The Heart of Medicine
An Interview with Tieraona Low Dog, M.D.
We all long for a doctor who takes the time to listen to our true concerns: someone wise enough to have answers, but open to others’ ideas; someone we can count on in good health and bad, a partner in our personal care.
And while the movement towards integrative medicine and complementary modalities encourages whole person care, according to Tieraona Low Dog, M.D., a leader in this movement, instilling humanity back into medicine is the key to true change.
“I believe that so much of what we do as doctors really comes down to the art of medicine. All the science in the world will not help you have a conversation with a 26 year-old woman who asks why her 18 month old has cancer,” Dr. Low Dog stated in a recent interview with Desert Health. “So many clinicians are not prepared to have those conversations because we don’t offer chaplaincy or contemplative care in medical schools. And while it is great that we are pushing for complementary medicine, I actually feel that it is more important to patients that they have someone they can partner with on their journey; someone who understands that life is more than our organs and cells.”
Dr. Low Dog is an internationally recognized expert in the fields of integrative medicine, dietary supplements and women’s health. She was appointed by President Bill Clinton to the White House Commission on Complementary and Alternative Medicine Policy, served as the elected Chair of the US Pharmacopeia Dietary Supplements and Botanicals Expert Information Panel, and was appointed to the Scientific Advisory Council for the NIH National Center for Complementary and Integrative Medicine. She has appeared on CNN, ABC’s 20/20, and is a frequent guest on the Dr. Oz Show and NPR’s The People’s Pharmacy.
On January 25, Dr. Low Dog will appear as the guest speaker for the 11th annual Leonore Annenberg Lecture at the Annenberg Center for Health Sciences at Eisenhower in Rancho Mirage. The free event is open to the public and made possible by the Eisenhower Medical Center Auxiliary.
Our inspiring interview with Dr. Low Dog opened our eyes to the heart of medicine and the movement she sees that will truly change the way medicine is practiced.
Breaking down the Barriers
The words integrative and complementary medicine can often create barriers, she feels, instead of using language that brings people together.
TLD: I teach and practice integrative medicine, but I know a lot of physicians who would not call themselves integrative who really are; and I know some who call themselves integrative, yet all they do is push a lot of supplements. This nature of integration, this notion of partnering with a patient, is not that big a leap for most clinicians, and I think we have to be careful with our language that we don’t push away physicians who are committed to easing the suffering of their patients; and are open to knowing more about nutrition, motivational interviewing and understanding more about mind-body practices. They are open, however, sometimes our message can feel divisive or make them feel bad about what they do or don’t know, or about what they are contributing. It sets up barriers; it is not an invitation.
TLD: Integrative medicine is not something that you [simply] learn; it is something that you are. It is the way you move in the world and the way you see the world. I have been to an acupuncturist who I would consider the least holistic person I know, and have watched a trauma surgeon sit at the bedside of a woman he had done surgery on, late at night after a long shift, reading her the Bible until she fell asleep.
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She advises not getting hung up on labels which can serve to separate us versus bringing us together. “There is enough divisiveness in the world right now. We need to find common ground, and that is really what our patients are asking for.”
Finding Common Ground
The reason most health care practitioners entered their field is the common ground that can bring them all together, she adds.
TLD: I believe we were called to medicine for a reason. We didn’t choose this path because we wanted to be rich and famous – there are easier ways to do that. We were called to medicine because we wanted to ease suffering and to help people, and you can lift people up by reminding them why they choose medicine in the first place.
TLD: Much of what we are seeing in clinical practice today is the result of stress and lifestyle – poor eating, not enough exercise, too much processed, sugary, and carbohydrate-rich food. This is what is driving diabetes and heart disease, and much of what we learned in medical school is not going to give us the tools we need to really help all these people; It is going to take working together in teams, working with dieticians, getting a PharmD on the team, working with social workers, and being open to acupuncture and other integrative approaches to help deal with pain because we cannot keep giving out opioids the way we are. It is going to take a team approach. Those things that we have in common give us the common ground to move forward.
Opening Our Minds
TLD: It is difficult to spend all those years and long hours training to be a clinician and to believe that there was a large body of knowledge that could heal people that we didn’t learn. However, with the amount of information out there and the speed at which science is building upon itself (they estimate that in another 10 years or so everything we know in clinical medicine will be doubling every 73 days), it is impossible to think that any individual clinician could “know it all.” Part of what we have to surrender is the belief that we have to know it all and embrace the fact that there will always be so much more to learn.
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In 2013, Dr. Low Dog was diagnosed with stage 4 cancer which spread to her liver. While she is now cancer free, she feels that cancer was a gift that made her a better doctor. “Nobody would want cancer as a gift. However, some challenges that are so great, they humble you. I think it made me a better servant, a better teacher, a better listener, and it made my capacity for compassion and empathy much larger. No hardship comes without some gift, and it is up to us to find that gift in every challenge handed us.”
Teaching the Next Generation
Dr. Low Dog is beginning to see changes in medical institutions. “In medical school, no one wants to give up their time; biochemists feel that you can never have enough biochemistry; pathophysiologists feel you can never have enough pathology and physiology. There is a lot of vying for time, so when I hear about nutrition being added and small steps like that, I feel they are steps forward in the right direction.”
The greater change she sees is that more and more medical schools are not just looking for physicists, chemists and biologists, but also anthropologists, sociologists and philosophy majors who may present a different perspective or interpersonal skills.
What advice would she offer clinicians in our community?
TLD: I would say that it is an invitation to think more broadly about how we can help our patients and how we can help ourselves so that we don’t burn out and don’t want to leave medicine because we are being asked to do so much. So much of what we do is the art of medicine. Science informs what we do, but we are all craftsmen, artists, and part of the way that we stay connected to that is through nourishing ourselves, by taking good care of ourselves so that when we show up, and we listen, and we care for our patients, we have the energy to partner with them.
TLD: This is [also] an invitation for us to work together; for us to share our experiences and to remember that it may seem like a very large jump from acupuncture and Traditional Chinese Medicine to surgery, but it doesn’t mean that we aren’t all wanting the same thing, which is to help people feel better – that is what we have in common.
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We noted that this is quite a change in mindset for many clinicians. “The way you open people’s minds is by opening their hearts. We see each other as allies and friends all with a common goal of helping people. So, it’s not just a shift in our minds, it’s a shift in our hearts.”
Clinicians, health care practitioners and all Desert Health readers are encouraged to attend Dr. Low Dog’s lecture on January 25. For more information call (760) 773.4500. Editorial by Lauren Del Sarto.