The Winter Solstice

By Sara Thyr, ND


Photo by ItzaFineDay, via flickr, used under the Creative Commons License.

I took one of the little snowmen chatchkis to place on the alter at the Solstice Circle I went to on Sunday. I have mixed feelings about him, but such deep appreciation for the spirit in which it was given. And the spirit of celebration, which my mother always fostered this time of year. I appreciate that sometimes the gifts that we unwrap are not always the sum total of what we really get.

The Solstice is an important day of the year for me. I crave the long days, so the Winter Solstice always feels like I can start getting excited about spring again. I know. It’s the middle of what most of us experience as winter. (Similarly, the Summer Solstice always makes me a little sad, even though we are at the apex of long days.)

The Winter Solstice is considered the strongest point of the four main power points of the year. We naturally let go - in our bodies, minds and hearts - that which we don’t want to carry with us into the next cycle of increase. This was an interesting concept to learn at the circle, as I had already begun purging some things in my life - which I really dug into on the Solstice. I felt I had given myself a powerful gift of starting this next part of the year clinging onto less unnecessary baggage.

I ran into a patient who I’d not seen for a long time at a holiday party recently. As we were chatting, she went expressed how much I had helped her sleep. She was very grateful. Her husband is grateful. On an evening that was all about merriment and holiday gifts, I received the best one…appreciation for passing along naturopathic medicine to one who needed it.

What can you gift yourself during this time of year? What idea or habit do you long to leave here in this natural time of removal, moving into spring lighter, gentler, happier? Perhaps it is time to eliminate old mental imprinting that you have been running on from past decades.

I have never been big on New Year’s Resolutions. It’s always felt ripe for setting myself up for failure. Taking time to notice the movement of the seasons - to really feel them and to be a part of them, letting go when that is appropriate, feels more natural to me.

At the end of my yoga class on the Solstice, we did a chant in Sanskrit which I’d like to carry with me into this next phase: May everyone feel peace and happiness. May my actions contribute to the peace and happiness of everyone in the world.

What I Learned From My Nursing Colleagues

By Marica Prenguber, ND, FABNO


Photo by *Sally M*, via Flickr, used under the Creative Commons License.

As the year end rapidly comes upon us, I am assessing the work I have done toward achieving both personal and professional goals that I set out for 2009. One of the goals that I had established was to better understand what the day to day experiences are of the nursing colleagues in the infusion room of the cancer center in which I work. So I spent a few hours with them in the past couple of weeks (and yes, although the goal was made for this year, I still managed to put it off until December 2009). I am so glad to have spent that time with the infusion room nurses, and been able to better understand what their perspectives are in working in that environment with folks who are undergoing chemotherapy as part of their treatment program for their cancer diagnosis.

Although I work with this same group of patients, my work brings me somewhat different experiences with these patients. So, during part of the time that I spent with these remarkably dedicated nurses, I asked them many questions, including why they do this work – in oncology. Universally they shared very similar reasons. Each of the nurses with whom I spoke told me that they chose oncology because they felt that they could make a difference in someone’s life – in the lives of patients who are going through very difficult situations. And that is helps them to keep their own lives in perspective – to keep a measuring stick against their own trials and tribulations.

I asked about their fears – working in this environment. (It’s very common among folks who work in oncology, at some point, to be very concerned about a symptom that we experience that makes each of us wonder if we have just found the first symptom of a cancer within us.) The vast majority of these nurses are of child bearing years – and the vast majority of them have either been pregnant or their partner has been pregnant at some point during their years working in the infusion room. They all shared that they have feared a specific cancer diagnosis at one time or another, and even now ponder what type of cancer it may be, if not today - then one day. Yet it has never caused them to consider switching to another department. Despite their newborns, their toddlers, their growing children waiting at home for them everyday. Their work with these patients is too much a part of who they are to allow their fears to take over. And still they take the emotional disappointments and triumphs home with them.

What about the frustrations? The loss that comes with the territory – getting close to patients that come in regularly for their treatment, and the family members that come with them, and the battles that are lost. Many shared that come to know the families well – often spending 6-8 hours caring for a patient (and family members!) each time they come in- you get to know them pretty well. Suffering and loss with a relationship that has developed through difficult times over weeks and months can be very painful.

And they still say the good outweighs the difficulties. They have learned to personally be “more spontaneous, to appreciate health (their own) more, and to live on a day to day basis rather than living for the future – appreciating family and friends, and not to live in fear.” They are inspired by these patients – patients who face such challenging situations and yet have such great attitudes – how they get up every day and face the challenge. It seems to me that these nurses do the same - and for this I admire them. I am certain that we all have challenges that make us better, but I am in awe of these RNs who look those issues square in the face every day, and although they drop some tears along the way, they never turn their back on the challenge.

I am fortunate to be able to work alongside an impressive and inspiring group of people. And am happy to be able to have accomplished this goal for 2009, and hope I am better for it. Hoping not to sound too philosophical, I do think it’s important to set goals, personal and professional, and evaluate them at year’s end. Maybe it is just the former school teacher in me, but there is so much to learn and to allow ourselves to be inspired by - with every experience. So my advice for 2010 - set some goals – the research tells us that those of you who do, achieve more, and are happier! Goals provide a focus and enable you to measure your progress. I have read that goals are motivating, and I would agree – it may have taken me until December – but I got it done! And am so glad that I did.

Happy New Year.

My Final Message as AANP President

By Lise Alschuler, ND, FABNO
AANP President
Vice President, Quality and Education, Emerson Ecologics


Photo by Dare*2*Dream via flickr, used under the Creative Commons License.

This is my last message as President of the AANP. Thank you for giving me the opportunity to share my ramblings with you in this venue over the past two years. As my last one, I am taking some liberty and exceeding my word limit just a bit. I have a lot of gratitude to share. As I sit here reflecting upon my time as President, I feel good. We have done a lot! Despite the turmoil of the past many months in our economy, our globe citizenry, and our national health, the AANP has thrived. Naturopathic medicine is more visible in proposed Federal legislation, we have a multi-series documentary on naturopathic medicine and an intricate PR campaign about to launch around it, we have a stellar on-line journal, we have more and deeper alliances with other professional and trade associations. The AANP is actively advancing its mission, has added new members, and has expanded its corporate support. The AANP has matured into a governance model which facilitates visionary leadership. So, as my tenure as President of the AANP draws to a close, I am filled with gratitude and optimism. Let me dwell on these for a moment…

I am grateful for many, many things. I am grateful for the incredible integrity and intelligence of my fellow Board members. The AANP Board has thoughtfully and gracefully transformed itself into a Governance Board. This model has allowed the visioning and leadership activities of the Board to blossom. I am also grateful for the exceptional dedication, passion and talent of the AANP staff and consultants. We are extremely fortunate to have such a capable staff implementing the work of this Association. I am deeply appreciative of all that I have learned from the staff and for their friendship over these past years. I am grateful to every member of the AANP. These doctors understand the criticality of supporting the national association of naturopathic physicians in order to both solidify and grow naturopathic medicine. I am also grateful to those companies who are our corporate sponsors. They understand the integral role that naturopathic physicians have in optimal healthcare and are investing in our future. Finally, I am grateful for the patients that have sought care from naturopathic physicians. Not always an easy thing to do, these individuals have stepped out and sought a different kind of healthcare. Their willingness to experience the benefits of naturopathic medicine is the bedrock of our profession and our continued success is absolutely dependent upon our patients.

My optimism emerges from the confidence that I have in people who comprise the AANP and in the future landscape of healthcare. There is a place in healthcare for naturopathic physicians, and while this place has always existed, more and more people outside of our profession now recognize this place and want it to be larger and more visible. I can think of nothing more exciting than knowing that soon, in my lifetime, many more people throughout this country will enjoy access to naturopathic doctors.

I want to thank you for allowing me to serve at the President of the AANP. I carry the honor of this service deeply. I hope that I contributed to the profession’s well-being and made it easier in some way for each member to be more proud about the AANP and about our profession. Everything I have done is the result of the work of the entire board. I want to thank Dr. Vanessa Esteves, Dr. Chad Aschtgen, and Dr. Steve Bailey for their service as Directors on AANP Board. Their terms have come to a close and these individuals have enriched the Board with their perspectives and have donated extraordinary amounts of their time to this profession, often at the expense of time with their loved ones and other professional endeavors. I also want to extend my deepest gratitude to the current board members, who, as immediate past-President, I will have the pleasure of continuing to learn from and work with. Drs. Michelle Clark, Bill Benda, Tabitha Parker, Sara Thyr, and Michael Cronin. Leaving the role as President is easier with such a fabulous next President in the waiting. I welcome Dr. Carl Hangee-Bauer as our next AANP President. I cannot imagine anyone I would rather hand the baton to. He brings his immense talent, huge passion and great integrity to this role. Dr. Carl, at 12:01 EST January 1st, 2010, it’s all yours! I bow to all with immense respect and love in my heart.

Digitus Impudicus

By Jacob Schor, ND, FABNO


Photo by woodleywonderworks via Flickr, used under the Creative Commons License.

It wasn’t until the woman driving the Range Rover in the next lane raised her digitus impudicus that I realized I had been glaring at her. It was on the way to work this morning, driving south on Monaco Parkway; we were driving side by side while she read her email using an iPhone. Any other day I might have admired her talent but that day's feature article in The New York Times was on my mind. The article, a full three columns on the front page, revealed how from the start those engineers who developed car phones knew they were going to be a hazard. One early developer, Martin Cooper suggested locking the dials while driving. This was back in the early 1960s.

By 2007 the government estimated that 11% of drivers were talking on their phones at any given time. Harvard researchers estimate that during 2002, drivers using cell phones caused 2,600 fatal crashes and 570,000 accidents. It’s unlikely that any of these statistics have improved. More people are using phones and with texting and other new uses for these phones, accidents have most likely increased.

It was these numbers that I was trying to fathom as I watched this young woman adeptly use her index finger to scroll down the screen on the phone as she pinned it to the steering wheel with the other hand.

Large number of fatalities invariably get translated in my mind into multiples of the 9/11 deaths. For example the yearly mortality in the US due to lung cancer is equivalent to 108 twin towers lined up and falling like dominoes. Cell phones now account for a pair of towers collapsing annually.

Thinking of those towers as we paralleled our way down the road, I probably wasn’t smiling. I was wondering why we make such a fuss over terrorists and barely notice these insidious causes of death. What’s the difference? Terrorists kill us for political and religious reasons. Businesses can ignore the fact that they kill us because they make a profit. The later is ok and the former isn’t? A 166,000 people die from lung cancer every year, almost all a direct result of smoking cigarettes, and it no longer makes the news. At least with cigarettes we can pretend there was a time when we didn’t know they were dangerous.

But cell phones? No one pretended that talking on the phone would make cars safer. One needn’t be a rocket scientist or a Bell Laboratory engineer to realize they would increase the risks of driving. Using hands free phones are still risky but handheld phones are four times as dangerous. While she read and responded to email on a tiny touch screen, I don’t want to guess how much this woman increased our collective risk of having a bad day, a really bad day.

Why do we tolerate these pernicious incursions on our health and safety? Our patients come to us worried about how much vitamin E they should take, whether coconuts are healthy for them and other relatively trivial questions. Using a cell phone while driving is more likely to kill them than bisphenol-A or any of a dozen other things we put so much effort into protecting them from. Some days we might do everyone more good by becoming public advocates, making it harder to smoke and making it difficult to talk and drive. We could count the lives we save by the thousands.

Why is it so easy to look the other way? There was a brief flurry a few years back of bumper stickers that read, “Hang up and Drive.” The sentiment never took hold, perhaps because phone receivers no longer exist. The generation that needs to hear the message most has never ‘hung up’ a telephone.

I called a colleague last week at a time we’d prearranged. I caught her in the car ferrying her kids somewhere. I can’t name anyone I know who shuts off their phone when they get in the car. These are people who would go hungry rather than eat trans-fatty acids. There’s a disconnect here.

It is time to shift public perception. Talking on the phone in the car is no longer ok. It’s no longer multi-tasking, it’s no longer being efficient and productive. It’s being stupid. It’s sociably unacceptable, or at least it should be. As doctors we have a responsibility to teach our patients. Let’s teach this lesson by example and shut off our phones while we drive.

Nature’s Way

By Bill Benda, MD


Photo by Rennett Stowe, via flickr, used under the Creative Commons License.

This article is reprinted with permission from the peer-reviewed journal Integrative Medicine: A Clinician’s Journal (www.imjournal.com), vol 7 issue 1, pp 64. Copyright 2008, InnoVision Health Media (www.innovisionhm.com).

My world burned on June 24th of this year. I witnessed its genesis on a beautiful Big Sur summer day, clear and warm, the Pacific luminescent in the afternoon sun. And then, from the north, 3 small, innocent, tumbling clouds, passing overhead barely noticed, until . . .

Boom. Five rapid lightning strikes: 4 over the ocean and 1 touching down half a mile south of my ridge. Ten minutes later, a puff of smoke. After 24 hours, 4 neighboring houses burned to the ground and I began what became a 7-week exodus from my home and bed. More than 200 000 pristine acres and 30 structures destroyed within a month, and nothing we humans, even with our sophisticated airborne fire-fighting technology, could do to stop the advancing flames.

And then, once we were finally allowed to return to our blackened homes, something quite strange and beautiful occurred. The smoke cleared, the ash settled, and the earth, instead of gasping in pain, began to breathe as it hadn’t in a hundred years. The sky acquired a blue not before seen by those now alive, and the coyote pups and fox cubs I feared had perished reappeared, thrilled with the epicurean fare now exposed on the barren earth. The land loved having been burned. It turns out only we humans had suffered from what was, in fact, the ecological equivalent of a good housecleaning. As the only species allowed access to the process of combustion, we were, ironically, the ones who suffered most from its ill temper. It turns out we have become so adept at fire suppression that we have interfered with Nature’s perfect means of clearing away the debris of her own life cycles. It took but 1 lightning strike to dissipate both our sense of security and our delusion of eminent domain.

Which brings us (at last!) to the topic of healthcare. Our media is laden with stories of epidemic obesity and hypertension and diabetes. But obesity, hypertension, and diabetes do not kill. Stroke and myocardial infarctions kill. And ketoacidosis. And sepsis. We, in our exuberance to suppress the unpleasant symptoms of chronic illness, have, with our pharmaceuticals and surgeries, allowed our own toxic accumulation of unhealthy protoplasm—cells and organ systems unable to breathe, to cleanse, to heal. The patient need not really pay attention to nutrition and exercise if a little blue pill can make the pain go away.

But when the lightning strike of a clot hits us or a bit of inflammation starts a forest fire, the results are catastrophic rather than merely inconvenient. We suffer a stroke rather than a little more senility. A cellulitis becomes sepsis.

Life’s disasters have a way of teaching us lessons that we, in our mortal arrogance, tend to ignore until painful remediation engulfs us. Some tutorials are of extraordinary value, such as the rediscovery of compassion that had been nescient until a friend faces heartbreak. Others are more poignant than tragic, as in the revelation that one really does not need and does not miss all that stuff in the drawers and closets.

But above all, through catastrophe we learn that we are not in control, no matter how powerful our war machines or how small our computer chips. Nature trumps all, and when she wishes to correct the insanity of our plans for her planet, we are helpless to stop or even slow her down. “It’s Nature’s way,” goes the old ’60s Spirit tune, “of telling you something’s wrong.”

Perhaps it is time to surrender back to Nature her thrones of omniscience and omnipotence. During some points in our lives, we must become ill. We must age. We must die. Our task as practitioners is not to suppress the symptoms of blocked arteries and failing memories but to clear the toxic load of adipose tissue and calcium deposits and free radicals that will feed the flames of an acute medical event. Most of all, it is time to come to the understanding and acceptance that we are not in control, and that, in fact, we would not benefit by being in control. Nature has given us the most advanced healing technology on the planet, one that has been perfected over tens of millions of years and needs only our respect and attention to function at top performance—our own personal human body.

It is time to stop interfering with the natural processes that possess their own timetable of living and of dying; rather, we should focus on lending support to a cycle we may not fully understand and may never fully accept. This life is not our life. It is but a beautiful, perfect cell in the organism that is our natural world, a place not ours to control but only inhabit. And when we do return to ash, we will assist the earth in breathing deeply, once again.

Gratitude and Naturopathic Medicine

By Sara Thyr, ND


Photo by controltheweb via Flickr, under the Creative Commons License.

I have a bumper sticker on my car that says, “What are you grateful for?”

It is one of my favorite questions…. to others as well as myself. I use it often if I can’t sleep at night. It serves to put me in a positive state of mind, reminding me of all of the many blessings and abundance in my life.

Being a naturopathic doctor gives me more to be grateful for each day.

I get to practice cutting edge medicine in a calm and comforting environment. I have the training to diagnose and treat disease, working to uncover root causes of many illnesses like few other practitioners have the opportunity to do. I get to utilize safe and effective medicines, including herbs, nutrients and homeopathy, helping to find the perfect right thing for my patients that will not interfere with other medicines or cause unwanted side effects.

My colleagues are smart, kind and good-humored. Many of them I count among my best friends. I can always rely on them for an insightful opinion and words of wisdom. The years that I volunteered as president of the New Hampshire state association, and more recently on the board of directors of the AANP, have led me to be a part of a greater good. This has also afforded me the opportunity to interact with truly amazing, gifted people. I feel so lucky to be associated with this profession.

I am grateful that naturopathic medicine makes so much sense. That is what struck me when I first learned of it. Treat the whole person, remove obstacles to cure and find and treat the cause of disease…why don’t we do that in our lives more often.

Naturopathic medicine makes me more connected to nature. It brings my attention to making our planet a better and safer place. It creates awareness in me and then those I work with to avoid toxic chemicals in skin care products, cleaning products and in the food we put in our bodies. I am more grateful for pure water and organic food because of my acute awareness that everything we put in our bodies matters.

I am most grateful that my patients get better. That I can give them the tools to improve their health in a dramatic way, when no one else has been able to get to the bottom of their illness. One woman doesn’t need to get a hysterectomy; a young woman has a baby where she’d not been able to have one; another has resolution to very painful digestive problems; a man who came to me can breath without allergy medications, and another is able to wean off his asthma medications as his symptoms have resolved. There are many more stories just like these. It is rewarding to see that they are so happy, healthy, and yes, grateful.

One of my favorite things to do is to speak to prospective students of naturopathic medicine. I can’t imagine a more rewarding profession.

"Gratitude unlocks the fullness of life. It turns what we have into enough, and more. It turns denial into acceptance, chaos into order, confusion into clarity.... It turns problems into gifts, failures into success, the unexpected into perfect timing, and mistakes into important events.

Gratitude makes sense of our past, brings peace for today and creates a vision for tomorrow. "

-Melodie Beattie

Clinicians and Educators’ Desk Reference

By Marica Prenguber, ND, FABNO


Photo by Honou, via Flickr, under the Creative Commons License.

Another excellent reference to keep on hand! Developed by the Academic Consortium of Complementary and Alternative Health Care, the Clinicians and Educators’ Desk Reference, is a handy guide to the five licensed complementary and alternative healthcare professions. It has been vetted by experts in each field, and provides information on emerging fields of traditional world medicines, holistic nursing, and holistic and integrative medicine.

The American Massage Therapy Association Council of Schools, the Association of Accredited Naturopathic Medical Colleges, the Association of Chiropractic Colleges, the Council of Colleges of Acupuncture and Oriental Medicine, and the Midwifery Education Accreditation Council were instrumental in the organization and information development. In addition, the American Holistic Nurses Association, the American Holistic Medical Association, the American Medical College of Homeopathy, the Consortium of Academic Health Centers for Integrative Medicine, the International Association of Yoga Therapists and the National Ayurvedic Medical Association also contributed to the content.

Naturopathic input was provided by Paul Mittman, Michael Traub, and Pat Wolfe. Authors wrote to a template which provides key information on the profession, its standards, regulatory status, and more. Each chapter covers one discipline and provides the following information (and much more!) for that discipline: Philosophy, Mission, Goals, Clinical Care, Approach to Patient Care, Scope of Practice, Referral Practices, Education, Schools and Programs, Curriculum Content, Faculty and other Training Information, Accreditation, Regulation and Certification, Regulatory status, and Organizations and Websites.

This reference can be helpful when responding to patient questions regarding other disciplines, as well as when referring patients to those same disciplines. Admittedly I would not call this edge of my seat reading, yet I find that it is a great resource. We know what we do as naturopathic physicians, but what do we know about the details of those other approaches that we find patients also utilizing? Having additional information about those approaches might help us to better select which one is a better fit for referral for our patients. So give it a read – it’s a short 124 pages, and packed with useful information!

Diversity and the Changing Face of Naturopathic Medicine

By Lise Alschuler, ND, FABNO
Vice President, Quality and Education, Emerson Ecologics


Photo by DC John via Flickr, under the Creative Commons license.

I had the honor and privilege of spending a few days at the Canadian College of Naturopathic Medicine this week. I was invited to the school as part of their naturopathic elder series, which still makes me giggle a little. Perhaps being an ‘elder’ means simply having had enough time in the profession to gain a perspective. It is true that with each passing year, I find myself settling a little further back into the proverbial armchair and surveying the profession. One element that I have been observing for awhile and was beautifully brought forward during my visit to CCNM is diversity. For many years, I have been alternatively disappointed and alarmed and the lack of racial and ethnic diversity in the naturopathic profession. When I was in naturopathic school, I think there were two people of African American descent in the entire school. Even to this day, the faculty at our US schools are overwhelming Caucasian. That is the bad news. The good news is that things are finally changing. Nowhere is that more evident than at CCNM. I was amazed and impressed with the incredible ethnic diversity in both the student body, faculty and administration at CCNM. Certainly the fact that CCNM is located in Toronto, one of the most ethnically diverse cities in the world, has helped to diversify the school. Perhaps against steeper odds, I have been also been impressed with the significant and growing ethnic diversity in the student populations at a couple of our US naturopathic schools. These trends are encouraging.

It only makes sense that the naturopathic profession, as a part of its inexorable emergence, embrace diversity. Our medicine is the amalgamation of healing traditions from around the world. Naturopathic medicine, itself, is color blind. The society within which we practice is increasingly colorful and heterogeneous. Without diminishing the significant accomplishments towards ethnic and racial diversity made by all naturopathic schools, I assert that there is more to accomplish in this regard. Adding more ethnic and racial diversity to the faculty at all schools is of paramount importance. This, in turn, will bring more cultural sensitivity to naturopathic education and will provide critical role models for students of color. We also need more of our doctors of color in leadership positions. Right now, the AANP Board of Directors are all Caucasian. It has been that way for some time. I invite our African American, Asian, Hispanic and Native American NDs to run for the Board, to submit abstracts at our convention and to continue to be a visible and active part of our naturopathic community. I also urge my fellow Caucasians to exemplify cultural and racial sensitivity and inclusiveness. In the meantime, instead of leaning back into my proverbial armchair, I find myself leaning forward, eager for the next, very colorful, generation of naturopathic physicians to infiltrate all aspects of our profession.

I Know You Are, But What Am I?

By Bill Benda, MD



Photo by dotjdotsmith via flickr under the Creative Commons License.

There is a lexicon war going on this year, have you noticed? The first shots were fired last February at the Institute of Medicine Summit on Integrative Medicine in Washington, DC, where non-MD practitioners (specifically nurses and social workers) lined up at the microphone during the public commentary sessions to insist on the substitution of “healthcare” for “medicine” in all future language. Then, over the summer, the American Medical Association launched the first wave of its Scope of Practice Partnership, intent upon preventing doctorate-level professions from calling themselves “doctors” and “practicing medicine” and defining exactly what a “physician” is. On the other hand, a few short weeks ago, the US Department of Labor confirmed the legislative validity, among other things, of the official titles “naturopathic physician” and “naturopathic doctor.” So in general it appears people are happy being called “doctor,” unless they don’t want to be, or aren’t legally qualified, or someone else doesn’t want them to be, and that “healthcare” is the politically correct phrase from now on, unless we are talking about naturopathic “medicine” or Traditional Chinese “medicine,” in which case “medicine” doesn’t mean MDs, unless we are talking about the AMA, in which case “medicine” or “doctor” can only mean MDs. Or DOs. Or dentists.

Sheesh. What ever happened to Why Can’t We All Just Get Along? Where has the egalitarian, its-about-the-patient-not-us, change-the-paradigm conversation gone? If we agree that we all want a new definition of healthcare, why are we arguing over old classifications of entitlement? Don’t get me wrong – classifications are essential in the bureaucratic world of reimbursement and such. But doesn’t this war of the words seem a bit childish when so much is at stake in both the national and global arena?

I am, by all traditional criteria, a doctor who practices medicine. And I actively discourage anyone knowing this particular fact before they first get to know me as a person, as I usually will encounter one of two reactions – either an undeserved deference or an equally undeserved dismissal as likely being a jerk (which, by the way, if true is unrelated to my medical degree). In fact I propose that anyone making a restaurant reservation using the title “Dr,” whether medical or naturopathic or veterinarian, should be immediately seated next to the bathroom and then ignored.

The fact is that none of us is actually a doctor, or a nurse, or a naturopath, or an acupuncturist. We are simply human beings who have chosen a particular profession in our desire to help other fellow human beings, which is by definition the antithesis of entitlement. And to fight over a title while denigrating the AMA for its aggressively jealous obsession with that particular idiom is not simply childish; it’s hypocrisy.

And anyone that confused needs to see a doctor.

Charlie Chaplin, Mr. Bean, and Medicine

By Jacob Schor, ND, FABNO


Photo by Emmyboop via Flickr, under the Creative Commons License.

I've been reading up on what I call the Chaplin Studies over the last few weeks and they've given me a curious platform on which to observe both my daily life and that of my patients. By Chaplin Studies, I'm not referring to some academician by the name of Chaplin. Instead I'm thinking of the studies on laughter and humor's physiologic impact, most of which use a Charlie Chaplin movie, Modern Times, as their experimental control. In recent years though, Chaplin has been supplanted as a laugh inducer with videos of Mr. Bean in order to achieve similar effects. I suppose to be more accurate I should think of these studies as Chaplin, Bean, et al.

However we want to refer to them, there are an elegant group of research papers that was initially triggered initially by Norman Cousin's book on how he cured himself with laughter. Kimata's work an how laughter tempers allergic responses is probably the best known; laughter calms atopic dermatitis, asthma and related illnesses in adults and infants, even to the degree that having nursing mothers watch funny movies improves eczema and night time sleeping in their infants. Hayashi and his group of researchers have taken this a few steps further analyzing which genes are activated by laughter, analyzing thousands of genes before and after laughter provoking videos and no surprise the genes turned on mostly affect immune response, NK Killer Cell activation for the most part.

This isn't what I've been thinking about actually. I've been thinking about the controls they've used in these studies. For the most part in contrast to watching video of Chaplin, Bean et al. used to provoke laughter, the control groups in these studies usually got to watch the weather channel.

That the weather channel is a neutral control has triggered a chain of thought. There was a time that we watched television for entertainment, we would sit down to be amused, engaged but mostly entertained. Of course I may simply be thinking back to my childhood watching cartoons and the Three Stooges. Instead these days many people leave the television on to keep track of the weather, the news, or sports. As if I care what the weather is in Boston today? This does nothing good for us. What of the shows that fall on the opposite side of the spectrum from laughter, shows that my daughter groups under the category, 'Dead Body Shows?' If laughter improves or balances our immune function, what does the casual and constant viewing of shows that portray postmortem examinations? Is this good for us?

These ruminations have colored my observations during the day, as if I am turning a meter towards all experience. Does this make me laugh? Does this make me cry? Does this simply bore me to no end? These experiences are probably reflected in genetic expression and immune function.

Thank goodness for NetFlix and Mr. Chaplin and Mr. Bean I say. They have become my new after work antidote.

Where's the "health" in health care reform?

By Sara Thyr, ND


Photo by D Sharon Pruitt via Flickr under the Creative Commons License.

Back in August, I read an op-ed in The Washington Post by Kathleen Sebelias, our new Secretary of Health and Human Services. It brought this issue that has been nagging in the back of my head to the fore. She really believes that Obama’s plan will improve the health of Americans. But that is impossible. That is not at all what it is designed to do. It appears to me more likely to increase the number of people who have health insurance, which has not been correlated with Americans being free of symptoms and disease.

The problem with that is that in my experience, the insurance companies have no interest in health. Their focus is by and large money.

If you want to improve the health of Americans, you must begin to look more deeply at what is causing them to be ill. Look at what they are eating, what their stress is, what their daily habits are, and assess their exposure to toxins. If we spent even a fraction of the money that currently goes to insurance companies (who’s kneejerk habit is to reject claims, not promote health) on taking the time to actually figure out the underlying causes of symptoms, we would be at least heading in the right direction.

At some point, Americans must realize that they will pay for their own health. Whether or not they want to filter that money through the pockets of insurance executives and the yachts of the owners of big pharma is up to them. But pay they will. I figure they might as well actually get healthy in the process. Something others seem less interested in.

What makes me think Americans are ready to pay for your own healthcare? They already are.

On the board of directors for the American Association of Naturopathic Physicians, we have been having the conversation about DSHEA and the supplement industry in general. Even in the currently unregulated state, it is a multi-billion dollar/year industry. I want my patients to have high quality supplements. But I also want them to have access. The real point is that people are ready to implement changes that are not advocated by their insurer. Not only ready, but happy to pay for it themselves. This is because they want to be well. Not just insured. But actually feel good, live longer, sleep soundly.

If you want to improve the health of people in America, you must work with the people who care most about their health. The two most important groups are the people themselves and the physicians who are caring for them.

When insurers control the amount of time physicians spend, as well as the practice of medicine, the care given is not better. And with all of the overhead and CEO bonuses, it is not cheaper. Mostly, the people are not more well. Most physicians do care about their patients, but have such contraint on their time, they move towards the habitual “here’s your prescription.” The drug may have serious side effects, and rarely does it get to the root of the problem.

Without getting to the root of the problem and supporting the human body, true health is outside our grasp.

If your car’s tired are going flat, is it really ideal to just keep adding air? Sure, that might work to get you to the grocery store and back. But what you really need to do is find the hole. Don’t call your car insurance company. Take it down to the shop and get it fixed. Or buy new tires. Don’t expect someone else to pay for it. They’re your tires.

We spend more than any other nation on health care. If access and money would make us well, we would not rank 25th in the world for infant morbidity and mortality. We would not be lagging behind other nations in overall wellness. Nations who spend a mere fraction of what we do on health care.

As my friend Bill Benda, MD says, this current plan will be short lived. Until we look at increasing health, not increasing insurance coverage, we will be drinking the same old wine out of a new bottle. The public will not tolerate this for very long. The proof of the pudding is in the eating. Are you well or are you not well? Believe me, you care more than anyone about your health issues, not matter how simple or serious.

All in a Day's Work

By Marcia Prenguber ND, FABNO


Photo by fmc.nikon.d40 via Flickr, under the Creative Commons license.

All in a day’s work – a day of repeated inspiration. The challenge is how to record the events of the day, to savor the beauty, to reflect on the challenges, and process the losses. Starting the day with an early morning meeting referred to as Breast Clinic, the team of providers (pathologists, radiologists, mind-body counselors, naturopathic residents, medical, surgical, radiation, and naturopathic oncologists) sit in a darkened room to view scans and path slides. The details of the diagnoses of patients with newly diagnosed or recurrent cancers of the breast are presented, reviewing the pathologic nature of cells projected more than 200-fold on the screen in some ways give us a more real view of the enormity that these cancer cells play on an individual’s life. The stains that color these larger than life cells cast them in a friendly hue, but the meaning that those stains convey is not so good natured. I’ll admit, at first glance, this environment may not appear very inspirational. However…

The intensity of thought and depth of care that is evident during the discussion of the PET/CT scans, the path slides, and the Breast Surgeon’s review of each patient’s story as told to her by the patient is inspirational. The focus on the significance of each assessment, the conflicting information, the challenge to weigh the details appropriately make it very interesting, but inspirational? The details of each patient’s efforts to cope with the circumstances of the changes in their lives since the diagnoses, their lifestyle habits and all the rest of the information gathered by each of us in the time spent with the patients contribute to our understanding of the patients and fuels the fires of inspiration. Knowing these details about their lives gives us pause to reflect on what we do with our own moments in time. These patients inspire us to pay attention, to focus on the details, to bring to them the best that we can be, in whatever discipline we represent.

As a naturopathic physician, all of those details that patients bring to the cancer center matter to me. I look at this as winning the big prize – I get to use all that information in developing my treatment plan. And then to put icing on the cake, I get to spend time exploring these pieces of information with the patient – and just getting to know the patient. The most significant source of inspiration comes from learning who each patient is and how each one of them is dealing with this new challenge. What strategies do they each use? When and why do they choose not to know more? How do they deal with pressure from family and friends to try everything under the sun to try to treat the cancer? That these patients share this is such a privilege. Their courage, their strength, and their vulnerability inspire me. And makes me look a little deeper.

So, as the sun starts to come up in a spectacular sunrise and the morning meeting comes to a close, I am reminded that it is the start of another gorgeous day that I have the good fortune to go spend time with those patients. And to do so as a naturopathic oncologist – what a fabulous profession.

Monthly Payments Coming in 2010

By Carl Hangee-Bauer, ND, LAc
AANP President-Elect

I don't know about you, but I've always found it a bit of a financial stress for my business in January when my AANP membership renewal is due. With the last few weeks of December's cash flow slow due to the holidays and quarterly tax payments due in January on top of all my other bills, it can be tough to find the funds to renew my AANP membership for the entire year. That's why I'm happy to see the AANP move to a new dues structure where one can make monthly membership payments over the course of the year. Starting December 1, 2009, the monthly payment option will be made available to all AANP members. One can still pay upfront and receive a 16% discount, or stretch out their payments over the year to keep their cash flow running smoothly. I already do this with my state naturopathic and acupuncture associations and have found it to be an easy way to keep up my membership and support the important work of my professional associations.

There are more benefits to AANP membership than ever before. The popularity of www.naturopathic.org, the AANP web site, has soared 400%, with traffic to "Find an ND" increasing 30% in the past year. If you haven't checked out the members page on Practice Development, please do so; there are many articles geared to helping you grow and maintain successful practices. Politically, The AANP has joined the debate on health care to make sure that the message is heard that true health care reform is not just about changes in the insurance system. With AANP input, the definition of naturopathic medicine has been dramatically revised by the US Department of Labor to more accurately reflect our profession. We are involved in coalitions with other health professional associations with common goals as well as the Coalition for Patients Rights to combat the AMA's efforts to limit our licensing and scope of practice. In the past year, the AANP has worked with American Health Journal to develop a 7-part PBS series on naturopathic medicine, launched a national public relations campaign, and the new Natural Medicine Journal. I could go on but I think you get my point: The AANP is working hard for you to be the successful naturopathic physicians you are trained to be and we need your active participation so we can meet our mutual goals.

In 2010, we will celebrate the 25th anniversary of the AANP. I attended the first convention in Scottsdale back in 1986, became one of the first members of the AANP, and have maintained my membership ever since. I strongly believe that my participation along with hundreds of others have helped this organization and profession grow in ways we could not have imagined back then. Membership renewal notices will be sent out soon. I encourage you to join the AANP, get involved, and help guide the naturopathic profession for the next 25 years.

Renewal in Nature

By Lise Alschuler, ND, FABNO
Vice President, Quality and Education, Emerson Ecologics


Photo by walknboston via flickr, under the
Creative Commons license.

As I sit looking out of my new window, or rather, the window of my new home in New Hampshire, at the early splashes of fall colors, I am elegantly reminded of the beauty and grace in this wonderful world. Nature, in particular, is such a resplendent display of richness, vibrancy, and creativity. I think, deep down, it is this intense celebration of nature that inspired each of us to become naturopathic physicians, natural product manufacturers, or holistic practitioners. I am convinced, in fact, that our individual and collective respect for nature is the main twine connecting us to one another. When I think about Nature, I think about the dandelions forcing their way up through cracks in the sidewalk. I think about the collective sigh from a grove of fir trees bending in the wind. I think about the sweet stillness of the sun setting over gently rolling hills. These recollections bring me into immediate presence – the beautiful here and now of this world. What a joy.

I know, without a doubt, that my inspiration from, and confidence in, nature and the beauty of this world is due, in large part, to being a naturopathic doctor. The philosophy and community of naturopathic medicine built and then buttressed my connection to nature. Without this medicine, I can’t really imagine how I would maintain my sanity in this chaotic world. Where would I be without my weeds, trees and sunset as equalizers? This gift – rich and poignant as it is- is a gift that is meant to be shared. How does one share a confidence and inspiration in nature? Quite simply by remaining an active part of the naturopathic community, the very community that builds this inspiration. I swear to you, that there is a direct and pulsating link between active membership in the AANP and being an inspired naturalist. Admittedly, I am biased by my own experience. I have been an active member of the AANP and volunteer in the naturopathic profession since my second year of naturopathic medical school. When I reflect back upon my volunteerism, every action – as challenging as they may have been at the time – solidified my belief in, and passion for, naturopathic medicine. Out of this passion, my love affair with Nature intensified and my sanity remained (more or less) intact. That is, perhaps, the most compelling and selfish reason for being an active part of the naturopathic profession. I not only admit it, I encourage you to take your share. Join, volunteer, gain inspiration, feel the tremendous vitality of this profession and of the stunning natural world around us.

Updates from Natural Doctors International

By Tabatha Parker, ND


A group meeting, at an NDI Clinic, in Nicaragua. Photo Via NDI.

NDI Now Offers 60 Hours of CE for Global Health Course: In the world of international medicine, Natural Doctors International continues to pioneer and create inroads for naturopathic physicians and other health providers in global health. The very first Global Health Course of it's kind is now CE certified thru the OBNE! Yes, naturopathic doctors who participate in our courses will receive 60 continuing education credits, 3 of which will be granted as pharmacy credit. "This is a huge step for us", says Dr. Tabatha Parker, Executive Director of NDI, "as it will open up the doors for many doctors that want to do service work but must juggle the cost of other obligations like CE". CE courses will run throughout the year, and NDs are encouraged to sign up for the courses quickly as spaces are limited and sell out quickly. "This year we just finished our courses and graduated over 88 participants - creating a pool of naturopathic physicians that will be trained to be global health providers." You may find more information about our global health courses at www.ndimed.org.

NDI Annual Auction
NDI is also reinstating their Annual Auction and Volunteer Appreciation Gala this December 4th of 2009 so mark your calendars and come celebrate in Portland, Oregon! If you would like to nominate a volunteer, intern, student NDI president or board member to receive an award, please email ndvolunteers@ndimed.org with your nomination.

CALLING ALL NDs - International Collaboration with Red Cross to Teach Locals Natural Medicine
When the Red Cross (Italy) decided to do a huge program on the island of Ometepe with over 90 classes in natural medicine, they naturally came to NDI to collaborate. This is very exciting news and very much in line with the idea set forth by NDI volunteer Anthony Trujillo who won $2000 and 1st prize for his natural medicine sustainability video. If you are interested in helping to develop basic classes in natural medicine for this project, please contact us immediately. We are looking for physicians to provide some basic powerpoints about natural medicine in general OR utilizing natural medicine to treat diarrhea, parasites, flu and cold, upper respiratory infections, heart disease, diabetes, and other diseases. The presentations will be edited for content and tailored for our audience here in Nicaragua and translated into Spanish. We will be selecting interns to help implement this program in early 2010.

Happy New Year: Welcome to the year 5770

By Jacob Schor, ND, FABNO


Photo by RonAlmog via Flickr, under the Creative Commons license.

We celebrated the Jewish New Year last month and we have arrived into the year 5770. It is a little more than five and a half millennia since Genesis.

Denver’s annual Gem and Mineral show was held here in Denver several weeks ago. I had hoped to go Sunday but got caught up staining our deck and ran out of time. I was hoping to find a fossil for the office. It gives me pleasure to touch something that was alive hundreds of millions of years ago. Is the world 5770 years old or, as the geologists tell us, 4.54 billion years (109) years old? Or does it matter?

Much of the time it gives me pleasure to let these two different worldviews coexist in my mind. To paraphrase Whitman, “Do I contradict myself ?... I contain multitudes….”

We live in a world of plurality, where we coexist with people and cultures that see the world differently than we do and we learn to some extent or see the world from multiple viewpoints. Our modern view is informed by scientific principles, of hypotheses tried, proven or rejected. Yet retaining some part of other perhaps unscientific worldviews has its place. Doing so gives the world more dimension and makes it a more interesting place. I have no problem with the world being both 5770 years old and at the same time being unfathomably old.

Disregarding the newer scientific worldview in favor of other views may not be the best idea. We can certainly find examples of what happens when individuals cling too fixedly to a view that is wrong.

The first example that comes to mind is how South Africa’s former President Thabo Mbeki based healthcare policy on his opinion that HIV infection does not cause Aids. Current research suggests his denial and the policies it engendered are responsible for 365,000 premature deaths.

Or consider the slaughter of pigs in Cairo. Late last Spring Egyptian authorities slaughtered all the city’s pigs out of fear of the ‘Swine Flu.’ Never mind that the flu was spreading person to person already. The people raising the pigs were Cairo’s garbage collectors and without pigs to feed they now see no profit in collecting garbage. A little bit late, authorities in Cairo are wondering what to do with the garbage that has piled up on the streets since May.

An example closer to home; I wrote about the book Catching Fire several weeks ago. This is the book written by Harvard anthropologist Richard Wrangham who argues his theory that cooked food was the driving force in evolution of habilenes to homo erectus some 1.6 million years ago. One of my former newsletter readers did not like that I wrote about human evolution. She emailed asking to be removed from my mailing list writing, “I did not evolve from slime or from monkeys; I was created by God. I do not want to receive a newsletter from someone who believes otherwise.”

There is clear advantage to seeing the world in black and white, of having set and narrow views as to how things are. Unfortunately, these sorts of views limit scientists from exploring new ideas and more importantly for me, make the practice of medicine difficult. Although it is perhaps more comfortable and easy to stick with one’s view of the world undisturbed, it does not serve the care of one’s patients to hold so fast that we miss new developments.

These ramblings bring us to a study published in the August 19 issue of JAMA that suggests that estrogen may be a useful treatment in some types of breast cancer(1). Most breast cancer cells have estrogen receptors on their surface and when estrogen binds to these receptors it stimulates the cancer cells causing them to multiply. Tamoxifen has been used for 30 years to block these estrogen receptors. This is so basic an understanding after all these years that it is hard to imagine that estrogen might be useful in treating breast cancer. Yet it seems that at least in some breast tumors estrogen will also trigger apoptosis. Apparently in the years before Tamoxifen dominated treatment, estrogen like compounds, for example DES, were used to treat breast cancer. Somehow we forgot about this.

As many of us have sadly witnessed, estrogen blocking therapies used to treat women with breast cancer stop working after awhile. The tumors become insensitive to the hormone and grow without it. In this study, Matthew Ellis and colleagues report on their treatment of 66 breast cancer patients experiencing cancer relapse and showing no benefit from estrogen deprivation treatments. Half the women were given high dose estrogen, 30 mg/day and half low dose, 6 mg/day. After 24 weeks of treatment the tumors had stopped growing or shrunk in about one-third of the women in both groups.

The researchers say they found a way to predict which women were likely to respond. Using combined PET-CT scans with a tracer attached to glucose produced a specific reaction on the scan that predicted the responders with about 80% accuracy.

How many of us will be able to let go of the world view that estrogen is bad for breast cancer and how many will be able to see that, ‘estrogens effects on a tumor are not one-dimensional,’ but rather multi-dimensional? Can we let go of our long held view and adjust to this new information?

This is part of the reason why I keep the age of the earth variable in my mind. We need to stay flexible if we hope to keep up with the science.

1. Ellis MJ, Gao F, Dehdashti F, Jeffe DB, Marcom PK, Carey LA, et al. Lower-dose vs high-dose oral estradiol therapy of hormone receptor-positive, aromatase inhibitor-resistant advanced breast cancer: a phase 2 randomized study. JAMA. 2009 Aug 19;302(7):774-80.

Their Generation

By Bill Benda, MD

I’ve experienced an epiphany in the past few weeks, keeping in mind of course that one man’s epiphany is another man’s delusion. As I reach the end of a decade attempting to build bridges between various integrative/holistic/CAM vocations, I’m beginning to think that a true inter-professional coalescence of energies and efforts to change the foundations of our healthcare system may happen in my lifetime, but not via my generation. There are tremendous efforts, don’t get me wrong – ACCAHC and CAHCIM and IHPC and a veritable alphabet soup of organizations and individuals meeting and conferencing and symposiuming. But it seems like such a slog at times, with no cohesive voice yet to be heard above the “we need better insurance coverage” cacophony from today’s political parties.

Then I walk into a gathering of students, whether of the Naturopathic Medical Student Association (NMSA) or the American Medical Student Association (AMSA), or the chiropractic or the nursing schools, and all of a sudden issues such as competition and licensure and who gets the biggest piece of the pie are not even whispered, much less argued. Those coming after us are apparently fairly free of the baggage we tend to drag along behind us – baggage gathered over years of battle with the status quo or as the status quo. These young (and often not so young) people see the students of another healthcare profession as actual people, not adversaries - as fellow travelers on an academic sea with whom to commiserate rather than compete. For years AMSA has housed a Humanistic Medicine section, and three years ago established a Naturopathic Medicine Interest Group with an ND student from NCNM as chair. NMSA itself sits at the table with the grownups of AANP and ACCAHC and in the Naturopathic Coordinating Council. And when these scholars speak to us it is about how we are all alike, not disparate.

And another consequential point – among these student bodies are, by default if nothing else, our next AANP officers and board members, and medical school presidents and faculty, and industry leaders and lobbyists. What an amazing one-two punch – energetic youth without prejudice against traditional healthcare enemies already making inroads that their parent organizations can only long for. A virtual dream team in the healthcare game.

So this leaves us with both and opportunity and a challenge. An opportunity to move our campaign forward by giving our moral and financial support to the student cause, as it is our cause, only in a more pure state. A challenge to step back and consider that perhaps we in our later years are as blind in some ways as we are wise in others. That perhaps we should call in a less sophisticated perspective from a less “experienced” source.

I’m talking ‘bout their generation . . .

Think Diet Doesn't Affect Your Immune System? Think Again.

By Sara Thyr, ND

I’m writing in response to Jennifer LaRue Huget’s article in The Washington Post, “Even Carefully Selected Foods Won't Make You Immune to the Flu”. I appreciate that the author wants to explore the possibility that nutrition might prevent illness, but she seems to have taken a rather short-sighted approach. Huget’s article investigates if one food can prevent the flu, instead of looking at the effect foods have on the body and the immune system, both positive and negative. Food has a profound effect on the body. It doesn’t take a PhD in biochemistry to figure this out. The cells of the body, including the immune system, all chug along using the fuel that they get from what we ingest. So if you are ingesting mostly Twinkies, you may have fewer necessary nutrients in your cells than if you are ingesting carrots.

But let’s not be too extreme. Really, how many of us are eating Twinkies these days? But if you eat sugar, let’s say delicious homemade cookies, or an iced mocha, it can depress your immune system for hours afterward. If you are having sugar all day long – even in small amounts – you will be much more likely to catch whatever is going around.

I’ve often marveled at the large offices with candies on many people’s desks. They are more likely to pass around illness just due to their proximity. Then add in lots of sugar – recipe for spreading the flu.

Huget draws bizarre conclusions about how foods affect disease. Take this paragraph:

"The immune system is the result of an extremely complex interplay of various functions within the body," said Darwin Deen, senior attending physician in Montefiore Medical Center's department of family and social medicine in New York. "We know that if the system is deficient, you're susceptible to infection. That's the case with HIV. But we also know that if the system is hypersensitive, you'll have allergies, and if it's turned toward the wrong tissue, you have autoimmunity" -- where the body turns on itself. So efforts to "boost" the system, even through diet, might produce unintended consequences.

Too many organic greens and blueberries and you’ll turn up with Lupus? That’s a really broad conclusion to draw - not to mention, completely counter intuitive.

Huget should have talked to people who actually believe in healthy food and prescribe it for their patients. There is good research showing that eating garlic, turmeric and maitake mushrooms does improve immune system function.

Not that I insist that my patients eat 10 cloves of garlic a day to stay well (although that’d probably do the trick). I think that food for us is a hotbed issue. And the trick is to eat whole foods, healthy foods, while avoiding the foods that suppress the immune system.

Don’t buy into the latest superfood that’s backed by a trade group? I’m not advocating for trendy natural foods eating – far from it. But you should keep in mind that, here in the fine capitalistic America, someone is bound to profit from your purchase. How do you think the whole food pyramid was built? Pretty much by the milk and bread industries.

What is most discouraging to me is that the millions of people who read the Washington Post weren’t encouraged to eat foods that are good for them. They are told to get the shot, wash their hands and hope for the best. The lives and health of Huget’s readers have so much potential to be improved – cavalierly tossed away.

In truth, the best option for readers hoping for an alternative to the flu vaccine, is to seek care from a naturopathic physician, who will likely assess your adrenals, make sure that you don’t have food sensitivities (which can really throw your immune system out of whack) and create a personalized plan to keep you well this flu season and all the seasons to come.

What Do Naturopathic Residencies and Pygmy Goats Have In Common?

Posted by Marcia Prenguber, ND, FABNO

Just as Lise noted in the previous blog, it has been a several weeks since the conference and, having taken a week’s vacation after the conference, I am still trying to catch up on things. Part of that process is reflecting on the various happenings at the conference, and what we all accomplished during that week.

The top of the list for me is the brand new residency organization – the NPGA! No, it is not the National Pigmy Goat Association, nor the National Propane Gas Association. It is the Naturopathic Post Graduate Association!

Lise Alschuler, Christine Girard and I have a driving passion for post-graduate medical education, and have talked about it for quite some time. So, knowing that there is interest by a number of folks in or associated with the field, and many examples of progress with the increasing number of ND residencies, we decided to move forward and ask for some assistance. How do we address the wide number of needs surrounding naturopathic residencies? The answer? An organization specifically focused on residencies for NDs! The goal of the NPGA is to be a resource to the profession by providing the infrastructure to support the growth of post graduate medical opportunities, to offer information to legislative bodies, to board certification organizations and to the public. The vision of the NPGA is to create universally available naturopathic post-graduate medical education.

The NPGA board is comprised of representatives from various organizations, from private practice, the public, and a representative resident in order to move these goals forward. We will explore a universal application process, residency/resident matching programs. In addition we will look to increase the availability and diversity of residencies as well as expand and diversify funding sources. I admit, pretty big goals. And, I am certain that they can be achieved over time with as dynamic a board as we have in the NPGA. So please join me in celebrating this newly founded board and the naturopathic determination to accomplish these goals!

Feeling That Post-Convention Glow

By Lise Alschuler, ND, FABNO
AANP President

It is several weeks now since our annual AANP Convention in Tacoma. And, yet, I still feel warmed by it. There is something so incredible about a gathering of hundreds of passionate, intelligent and like-minded people who actually like being with each other. I don’t know if it was the genuine joy that I felt and witnessed as people greeted each other, or the reverence with which we listened to some of our speakers and presenters, or simply the act of sharing good food together… but something makes our convention feel good. Really good. And that good feeling lasts. I still have a little glow emanating from me.

All this makes me realize that despite health care’s highly contentious politics, heartbreaking inequities and confused analysis and repair, there are points of calm amidst this storm. The naturopathic community is one of these and is like a hearth fire. The steady flame that we keep alight draws people towards us. People who are embittered with the cold void of depersonalized healthcare seek us out. We warm them up, remind them of our shared humanity, and give them the gift of optimism and possibility. Some stay with us and our collective grows. Others leave as ambassadors to bring guidance and insight to the great, diverse and rugged terrain of health care.

I realize that this may sound a bit grandiose. I mean, really, how could a profession of thousands, in gatherings of hundreds, possibly influence the world around us in this way? I can’t prove that we do. I believe that we do. In the new physics, we know that there are a multitude of fields around us at all times – most of which are in dimensions that we don’t even know exist. Physics also tells us that every thought, every action and every intention impacts these fields and creates change that affects everything else. Following this same logic, collective intention that is manifested as cohesive action (e.g. our naturopathic convention) has major impact on these fields, becoming a force in the universe. The force of naturopathic medicine – directed, resilient and powerful.

We know our world is in great need and I am deeply grateful for the wisdom and love that the naturopathic profession holds forth. I simply cannot imagine this world without it. And, I have every confidence that we will continue to help shape a better future.

All this from the convention!

A Different Approach to Practice Building

Jacob Schor, ND, FABNO



The smartest thing we ever did for our practice is bring a dog in as a coworker. Almost five years ago my wife and I succumbed to the pleas of our daughter and the oaths that she would share the added chore and committed ourselves to adopt a 4 day old puppy. She came home to live with us a two months later. Two weeks later she started coming to the office.

We thought this would be temporary plan, only until she was old enough to stay at home with the cat. Were we wrong, so very wrong. Our patients were furious when they showed up and the puppy wasn’t at the door to greet them. In the end, the puppy, now a 95 pound Poppy, became part of the office staff. Our mailman, a fellow in possession of a conservative political belief system that is in no way congruent with the way we see the world, is in love with my dog. He has several hunting dogs at home and aptly describes Poppy as a working dog, a whitecollar working dog. He now carries dog treats in his mailbag and will often take a breather from his route sitting on our floor.

Poppy is a talented assistant and office greeter. She makes people feel comfortable, the kids feel safe and it seems they open up sooner. In our medicine the challenge is to find out what’s really going on, not the numbers on the lab tests, but the challenges of the soul, the traumas to the heart, the fears and the driving hopes. Our experience has been that having a kind and loving dog present in the office has made this easier to achieve.

Thus it comes with no surprise to read about how dogs can trigger oxytocin release in humans. I recently stumbled on an abstract from the journal Hormones and Behaviour that told me a dog’s gaze can trigger oxytocin release in people, as much as a 20 percent increase in blood oxytocin levels. Recall that oxytocin is the hormone that helps us form and cement emotional bonds.

So there is actually science behind what we’re doing. In a scientific manner according to peer reviewed scientific publications, our sweet dog is helping us build trusting relationships with our patients. And our mail man, UPS driver, FedEx lady and everyone else who walks in the door. Our experience is that although work is still work, we do the work in an environment of friendship and trust, what sometimes feels like an oasis in a world that lacks these things. It’s all because of the dog.

Granted, before you all run out to the pound to get your own office dog, keep in mind we were lucky and unknowingly stumbled upon the perfect dog. Poppy is what we call a Hybrid Retriever; her mom was a golden retriever and her dad a Labrador. She has inherited the better characteristics of both breeds. She is intelligent, mellow, affectionate and tolerant of children who want to ride her like a horse (well, most of the time). It’s only after she came home that we learned that our local service dog trainers favor this cross.

Our medicine depends on building relationships. This is Poppy’s job description, it’s what she does every working day. She has helped our practice immensely and helped us do the work we try to.

I know this isn’t the sort of thing you’ll be taught in your business courses. It goes against the entire white coated professional image we were trained to portray in school. Granted we do practice in an unlicensed state and shy away from many ‘medical procedures’ in our office. No need to worry about sterile fields in our practice.

Some of my colleagues will likely be able to enumerate a list reasons why you shouldn’t have a dog join your practice.

In the meantime, it’s a beautiful morning and the dog and I are off to splash in the river and enjoy the day.

Ruminations from Tacoma . . .

By Bill Benda, MD

I have always found AANP annual conventions fascinating, although exhausting, most likely because as a non-ND I attend exclusively as Board member, lecturer, and journalist. No alumni reunions or interesting practice enhancement presentations for me, replaced instead by meeting after meeting after presentation after exhibitor appreciation after AANP after HOD after SALT after NMSA after NDI, with a final acronym of zzzzzzzzz.

And still I look forward to it every year. There is something about this particular field of medicine, a certain cultural attitude I resonate with. Probably a déjà vu of my formative years in the 60s and 70s, life relatively unencumbered by social protocol or political correctness. Only it seems I get to exhibit less inhibition this time around; as I am not a native of this tribe, I am a bit more free to travel in and out of the lectures and social gatherings. A bit more lonely as well - a hybrid of participant and observer, collecting thoughts and perspectives rather than disbursing tales of what I’ve been up to since “the last time I saw you.”

The crowd in the conference center seemed a bit more sparse than prior years, fully expected by staff and convention planners in economically challenged times (although the hotel bar appeared to not suffer from inattention). And there were a few novel presentations, such as the “naturopathic approach to global warming” and “here come electronic medical records.” But this is the year that I discovered the real future of naturopathic medicine, unwittingly lured by an innocent request to fill the role of moderator at the annual ZRT Cup, an answer-the-medical-question competition between our seven naturopathic medical colleges for bragging rights, a trophy, and a check for $10,000. I find these students to be a treasure – innocent and worldly, full of desire to change a world that still confuses their (and our) minds and souls. I can easily perceive a distinct difference between them and us, a touch of purity and excitement and energy (in them). I don’t know where they coalesce in the evenings, but it doesn’t appear to be at the bar, at least not before this writer’s curfew. I imagine they are off somewhere strategizing how to fix this global mess we have gotten ourselves into. Or drinking in their rooms. Who knows?

Back to the ZRT cup competition. The early rounds were populated primarily by students participating or awaiting their turn, along with a few institutional mentors. But the competition was hot, with each panelist hungry for the opportunity to elevate their school to the top of a seven-institution academic pyramid. And one by one they rose or fell, with the final round to be between Bastyr and NCNM the following evening.

And what an evening it was. Beautiful room, full bar, and packed standing room only with students and graduate supporters (quite noisy supporters at that). As moderator I had my back to the crowd, but could feel the heat of expectation on my backside. No place for goofs on my part here – there was far more than the $10,000 prize at stake. NCNM won handily, although not so much from superior knowledge as from a somewhat risky strategy that paid off far more than left them stranded: hit the buzzer early, and trust you’ll know or figure out the right answer. A bit of aggressive behavior coupled with confidence bordering on cockiness, which certainly will come in handy when they enter our healthcare system.

Following the night of the ZRT came days of keynotes, and yes, more meetings. The Gala on Saturday night was quite sweet, and thankfully we finally had a band playing music I could dance to. After the final set, its off to the hotel bar, where last calls were called for over a half hour before security showed up to inform the naturopathic crowd that, yes, we are done for the night.

Sunday is the day most conventioneers reserve as a travel-home-hung-over day, but for our young charges it marks the annual Naturopathic Medical Student Association (NMSA) conference. I won’t list the speakers or content for the weary reader, but will emphasize that this fledgling organization already has a seat at the AANP board table, the American Medical Student Association (AMSA), the Naturopathic Coordinating Council (NCC), and the Academic Consortium for Complementary and Alternative Health Care (ACCAHC). If any of you eyeing this diatribe truly wish to invest in the future of your profession, support this organization. Now. With money. And time. And volunteerism in any way possible. www.naturopathicstudent.org.

AANP Convention: Friends, Medicine, and Dancing

By Sara Thyr, ND

Where else can you go and be surrounded by people who love you completely, learn cutting edge information in the most exciting healing field in the world, eat healthy food and dance your hiney off in the same week? Not to mention stunning views of Mt. Rainier?

This year's AANP convention in Tacoma was too good to be true. I didn't get enough sleep, and the only exercise I got was the dancing. But those small injustices aside, I truly had a great time.

I learned some things that I will bring back to my practice that will help my patients - always my favorite thing about convention. Many docs wave off atrial fibrillation - Dr. Paul Saunders did a great talk showing us all of the therapies we can use that work. The vaccine question plagues many of us who see children - Dr. Matt Baral gave an insightful presentation that cleared much of the muck around that issue.

I got some good information about some new products - another fabulous benefit.
And best of all, I really got filled up by the love of my community of exquisite healers.

There were too many great ones to list here. Well, you know...you were there!
What? You weren't? What's the matter with you?

Why I Love the AANP Convention

By Tabatha Parker, ND

The reason I LOVE AANP conferences is because you can stay up all night having amazing discussions with NDs and then every morning you all gather together to keep learning and growing. I am constantly amazed at the work our profession is doing, at the intention with which we move thru the world and at the passion we all carry with us as we walk upon the earth. I truly thank each of you for inspiring me to be the best ND I can be. And of course, there is nothing like late night conversations with Russell Marz to put you in a whole new frame of mind!!!!

Tabatha Parker, ND
AANP Board Member
Natural Doctors International
Executive Director, Medical Director NDI Nicaragua

Hello From Tacoma!

By Sara Thyr, ND

Day one of "Physician, Heal Thy Planet" started out with James Stark of the
Regenerative Design Institute talking about renewing our connection to
nature. As physicians who talk about the healing power of nature, we fall
prey to losing our own personal connection to it like everyone else on the
planet. Asking us to think about a moment in nature from our childhood and
then sharing it with those next to us was an insightful exercise. He also
showed some great footage of Joanna Macy from the documentary "The Great
Turning" where she talked about the benefit of uncertainty. That is where we
are most courageous and innovative.

I didn't get to see too many talks today, but did get to connect with many
old friends and classmates. In those priceless moments of hugs and quick
catch-ups in the hallway reminds me of the joy of being in this amazing
community.

I loved hearing about the escharotic treatment for cervical dysplasia. We
have an amazingly powerful non-surgical treatment in our repertoire and many
NDs are forgetting about it, or have not been properly trained to perform
it. Drs Windstar and Jones are to be commended for reminding us about it's
effectiveness and clarity on how we can all do this in our offices.

Matt Baral did a wonderful job with lots of research and insights in his
vaccine update. I think I will have to get the recordings to hear it all
again.

Not to mention the many fabulous presenters who I didn't not get to venture
into their presentations today. There is so much fabulous information being
presented.

My assessment - it's great, overwhelming, and I'm ready to rest up for
tomorrow.

Julie, Julia, and Naturopathic Medicine

by Marcia Prenguber, ND, FABNO

So I have just returned home from seeing Julie & Julia – fantastic movie! As soon as I arrived home, I immediately went in search of my copy of Julia Child’s Mastering the Art of French Cooking. The sense of enthusiasm and the excitement of the projects these two women undertook is some significant bit of inspiration. And what does that have to do with a blog on naturopathic medicine? The pounding heart excitement about the world of cooking and the pleasure of food in the movie is the same as that which I feel about our medicine. No, I have not lost my mind – I am just recognizing my joy as it is portrayed in the movie. The chance to explain our medicine to a patient who is unfamiliar with the principles and tools of naturopathic medicine, the opportunity to educate a group of health care librarians who are naïve about the medicine, or the questions that come from the group of medical doctors listening to a presentation on the integrative approach to treating cachexia makes me feel like the Julia Child played by Meryl Streep. Yes, I can get that excited and I am sure many of you do as well. I know that this is passion – but really – that is such a tame label compared to what I saw in this movie! Julia makes her passion sooo much fun! Maybe it’s her voice.

My husband and I recently had the delightful opportunity to visit a gentleman who is also a patient of mine, and his wife, at their home. We live in a rural area that is home to a large group of Amish, known for their choice to live without electricity, to use horse and buggy for transportation, and for their magnificent vegetable and flower gardens. As we visited with this Amish couple and enjoyed the strawberry pie they made that afternoon, their children and grandchildren began to gather in their home. Word was out that we were there to visit and it was an opportunity to chat. We talked about organic gardening, about energy production, and about various approaches to health - conventional, naturopathic, and Amish healing. We all had lots of questions, ideas to share, and great pie. How much better can it get? So my enthusiasm, like Julia’s, is organic, local, and renewable.

Letting Nature Heal

By Jacob Schor, ND, FABNO

Reading Lise’s blog just now generated a response that isn’t suitable for print that questioned what I could write that might be appropriate to follow her treatise on universal love and chronic disease.

I’ve been thinking about much more mundane matters; how cold and rainy it’s been in Denver in contrast to Portland which apparently has had a bit of a warm spell. Those sorts of things. OK, let’s try writing this AANP thing:

I was up later than I wanted to be last night following an interesting trail through PubMed. There is growing awareness that serotonin may affect bones for the worse, increasing bone loss and increasing risk of osteoporosis and fractures. The first hints appeared a decade back and have gradually accumulated over the years. At this point it’s pretty much a sure thing. Taking SSRIs in order to increase serotonin levels increases bone loss.

This new knowledge shows up as our suppliers are once again selling l-tryptophan and promoting its use to increase serotonin levels.

OK, so we should be a bit more cautious with blindly raising serotonin levels in our patients. But the bigger issue is what were we thinking in doing this in the first place? After all, we are we not supposed to be naturopaths and is not our goal supposed to be to stimulate the vital force or the vis medicatrix naturae or something along that line. What does feeding our patients with isolated chemicals, in this case l-tryptophan or 5HTP, have to do with stimulating the vis?

What we were thinking of course is that Prozac works by raising serotonin levels and sometimes makes people happier. If Prozac and l-tryptophan do kind of the same thing, well the later is more natural and seems like an ‘alternative medicine.’ The thing is that we are not ‘alternative medicine doctors.’ We did not go to ‘alternative medicine school.’ Perhaps we need to remind ourselves this once in awhile.

The more we understand about the human body, the less sure I am that I really understand anything. Serotonin is made in both the brain and the gut. L-tryptophan is converted into niacin or serotonin and can then be made into melatonin. The gut makes far more melatonin than the brain does. Serotonin and melatonin play at least several roles in the intestine, helping regulate intestinal motility, healing injury and moderating inflammation.

So though exceptionally easy to reach for a bottle of l-tryptophan or of melatonin I still wonder, is it the right thing to do? Might we get a deeper and more profound effect by taking a more ‘naturopathic’ approach? I often find myself imagining how particular patients might respond to a month of old time nature cure. If they were to spend day after day on forced hikes through the Austrian Alps, early to bed and early to rise, bathing in cold water, the whole deal, how many of their complaints might resolve without further intervention? Would this push start a more robust circadian cycle and by strengthening melatonin fluctuations not have some positive influence on serotonin production as well?

Neither we, nor our patients, often have the luxury of really testing out these imagined months away from job and family so we are left with the simple question. How best to restore normal function with the least intervention? In the end, patients don’t come to us for philosophy, they come to us for help. If a bit of an amino acid nudges a patient’s chemistry so that she sleeps better, it’s not the end of the world. Yet, few of us are satisfied that this is a cure, but it is an improvement.

Although my concerns over serotonin and bone mass are new, the questions it raises in my mind are old. Not just for our profession, but through the history of medicine. How much does the physician intervene? How much do we step back and let nature heal? Do we know enough to help nature heal? Are our theories correct or will our misinformed attempts backfire and interfere with nature’s own efforts? Or to ask the sacrilegious question, ‘Does nature really know what to do in the first place?’

As a profession we can be almost cultish in our belief in nature as an all-knowing omnipotent healer. Let me quote a respected medical writer on nature’s healing properties:

“If the organism alone is left to the task, by its own forces and without external aid, …. we then witness nothing but painful, often dangerous efforts of nature to save the individual at whatever cost, which often terminate in extinction of the earthly existence, in death….What the vital force does in these so-called crises and how it does it remains a mystery to us like all the internal operations of the organic vital economy. One thing, however, is certain: that in all these efforts more or less of the affected parts are sacrificed and destroyed in order to save the rest.... In short, the entire operation of the self-aiding power of the organism when attacked by disease displays to the observer nothing but suffering, nothing that he could or ought to imitate if he wishes to cure disease in a truly artistic manner…..

“……the unreasoning life-preserving power when left to itself in disease, which, entirely dependent as it is upon the organic laws of the body, is only capable of acting in conformity with these laws, and is not guided by reason and reflection—the crude nature, which cannot, like an intelligent surgeon, bring together the gaping lips of a wound and by their union effect a cure; which knows not how to straighten and adjust the broken ends of a bone lying far apart, ……which cannot put a ligature on a wounded artery, but in its energy causes the patient to bleed to death; which does not understand how to replace a dislocated shoulder……which in order to remove a foreign body from the cornea, destroys the entire eye by suppuration; which with all its efforts, can only liberate a strangulated hernia by gangrene of the bowel and death; and which by the metaschematisms it produces in dynamic diseases, often renders them worse than they were originally.”

-Samuel Hahnemann

Our image of this Vis that we so eagerly wish to embrace and employ to heal all patients of all things is perhaps oversimplified. Great doctors for centuries have professed and debated the nature of this ‘power’ and how best to aid and abet it.

Our image of the Vis is a conglomeration of the ideas put forth by these great practitioners, often very conflicting ideas, that in our innocence we think are all one and the same. The proponents of the Vis Medicatrix Naturae would view our interpretation of their ideas as a hodgepodge of opposing thoughts and our attempts to utilize the healing power of nature as to be inconsistent. We are justified to criticize some of these practitioners for using violent treatments on their patients justifying their actions because they were mimicking the healing power of the body when it triggers vomiting, diarrhea, ulceration and hemorrhage.

So who am I to question whether l-tryptophan is good or bad. The only thing I can say today is that current information suggests the need to balance Tryptophan use against risk of osteoporosis.