Tuesday, March 30, 2010

Permaculture and Naturopathic Medicine

By Sara Thyr, ND

Photo by one2c9ood via Flickr, used under the Creative Commons License.

I have long felt a connection between the earth and naturopathic medicine, so it wasn’t much of a stretch for me to want to investigate how permaculture principles might influence its practice. I took a year-long course recently at the Regenerative Design Institute (RDI) in Bolinas, California, one of the premier permaculture centers in the U.S. This missive includes my thoughts on how the fields of permaculture and naturopathic medicine work similarly.

Global warming shows us that we have a detachment from what we do/put onto and into the earth. We have a similar detachment from our bodies and our healthcare. Many times, people relinquish their power in their own health to their primary care providers. They hand over their wellness whole cloth to a medical profession that is largely untrained in looking at nourishment of the body, as well as in finding the underlying causes of illness, as naturopathic doctors are.

Most of the world’s problems can be solved in a garden. In the garden, we work with water, waste and nourishment – many of the same things with which our patients struggle. Permaculture is a design science rooted in the observation of natural systems. The goal is to design human settlements that have the stability and resiliency of a natural ecosystem. Similarly, two main principles of naturopathic medicine “first, do no harm,” and “find and treat underlying cause of illness or disease” work to produce sustainable health for the people it touches.

Reductionist science sees each component separately. Permaculture recognizes the interconnectedness of humans and nature and all of the aspects that nourish and harm both. Naturopathic physicians recognize the interconnectedness of all of the body’s systems, bringing to light the principle to “treat the whole person.”

One thing that becomes apparent immediately upon arrival at the Regenerative Design Institute is the incredible diversity of bird species. This diversity is indicative of the ability of the ecosystem there to handle stressors. In naturopathic medicine, we welcome diversity in the profession. It serves to make us all stronger, and increases our ability to morph, support and deal with change – to deal with stress on the system (the entire profession of naturopathic medicine). In order to support this diversity, you may give up one thing in order to have another, but what you get in return will outweigh this sacrifice.

The first principle of permaculture is observation. It is through careful observation that we can truly see what the ecosystem needs. It is similar in human health. It is important for me to spend a lot of time with my patients, to get a very good idea of all of the aspects of their health. If someone comes in with migraines, it is important to focus not only on the head, but also to assess digestion, hormones, hydration, nourishment, absorption, etc. In the garden, you can’t jump in with plow and pesticides until you see how it is all working together. Each part of the system affects the other. How can we create balance? First you must observe the whole being in order to become familiar with all of the players in the illness.

I recently purchased a new worm bin (my new favorite topic if anyone has questions or comments!!) and decided to put it closer to the house so that we could put our food scraps in the bin more quickly and easily. My husband was worried about it getting too much sun exposure (bad for a worm bin). I was happy to report to him that I had been watching what happened with the sun on our back deck for the past year. I had also been watching the moonlight, as the full moon will reflect the sun path six months hence. So our worm bin will be safe in the corner by our hedge, but I could only come to this by careful observation over a long period of time.

People with illnesses often come to us wanting a quick fix. That can happen occasionally, but the observation of that human system takes time. Similarly, real and true healing (and guidance in that healing) takes time.

Another permaculture principle that I love for its relationship to naturopathic medicine is stacking functions. The goal is to get at least three functions out of any one project. In the case of my worm bin, we are reducing the amount of waste that goes to the landfill, decreasing the number of trash pick-ups we need, and producing some of the finest compost money can buy. All from our food scraps.

In naturopathic medicine, I am always working to stack functions, even before I was aware that it had a groovy name. Women who seek my care for hormonal issues, and who happen to have digestive issues also, will benefit from a good source of fiber. The fiber prevents re-absorption of the hormones in the GI tract and gently corrects digestive function.

Every time we utilize another piece of permaculture in our lives, we are healed, too. We connect to as much life force as possible. Work in the garden is so appealing because it is so close to the life force. Helping our patients into the garden will connect them to it as well.

James Stark at RDI speaks about the homeopathic intervention – something that gently and slightly makes a motion that creates a profound effect as it ripples outward. Moving in harmony with natural systems, you can create more food, more water, more beauty, and more health. The homeopathy that I use on my patients helps them heal gently from the inside out, yet quite profoundly once the appropriate intervention is chosen.

Lastly, a word of caution on getting rid of weeds. Different types of weeds are clear indicators of what your soil is lacking. Similarly, in our relations with colleagues, patients, friends and even adversaries, the “weeds” can show us what we need to do to improve our own “soil.” So welcome the weeds to help you see what is missing in your own ecosystem.

The healing of ourselves and the healing of the earth are the same journey.

Wednesday, March 17, 2010

Visiting Elder's Series Program at CCNM

By Michael Traub, ND, FABNO, DHANP

Na Pali Coast, Kauai, Hawaii
Photo by Jeff Kubina via Flickr, used under the Creative Commons License

I admit it is a dubious distinction to be invited to participate in CCNM’s Visiting Elder’s Series program. At the age of 57, an elder to me is someone in their 70s or 80s or older. However, as you may know, the naturopathic profession has a missing generation, and there are very few NDs who are 70 years old or older.

The previous time I had visited CCNM was about 10 years ago, as AANP President. When I spoke to their faculty and student body, I cried. I was trying to convey to how, but for a few brave, committed souls, the profession of naturopathic medicine had almost died out, and that we owed a huge debt of gratitude to those who kept the flame alive. As I said this, I was overcome by emotion. Tears streamed down my face and I got choked up.

Ten years later, and the naturopathic profession is thriving and I was happy to share this earlier experience with those who came to hear me speak this time at CCNM, full of the confidence that our profession continues to make great advances.

CCNM’s Visiting Elders Series program is sponsored by Metagenics, and I am told it is one of the many good things that David Schleich instituted while he was President at CCNM. My visit was coordinated by Aeryn Twidle and Jasmine Carino, ND, Associate Dean of the Curriculum and Residency Program. They kept me very busy, from 11 am to 8 pm on Day 1 and 10 am to 9:30 pm on Day 2. Perhaps this had something with me coming all the way from Hawaii. And as I was in Toronto in early February, my body was shocked when I stepped outside the airport terminal to catch a cab in minus 10 degrees centigrade weather!

My lectures included practice management, commitment to the naturopathic profession, homeopathy, oncology case presentations with residents, Hawaiian Diet, current research I am conducting on vitamin D and elderberry syrup for flu prevention, and continuing education in dermatology, as well as working for four hours in the teaching clinic with students and supervisors.

Having taught at most of the naturopathic colleges over the past 30 years, I am struck by the variability in the quality of students. Sometimes I am very impressed, sometimes underwhelmed. At CCNM I was very glad to see the aptitude and high level of knowledge of all the students I encountered. I thoroughly enjoyed every moment of my time on campus, and felt very welcomed and well-cared for. I particularly wish to thank Aeryn, Jasmine, Nick Degroot, Nadya Bakir, Alex Hall, Rena Zambri, and Sasha for the generosity and kindness they extended to me during my visit.

As a bonus, I will be hosting 4 CCNM students this summer who have decided for some odd reason that they want to come all the way to Hawaii to preceptor with me.

Monday, March 15, 2010

AANP Building Relationships, Expanding Our Reach

By Carl Hangee-Bauer, ND, LAc
AANP President

Lamp Post in Snow in Madison Square Park - New York City (NYC) - February 2010

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

We’ve all heard about the value of relationships before. “It’s not what you know but who you know” and “politics are all about relationships” are but a few of the common sayings and beliefs many of us have. Whether or not we believe these sayings are fully true, I think we can all agree that the relationships we have with others are important aspects of our personal and professional lives.

Over the years, I’ve come to believe in the importance of forming close professional relationships and have seen these come back to benefit our professional goals in many important and sometimes unexpected ways. With our training as naturopathic physicians and our deep connection with our patients, these relationships are often as powerful as the medicines we prescribe and the therapies we use in enabling our patients to heal and move toward wellness. The referral networks we all develop deepen our connections with other health practitioners as well as get our patients the care they require. As NDs we join together at our state and national naturopathic conventions not only to learn about new therapies and freshen our skills, but to reinforce our bonds with old friends and form new relationships with our naturopathic colleagues.

In California, where a relatively small band of NDs worked for years to educate legislators and establish ourselves as a political force in Sacramento, a tipping point came when a student at NCNM who wanted to return to California to practice connected the CNDA with his father, a principle in a prestigious lobbying firm. With the access to the legislature this provided as well as the personal connection that made the costs affordable to the association, we were able to finally get a law passed licensing NDs in California.

Last month, as a powerful snowstorm descended on New York City, I attended the Integrative Health Symposium that brought together practitioners from various health disciplines to share our knowledge, learn from each other, and, yes, form and deepen our relationships on both personal and professional levels. The naturopathic profession was well-represented, with many NDs both attending and leading some of the sessions. Interestingly, the largest group of practitioners at the conference were MDs, which reinforced my belief that health care is moving to a more integrative model despite the turf battles we often find ourselves engaged in. I was a member of a panel discussion that brought diverse groups such as the national acupuncture and chiropractic associations, the AHMA, IHPC and other groups interested in federal health policy together to discuss common goals and challenges in this age of health care reform. I’m sure the relationships I’ve just begun to develop in this one setting will lead to bigger things for the AANP down the road.

Our external relationships is one of the key areas the AANP Board is focusing on as I write this. As an association, the AANP has many relationships with other groups, some formal and some informal, and is a member of several coalitions centered on issues that affect our profession on a national level. We are constantly in dialogue with other groups, and are often approached by groups and associations wanting to be in relationship with the AANP. When we evaluate our participation with these other groups, we come from a place of strategic intent. Do we share a common vision and goals? Does entering into a new relationship further our organizational goals and our work plan? Does it fill in a missing piece for us or overlap with what we are already doing? Would it be mutually beneficial? Do we have the human and budgetary means to make the relationship work toward our ends?

A few examples of organizations the AANP is formally aligned with include the National Federation of Woman Legislators (NFWL); the Coalition for Patient Rights (CPR), representing more than 3.5 million health care providers, and the Coalition to Preserve DSHEA. In addition to these, the AANP is aligned and in regular dialogue with a number of groups and associations including the Integrative Health Policy Consortium (IHPC), professional associations such as AAAOM and AHMA, and the Integrative Healthcare Symposium.

The challenge before the Board is to create a bigger view of our relationships and determine directions to move ahead as we enter in to more relationships and coalitions. How should we interact with the natural products industry and the LOHAS movement? What about like-minded groups in different industries such as the environmental movement or the Bioneers? How should we interact with other political and health policy associations?

As you can see, it’s a monumental task for a relatively small profession with limited budget and resources. But, having said that, the AANP is increasingly being seen as a leader in the coalitions and relationships we have engaged in, and the goal is to continue to grow our presence and influence in areas that are important to our association goals.

We can only envision some of the concrete ways our external relationships will benefit our profession and the health of our patients. It takes a leap of faith to know that in unexpected ways, our continuing involvement with our strategic partners will benefit us in ways we cannot foresee. In many ways, the journey is as important as the goal.

Carl Hangee-Bauer, ND, LAc
AANP President

Tuesday, March 9, 2010


By Jacob Schor, ND, FABNO

Photo by Jacob Schor, ND, FABNO

This has been an odd week, one in which several unrelated events seem to be telling me something, but the meaning of these messages remains elusive. Twice in the last few days, I’ve found myself ruminating over fingerprints. Well in one case fingerprints, in the second, claw marks. But in both cases I am ruminating over the marks we leave behind as we pass through the world.

Let me start with the fingerprints. A week ago in the wee hours of a snowy night, an enterprising individual dispatched a window from my daughter’s 1998 Honda CRV and removed the car’s stereo. As a similar fate befell several other cars on the block, the police speculate that we were the victims of a contest between individuals desiring to join a fraternal association striving to see who could collect the most car stereos in one night. The following evening two gentlemen from Denver’s volunteer CSI unit came to our home and diligently dusting CDs that had been in the car, looking for fingerprints. One clear print was found, lifted and dutifully run through their database. Most likely it was left either by my daughter, one of her friends or possibly me, and not the person who removed the stereo.

Later in the week, this same precious daughter accompanied me on our annual ‘hut trip’ organized by the naturopathic professional association in Colorado. Those of you not from Colorado may need some explanation of what a ‘hut trip’ is. In Colorado there exist things called ‘huts’ that are built and maintained by a prosperous non-profit group based in Aspen called the 10th Mountain Division Hut Association.

The term hut is a poor descriptor as in fact these structures are large, beautifully crafted buildings, situated in gorgeous spots in our National Forests. [Then again, relative to the houses in Aspen, they are huts.] The ‘huts’ were originally built for winter travelers, though the Hut Association now rents out sleeping space year-round; demand is so high that a lottery system is used to allocate reservations fairly.

We traveled in to this particular hut by ski through a wonderland of freshly fallen snow, climbing almost 3,000 feet over the six-mile trip in. A three thousand foot climb might not sound like much, but as the last trudge uphill was at an elevation over 11,000 feet, we were feeling it.

Early on our journey we crossed a clearing with a single tall Aspen tree in the center. Pausing to catch our breath and adjust our packs, I found myself staring at what first seemed to be random scars on the tree’s bark. Slowly, these markings coalesced into a recognizable pattern; a bear had once climbed high in the tree and each step of the way its claws had dug deeply into the bark. Probably a frightened bear by how deep the marks were and how high up the tree they went.

A criminal’s finger print, a bear’s claw print, our hands leave their traces as we move through the world. All of us, be we petty thief or frightened bear, leave our mark on the things we touch whether we mean to or not.

There are those people who are driven to leave a mark on the world, to leave some lasting legacy so they are not immediately forgotten. There are other people who prefer to go through life quietly, leaving few footprints, be they literal or carbon.

It is this idea that we leave a mark on the world that is central to these two stories. Whether we mean to or not, our passage through this world leaves traces of ourselves that linger on into the future. These traces may remain long after we cease to live in this world or perhaps like ski tracks in the snow, fade quickly after we pass by.

How shall we move through the world then? Thinking of the traces we leave to minimize our impact, or striving to leave a deep mark that future inhabitants will trace back to us? Neither approach feels right to me. Rather, if I had some say in this, I would rather my passage be a gentle ripple, a movement, a catalyst, that leaves little trace, but changes what it touches for the better.

As I think about this it probably isn’t the things we touch where we leave our deepest marks but the people we come in contact with. We are always touching others, physically, emotionally, intellectually, whether with our hands, our words or our gestures. These touches can contain an idea that may act like a seed and sprout, take root and grow within the person we’ve touched.

From the opposite perspective, we are constantly being touched by the world; people and things are leaving their imprints on us. Is it possible to discriminate and decide which of these will take root within us? Can we weed out those fingerprints that lead nowhere good and nurture those that we would prefer to see flourish? Can we in our words and actions plant seeds that we would wish to see bloom?

Tuesday, March 2, 2010

Pogo Wisdom

By Bill Benda, MD, FACEP, FAAEM

2010 02 24 - 2014 - Washington DC - Capitol
Photo by thisisbossi via flickr, used under the Creative Commons License.

I had planned to write this blog submission as a reflection on my three days attending the Integrative Healthcare Symposium (IHS), which just concluded in New York City this past week. I was brimming with cutting editorial analysis about the keynote speakers, and the content, and the panels, and the vendors, and the commercial and political negotiations that take place in hallways, at dinner tables, and in bar booths. A curmudgeon’s commentary about the same faces, same speeches, same arguments and same deal making as last year and the year before that and undoubtedly returning to afflict us again next year.

But something changed for me during the flight back to California. Perhaps instigated by the fatigue, or the frustration, or the unexplained pain in my right hip. An insight, one might say, into the reality that there are, and never will be, any definitive answers, or solutions, or final agreements that address the issues that have been with us since the first caveperson argued with the second caveperson at the first Integrative Cave Conference (ICC) about who’s rock was going to best cure the physical and political ills of the cave community.

What I began to understand, and have begun to accept, on that long flight home is that we will never solve this healthcare conundrum. Ever. Not with legislation, or research, or drugs, or botanicals. In fact this whole process we have been battling over is not about therapies, or modalities, or titles. Its not about who gets the most money or power. It’s not about anything found in the conference brochure or the behind the scenes deal.

It’s about us.

Its about how we respond to the people and information put before us, and how they and it are the same as last year and the year before only because we am the same as last year and the year before. And how continuing to work within this system and attend these conferences can remain of interest and worth year after year only if we find the capacity to see things in a different light each time.

I must confess that one of my greatest teachers here has been our own Karen Howard, who I have watched work relentlessly for an outcome, and, when finding that it has slipped away through universal serendipity or someone else’s stupidity, has the capacity to hold the situation in wonder along with the inevitable frustration, and then let it go and move on to the next beautiful disaster. It really is a study in grace, and I hope to achieve even a fraction of it before I leave this field of endeavor.

We have met the enemy, and he is us . . .

The Real Deal

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

Fruit Bowl
Photo by norwichnut via flickr, used under the Creative Commons License.

A very fit and clear-eyed gentleman introduced himself to me at the recent Integrative Healthcare Symposium. He appeared to be in his late 60’s or early 70’s. He was of medium build and thin. He was wearing a bright yellow sweater that fit tightly over what appeared to be a toned chest. He was wearing running shoes which cushioned his energetic stride as he walked toward me.

He began the conversation with questions. He reached into his conference bag and pulled out a sample bottle. He proceeded to ask me about its particular virtues. I gave him my best explanation. He appreciatively nodded his understanding and followed this with more questions. He listened patiently and appeared to appreciate my explanations. He then commented about his long-standing way of living – relying on whole foods and daily exercise as the mainstays.

He reached back into his bag and pulled out a worn looking printed cardboard.He handed this to me and I read the cover of a book that he had authored in the 70’s about healthy living. Abram Hoffer had written the foreword and was his friend, this gentleman sadly told me as he lamented his death. He then pulled out a magazine which featured a write-up of his next book - yet to be published – on cholesterol. He explained his central thesis about the medical myths related to cholesterol with fervor.

Meanwhile, I had been doing some calculations and I finally had to ask. “How old are you, if you don’t mind my asking?” “I don’t mind. I am 85 years old.” All of sudden, I realized that I was talking to the real thing. Here was an outstanding specimen of the human life form, who was, in addition, passionate to his very core about natural health, and who had stayed the course over decades of change and transformation in the natural healthcare industry and in medicine.

I had, admittedly, found myself somewhat bemused by him at first. Now, I was seriously and, gratefully, humbled. I realized, as I listened to this humble and clearly fervent elder, that I still have so very much to learn.Furthermore, most of what I have left to learn is likely very simple – those things which form the foundations of our health – such as diet, passionate living, movement.

It is, I reflected, quite easy to become engrossed in the myriad of details attendant to the progress of medicine. While valuable, and, in fact, essential to safe and effective practice, modern understandings and therapeutic rationalizations do carry the danger of distracting us from the foundations of health. Untethered, we can become adrift amidst our bits of information. I think was somewhat adrift. It took a spry 85 year old in a neon yellow sweater to help me touch back down again. As our conversation concluded, I wished him well and thanked him for his contributions and inspirations.

Watching his lively figure stride away, I smiled and felt a little lighter on my grounded feet too.