work is also that you — it’s grounded, actually, for each of you, also in an experience of a health crisis. So Penny had her cancer. Jim, you work with depression and you’ve walked through depression as well. And Mark, you were medical director of Canyon Ranch, is that right? And three months into that — so you were already on this path, but three months into that you came down with chronic fatigue syndrome, and there’s one place you said it was like having A.D.D., dementia, and depression all at the same time.

[laughter]

Dr. Hyman: Pretty much.

Ms. Tippett: Sounds pretty bad.

Dr. Hyman: And a lot of other things, yeah. No, I was super healthy. I was a yoga teacher before I was a doctor, studied nutrition in college. I really focused on wellness and I ended up living in China for a year and didn’t realize it but I got mercury poisoning there from the pollution. And I literally went from riding my bike 100 miles a day and remembering 30 patients without notes and dictating charts to not being able to walk up the stairs, to not being able to remember where I was at the end of a sentence, to having a whole system breakdown where my gut broke down and my immune system broke down. I mean, everything was just off. And I went to doctor after doctor, went to top experts at Columbia and Harvard. They just searched and searched and came up completely blank. They’re like, take Prozac, you’re depressed, you’re stressed, you’re this, you’re that, and I’m like, “I’m not. Something’s wrong.”

And it was then when I realized that I sort of reached the limit of what actually we could do with the kind of thinking we have in medicine. And I was invited to hear a talk by a guy named Jeffrey Bland, who’s a nutritional biochemist who worked with Linus Pauling, and he was a big thinker. He was a systems thinker. And he painted a picture of medicine that was completely different than what I learned in medical school, which was not disease-based, but based on systems thinking. And I said, either this guy’s crazy or he’s a genius, and I have to figure it out. So I started to just imbibe everything I could about this, and try it on myself, and try it on my patients. And I kept seeing miracles in my patients, that people are getting better from things that I never would have imagined.

Ms. Tippett: There’s a way you’ve talked about this through your own experience, you wanted to understand “the puzzle of yourself...”

Dr. Hyman: Yeah.

Ms. Tippett: ...and understand how the body works as a network, which is...

Dr. Hyman: Yeah. So, basically I had...

Ms. Tippett: ...the systems ...

Dr. Hyman: ...to break down how we get sick and how we get better...

Ms. Tippett: Yeah.

Dr. Hyman: ...and in chronic fatigue, everything goes wrong. So I literally had to understand my body from the inside out, and through the lens of functional medicine, which is really a systems view of health. It’s based on dealing with the causes and not just the symptoms, dealing with the body as ecosystem, or looking at the whole organism, not just the organs. And it’s as big of a paradigm shift as the Earth is not flat, Earth is not the center of the universe. It’s huge. And it’s basically dismantling our concepts of disease as we speak, and yet it’s completely absent from most medical institutions and thinking in medical schools. I mean, just the concept of the microbiome, for example, is now...

Ms. Tippett: Yeah. Right.

Dr. Hyman: ...taking hold, but we don’t know what to do with it. How does it make sense that your gut flora could cause depression, anxiety, autism, autoimmune disease, diabetes, obesity, cancer, heart disease? I mean, that doesn’t make sense given our way of thinking.

Ms. Tippett: Yeah. I mean, I first heard you speak — we were both at a conference a few years ago, we didn’t meet there — and you talked about functional medicine, and that was the first time I’d heard the term. And I’d actually had a lot of conversations with people like Penny over the years about integrative medicine, and I thought, the fact that you have to create something called “functional medicine...”

Dr. Hyman: Yeah.

Ms. Tippett: ...it reveals what kind of a rut we’ve been in.

Dr. Hyman: Yeah. No, it’s true. It’s just the evolution of medicine, right? We went from — you go with a head pain to the head doctor. You go with a stomach pain to the stomach doctor. You go with a joint pain to the joint doctor. It sort of makes sense, right? It’s very crude...

Ms. Tippett: Sort of, yeah.

Dr. Hyman: ...it’s very rudimentary and — but it doesn’t actually reflect science anymore. So as we’re beginning to shift out of it, we have to sort of reorganize our thinking, and it’s tough. It’s tough.

Ms. Tippett: Penny, do you want to say something?

Dr. George: I think it goes a lot to some of our deepest assumptions about things. And I think when we discovered the antibiotics and the sulfa drugs in the early decades of the 1900s, it created this idea that there’s a pill for every ill. And I think we’re still in that mindset, and I think there are some sort of sacred cows involved in it as well — the presumption is that there is a pill, and we just have to figure out what it is, and if it isn’t a pill it’s an herb.

Dr. Hyman: Right.

Dr. George: But if we don’t get beyond substituting herbs for pills, we won’t have gotten very far.

Dr. Hyman: Right. Right. I mean, that’s the sort of the evolution, right? We go from that to alternative medicine, which is other modalities from other countries that have use and that are integrated systems, and they go, well, that’s great. Why don’t we bring that into conventional medicine, and we call that “integrative medicine”? But you need a different roadmap to know how to apply those tools. Those are tools. Functional medicine, I say, is the map. It’s the GPS, the operating system, and it’s agnostic when it comes to the tools. It could be surgery. It could be meditation. It could be exorcism or exercise. I don’t know, whatever it is.

[laughter]

And you know those patients you need something ...

Ms. Tippett: OK, this is public radio, all right?

[laughter]

Dr. Hyman: I know. I gave a talk once at Cleveland Clinic and I said that joke, and someone complained to the C.O. that Dr. Hyman’s recommending exorcism...

[laughter]

...and I’m like, no.

Ms. Tippett: So, let’s name the completely different center of this new vision, which you all work on and write about, which is, it’s not focused on disease, but on health, right? That, Mark, you talk about medicine as the science of health. You say, I don’t really think in terms of diseases anymore, and...

Dr. Hyman: Yeah.

Ms. Tippett: ...Penny, to me, that’s also there when you say, “Wholeness, to me, meant a lot more than just whether or not the cancer cells were gone for good.”

Dr. Hyman: I mean, it’s about balance, right? We now think you have a disease or you don’t. But the truth is that disease arises from an imbalance in the system. So I think of functional medicine as being like a soil farmer, as opposed to an industrial agriculturist is putting chemicals on the plant. We’re actually taking care of the soil so disease can’t actually occur, or it goes away as a side effect of creating health. So most of us who are doctors in this room probably never took a course in medical school called “Creating Health 101.”

Ms. Tippett: So you deal with the system. You...

Dr. Hyman: Right. It’s very simple.

Ms. Tippett: ...get the ecosystem functioning.

Dr. Hyman: Yeah. You take out of the bad stuff...

Ms. Tippett: Flourishing.

Dr. Hyman: ...you put in the good stuff. What are the ingredients for creating a healthy human?

Ms. Tippett: Yeah.

Dr. Hyman: It’s a pretty dumb, short list. It’s obvious, right? The right food, the right nutrients, the right balance of hormones, light, air, water, connection, sleep, movement, love, community, meaning, purpose. Those are the ingredients for healthy humans. It’s not rocket science.

[laughter]

Dr. Gordon: I think what’s important also is that we’re really going back to what’s basic to all the great, ancient systems of healing. Now we have the modern science so that we can test more accurately for these imbalances, but understanding exactly what Mark is talking about, about the basic functions, this takes us back to Hippocratic medicine...

Dr. Hyman: Yeah.

Dr. Gordon: ...Chinese medicine, Ayurvedic medicine, it’s all there. And I think one of the things that’s crucial in this transformation, though, is the transformation in consciousness. That without that, the danger that we face is of lapsing into the same kind of mechanistic treatment, and that’s the part that I’m most...

Dr. Hyman: Yeah.

Dr. Gordon: ...interested in. And, with that change in consciousness, then it becomes possible to use all the modalities, to be open to all these ways of working with people. But even more important, you become open to seeing the incredible power that each of us has for healing, and to creating the context, whether it’s a small group or a whole community, in which people can come together to heal themselves. And to me, that’s the most fundamental and the most difficult shift to happen...

Dr. Hyman: Yeah.

Dr. Gordon: ...because it threatens a kind of ...

Ms. Tippett: The consciousness, the shift in consciousness?

Dr. Gordon: The shift in consciousness is absolutely fundamental, and it’s most difficult for the medical establishment, because that threatens the role of the physician. It threatens the whole way that medicine is done, which essentially is that the physician or the institution does things to or for people, which of course you need if you’re hit by a truck, or you have an overwhelming infection. But for most of the problems that most of us have, it doesn’t work very well.

Ms. Tippett: Hmm.

Dr. Gordon: And that’s why we need to understand that, and we need that to be part of the education of all physicians, part of the education of all of our children, so that that becomes a given.

Dr. Hyman: Yeah.

Ms. Tippett: It’s a huge tradition and a huge complex of structures to change, right? And what we’re up against is also just the human condition, that change is unfamiliar and many of us resist it and systems resist it.

Dr. Hyman: Yeah.

Dr. Gordon: Yes.

Dr. Hyman: Jim’s work is so critical because it answers the second piece of the question, which is — one is, how do you change biology, right? What’s the science of that? And the second is, how do you change behavior? How do you get people to actually do the things that are going to be necessary for self-care and transformation and awakening? And that’s really at the heart of Jim’s work, and is really the power of each other. It’s the power of connection, community, peer pressure in a positive way, and that’s the insight that I had when I helped develop the Daniel Plan, which is this faith-based wellness program with Rick Warren, where we used his small groups in his church of 30,000 to help transform the health of that community. And they were very sick, very overweight — the average weight was 210 for men and 170 for women. That was average. And yet they were able to change their culture, change their behavior. They did it together, they supported each other. And people lost a quarter million pounds in the first year, and they had all these health transformations. We ended up writing a book called The Daniel Plan. I wanted to call it The Jewish Doctor’s Guide for Christian Wellness.

[laughter]

Ms. Tippett: Yeah.

Dr. Hyman: They didn’t go for that. But, actually, we did win the Christian Book of the Year award, which is...

[laughter]

...amazing to me that I’m probably the only Jewish guy who’s ever won the Christian Book of the Year award.

[laughter]

But the power of that is not that it’s faith-based, but it’s really that it’s the power of community, and that’s the model that is being used — with Jim with great effectiveness in all sorts of environments, but really needs to be central to healthcare, and it’s...

Ms. Tippett: Yeah.

Dr. Hyman: ...hard for people to get that.

[music: “Tracks” by Broadway Project]

Ms. Tippett: I'm Krista Tippett and this is On Being. Today, in a public conversation on the transformation of medicine. I’m with three visionaries on front lines of this change: functional medicine pioneer Mark Hyman, psychiatrist James Gordon, and philanthropist Penny George.

[music: “Tracks” by Broadway Project]

Ms. Tippett: You’re also touching, you’re all touching on something that is — it’s another really obvious, common sense human piece of this, which is just the human connection, and also that on the one hand it’s about individuals taking charge of their health...

Dr. Hyman: Yeah.

Ms. Tippett: ...but it’s also about us being there for each other.

Dr. Gordon: Yeah.

Ms. Tippett: And, Penny, your father was a surgeon, and do you remember times when he — I mean, he made house calls, right? So, I feel like there are these pieces, as you said, Jim, where we’re on all these frontiers technologically, and then there are also old truths that we forgot that are getting reintegrated. It seems to me that kind of human touch was baked in in another era of medicine.

Dr. George: And also I think they understood just the power of caring, and I think we’ve forgotten that. And I think — another piece I want to bring into the conversation is the importance of the idea of well-being...

Dr. Hyman: Yeah.

Dr. George: ...because health is a piece of well-being, but there’s...

Dr. Hyman: Yeah.

Dr. George: ...more than that. And altruism, for example, the doing for others has tremendous physical benefits. If that were — we should probably prescribe that for people.

Dr. Hyman: Yeah. It stimulates the same receptors in the brain as sugar so ...

Ms. Tippett: Wow.

Dr. Hyman: Pretty good.

[laughter]

Ms. Tippett: That’s good. And I was really intrigued that the George Institute, the Penny George Institute, has this transformative nurse training, which is all about, again, deepening that first level.

Dr. George: Well, nurses never lost the appreciation for healing. And I think giving them license to go back and do what it is they most want to do has been liberating. I think it’s helped with turnover. I think it certainly helped the patients.

Ms. Tippett: Well, and how many of us have had an experience of being in the hospital and the people you feel healed you — the doctors treated you, I mean, not to dismiss that — but the nurses brought you back to life.

Dr. George: I have a short story about that. When I was in the hospital, it was for a different procedure before my breast cancer, and I woke up and there was a woman standing with a mop in the doorway, and she said, “I will be gone when you leave, and I just wanted to tell you I hope that you heal really well.” And that stands out for me more than anything else in that entire hospital. It was like she...

Dr. Hyman: Wow.

Dr. George: ...really embodied that caring, and I felt it in a way that I didn’t feel it from the physicians or anyone else. So it doesn’t have to be high on the...

Ms. Tippett: Yeah.

Dr. George: ...medical food chain to make a difference.

Dr. Gordon: Penny — because, so often, nurses are pushed into bureaucratic roles, and they’ve been pushed out of patient care, and they’re sitting in front of computers all the time. So we’re working with the largest hospital system in Indiana and creating what we hope will be the first wellness hospital, The Center for Mind-Body Medicine, with the Eskenazi. And we’re training 200 of their key leaders — clinical leaders, administrative leaders, and natural leaders — the security guard everybody likes to hang out with, or the Starbucks lady who has lots of good stories that make people feel good. We’re training them in mind-body medicine and nutrition, and they’re going to work with all 4,000 employees and, in turn, with a couple hundred thousand patients using this model.

But we see just how much — and this was a lovely hospital to begin with — but still, there’s so much frustration, and we see them drink up what we have to offer like they’re sponges, and losing lots of weight, and starting their department meetings with meditation, and then if things get tense and tight, everybody gets up and shakes and dances for a while...

[laughter]

...and they come back. And I think all of us, we see the importance of working with institutions and really creating a whole different atmosphere.

Ms. Tippett: Jim, you have some practices of self-care that you talk about and it’s just like Penny, you said these things don’t have to be high on the food chain. You just mentioned shaking and dancing, which I have to say makes me a little nervous.

[laughter]

But there’s also...

Dr. Hyman: The dancing or the shaking?

Ms. Tippett: ...soft belly breathing, which sounds like something you could do in private.

[laughter]

Would you just talk a little bit — and again, these are simple, but you talk about them as profound, that there are all these ways that we can begin to integrate transformative practices into our very ordinary lives.

Dr. Gordon: Well, the world has so many beautiful traditions to help us quiet our nervous system, mobilize our imagination, break up fixed patterns in all the chronic illnesses that we’re talking about. The body and mind all get shut down, and to break those patterns up and to bring in what Hippocrates would have called the vis medicatrix naturae, if he spoke Latin instead of Greek.

[laughter]

“The healing force of nature.”

Ms. Tippett: And if he spoke English? Yeah.

[laughter]

Dr. Gordon: That’s what we’re looking for. We’re looking to help people to create the opportunity for people to heal themselves and to create that environment. And that’s what we do, whether we’re working in the middle of a war, or after a natural disaster, or with a hospital system, or with a corporation. It’s all the same.

Ms. Tippett: What’s — the soft belly breathing is something you’ve taught people even in war zones, so just teach us that.

Dr. Gordon: So let’s say we’re in the middle of Gaza and the civil war is going on and we happened to be there during ...

Ms. Tippett: And you’ve been there.

Dr. Gordon: Fatah and Hamas are fighting each other. People are being killed in the streets. Nevertheless, people are coming to our training. So what we do is we say, OK, we can’t do anything about what’s happening outside so sit comfortably in your chair, and if you feel comfortable and safe enough, which you may or may not, but close your eyes, which will eliminate a lot of external distraction. [deep breath] And allow your breathing to deepen, [deep breath] and breathe in through your nose, [deep breath] and out through your mouth, with your belly soft and relaxed. [deep breath]

And just experience that, feel yourself relaxing with each exhalation, [deep breath] and know that when your belly is soft and relaxed, it helps to activate the vagus nerve. Vagus means “wandering” in Latin, and this big nerve, which comes up from the abdomen, through the chest to the central nervous system in the brain, quiets the body and the mind. It’s the antidote to the fight-or-flight response, the antidote to the stress response. And one branch of the vagus nerve, which is activated when you breathe slowly and deeply with your belly soft, allows us to connect more easily, more harmoniously, to other people. Activates centers in our cerebral cortex, which makes bonding easier. [deep breath] And notice how you exhale, how all the muscles in your body relax, [deep breath] and to encourage this process you can say to yourself, “soft,” as you breathe in, [deep breath] and “belly” if you breathe out.

Ms. Tippett: OK. We’ll have public radio listeners all over the country doing that.

[laughter]

Dr. Gordon: Well, that’s the idea. This is ...

Ms. Tippett: What I really love about that is the interwovenness of immediately accessible experience practice, and also it’s a very sophisticated understanding of physiology, right? All of those things working together. I mean, Mark, you also talk about — and of course we talk a lot about food, and eating well, and nutrition but – you talk about using food as medicine. And you’re speaking that way in terms of what we are learning, right?

Dr. Hyman: Yeah. I think that one of the biggest scientific discoveries of the last 30 years is that food isn’t just energy, that it’s actually information that actually provides instructions in a literally minute-to-minute, bite-by-bite basis to everything that’s going on in your body. So, literally, you change your gene expression with every bite. You change your immune system. You change your gut flora, you change your hormones, you change all the protein functions in your body, and it literally has a direct effect on every function, either for good or the bad, depending on what you’re eating.

So when you realize that, then it changes your relationship to food as not just a source of energy or pleasure, but actually transformational. And we don’t, in medicine, know how to use food as medicine. We use drugs, we use surgery, but we have no insight that food is connected to health in most cases. And yet it’s the most powerful drug, and it works faster, better, and cheaper than any drug on the planet. I mean, I’ve had people change their diets in three days, they got off 50 units of insulin. There’s no drug that can do that. People have autoimmune disease, they can be pain-free in weeks simply changing their diet and that — and get off very expensive medications. So we really can shift the way we think about treating disease to be primarily food based, and I think the two big insights, really, is that food is medicine, and that the group of medicine, that the community is medicine. It’s not just a delivery mechanism. And you put those two together it’s like rocket fuel for transforming health.

Ms. Tippett: Well, and also because, on the one hand, if food is a drug, it’s a drug that we consume all day long, right? I mean, it’s there. It’s woven into our lives. On the other hand, changing behaviors around eating ...

Dr. Hyman: Yeah.

Ms. Tippett: We need so much help to do that.

Dr. Hyman: It’s true. I mean, it’s the social determinants of what we eat, what’s accessible and available. It’s our economic situation. It’s our social community and cultural situation. It’s our education. Part of this movie that was sort of shocking to me, this little episode that I’m going to share with you — because even though I believe that most people want the best thing for themselves, I figure some people just know what to do but they don’t do it. And that’s part of this movie, Fed Up, and if you haven’t seen it it’s about childhood obesity and sugar and the food industry.

And I went to this family in South Carolina, and easily it’s one of the poorest communities, one of the worst food deserts in America. And there’s a family of five — lived in a trailer, food stamps and disability, thousand bucks a month for food — and the mother was massively overweight, the father was diabetic and had renal dialysis, kidney failure. The son was practically diabetic, was 50 pounds overweight at 16, and they were desperate to the do the right thing. They wanted to — had Diet Mountain Dew because it was no-calorie, they had low-fat salad dressing which was full of sugar, they had Cheez-Its because they were baked and not fried, they had Cool Whip because it said “zero trans fat” on the label, which is just full of trans fats and only was able to say that because the food company used a loophole from the FDA. And they never cooked. There were two generations in that family that had no idea what to cook. They didn’t have cutting boards. They didn’t have knives. We made turkey chili and roasted sweet potatoes, and the kids came running from the other side of the trailer from their Xboxes. They never smelled food cooking. They ate it and they loved it, and I’m like, you can do this. You can do this. And they did it. And they lost — the mother lost 100 pounds, the father lost 45, got a new kidney, the son lost 50, and he went and gained a bunch of it back working at Bojangles, but then he kind of — there’s nowhere to work down there for them — then he lost it.

But what it made me realize is that we actually have a solution to this problem, and a lot of it has to do with education. A lot has to do with skill sets that we don’t teach people. And health doesn’t happen in the doctor’s office. Health happens in your kitchen, it happens in the grocery store, it happens in your community, it happens in your workplace and the school and your faith-based communities. That’s where health happens.

[music: “If I'd Have Known It Was the Last (Second Position)” by Codes in the Clouds]

Ms. Tippett: You can listen again and share this conversations with Mark Hyman, James Gordon, and Penny George through our website, onbeing.org. I'm Krista Tippett. On Being continues in a moment.

[music: “If I'd Have Known It Was the Last (Second Position)” by Codes in the Clouds]

Ms. Tippett: I'm Krista Tippett and this is On Being. Today we’re exploring a transformation of medicine that many feel is underway — a transition from a science of treating disease to a science of health. I’m with three visionaries who’ve been ahead of this learning curve from several directions: functional medicine pioneer Mark Hyman, psychiatrist James Gordon, and philanthropist Penny George. We’re with a live audience on the campus of the University of Minnesota.

Ms. Tippett: I’d like to talk a little bit about spirituality, which has been, certainly, a suspect word in science or medicine. But it is also, certainly in medicine, inescapable, right? So let’s talk a little bit about the words we can put around the integrity and the validity and the substance that this thing called spiritual life — which has as many interpretations as there are people — how this is part of this new vision, this new consciousness about illness and healing.

Penny, you wrote some really beautiful things about this, that “serious illness or disability is as much a spiritual crisis as a physical one,” and that healing is sometimes possible on a spiritual level, even if it is not always possible on a physical level.

Dr. George: Right. And it has to do with what animates your life. What’s the meaning and purpose? For some people, faith is a deep part of it, but it can also work against it. There was an article in Time magazine, I think, and it was called “A Week in the Life of a Hospital.” I don’t know if any of you remember it. And the very last page of it, there was an article about the chaplain, and I finished reading that and I thought, let this person never enter my room. And both my grandfathers are ministers, so I’m not anti-religion, but it was something about that that felt coercive. So ...

Dr. Hyman: When you think about, though, historically the doctors were shamans. They were medicine men. The monk bodhisattva doctor.

Ms. Tippett: Yeah.

Dr. Hyman: This is actually what tradition we came out of, was spiritual healing, because that’s pretty much all we had.

Ms. Tippett: Yeah.

Dr. Hyman: And now when you think about what happens in that space with a doctor and a patient, or a healer and a patient, it’s a very sacred moment.

Ms. Tippett: It is. I mean, I was going to say I feel like doctors are godlike figures. And there is a sacred trust, and we trust what doctors tell us, whether we should or not because they have this ...

Dr. Hyman: Yeah. I mean, there’s that aspect of it, but from my point of view as a physician, when I’m in a room with someone, and they open their heart, and open their soul, and tell their story, that’s a sacred moment. That doesn’t happen in real life, right? We are privileged to be able to be in that sacred space with someone, where you can say anything and talk about anything, and be in that little window where magic happens. And doctors don’t talk about it, they don’t think about it, but if they let themselves feel that, it’s powerful. I mean, there’s a woman at Cleveland Clinic that’s called the Chief Experience Officer, and I said, you need to change your title, call yourself the Chief Compassion Officer because that’s really...

Ms. Tippett: Yeah, right. [laughs]

Dr. Hyman: ...what it’s about. It’s about, how do you get in those relationships that matter, and how do you cultivate that in medical students and healthcare institutions? Because that’s where healing happens.

Dr. Gordon: What I would say, and what I do say, people will come to our trainings, and they’ll say, “When are you going to talk about spirituality?” I say, well, we’re going to talk about it a little later, but the most important thing is how we treat each other. That’s the way...

Ms. Tippett: Right.

Dr. Gordon: ...we manifest the spirit and the way — whether we’re teaching, or we’re physicians with patients, or we’re just with other human beings anywhere. So that’s the number one thought. Number two is that the work of healing is the work of transformation at its base, where you’re not just treating symptoms. It is all about spiritual transformation, and that’s, potentially, what comes to people. Another important aspect is that when — what I have seen, whether the illnesses manifest in a physical way or a psychological way, that the sense of meaning and purpose and connection to something beyond ourselves is critical to healing, almost always, and even in the most dire situations.

Ms. Tippett: And that can have many, many interpretations in any individual life.

Dr. Gordon: Exactly.

Ms. Tippett: Yeah.

Dr. Gordon: And we just finished wonderful work at Pine Ridge Reservation. And we were working where 20 kids have killed themselves in the last nine months, and every day, one or two kids is going to the E.R. with an attempted suicide. And we saw how our work — and this is something that’s been so deeply instructive to me — how our work could come together, and we could work — the elders would do traditional ceremonies, and we would be teaching mind-body techniques, and there was a kind of dance between us, and it worked so beautifully.

So the other aspect of spirituality and healing is being able to go to other places — whether we’re working with a Muslim or a Christian or Jewish or Vodou healers, as we work with in Haiti — but learning from and bringing those spiritual traditions together, and having a little bit of humility about our own, and being students of theirs, and they doing likewise. So I think this work is all spiritual work that we’re doing.

Ms. Tippett: I think what can be off-putting or concerning when people are outside this sphere, when they hear that it kind of sounds like dabbling, you know? It can sound superficial. And also a lot of it is unfamiliar. So what you’re talking about is honoring all the places so many people come from and are planted in, right?

Dr. Gordon: Exactly.

Ms. Tippett: Yeah.

Dr. Gordon: The experience is so deep. As Mark said, it’s a sacred experience. So we just happen to be people working in a number of different cultures, and they’re our teachers. I think it goes as deeply as each human being is willing to let it go.

Dr. Hyman: And love doesn’t — is not an ideological thing, but it’s the core of all religions, right? That’s really what it’s all about. [laughs]

Ms. Tippett: What is? Sorry?

Dr. Hyman: Love.

Ms. Tippett: Love, yeah.

Dr. Gordon: And I think, the other thing is people are afraid. They’re afraid of the spiritual dimension. They’re also just afraid of looking at themselves. And that’s why all of our work is more challenging than perhaps it should look like it should be. So it’s easy to dismiss it, to say, “Oh, we don’t have the randomized control trial, or seven of them.” If you have one or two...

Ms. Tippett: Yeah.

Dr. Gordon: ...that’s not enough. Or people will come and they’ll say, “Well, I want to learn the techniques, but I really don’t want to work on myself.”

[laughter]

So this is the process of education. This is part of everybody’s experience.

Ms. Tippett: Yeah. And I think what you just said — spiritual life is that place where we work on ourselves.

Dr. Gordon: Yes.

Ms. Tippett: To demystify it.

Dr. Gordon: And that’s the challenge. That’s what makes people uneasy. And it’s easier to have a belief in a dogma, whether the dogma is religious dogma or scientific dogma, than to actually open oneself up to, as our tradition tells us, to looking for the truth.

Ms. Tippett: OK. So let’s bring you into this.

Audience Member 1: Hi, there. I was just wondering — I would love to see in my lifetime a functional medicine approach to eating disorders. I struggled with an eating disorder for about 21 years, and once I addressed my nutrition and my microbiome, within a week and a half I went — I worked out four to six hours a day, every day, a compulsion to exercise — within a within a week and a half of changing my diet that compulsion was gone and it never came back.

Dr. Gordon: Yeah.

Audience Member 1: And so I’ve gone back to clinics. I’ve talked to doctors and nutritionists, and saying, we really need to address this. I mean, what I ate in hospitals was mostly sugar, trans fats...

Dr. Gordon: Yeah.

Audience Member 1: ...just poor quality food, and then heavily medicated. So I’ve got this intense passion for nutrition, but my dream is to see a functional medicine approach to eating disorders. And the clinics are growing. I mean, when I started out there were few people, and then when I would go back I’d see the same people in treatment over and over, and then younger and older, and both men and women. But I don’t know if you’ve had much experience with that.

Dr. Hyman: I’ve treated many, many patients over the years with functional medicine and eating disorders. And, often, the problem with mental illness is that we often attribute meaning to it that is the wrong meaning. There’s a wonderful book called Madness in Civilization which talks about the different views of madness over the centuries, whether it’s a spiritual, divine thing, or whether it’s — now it’s a biochemical imbalance, and the truth is that we attach all this meaning to mental illness when it actually may be something else, right? Sometimes it is a spiritual illness, or a psychological problem, but often it’s a physical problem that manifests in the brain because everything is connected. So when you change your diet, and you change your gut, you see transformations. I’m working now with building a prostate — functional medicine program for prostate cancer, for brain health, for women’s health, for pediatrics, cardiac care, endocrine care, autoimmune disease, we’re just sort of spiraling out throughout the institution. It’s not sort of an add-on on the side. It’s really central to what we’re doing there.

Audience Member 2: Thank you all. I feel like I was fortunate 12 years ago, when I was in school, to see a Sun Simiao quote, and he’s a founding father of Chinese medicine, and it said, “A superior physician doesn’t just treat disease, but teaches society and helps form the intentions of humanity.” And so I use that as a benchmark. And at first, it was more about teaching skills, like how to breathe, and how to eat, but the longer I do it, the more I realize it’s really about the intention. And so I was wondering if each one of you could say what one of your biggest hopes for changing the intentions of the people that you work with and for us as practitioners would be.

Dr. Gordon: My core intention is to be there with another human being. So that’s why meditation is central. You practice Chinese medicine? Chinese medicine, anciently, and perhaps still in the best schools, meditation is central. Some kind of meditation, moving meditation, qigong, tai chi, sitting meditation — and everything is done in a meditative way. So my intention is to be present with myself, and present with the other person, and then use whatever the tools are that I have at my disposal. I practice Chinese medicine. I use those tools. I know Western medicine. I use those tools. I’m a psychiatrist. But in that presence, it comes to me, and I would hope it comes to you, and all of you who practice, what to do. And the human being is changing every moment. So we need to be with that human being and respond. And that’s really my only intention. And even very early on, I want to give that person the tools to heal herself. So that’s my intention as I come to people.

Dr. George: I went to a conference and it was a strategic planning conference for NCCAM, National Center for Complementary and Alternative Medicine, and there was a reception before, and there was a physician from a large health system in Minnesota, very well-regarded, and he was saying, “I’m really excited about finding the dose response for massage.” And I thought to myself...

Dr. Hyman: It’s a lot. For me, it’s a lot. It’s a lot.

[laughter]

Dr. George: ...this is crazy, because...

Dr. Hyman: It’s a very high dose.

Dr. George: ...I’d rather have 15 minutes with somebody that I know cares than an hour and a half with somebody who doesn’t. And that is about intention, and you can feel it. You can feel that.

[music: “Lullaby [Instrumental]” by Wes Swing]

Ms. Tippett: I'm Krista Tippett and this is On Being. Today, in a public conversation on transforming medicine with functional medicine pioneer Mark Hyman, psychiatrist James Gordon, and philanthropist Penny George. We’re taking questions from the audience, comprised largely of health care professionals and students.

[music: “Lullaby [Instrumental]” by Wes Swing]

Ms. Tippett: There’s one up here.

Audience Member 3: Well, I thought you had a beautiful discussion on spirituality and what’s the role of spirituality in healing. In the past two weeks I’ve been with two friends who are in two of the leading medical centers in the world, both near death, and they could recover. If they do, they’ll have long-term chronic diseases. And the question they’re asking, what’s the purpose for my living? What is the role of having that essential purpose for living as you see it?

Dr. Hyman: Yeah, it’s essential. One of the ingredients for health is purpose and meaning, and life doesn’t make sense without it. It just reminded me of a story of this woman who I saw, and she had crippling rheumatoid arthritis, and I knew if she changed her diet and got healthy, she could fix it. And she was in her mid 50s, or late 50s, and she had these two young kids who were from her daughter or son who was a drug addict, and she got the kids. And they’re five, and they’re cute, and they’re amazing, and she told me all about them, but she was really not doing very well, and she really wasn’t listening to me. And I, literally, I walked out of the room and as I was walking out of the room I turned around and I said, “Don’t eff it up. You’ve got these kids, don’t eff it up.” And she came back yesterday, and I saw her in clinic, and she was completely transformed. [laughs] She did everything. Her arthritis was all better, and it was because I connected to what mattered to her. What mattered to her was being able to parent those little kids and be there for them. And every patient has that little thing, and that’s part of the spiritual surgery that you have to do to find out what is that for that person, and find out that meaning.

Dr. George: There was a book by Jean Shinoda Bolen called Close to the Bone: Life Threatening Illness and the Search for Meaning that I found just enormously helpful. But that was — probably goes back to early childhood things. And I think that is also triggered a lot when you have a life-threatening illness, is these — what are your deepest assumptions about life? And that’s another reason why it’s important to hear the story. And it doesn’t have to be, and probably shouldn’t, sometimes, be the physician, and that’s why team-centered care like this — because everybody’s got different preferences. And I might find somebody appealing to me to hear my story and it doesn’t have to be a long-term kind of relationship to hear their story. But getting at that ...

Dr. Hyman: Well, that’s why the circles and the groups — because you don’t have to be anything. You can just be another human and that’s the beauty of it. You don’t need some great figure to hold that space for you.

Ms. Tippett: Yeah. Rachel Remen, who you first introduced me to all those years ago — every disease, no cancer and no heart disease, no diabetes is the same because, it all has a story attached, and you’re connecting — the purpose is in the story, the thing that’s going to keep people living.

Dr. Gordon: I would say that another, somewhat different way to look at it is, first of all, if we’re talking about what we can do as physicians, as helpers to other people, it’s to be, in our own way, wanting to be, and hopefully being, connected with something beyond ourselves that is also within. That’s how we communicate it to others, by our being. One of our faculty in Gaza said to me, there’s a saying in the Qur’an that when you do not have hope, you have to find it in the face of another. And he said to me, we found it in your face, my face, and face of your team. And now we are able to bring it to the people of Gaza.

Ms. Tippett: Let’s take one more.

Audience Member 4: Dr. Hyman, you prove to be pretty clear about what the nutrition formula is for a certain state or — there seems to be a science in the way this is done. How established is the science and how consistently accepted is it amongst your colleagues, in the medical community? And, if not, why not?

Dr. Hyman: I mean, the evidence for how food affects biology is very well established. And most physicians don’t understand that food actually can play a role in the therapeutic process. They don’t understand how it works. They don’t understand why, they don’t know anything about it. And so it’s sort of this big vacuum in healthcare right now. So I think it’s starting to shift, but it’s really tough to sort of bridge that gap, and I think, unless doctors actually see this in a real way for diseases that are proven, it’s tough.

We’re working at Cleveland Clinic, and we’re trying to show how we can get people off of insulin. That’s our study. We want to get people off insulin which, in conventional endocrinology, it’s a one-way street. You start on diabetes medications, it just progresses, you get on insulin and you manage your sugars, you manage diabetes. And I’m like, no, you can get rid of it. And we do, and quickly. And there’s evidence that that’s true, but they’re concerned about even being part of the study because they think it’s a waste of time, because they know it’s not going to work. And I’m like, wow, that’s really not very scientific.

[laughter]

There are challenges to getting it pushed through, but I think it’ll happen.

Dr. Gordon: There was an article, I think it was in the Annals of Internal Medicine maybe 15, 20 years ago, and it sort of raised the question, why don’t doctors know more about nutrition? And the fundamental reason is that information about nutrition is not included in medical education, and it goes out to people around the doctors and not through them. So doctors don’t control that information. It’s not their field of expertise, and so many of them have just totally ignored nutrition. So that’s the other element.

Dr. Hyman: Yeah. I mean, most of the disease we have is caused by food, can be cured by food, and doctors know nothing about food...

[laughter]

...and it’s just — it’s stunning to me.

Dr. George: And didn’t Hippocrates say “Let your food be your medicine?” Wasn’t that Hippocrates?

Dr. Hyman: Yeah.

Ms. Tippett: So we’re talking about a shift in consciousness, and an evolutionary shift, and the issues and the clusters of issues are correspondingly complex. But I just want to close, and I’m not actually sure how to form this question. But just to say, as much as we’re talking about health and healing as the point of medicine, there’s also an aspect of this realization that illness is not only inevitable, but that illness also is a gift, right? That illness somehow is part of life’s wholeness, and life’s trajectory, and that it is transformative. And, Mark, you’ve said illness tells us things, right? Illness is our teacher. And, Penny, your whole life’s course was changed by illness. And, Jim, you’ve talked about illness as an opportunity for personal growth and transformation. So it seems to me that this is also a truth to name as part of this shift in consciousness. As you say, in traditional medicine — death was failure. It was defeat, and illness was a problem. So, again, I don’t know what the question is, but I wonder if you would reflect a little bit on that as part of this transformation, and also, again, if there’s anything else you want to say based on what arose here. So, I don’t know, Jim, would you like to start?

Dr. Gordon: I’m speechless.

[laughter]

No, I mean, you said it so beautifully. We were just — in working with the Lakota elders, they understand exactly what we’re saying here. They say, in order to heal others — and this is a deep aspect of shamanic healing all over the world — you have to have been through the fire yourself. Otherwise, you cannot know what it’s like. You cannot know how to help others with the respect and the deep personal knowledge that’s necessary for that. I think it’s really so important going forward. This is not our enemy. Illness is not our enemy. Death is not our enemy. This is part of life, and all of life is our great teacher, if we’re open to it. And the more we are open to it, the more we can be open to helping other people also open themselves.

Dr. George: I would just add to that the idea of, what is the invitation in this illness? Which — you have to be careful, because it’s not to imply, what did you do to cause your illness? But I think there is an invitation in any illness, and part of it is recognizing that life is short. This is not a dress rehearsal. And what is it for you? And, for me, it led to this. I didn’t intend this. This was not a logical conscious thing, but it was like — it unfolded as I sort of became the agent of my own health. And I would wish that for everyone who has any kind of illness, even if it’s not life-threatening, is to see what the invitation is to a fuller life, and greater well-being.

Dr. Hyman: Yeah, I echo what Jim and Penny said but what sort of came up in my feeling, my body, was the sense that a lot of illness today — and illness has changed over the millennia, but a lot of illness today is the result of social, political, and economic drivers that are so unnecessary and so solvable. We can’t end climate change tomorrow, but we could end chronic illness, most of chronic illness. We know how to do it. It’s not difficult. And yet we don’t address the problems in that way. We’re dealing with the downstream effects instead of the causes. And it’s the thing that really keeps me up at night — is how do we, as a society, begin to grapple with that? And the only way I can come up with is really to sort of — to begin to create these healing circles, these talking circles, these small groups, the things that Jim does where we rebuild community, and connection, and meaning, and love in communities where people can begin to transform and own their lives and own their communities, and transform the food system, and transform their behaviors, and transform the schools. It has to happen, but it can happen not in a big kind of global way. It has to happen very locally, essentially as local as your own kitchen, as local as your — if you own a company, if you have a workplace, if you’re a part of a school, it can be a very small space that it starts in but, really, it ripples out and it’s really transformational. And everybody in this room has that capacity to create that change in their own life, in their own body, and in their community, and that’s where it really has to start.

[music: “Hopopono” by GoGo Penguin]

Ms. Tippett: Mark Hyman is director of the Cleveland Clinic Center for Functional Medicine and founder and medical director of The UltraWellness Center.

James Gordon is the founder and executive director of The Center for Mind-Body Medicine and he’s a Clinical Professor in the Departments of Psychiatry and Family Medicine at Georgetown Medical School.

And Penny George is board chair of the Penny George Institute Foundation, and co-founder of the Penny George Institute for Health and Healing at Allina Health in Minneapolis. Full disclosure, On Being does receive support from the George Family Foundation.

[music: “Hopopono” by GoGo Penguin]

Ms. Tippett: This week, we have a request for you. We’d love ten minutes of your time to tell us how you listen to On Being, and how you take in or use what you hear. We have always grown by listening to our listeners, and this is your chance to participate in a survey that will help us shape our next chapter. Find the link on our homepage, onbeing.org, and thank you.

[music: “Hollisday” by Shawn Lee's Ping Pong Orchestra]

Ms. Tippett: On Being is Trent Gilliss, Chris Heagle, Lily Percy, Mariah Helgeson, Maia Tarrell, Annie Parsons, Tony Birleffi, Marie Sambilay, Tracy Ayers, and Hannah Rehak.

Special thanks for this show to Maureen Pelton, Laurie Hennen, Brad Kern and all the staff at the Best Buy auditorium in the Northrop Gallery at the University of Minnesota.

Our major funding partners are:

The Ford Foundation, working with visionaries on the front lines of social change worldwide, at fordfoundation.org.

The Fetzer Institute, fostering awareness of the power of love and forgiveness to transform our world. Find them at fetzer.org.

Kalliopeia Foundation, contributing to organizations that weave reverence, reciprocity, and resilience into the fabric of modern life.

The Henry Luce Foundation, in support of Public Theology Reimagined.

And the Osprey Foundation — a catalyst for empowered, healthy, and fulfilled lives.

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is the director of the Cleveland Clinic Center for functional medicine. He is also the founder and medical director of the UltraWellness Center. He’s a practicing family physician and a best-selling author.

is the founder and executive director of the Center for Mind-Body Medicine and a clinical professor in the departments of Psychiatry and Family Medicine at Georgetown Medical School.

is the board chair of the Penny George Institute Foundation, which supports the work of the Penny George Institute for Health and Healing at Allina Health in Minneapolis, the largest hospital-based integrative medicine program in the U.S.

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