How It Began: Origin Story

Iron maiden. Acrylic on canvas. Artjamming, Nov 2017

My daughter Erin recently asked me how I came to be this person who is a doctor, coach, and author on brain health and ageing. 

The story begins way back when I was a teenager. I had always known I wanted to be a doctor and to help people. Back then I had only the vaguest of ideas for what that even meant. I only knew that I wanted to have an impact. 

It’s funny to think back to my 1980s medical school personal statement, in which my ambition was to help third world China. No one knew then that the sleeping giant would awaken and grow so quickly that it could keep pace with first world economies within just a couple of decades. 

Modern medicine

Many medical students are chosen for their starry-eyed idealism, because after all the profession needs as many bright and enthusiastic altruists as possible. But so much happens during clinical training, it’s not surprising that few doctors are able to maintain this kind of sentiment by the end of residency.  

For me, the disillusionment was both subtle and gradual. I learned that modern medicine is mostly set up to treat the sickest people one at a time. It was rewarding to take care of patients when they responded well, but it often felt like we were winning small battles only to be losing the war. It was as if our medical troops were so busy dealing with individual skirmishes and we struggled to deploy more resources into diplomacy at an earlier stage.

Patients mostly just wanted to be able to talk to someone who cared

I was drawn to academic medicine early in my career because I thought that I could broaden my impact by teaching future generations of trainees. Later I became involved in administrative leadership roles so that I could facilitate the care of more patients by handling the business aspects of our work. And while it was a privilege to serve in the institution of academic medicine, I was frustrated with the system as a whole. On the frontlines of American medicine, we were inundated with demands to see ever more, sicker patients and to administer cost-saving strategies that put us at odds with their needs. 

Photo by National Cancer Institute on Unsplash

In addition, we seemed ill-equipped to actually help patients who were mostly coming to see us with complaints of pain, fatigue, chronic disease, and often unexplained symptoms. We could offer diagnostic testing, prescription medications, and referrals for surgery or therapy, but these would often turn out to either require  long delays or to not be covered by insurance. And at the same time, I found myself unable to do much for family or loved ones outside of the clinic setting—especially for those without health insurance. 

My patients were mostly quite understanding and even forgiving about my limited toolkit. I see now that they probably just appreciated the opportunity to be able to talk to someone who cared. The problem was that the system set doctors up to push interaction with data and technology, rather than allowing for the healing impact of human connection. 

Individual health

Contrary to popular belief, doctors don’t know everything. Our science is based on clinical studies which are tremendously valuable for informing us about the safety or effectiveness of treatments in large populations. But statistical data derived from these studies often fall short when it comes to an individual patient. For example, knowing that only 10% of people had side effects to a medicine isn’t necessarily reassuring, when every medicine has dozens of listed adverse reactions.

Preventive health happens at the individual level in daily life 

In addition what medicine calls preventive health is in practice early detection and intervention. Don’t get me wrong—health screenings and vaccinations are critically important, but the focus is still on what health practitioners can do. Consider instead the impact of empowering more people with the knowledge to protect themselves by making healthy lifestyle choices and strengthening their individual resilience. 

Turns out that actual preventive health doesn’t happen in the clinic, nor at the population level. It happens at the individual level in daily life, as we choose what to put into our mouths, how to move, and when to sleep. And of course patients intuitively know this when they ask for advice on lifestyle: How can I lose weight? What can I do to motivate myself to exercise regularly? What can I do about being tired all the time? 

Travis Illness- Wellness Continuum. https://en.wikipedia.org/wiki/John_Travis

I hate to admit that I used to dread these kinds of questions because I was neither trained to address them, nor was I given the time to do so. Even today, doctors and nurses are trained to treat illness, and most are ill-equipped to address the enhancement or maintenance of wellness. 

On the other hand, consumer demand in recent decades for wellness and longevity has driven an industry that manufactures solutions, sometimes with a strong commercial bent. The state of the science in lifestyle medicine is often controversial and remains difficult to interpret when it comes to advising the individual. Just because a certain diet works for some people, it doesn’t mean that it will work for everyone.  

Permission to heal

Things finally began to fall into place for me during my Integrative Medicine fellowship at the University of Arizona. That’s where I learned what had been missing from my Western biomedical training all along. It seems obvious now, but I somehow either hadn’t realized or hadn’t wanted to see, that medical training is dehumanizing, that medical science is about populations and not people, and that

healthcare systems are set up to push treatment, rather than healing.

We gave ourselves permission to heal 

My classmates and I had come to the fellowship in various states of burnout, disillusionment or both. Most of us understood the importance of self-care practices, but struggled to prioritize implementation. 

Our fellowship teachers taught us that the first step to becoming better healers was to get back in touch with our own bodies and humanity. And that meant being willing to take responsibility for ourselves with our own lifestyle choices and to give ourselves permission to heal from the traumas inflicted through working in a broken healthcare system. 

As we learned about food as medicine and the power of the mind-body connection, we were encouraged to see what worked best for us, so that we could share our experience with patients. The scientific term for experiments involving trial and error based on a single individual are called N-of-1 trials. I became my own N-of-1 trial, learning to tune back in with my own body’s signals—like figuring out what my gut was telling me, as I cut back on sugar and started practicing qi gong meditation. 

Dr Em’s personal photo archives, University of Arizona March 2018

While at my Integrative Medicine fellowship, I was mentored by Dr. Andrew Weil—his approach was a philosophy about lifestyle, emphasizing basic building blocks for healing through nutrition, movement, sleep and stress reduction. That two-year fellowship program proved to be pivotal for me in understanding how to integrate science with our human experience of health and healing. As I began to benefit personally from better lifestyle choices, I wanted to equip myself with the skills needed to address these habits with patients. And that led me to pursue further training in wellness and life coaching.           

Creating Impact

The iHealing Mag blog started out as a way for me to share my observations about medicine and health, and lessons learned through my experience as a doctor. I narrowed my focus to dementia prevention as I gained insight into the importance of brain health as we age. I was surprised that there were not more conversations about our collective experiences with ageing in general or as family caregivers. 

We believe in the impact of a future where elders are respected for our strength and wisdom

After writing 150 blogs, it became obvious that it was time to write a book. In many ways, this book brings me back full circle to the question of creating impact. I worked with my coach and teacher Emma Caronna to design a program that would help people to begin reimagining what ageing could look like. We wanted to encourage readers to let go of the stereotypes that say that we have to lose our strength, our looks, and our relevance as we age. 

Each of us has to be willing to individually commit to creating that kind of impact in our lives, because commitment requires work. After all, only we can choose what to put in our mouths, how to move, and when to sleep. 

The truth is that most of us already know where there’s room for improvement—the problem is that we struggle to put knowledge consistently into action.

Dr Em with Coach Emma. Winchester, May 2022

Coach Emma and I are the first to admit that prioritizing self-care is hard for women. We are constantly having to unlearn our habits of thinking that self-care is selfish, our habits of feeling guilty when we take time to exercise, and our habits of action in jumping to solve other people’s problems. These habits were ingrained over decades, so of course it will take time to develop new habits. 

Our book is about sharing and empowering. We want to invite you to join us on our ageing journeys, because we believe in the impact of a future where elders are respected for our strength and wisdom.