The Journey of an Unorthodox Allopath
I am dual board-eligible in obstetrics and gynecology and hospice and palliative medicine. Allopathic medical training is rigorous, and it provides a physician with an extensive tool kit, but, in sitting with thousands of births and deaths, it became clear that there is more to being human than what we can glean from medical textbooks. These two events are rites of passage, and our pathologization of both birth and death by the contemporary Western medical model ignores the deeper meaning of the human experience and our role here on planet Earth. Perhaps death is not an end but a beginning? Perhaps birth is not a new chapter but the conclusion of a different story? These contemplations can help to alleviate the pain and fear that comes with facing mortality. Western medicine ignores the reality that death awaits us, but death was, in fact, part of the deal when we were entrusted with mortal flesh to dance and embrace all facets of life while aboard this wild human ride.
To deny our own mortality is to defy nature itself. This may explain the deep suffering that many people experience at the end of life. Perhaps death is an opportunity to reunite with the collective whole. This is certainly the ubiquitous experience recounted by those honored with near-death experiences or who have explored the cosmos through altered states of consciousness. Framing mortality as the ultimate nightmare strips us of the ability to fully embrace the life we are given. It leads to shortsighted decisions about our health, our relationships, and how we spend our time. The body that your soul chose in order to heal through the grace of Mother Earth is composed of her bounty, yet the reductionist approach to healing offered by the Western medical model suggests that we are separate from nature and that healing must come from without rather than from within. Western medical practice is too often predominated not by investigation of the root cause of disease but by the mitigation of symptoms. For example, topical steroids may alleviate the discomfort of an eczematic skin reaction, but the inquiry stops there. This is ever-present in the Western practice of OBGYNs, where birth control pills and surgeries are utilized as a cure-all for everything from infertility to heavy menstrual bleeding to pelvic pain. The notion that the body requires toxic chemicals to return to homeostasis makes little sense, and, as such, is totally out of line with our very nature. The body, mind, and spirit are constantly in a state of repair; we must merely provide them with the resources to heal.
Dogma has been winning the battle over human intellect for centuries, and the conventional model of health care provision doesn't reward critical thinking. Indeed, your success in allopathic training hinges on your ability to answer the questions on the test and to stand by those answers even when they don't work for your patient. For instance, I have found that compassionate touch and focused attention to my patients' life stories is often far more therapeutic for chronic pain than narcotics and surgery, yet such observations have been chastised by colleagues. Carl Jung said, "the pendulum of the mind oscillates between sense and nonsense, not between right and wrong," and throughout a physician's allopathic training, many begin to lose sight of the true purpose of science, which is not to find evidence to support your internal bias but rather to explore truth. In sitting with so many patients and their families through two of the most exciting and scary events in the human experience - birth and death - it has occurred to me that we still have so much to learn about the interplay between humans, nature, and the cosmos. This acknowledgement is not a weakness nor a discouragement but rather an incredibly momentous boon to my own life as well as my healing practice. Surrendering to the unknown reengages both critical thinking and intuition without compromising the value of experience.
In coming to understand these limitations, I began to approach healing of the human body as a biodynamicist approaches farming. Healthy top soil has “tilthe”. Tilthe reflects rich biodiversity teeming with microorganisms and fungi, a delicate blend of nutrients and micronutrients, clean air, and adequate hydration. Tilthe provides the life force for healthy crops and grass, the latter of which nourishes healthy livestock. Humans, as the consumer of plants and animals, are thus only as healthy as the soil.
A biodynamic farmer studies her soil. She knows its history, and she communes with her crops and livestock. She knows their natural state and knows that nature tends towards homeostasis. She knows better than most that an ecosystem is comprised of many moving parts, working together for the benefit of the whole. Likewise in what I call "biodynamic medicine", the clinician knows their patient's story. They build a framework for how a disease state developed over years in cooperation with a toxic ecosystem. This practice of healing sees the body not as a collection of organs as René Descartes proposed, but as a delicate ecosystem. A carrot disassembled into nutrients and vitamins cannot later be reassembled back into a carrot (at least not a very recognizable one). The same is true for the human body. There is life force (chi, prana, etc.) that orchestrates the vitality within an organism, human or otherwise. This is your tilthe. When we fail to recognize that our organ systems are balanced in complicated ways through the mind-body-spirit connection and in conjunction with nature, we miss the opportunity for true healing.
As an example, imagine revisiting an old pond that you knew as a young child. The pond was rich in wildlife, so much so that you could hear the frogs' song from a mile away on a warm summer evening. But on your return, you find that the frogs are all gone. No more fish, no more tadpoles. One solution could be to simply replace the fish and frogs, but would this restore the vitality to your beloved pond? Was your pond merely deficient in wildlife? The other option is to find the cause of the loss of biodiversity and try to reverse it. Perhaps a nearby field has been showered with glyphosates or perhaps runoff from a local factory has damaged the ecosystem? Without cleaning the tank, the same fate will fall to your new fish and frogs. Cleaning the tank is the work of the biodynamicist, whether on the farm or in medical practice. This approach requires of the patient the investment of time and discipline, but rarely does it require pharmaceuticals or surgery. In the words of Voltaire, “One must cultivate one’s own garden.”
The restructuring of my healing practice affords me the opportunity to ask the bigger questions, to challenge dogma, and to truly heal people, communities, and the planet. I have the same skillset as most physicians: laboratory analysis, expertise in interpreting medical literature, medication, antibiotics, imaging studies, and surgery. The difference is in how I use these powerful but limited tools. Healing begins with your story, and it grows outward from there in concentric circles. This approach has been called "slow medicine" by author Victoria Sweet.
Lastly, I would be remiss to not comment specifically on how my practice in pregnancy care has changed. Whole-person care, especially in pregnancy, requires all parties to sit with the magic of procreation. Engaging with our nature is a foundation of my approach, which is very much in line with traditional midwifery practices. I see my role as an obstetrician as limited only to those occasions in which my surgical or other expertise is critical to achieve the goals of the birthing person. Birth is a natural, physiologic process, not a state of disease. We don’t need evidence-based medicine to demonstrate this; Mother Earth has had far more time to devise ways of returning biological processes to homeostasis. Trusting birth is not equitable to indulging in magical thinking (though I might encourage you to dip your toes into those waters, too). It merely encourages you to honor the divine feminine and the intuition of the birthing person. The burden of proof always lies to the those who wish to deviate from nature’s plan, and, fortunately, nature is pretty darn good at ensuring safe passage for most babies. The conventional hospital-based maternity model has yet to catch on.
I have already been working one-on-one with so many of my midwife, doula, and other medical colleagues in women's health. This type of collaboration is so critical if we are going to change women's health care, so in June 2021, I will begin setting time aside for this specific purpose. The name is this new project is Beloved Holistics, and I am providing it as a gift. If my journey resonates with you, then let's collaborate.