The second thing I do is to look at what kind of treatment you’re going to go through: Are you having surgery scheduled? Are you in radiation right now? Are you in chemotherapy? Are you doing radiation and chemotherapy together? I look at what nutrients can be used during that time and teach you about how your nutritional needs during that time of treatment change, and what you can do to help yourself during that period of time.

The third thing that I do is the thing that I’m most excited about. I have scoured the scientific literature to learn about what foods and nutrients have scientific evidence showing that they can help control cancer specifically for the type of cancer that my client has. That’s the area that I’ll talk the most about. . . . it occurs to me, as well, that cancer cells are not some foreign invader from outside your body. These are cells that are your own cells. They may have lost their regulatory mechanisms and in some ways they are just much more efficient. They have done what our society asks us to do. We need to be ultra efficient, multi-task and get as much done as possible. Cancer cells are busy doing that. They are still our own cells.

If we approach our treatment by attacking and doing a war on our own cells, it occurs to me that maybe that isn’t the best way to heal, so I’ve developed a different kind of model. I really look at healing from cancer as sort of like growing an organic garden. For those of you who grow organic gardens, you’re starting to get a glimmer of “Oh yeah, I see what she’s taking about” but I often think of that commercial which you probably have seen where the guy steps out with the little canister and a dandelion or something pops up and he sprays it and it immediately dies – another dandelion pops up over here and he sprays it and suddenly they’re popping up all over the place. If we try to get rid of the “pest” in the garden by attacking, burning or poisoning it, we don’t get to the root of the problem and the problem continues.

What we need to do instead is to approach this from a more holistic organic gardening perspective. We need to say, for example, “What’s the pH of the soil? Are we getting enough water in the garden? Are there healthy organisms like birds and bees and worms and other things in the garden? Do we need compost? Are we getting enough or too much sunshine? Do we need to do companion planting? Are we giving our garden enough attention and love?”. . .because my garden certainly grows a lot more if I’m present in the garden . . . If I’m present in the garden and I listen to what the garden wants and give back to the garden, healing really happens. You are thinking this is a nice model; how do we actually apply it?

I think the place I’d like to start with is food. Our food is such an amazing thing. Most dieticians and nutritionists look at food and say “Well this has this many calories, and there are this many grams of vitamin C, it’s a fat, a protein or a carbohydrate”. Really, it’s so much more than that.

I had an experience that taught me just exactly how much more there is to the whole food subject when I was living in New Mexico on land where we were living a totally self-sufficient lifestyle. I was living in a canvas teepee and we grew all of our food during that time, it was really my introduction to organic gardening. I had an experience with someone who was really an amazing teacher. We were in the garden pulling carrots. I’d picked about five or six carrots, and she turns and says to me, “Put your finger in a carrot hole” and I said “What?” and she said, “Put your finger in a carrot hole” so once you’ve pulled a carrot out, there’s this little hole there where the carrot was growing, and dutifully I put my finger in a carrot hole and I pulled it out really fast because there was some energy there – there was something very palpable that I could feel. That experience stuck with me for a long time, and reminded me that every time I was eating fresh, whole food, that there was an energy. I was taking in not only calories, fat, protein and all that boring stuff; I was also taking in that energy. It was an energy that was very healing to me. I guarantee you that if you put your finger in a Twinkie wrapper; you’re not going to feel anything!

While I first got this lesson on an energetic level, now science is starting to catch up with this. Probably the experiment that has happened most recently that most inspires me about this is the Brussels sprouts experiment . . . Gladys Block, an epidemiologist down at UCLA, is one of the lead researchers in this particular experiment. Many of us have heard that the cruciferous vegetables, like broccoli, cabbage and cauliflower are really healthy and they have vitamins, minerals and things called phytonutrients that really help to fight cancer.

One of those phytonutrients is something called sulforaphane- it looks very potent as a cancer protector and fighter. She developed this experiment where they wanted to see the influence of food on genes, in particular they were looking at cancer genes that promote cancer-like oncogenes, and then an opposing group of genes that we have called tumor-suppressing genes. Researchers wanted to see if a food would have any effect on the genetic material.

They lined up a group of women and they measured these particular genes – the oncogenes and the tumor-suppressing genes. Then they randomly divided them into two groups so that they could have a double blind placebo controlled trial, a fancy word for the way we do science. They fed the first group of women real, honest to goodness, Brussels sprouts for about six weeks.

Their problem was that they needed to find a placebo for Brussels sprouts. The placebo has to look like Brussels sprouts, taste like Brussels sprouts, and smell like Brussels sprouts, but it can’t have any vitamins or minerals or sulforaphane in it. Where in the world are you going to find a placebo for Brussels sprouts? Hospital Brussels sprouts! Yes, they cooked them at six in the morning and kept them in those warming trays for six hours. They were dead – no energy left, right? So they fed the other half of the women the placebo Brussels sprouts and they got to the end of the trial. What they found is that actual honest-to-goodness Brussels sprouts changed the genetic expression. It downplayed the oncogenes – the genes that promote cancer. The tumor suppressing genes were up-regulated.

This was the biggest thing I’ve heard in nutrition in a long time. What this actually means is that fruits, vegetables and your healthy foods are actually talking to your genetic material. When you have the “gene” for cancer, you are not stuck with that. That gene has a plural potentiality – it can express itself in many different ways. If you’re eating healthfully, you may be able to alter that expression in a way that can really make a difference in your treatment.

What do I mean by eating healthfully? I mean eating lots of fruits and vegetables. I think fruits and vegetables should be at the bottom of the food pyramid so you should be eating mostly fruits and vegetables, because those are where you get your phytonutrients that can talk to your genes and make a big difference for you. You should be eating whole, unrefined foods. Just go back 200 or 300 years. If you could have been eating that food 200 or 300 years ago, it’s probably pretty good food to eat. If it’s a new fangled invention, it’s probably a good idea to stay away from it. My favorite rule is the unpronounceable rule: If you’re reading the ingredient label and you come across something you cannot pronounce, and even your Harvard trained friends cannot pronounce, you had better stay away from that food. That’s a good place to start.

Another way that we can influence our organic garden is through inflammation. This is really a surprise to people when I talk about this because, Cancer – Inflammation, is there a connection? What’s the connection? This is actually an interesting thing that I’ve been working on for quite awhile. The relationship between the inflammatory process and cancer surfaced back in the 1970’s when they were developing drugs for arthritis and other inflammatory conditions. They did long term trials to make sure that the new drugs of the time like Advil and Ibuprofen and such were actually safe to give people. Thousands of people were in these trials and they wanted to see what the side effects were. At the end of the trials, two, four and six years later, one of the things that they notice is that the individuals who got to take the anti-inflammatory drugs, their risk of almost every type of cancer is half or less than half of those who didn’t take the anti-inflammatory drugs.

At the time in the 1970’s, they didn’t know why this was and they just sort of shelved it. Then more recently, particularly in the last five years, when we’ve been looking at the molecular structure of cancer cells, the biology, the physiology of cancer cells, one of the things that came up is that the enzymes in the body that drive the inflammatory process also drive cancer growth – so much so that the process of inflammation is directly linked to the progression and growth of cancer; every type of cancer that we’ve looked at so far – to suppression of the immune system, to angiogenesis (that growth of new blood vessels that feeds the growth of a tumor), and to the spread or metastases of cancer.

This link is so strong that at least eight studies I know of have directly linked the level of inflammation with prognosis in cancer patients. For example, in a brain tumor study, people who had stage four brain tumors and low levels of inflammation were all long-term survivors. People who had high levels of inflammation did not do so well.

What this means is, if you have a cancer diagnosis, you should be actively doing something about inflammation. Can I define inflammation here? I’m not talking about when you stub your toe and it swells up. That’s a little localized inflammation. What I’m talking about is a systemic inflammation that you don’t feel and don’t know you have.

There is a simple test that your doctor can run for you, which will tell you whether you have this systemic inflammation that fosters tumor growth. The test is called a C-Reactive Protein. This will tell you the level of inflammation that is currently in your body. You want the result of this test to be less than 1.0. If it’s more than 1.0 you begin to do something. You ask your doctor for an anti-inflammatory, or you consult with a nutritionist or herbalist practitioner who can advise you about the different nutritional supplements or things to do in your diet that will lower your inflammation.

Some treatments raise inflammation. For example, getting radiation therapy will increase your inflammation. If you take anti-inflammatory agents during your treatment, studies show that your treatment will work much better for you. Some of the nutritional supplements that are commonly used as anti-inflammatories are things that naturopaths and other forms of medicine like Aryuvedic medicine or Chinese medicine have used for this condition for hundreds of years. Things like Bromelain, which comes from pineapple; or Curcumin, which is in the news over and over again and has dozens of studies on its effects on cancer; or Boswellia.

To flush this inflammation story out a little bit more without giving too much detail so that I overwhelm you, inflammation comes from the fats that you eat in your diet. When we talked earlier about eating vegetables, that was goal 1 in your diet. Goal 2: Every fat that you eat becomes the cell membrane of every cell in your body – both your healthy cells and your cancer cells if you have them, which most of us do. Some fats belong to a family called the Omega 6’s. These are the most inflammatory types of fats.

The other fats belong to a family called the Omega 3’s. These are anti-inflammatory. Your Omega 3’s are cold water fish, flax seed oil, perilla oil (which is difficult to find in the United States), hemp oil, and olive oil is close to that family – it’s a neutral anti-inflammatory. Everything else is an Omega 6. So the animal source fats, dairy fats, and all those fun bottles of canola/soybean/peanut/sesame, all those other oils that you find on the shelves in the supermarket, are Omega 6’s.

This is not about vilifying the Omega 6’s. You don’t stop eating all those “bad” fats…no, no, no. What you’re trying to do is get a balance between these two families of fats. You’re trying to incorporate more cold water fish or take a fish oil supplement if you won’t eat fish, and use flax seed oil which you won’t cook with because it smokes, but you use it for cold uses only like salad dressing. For a bottle of oil in the house, use olive oil. You want to use those as your predominant sources of oil.

You want to limit the Omega 6’s. So if you’re choosing dairy products, you get low fat or no-fat. If you’re eating meat products you choose the leanest cut and you cook it so all of the fat drips away. You don’t want bottles of oil in the house that are Wesson or Canola or corn or peanut or safflower. You want to use olive oil instead. Performing an oil change is really goal number 2 with your diet.

Once you have these fats in your cell membrane, there are two different groups of enzymes that can turn them into the inflammatory compounds. There’s a group of enzymes called cyclooxygenases or COX – that takes fats and makes them inflammatory. We now have a drug that blocks that: Celebrex and Vioxx are specific targeters of that group of enzymes, and many doctors are now using that. There are large scale trials at the NCI for breast, prostate, lung and colon cancer that are ongoing right now showing that using Celebrex or Vioxx as an adjunct to your treatment can make a big difference in how well you do. You can also block those through herbs, like Bromelain or some type of enzymes like pancreatic enzymes.

If you’re going to use nutritional supplements, I highly recommend that you see a practitioner who can screen you and pick the agents that are appropriate for you. Make sure that you’re not going to run into any drug/nutrient interactions.

However, there is this one group of enzymes, the cyclooxygenases; right now the pharmaceutical industry has a drug that blocks that. Unfortunately there is a whole other pathway to take those fats and turn them into inflammation. That pathway is lipoxygenases, not important information for you; what’s important is to know that there are two ways to create inflammation. If you take a drug that blocks the first one, all your fats just go skipping over to the other side and they get metabolized into the inflammatory compounds over here. If you’re taking Celebrex or Vioxx, you should probably talk to someone who’s a practitioner of nutrition or herbal medicine to learn how to block lipoxygenases. The most common ways to do that are with the following herbs: Boswellia, which many of you know as Frankincense, Curcumin or Resveratrol.

This is key – like I said, if you have cancer or if you’re healing from cancer right now, doing something about inflammation – measuring inflammation with a C-Reactive Protein Test – and if it’s elevated above 1.0, take steps to bring that down. Repeat the test. If it was high the first time, add some anti-inflammatories and repeat the test in a couple of weeks. If it’s down then keep that protocol and its good. You probably want to keep running that test on a three-month interval. What if you don’t have cancer yet and you’re interested in not getting cancer? Run the test on an annual basis as part of your physical. Not only can this test help predict the risk of cancer; it also can help predict the risk of heart disease and stroke. It’s an important thing to do.

Enough about inflammation – several sentences ago I mentioned a word that is probably new to many of you: angiogenesis. It’s been big in the headlines a lot the last year or two. Angiogenesis comes from Latin: “angio,” which means blood vessel and Genesis, to create or to produce. A Harvard doctor, Judah Folkman, discovered this about 15 years ago. In his experiments he noticed that when you do surgery and you find a tumor, what you find is that these cells are deeply and richly vascular, the density of blood vessels around the tumor is much more dense that you would find anywhere else in the body. Particularly in a well developed tumor. He wondered about that: “Why are there all these blood vessels?” If you find a small tumor that’s just in its process of getting started, you don’t find these blood vessels.

So in a series of experiments what he was able to determine is that as the tumor progresses, the supply of blood vessels increases and increases. In further experiments, he found that if you could stop or halt the process of growing those new blood vessels, a tumor would sit there at about the size of a pencil eraser head. It would just sit there at that size and never grow, never spread. Of course when he first found this out, do you think the medical establishment applauded him and said this is wonderful, and we have something new to do about cancer? No, they just laughed at him and they thought it was crazy, until the pharmaceutical companies started coming up with some drugs that target this angiogenesis process. Many of the new cancer trials are about drugs that can stop the growth of new blood vessels.

Unfortunately the body is redundant, which means that if the body would like to do something it has more than one way to accomplish that goal. We have all kinds of back up mechanisms for everything and this is true for angiogenesis as well. There are, to date, about 12 to 16 different enzymes that have been linked to this process of angiogenesis. The pharmaceutical companies are busy targeting them one at a time to make a difference for cancer patients. So far the trials have been really disappointing because just targeting 1 of 16 enzymes is not really helpful.

Here’s where nutrition comes in. Each of these enzymes – all of the enzymes that drive angiogenesis – requires copper in order to be effective. So Steven Brem at Moffitt Cancer Center down in Southern Florida initiated a series of experiments where he first took animals that had various cancers, and he put them on a low cancer diet and gave them a drug to remove copper from their bodies, just enough so that they were still healthy and didn’t have copper deficiency disease, but to pull their copper down as low as possible. In those experiments he found that you could stop the growth of tumors by taking copper away. So George Brewer at the University of Michigan decided he would follow up with a human experiment. He took 68 people with various different cancers, predominantly ovarian, breast, colon, and lung cancer, and he also put them on a low copper diet and gave them a nutritional supplement to lower their copper. In everybody whose copper came down, they were able to achieve stable disease – no further growth of cancer.

This is the third thing I really want you to take away from today: first was eat your vegetables; get an oil change and do something about your inflammation; and now, stay away from copper. If you’re taking nutritional supplements, please read the labels of your products. If you find copper, stop taking that particular product. The foods which are highest in copper which are probably wise for you to avoid are shellfish; the RDA for copper is 1 milligram – if you eat an entire lobster tail you will get somewhere between 36 and 40 grams of copper – stay away from shellfish; the next, which you’ll be so pleased that I have asked you not to eat, are organ meats like liver. Organ meats like liver and kidney are very rich in copper. These are the foods that are highest in copper.

It’s impossible to go on a no-copper diet because every food has trace amounts of copper. Well, okay, not Twinkies, but we certainly don’t want you eating those. If you have copper water pipes to your house and you’re drinking your tap water, you may want to get a filter that can remove copper. Some filters that do that are the Britta filter and the PUR Filter. If you have a different filter you can call the company and ask them for the assay to see if it removes copper.

So that’s the angiogenesis process – and you can see we’re using this organic gardening model – we’ve looked at the pH and compost. We’re looking at all these different variables and what they can do.

The third thing I want to share with you is something called oncostasis. In science we’ve learned that you can stop a tumor growing by trying to kill the cells, but you can also often just quiet the tumor. You can influence it to just sit there. This is a really radically different model because the way that Western medicine works right now is kill, attack, eradicate, shrink, get rid of the tumor at all costs . This approach is more like, “Well, maybe if we don’t get rid of the tumor we can make it just be quiet and sit there.”

Cheryl was diagnosed with a stage 4 brain tumor in October of 1997. At the time of her diagnosis the doctors told me that she probably had a six-month prognosis and if she did aggressive chemotherapy from now until “the end” she might make it a year. But she’s now at her five-year anniversary. Here’s the kicker: we never tried to kill the tumor or get rid of it. In fact the spot that the doctors had been calling tumor for the first two or three years – that spot is still there on the MRI. It’s just sitting there – it hasn’t done anything. Now every time when the doctors look at the spot and say, “You need to start chemotherapy immediately” we say, “Yes, we hear you. Thank you very much. That’s not our choice”. It might be somebody else’s choice and that’s good, but in this particular situation it’s the perfect example of oncostasis.

There is such a focus in western medicine on shrinking the tumor and yet if you do a meta-analysis, if you look at dozens of studies, what you find is that shrinking the tumor is not correlated with prolonging survival in cancer patients. Perhaps you might want to think to yourself, “What’s my real goal here?” Is shrinking the tumor the most important thing? In Cheryl’s case we learned it wasn’t the most important thing.

There are lots of different nutritional supplements and herbal things in foods that have shown an oncostatic effect in test tube experiments and in animal experiments. In human experiments, something that really stands out as an oncostatic – something that controls or makes the tumor go quiescent – is melatonin: your sleep hormone. At night if you’re sleeping in complete darkness, you have to be sleeping in complete darkness, if it’s completely dark, your pineal gland, sort of where your third eye would be, down here in the center of your head, secretes melatonin.

If you’re the type of person who has very low melatonin and who’s not sleeping in complete darkness, who’s working at night and exposed to light during the night phase, then the cancer cells are busy growing all the time. Since this time there have been about 68 studies on melatonin, 34 of which have been human studies. They have been done for every type of cancer from leukemia and lymphoma to lung cancer, breast cancer, brain cancer; for every type except ovarian cancer – do not take melatonin if you have ovarian cancer, the studies are iffy, they go both ways – but for every other type, humans in these trials who have been given melatonin supplements at bedtime fair much, much better that those who get placebo; who don’t get to take actual melatonin.

In your day to day life the most important thing you can do about this is make sure you’re sleeping in complete darkness and make sure you go to bed early enough. Don’t stay up through the night. If you’re working the night shift switch if you can. The recent trial looked at nurses who worked the night shift and found that their risk of breast cancer was 2-3 fold higher. Simply because they work under artificial light and they don’t get their melatonin up where it should be.

I’ve talked a lot about diet and I’ve shared with you three different factors that could influence cancer. I hope that one thing you’ve been able to take from this is a new view: not to see your cancer as a foreign invader that needs to be attacked, eradicated, poisoned or whatever, but to see these cells as part of your own body that has lost their regulatory influence. We’ve also learned that your diet and lifestyle can help return that regulation to those cells to make them part of you again.

I’ll share a fourth influence or variable with you before I close. This again is something that just boggles my mind that this is possible. There’s a process called differentiation. We talked about how cancer cells were once your own very healthy cells. Something has happened to them: maybe some damage to the DNA, maybe some influence on genetic material, so that they’re now behaving in a way so that they grow uncontrollably. Wouldn’t it be nice if you could just get them to relax and go back to being the way they were before?

I have to use my adolescent model or analogy here. Normally the way your cells work is you get a baby cell that’s born and it needs to get a set of instructions – basically a job description. It says, “Hello, welcome to the body, you are a healthy liver cell. Your functions are as follows”, and then the cell grows up, or it differentiates to become a healthy liver cell. In cancer, the cells have regressed and are wild adolescents. They’re teens who want to go out and party. They don’t want to take on their job responsibilities, and they want to have as many babies as possible.

If we could just influence them a little bit – if we could just be good role models. If we could get them the right job descriptions – if we could get them to go back we could differentiate them. Now this sounds very nice as an analogy, but can you actually do it? Can you actually make this happen? The answer is yes!

Many nutrients are known to differentiate cancer cells. There are some that look like they work for almost every type of cancer; for example Vitamin A is a differentiating agent for every epithelial type of cancer – so basically everything except for some ovarian cancers, lymphoma, and leukemia. Vitamin D is also a differentiating agent. Then there are others that are specific to a type of cancer. If its ovarian cancer a flavonoid from onions called Quercetin is a differentiating agent. If it’s a brain cancer an alkaloid from Goldenseal and other herbs is a differentiating agent.

Now let’s talk about Vitamin D since it’s one that seems to be really global. Vitamin D is one of those strange things. When I was in school they taught me Vitamin D is in milk and it helps your bones. End of story – end of chapter. There’s so much more to Vitamin D – we’ve learned so much more about it. In the cancer environment what we have learned is that most tumors have receptors for Vitamin D. If those receptors are latched onto by a Vitamin D molecule, it differentiates the cell. It gives the cell just the type of role model it needs to grow up and take on a healthy job description.

If there’s a cancer that’s growing very rapidly, and Vitamin D comes in and sits on the receptors of those cells, it will greatly slow down the growth of the cell. If you look at the cell under a microscope, it will begin to look like a healthy cell. The morphology; the shape, the way that cell looks, will look just like it’s a healthy cell. This is fascinating and it’s been shown in test tube experiments and in animal experiments, and right now there’s tremendous amount of research on this in human experiments.

Paul Trouillas, who’s a researcher and oncologist in France, has completed several of these studies. He just recently published a breast cancer study and also a brain cancer study coming out of his lab – the brain cancer study was the most phenomenal thing I’ve seen in brain cancer research in years. They took 27 individuals who had completed their radiation, surgery, and multiple rounds of chemotherapy; these people’s tumors were still growing. You get a sense that these are pretty aggressive tumors. The doctors said “We have nothing left to offer these people so Paul, go ahead, you can have these people for your silly little Vitamin D study”. Paul said “Thank you.”

He took these 27 people and he gave them something called Alfacalcidol: it’s a prescription form of Vitamin D that breaks down into natural Vitamin D 20 minutes after it’s in your body. He gave them a dose that was high enough but didn’t cause any symptoms. Vitamin D can be toxic if you get too high. Some studies had suggested that you might be able to make a really good defense against this cancer with Vitamin D, but you’d have to use a dose that was so toxic that it was useless, so he didn’t do that – he used a small enough dose.

Paul then gave these people this vitamin D and he waited to see what would happen. A third of the people had a complete response: their tumors shrunk up and were gone on MRI. These were people who the doctors had given up on, who had completed all this treatment. Paul ended up getting four-year survivors, five-year survivors, and one person was a seven-year survivor. From a type of tumor that usually has a six-month prognosis. So while this is a small trial, and we’re waiting on larger trials to confirm the results, you’re talking about something that’s non-toxic, inexpensive – you can get the dose for about $30 – and made this huge difference. The breast cancer study was similar, so this process of differentiation is very useful as well.

At this point we’ve thrown out several ideas. We’ve thrown out talking to the genetic machinery of the cancer cells by eating a healthy diet and looking at the influence of inflammation on the cancer cell. We’ve also looked at how copper can fuel angiogenesis and trying to remove copper, and at nutrients that can differentiate the cancer cells: get them to act more mature.

A point I think that’s really important here is that Western medicine keeps searching for the “magic bullet”. The one cancer drug – of course every pharmaceutical company wants to develop that drug and make billions and billions of dollars. What this actually then means is that we keep approaching the problem with the weed mentality: we use our one insecticide and spray and get everything. You can’t do that. Healing is so much broader than that. You know this from your own lives. You can’t just drink carrot juice every morning and get healthy. You can’t just meditate and do nothing else and get healthy. This is 24 hour, 7 day a week. This involves everything that you are on every level, and in cancer it’s the same thing.

When you’re talking nutrition it’s the same thing. What you really want to do for a healthy treatment . . . is pick up each of these ways of influencing cancer cells in this organic model and apply all of them. Maybe each of these things that we’ve talked about has only a 10, 15, 20% effect. However, if you have five, six, or seven of these different variables, you’re really going to grow a beautiful garden, and that’s what’s important, because that garden is really about healing.

I think the last thing I want to say is that I want to acknowledge that I feel like nutrition is important, but it’s not for everybody. Not everybody comes to my office, and sometimes family members pull someone in kicking and dragging and I say “go home”, because you can’t force feed healthy foods and have it work for you. You have to come to this concept (and your dinner plate) with a very open heart.

There are many different pathways to healing and that pathway is different for each of us. You have to honor that. You have to find the treatments where your gut feeling is “this is the right thing for me”. If your doctor says “well you should do this” and your gut reaction is “gasp, don’t do that, or don’t do that yet,” then give yourself some time to come to a place where you come to that treatment with an open heart about it. With that I’d like to wish you all a good journey on the path that you choose for your healing.

Healing Journeys, Post Office Box 221417, Sacramento, CA 95822

(916) 391-0549 /(800) 423-9882/ www.healingjourneys.org

Rachel Naomi Remen, MD is one of the earliest pioneers of integrative medicine. She is Clinical Professor of Family and Community Medicine at the UCSF School of Medicine. She is Director of the innovative UCSF course,The Healer’s Art, presently taught in 21 medical schools nationwide. She is Co-Founder and Medical Director of the Commonweal Cancer Help Program featured in the groundbreaking 1993 Bill Moyers PBS series, Healing and the Mind. She is Founder and Director of the Institute for the Study of Health and Illness at Commonweal, a post-graduate and undergraduate program for physicians who wish to reclaim their calling and integrate holistic approaches into their work. Dr. Remen has a 50-year personal history of Crohn’s disease and her work is a unique blend of the viewpoint of physician and patient. Dr. Remen wrote one of the first books on complementary and integrative medicine, The Human Patient (Doubleday, 1981). She is the author of The New York Times bestseller, Kitchen Table Wisdom: Stories That Heal( Riverhead Books, 1996), and the national bestseller, My Grandfather’s Blessings: Stories of Strength, Refuge and Belonging (Riverhead Books, 2000). She is the author of over 50 papers and articles on integrative medicine, and her books are used as teaching texts in medical and nursing schools nationwide. Dr. Remen has been the invited speaker at several medical school graduations and holds three honorary degrees.

I have been with many people in times of critical illness, when a door opens and the familiar falls away, to be replaced by something the person has never seen before but can recognize as their own. These are moments of profound and enduring change. For me as witness, they seem to be moments when the personality recognizes what the soul has always known.

At such times something familiar is lost, but something of great value is found. Our true life is offered to us-a life more transparent to our deeper values. I have seen people let go of many previously treasured, hard-earned things and begin to follow an inner compass rather than an old blueprint, no matter how respected that blueprint is by others. Often they take risks that were unthinkable before their illness. They seem, despite their loss and suffering, to have a greater trust in life than before-a greater sense of who they are and what matters.

Seen from this perspective, illness is part of a larger human tradition of initiation, an opportunity in life which is present for us all. As I understand it, initiation is a time when a shift in consciousness occurs and a new path opens for us. And while nothing has changed, everything is different. We see the same world differently. It is a profound personal transformation of experience.

Until recently I had viewed initiation in a more limited way, as a change in lifestyle, usually marked by ritual-joining a sorority, graduating, getting married, having a bar mitzvah-ceremonies that led to greater freedom and responsibility. But thinking back on similar events in my own life, I realized that at the end of such ceremonies I really never felt any different. I seemed, in some basic way, to be the same person that I was before.

To further explore this puzzle, I began to ask people who were not sick about experiences that had changed them irrevocably. People told me stories. This one was told by a physician.

The event took place when he was twenty years old and his brother, who was eighteen, was dying of leukemia. He was in engineering school and did not want to come home, but his parents insisted. About twenty-four hours before his brother died he was sitting in his brother’s room reading to him. His brother lay frail and very, very tired, in his bed. As he was reading he suddenly felt his brother’s hand on his arm. His brother was staring at a blank wall, his face all lit up. He said, “George, look, someone’s there! See? Someone has come for me.”

George put the book down and looked very carefully at the blank wall, but he couldn’t see a thing. However, he could feel it. He said there was a presence in the room, a “radiance” that he described as “profound and ultimately benign.” In that moment he knew he was supposed to become a doctor. And, in fact, after his brother died, he did go back to school and change his major from engineering to medicine.

“Whatever it was that came for my brother, it came for me too,” he told me. He added it wasn’t that he knew he was supposed to become a doctor; what he knew was that he was a doctor. His very nature was a doctor’s nature. It was the reason he had been born. He looked at me and smiled. “In that moment I felt sort of healed,” he said.

When a path of initiation opens, it’s not a path we travel. It’s a path we are. The traveling is not outward, it’s inward, toward our essence, toward our true nature. And because we are able to inhabit that nature more fully our outer life can become more transparent to it, more coherent with it, more true to it. The inner and the outer life become more of one piece, and the result is a sort of healing.

My first thought after hearing this story was “Why has this sort of thing never happened to me?” In thinking about it over the weeks that followed, I realized that I had gone through a major initiation. I had experienced a profound shift in my own way of seeing the world. I had gone from a person who was always fixing a broken world to a person who felt privileged to serve a holy world.

But this hadn’t happened as a single event. It had happened slowly over time through a series of events, and I could see what had happened only by looking back. And so I’ve come to think that experiences of initiation are very common, very ordinary, very subtle. They happen to all of us as a natural part of living.

We might view life as a movement toward the soul, a return to what is most genuine and unique in each of us. And in the trajectory of a lifetime this turning toward personal integrity happens not once but many times. Some of these turnings are small, some are large. All are important.

So an initiation need not be a moment of radical transformation, but rather a movement of return, a turning toward the soul. With each initiation we come closer, we turn more easily, until that final initiation, death, when we turn away from the personality and become the soul. Before then we have many rehearsals, many times when we have the opportunity to turn away from the false self which possesses us the person who we have been taught we are, and who others want us to be, even the person who we ourselves want to be-toward the true person who we are, and more closely follow the path of the soul.

Looking back, I can tell you the very moment my initiation began. At the time I knew with absolute certainty what my path in life was. I had been preparing for it for years, and had made many sacrifices in order to walk it. I was a young academic doctor managing the pediatric clinics at Stanford Medical Center and my life goal was to be the first woman to head a department of pediatrics on the west coast. One morning the man who ran the medical clinics at Stanford came to my office, put three colored xerox papers on my desk and said that a place called Esalen Institute was looking for twelve doctors as part of a research program. The doctors would get a free weekend a month at a beautiful retreat center for two years. They would meet people who had some different ideas about human nature, people who were part of the human potential movement. All they needed to do was to see whether or not they thought their ideas had anything to do with people’s ability to recover from illness, and with the practice of medicine. “I’m going to do it,” he told me. “Do you want to come?”

The year was 1972, almost a decade before the emergence of the field of Holistic Health. In that moment my direction in life, my whole future, was being offered to me, and I must say that I did have a moment of recognition. At a deep instinctive level I knew that this was mine. But what went through my conscious mind was a single thought: “What a great way to meet men.” So I applied.

Life is a movement toward the soul but we ourselves are attached to other things. So the soul has to take us and move us along by whatever handle happens to be sticking out. I had just ended a five-year relationship with a fellow, so I was very available to go and meet men. I believe that if I had seen the opportunity for what it really was, known what I was going to have to surrender, to give up in order to have it, I wouldn’t have gone. My family were Russian immigrants, and we believed that if you let go of anything it left a permanent hole in your life. So anything I had ever let go of at that time had claw marks on it.

This was the first step of my initiation. The second step happened very shortly thereafter, at one of my first weekends at Esalen. At the time I was learning how to make silver jewelry. I had designed and cast my first ring, and wore it that weekend. There were many craftsmen there at Esalen, people of the sort I had never met before, and they accepted me because of this ring. It was a very heady, exciting experience for a young academic physician. Several of them suggested I drive back up the coast to show the ring to the man who ran a gallery next to Route 1. So I did. The man loved the design and wanted to copy the ring and sell it. I was thrilled, so I left my ring with him.

That night a major storm hit the coast, and in the morning I was shocked to discover that we were isolated; a section of Route 1 north of Esalen had fallen into the ocean. The gallery and my ring were gone. I was numb. I could hear the usual inner voices sitting in judgment, my father’s voice the loudest, saying “This is what you get for trusting strangers.” And my mother saying “You always lose things-you can never be trusted.”

In anguish I went to the edge of the cliffs and stood looking at the Pacific, still wild from last night’s storm. Down there somewhere was my ring. Everything in me wanted to go down there and get it back. But this was impossible. As I stood there I slowly began to see in a new way-perhaps what had happened was not my fault. Pieces of the land had been falling into the ocean since the beginning. Perhaps these familiar blaming voices were wrong and there was nothing personal at all in this happening. It was simply part of a larger process, one that was natural. I glanced down at the empty space on my fourth finger where my ring had been just yesterday. What would happen now? What rings would the future hold? For the first time I was able to meet with loss in a new way, with a sense of curiosity, an openness, even a sense of adventure.

Coming into a new relationship with the unknown is a very important step in initiation. The unknown is seen differently, as mystery, something to move toward, not something to avoid, something which increases one’s sense of wonder, one’s sense of aliveness. In every initiation we move closer to mystery. We befriend it. It is what we will be serving for the rest of our lives.

About nine months later the third step of my initiation came about. It began with a series of panic attacks. These were terrible experiences. I would awaken in the night unable to breathe, feeling as if I were dying. I had no idea why this was happening and then I began to notice the pattern-they occurred the week before I was supposed to go to Esalen. I went to Dr Sukie Miller, who was directing the research program, and tried to quit. But Sukie, a master therapist, knew a moment of true freedom when she saw it and asked me if I wasn’t curious why these things were happening. She offered to accompany me as I tried to discover why. We did a very brief imagery exercise. She suggested, “Close your eyes and allow an image to come that is related to your panic.” At that time I was highly skeptical of such methods, but I was also very frightened of the panic. So I did what she suggested.

An image came immediately. It was a thin, flat, white rectangle. Sukie asked me if I knew what it was, and with all the authority with which I made a diagnosis in those days I said, “Of course I know what it is-it’s a business card.” “Are you sure?” she asked. As I looked at it again, I realized I had no idea what it was, and I could feel the start of the dreaded feelings of panic. Quickly I opened my eyes and found Sukie smiling comfortably at me. “Certainly you can leave the program but perhaps it is best to wait until you understand what these things mean,” she said. She told me she was absolutely certain that the meaning of this image would come to me in time, and it would be important. So I went home and waited. Not gracefully. I was very frustrated.

Nothing happened for several weeks. I remember exactly where I was when the mystery unraveled. I was driving up a very steep hill in San Francisco with all my attention focused on not shifting backwards into the car behind me. In the middle of one of the hill’s steepest streets the flat white rectangle came suddenly to mind. But it had begun to change shape. It had become a little shorter and puffed up in the middle. As I watched, it continued to change, and suddenly I was in the midst of a full-blown panic attack. It was so severe that I had to pull the car to the curb and park. I remember thinking, “I believe I am going to die here.”

And then I knew what this was all about. The flat white shape was not a business card at all, it was a marshmallow. This marshmallow had been under a steady external pressure from the moment it was born. The pressure which had flattened it, distorted it out of its natural shape, was now lessening and its shape was changing. The marshmallow was terrified. It felt as if it were dying. But this was not so. It was returning to itself. The shape most familiar to it was not its true shape. Something in it that remembered its own shape was reclaiming it now.

I started to cry then because I realized this was a story about me. I had been born into a medical family, where science and facts and logical thinking were very highly valued, and anything that couldn’t be measured was scorned. My medical colleagues felt the same way, so I had been under a lifelong pressure to conform to this way of being in order to belong. I had learned to be quite rational and analytical. I was even good at it. But by nature I was an intuitive, even a mystic. For the first seven years of my life my closest companion was my grandfather, a scholar of the Kabbalah, a rabbi. He had known me for who I was, and I had known myself then. He had stood between me and the rest of my family. But when I was seven years old he died. There are nine doctors in two generations of my family, and I had forgotten my grandfather and his way of being.

At Esalen, for the first time I had met people like my grandfather, people like Moshe Feldenkreis, Fritz Perls, Michael Murphy, George Leonard, and Elmer Green-people who were willing to wonder, to ask questions larger than the available research tools. People who didn’t know everything. They had reminded me that I was my grandfather’s granddaughter. I wasn’t dying. I was going back to a way of being I had never been able to live before, a way that would fit me perfectly when I got there. I was going home.

The last step of this initiation process happened about a year later. By then the way I saw the world had radically changed but my outer life hadn’t changed at all, except for one small thing. One of Kahlil Gibran’s paintings is a hand with a single compassionate eye in its palm. For some reason I had been drawn to this picture. It had struck me as enormously beautiful even before someone at Esalen had told me it was the “hand of the healer.” I had cut the picture out of Gibran’s book but was too embarrassed to put it in my office at the medical center. So I put it over my desk at home. This was the only external change I had made in the two years. I was still on the faculty at Stanford Medical School, and at about that time I received a faculty promotion. Everyone congratulated me, but somehow I wasn’t happy. It was strange, because all my life this had been my goal, yet now I felt trapped and suffocated.

Shortly afterward I flew to Miami to visit my mother, as I did every year on my birthday. We were sitting in the garden of her hotel, watching a woman playing with her small granddaughter. The woman drew little faces on the child’s fingertips with a felt-tipped pen, and then they held a little puppet show in which these “fingertip people” talked to each other. As we watched, charmed, my mother said, “Some things never change.” Puzzled, I asked her what she meant. She smiled. “You used to draw on your hands when you were a little girl. Don’t you remember?” I said, “No, I have no memory of that at all. Did I draw little faces on my fingertips?” “No, no,” she said. “You would take Daddy’s fountain pen, and draw eyes in the palms of your hands. Then you would hold your palms up on either side of your face, close your eyes and say, ‘Now I can see you!’ Do you remember?”

In that moment I stepped through a doorway into another reality in which all the odd parts and pieces of myself turned toward each other slightly, and for the first time they fit together seamlessly. I who had always felt an outsider, always felt like the wrong person, always covered up how different I was. I did remember, and I knew I belonged.

It had been two years since my colleague put those colored xeroxes announcing the Esalen program on my desk, and only now was I able to take my first step on the path that opened back then. I flew home, went to Stanford, and resigned. We have many rehearsals, many opportunities to get life right.

Much in life distracts us from our true nature, captures the self in bonds of greed, desire, numbness, unconsciousness and drama. These bonds seem strong and unavoidable. Yet every initiation, no matter to whom it occurs, is a witness to the possibility of freedom for us all-the evidence that the soul is stronger than all that, can draw us toward itself, despite all. Every initiation is a message of grace.

Recently I was present at the final step in someone’s initiation. Six weeks before a patient of mine died, I was sitting with him and his wife late one afternoon in his home. He was very sick with widespread cancer, struggling to live. We were awaiting the results of tests that were going to tell us if any further treatment was available for him. In this setting I asked him if he could remember a place of safety, and if he could go there in imagery and tell us about it.

He began talking about rural New Jersey where he had been a small child, and he recalled his earliest memory. At the time he was four or five years old and living in a house which was reached by a long road that ran along a small river. In spring, often the river would flood, and once after a flood he was walking along the road and found a rainbow trout washed up from the river, struggling to live in a drainage ditch beside the road. It seemed to him to be very wrong, this beautiful fish trapped in this small, shallow and muddy place. He was just a little boy and it was a big fish, but somehow he managed to get it up into his arms. He carried it across the road and waded out into the river a little way and put it back. I asked him what he remembered most clearly about this. He said he remembered the moment when the fish realized it was once again part of the river.

There are many stories in every story. On one level this is a beautiful childhood memory shared by a very sick man. On another level it’s a story about a man whose compassion goes back to his very beginnings. But perhaps there are even other readings. Certain practices run through all the branches of Buddhism. One of these is a practice done on those holidays that celebrate enlightenment and the promise of freedom. At such times, in China, Japan, Nepal, Korea, live fish are bought at the market and taken to running bodies of water and set free. These fish are symbols of the promise of return to the great freedom which is our true home.

Over many years of listening to people with cancer, their dreams, their poems, their stories, I’ve come across many images for the soul. I think the rainbow trout is one of the most beautiful. This man was not a Buddhist. He didn’t know any of this consciously. He was a vintner, a fly fisherman, a sailor, but there was something in him that was older than all these things. If you were quiet and listened, sometimes it would speak to you.

And so, as we were waiting together to find out if further treatment was available it spoke to us and told us this story, perhaps so that his wife and I would know where he truly was in his life, but more importantly, so we would know that despite appearances, all was well.

Initiation is a part of the vision quest, the search for new eyes. There is a saying that is very close to my heart: “The voyage of discovery lies not in seeking new vistas but in having new eyes.” I selected the title of this talk, “The Gift of New Eyes,” long before I knew that I was going to have eye surgery last month. In fact, I had a second, emergency surgery after the first one failed. For the last six or seven years I have lost much of my vision to glaucoma, and my one good eye had become covered over with a cataract.

But today I was able to walk through an airport unaccompanied for the first time in years. I was able to read signs, to see people’s eyes, to marvel at the play of light on the carpet. It gave me such a sense of gratitude. If initiation is the experience of having new eyes, perhaps we should think of it in just that way-not as something we’re trying to achieve through our personal ambition, but as a possibility ever-present in life. An occasion of gratitude, a witness to the fact that despite everything that is limited, small, unconscious and trapped in this world “all is well.”