Life is strange, isn’t it? We start off in one direction, our heads full of fantasies about the future, and, before we know it, we are somewhere far removed from our planned itinerary. I have often taken a road less traveled; not only has it made all the difference, but routinely I find I don’t know where the heck I am.
Where I currently am is back teaching in a conventional medical school, specifically in a brand-spanking-new emergency medicine residency program. And what is my new title? Wellness Director, undoubtedly reflecting my integrative medicine background. These people clearly haven’t taken a close look at my personal history, but hey—they say we teach what we have to learn the most. Anyway, the most common question I get in my new position is: What do I plan to impart to our young upstart residents regarding this unconventional approach to health care?
Hmmm … tough question. Where exactly is our field in the context of today’s academic and political environment? Renegade? Mainstream? Bipolar? Frankly, I’ve always seen us as somewhat the latter, a bit manic about how far we’ve come in the past 15 years, while simultaneously depressed about the lack of recognition by the cultural powers that be. So I thought I’d take a jog down memory lane, starting with my own foray into this feast of paradigm shifting (without a clutch) in the late 1990s. Back then, the main course was Andrew Weil, Dean Ornish, and Deepak Chopra, with appetizers of earlier work by Norman Shealy and Christine Northrup. Many of today’s big names were still in the oven, some of them only half-baked. Of course, I am talking about the MDs—the Joe Pizzorno and Michael Murray vegetarian fare was a well-established and growing specialty menu, and chiropractic and traditional Chinese medical schools were whipping up graduates for their own niche consumption.
Ah. As they say, “Those were the days.” I was a residential fellow at the University of Arizona’s fledgling program in integrative medicine under Weil, and our primary mission was to bring unconventional modalities, and ideology, into conventional medical school education. It was an exciting time, and we took our job seriously, spawning leaders who have accomplished far more than I have to elevate the field. Now, 20 years later, we seem to have come to some sort of hiatus in this endeavor, and although there are many allopathic schools with electives or one-off lectures, along with 8 integrative medicine/family medicine combination residencies via additional online study, conventional/naturopathic/chiropractic medical educations seem to once again be marching along side by side, casting wary glances at each other as we again pursue our individual goals of matriculation and clinical practice. What is of even more interest is that conventional medical education is finally taking notice of the need for student intervention in the realm of health and wellness, specifically to address the ever-increasing rates of depression, substance abuse, divorce, and suicide in our profession, especially in the years in study for that coveted medical degree.
So as wellness director of an allopathic medical residency, what are my plans? Of course there will be the usual discussions of nutrition, and physical activity, and connection with nature, as well as with one another. But there is one realm that has been passed not only by conventional education, but by unconventional training. And that is connection with one’s self, the cornerstone of every theological and psychological doctrine since stress was invented. So fine, Dr Wellness Director, how do we do this?
We do this by shifting our attention from patient-centered care, and from hospital-centered care, and from business-centered care, to self-centered care. By impressing on our students that they are not—and will never be—doctors, but human beings who have simply chosen this as our profession and our calling. If we identify with anything other than who we actually are as individuals, we will suffer profoundly when there is a poor outcome, or we are fired, or we are berated because we didn’t meet some irrelevant metric.
And aside from impressing this truth to my students and residents, the one action I can take is to protect them as they meander their way through this labyrinth of fact and fiction. No administrator will chastise them, no consultant will berate them, and no hospitalist will demean them without my intervention. It’s a cruel business environment out there, and the only way to survive, and perhaps thrive, is to maintain our sense of worth and value.
So perhaps Wellness Director is not the appropriate title. I’m thinking of going with Mother.
Biography
