Functional Medicine, Gratitude, Journaling

During the first week of this month, I attended a 5-day course in Washington, DC offered by the Institute for Functional Medicine (IFM) because I wanted to explore a new paradigm for providing health care that is based in science but with a wider embrace than the clinical practice model I have known for 30 years.  The defining features of Functional Medicine are looking for and treating root causes of illnesses rather than focusing on the disease itself, applying an understanding of inter-related biological systems (“systems” being the operative word here), and honoring the value of therapeutic partnership in healing encounters.

What does identifying and addressing root causes versus treating the signs and symptoms of illness look like? We can consider this using inflammatory bowel disease (Crohn’s disease, ulcerative colitis) as an example.  Conventional medicine recognizes the the auto-immune inflammatory process and uses a variety of medications to regulate that and shut it down.  Functional Medicine will ask, “What is the source of inflammation?  Are there contributing factors that can be corrected or eliminated to improve or resolve the inflammation?  Can we extinguish (or at last diminish) the fire at its source?”

When we start to look more deeply, we can see the integration of bodily processes and begin to understand how detrimental, self-perpetuating cycles are initiated.  A good example of this is how in response to chronic stress, the receptors for signals of stress up-regulate by becoming more numerous or more sensitive to their chemical messengers.  That means that the same number of chemical signals have a higher likelihood of “delivering” their message.  This creates a kind of hyper-reactivity that might be adaptive in some circumstances by building the response to an ongoing problem,  but over time it causes us to be increasingly sensitive to perceived threats, shifting us even more readily into fight/flight/freeze states that, in turn, rev up our sensitivity even more.

The value of gratitude journaling came up repeatedly during the week, and this made me think about the Mindful Writing series that have been offered by a couple of guys from Washington College here at The Seed House (more about that in a minute).  I was also intrigued that Nancy Illman who is teaching a monthly yoga class integrating essential oils that support the theme of the class chose as her November topic: Gratitude—See the Gift in Your Obstacles (learn more here or on MindBody.  I know Thanksgiving is coming, and just around the corner behind that is a month preoccupied with gift-giving, so this might not be kind of convergence of events but the interplay of timing and the attention I am paying to enrich my comprehension of the connections between mind and body and practice.

A physician teaching at the IFM course recounted her healing journey after being diagnosed with a particularly difficult form of breast cancer shortly after starting practice at the age of 30.  In her rear view mirror, her gratitude journal looms large as a major factor in her recovery.  She was really bitter about the unfairness of her diagnosis, and there was something powerful about finding one thing to be grateful for every day and writing that down.  What shifts?  What do we allow when we think AND write?  Nosing around a little bit, I found Robert Emmons, Ph.D. whose career is dedicated to understanding gratitude.  Besides the benefits accrued to the individual who practices it (maybe just by writing down 5 things s/he is grateful for each week), he identifies it as a relationship-strengthening, social emotion because “it requires us to see how we’ve been supported and affirmed by other people.”

Back to mindful writing.  Dan Teano introduced mindful writing at The Seed House last year, and John Linderman picked it up this year, having experienced it as a powerful and life altering practice with Dan last year.  John told me that he’d run into Dan on his way from a memorial service for another Washington College student who had committed suicide last spring and was understandably sad.  Dan was on his way to The Seed House when they crossed paths that day, and Dan invited him to join the group and possibly find a place to digest the loss, be among others.  John was hooked.  Unlke other writing support groups in which the writers share their work, this is more of an interior experience undertaking in the presence and support of a group and place.  Topics are offered to structure a stream of consciousness type of writing (I know, that sounds like an oxymoron), but paired with some meditative practices,  people have found this to be a safe and amazing way to get ideas down on paper, to reconsider long held assumptions, and to have ways to free the pen on the page.  This is not gratitude journaling per se, but they’re not mutually exclusive endeavors.  We’ll be re-booting John’s beautiful mindful writing series. You can sign up here on MindBody or here. Surprise yourself, find the gifts in your obstacles. 

You can learn more about benefits such as better sleep, decreased blood pressure, more balanced immune response, and positive emotions associated with writing down even 5 things a week for which you are grateful here.



liane-metzler-30296-unsplashOur skin is the largest organ of the body, and along with our gut and our respiratory tract, it is our physical interface with the world around us.  We absorb things through our skin (think of medication patches like hormones or narcotics as examples), and we detoxify when we sweat, releasing not just salts and water but other cofactors and waste products of physiologic processes.  And perhaps there is a metaphorical release and uptake through the skin, too, part of an ongoing dialogue with our central nervous system.  With these thoughts in mind and an interest in our overall health at The Seed House, we have stocked some select skin care products that have been made with the same values inspiring both the process and the results.

Samudra Skin & Sea is a woman-owned business that responsibly hand-harvests seaweed from the northern California coast and combines them with other plant-based ingredients to prepare organic, vegan skin care products in small batches.  Kelp is a rich source of antioxidants, minerals and vitamins that nourish the skin.  Owner Shilpi Chhotray has a background in marine science and ocean conservation and continues her advocacy work organizationally and through her products.   We stock Wild Seaweed Sea Soap for Hair and Body,  Body Butter, Face Cream, and Clay Mask (that also contains charcoal).

From Marble & Milkweed, we offer tinted and simple lip balms, body butters, and bathing salts.  Briar Winters sources organic and fair-trade ingredients and handcrafts her products, packaging them in environmentally sensitive compostable paper or glass.  I love Briar’s inspiration for the business name:

The scientific name of milkweed’s genus is Asclepius, named after the Greek god of medicine and healing. In Hindu mythology it is believed that the universe was created by a god drunk on the milky white juices of the plant. Today, milkweed is the primary source of food for the monarch butterfly. It’s my hope that the precious nectars you’ll find here will likewise nourish you into winged resplendence!

We are also introducing doTERRA Essential Oils.  We chose this product line not only for their quality and responsible sourcing but also for the educational support provided by our local contact, Nancy Illman.  There is a vast body of knowledge about plant-based medicine that we want to make available for the practitioners, students, patients, and clients of The Seed House.  Nancy will be offering a themed “yogaroma” class in a 12-month cycle to pair an asana sequence with a selection of oils to amplify the theme.  In addition, one-to-one Aroma Touch, Aroma Reiki, and aromatherapy-focused wellness coaching (choosing essential oils that support your wellness goals) will be offered by Nancy.  Nancy Illman is a former poverty lawyer now living her best life devoted to sharing and promoting holistic wellness practices. She has been an advanced practitioner of Usui Reiki since 2007, is a practitioner and trainer in the AromaTouch Technique since 2014, and certified in Plant Based Nutrition in 2012.  Nancy’s first yoga class will be Foundations, a Journey through the Lower Chakras, Sunday, October 14, 2018, noon-1:15.  Sign up here.

Thanks for the photo by Liane Metzler on Unsplash

The Journey Home

IMG_0750Down to the 0 kilometer marker, I have come farther along the Camino that I have before, the last few days taking me through enchanted forests that are characteristic of Galicia, but here near the coast, there is salt air and eucalyptus.  It is cool, damp and herbal, and the sound of crashing waves when the path weaves near the shore is  reminder of having come as far as it is possible to come this way.  There are signs of change in this largely untouched place.  In the last kilometers, cresting a 1000 foot hill before descending steeply to the shore, huge wind turbines are being erected, and swaths of trees have been cleared for massive power lines.  Tucked against a cliff is a multi-level modern wave of glass and metal construction overlooking a pristine white sand beach just before Muxia on northern Spain’s Atlantic shore.  I made my way into town, feeling that these are the last steps of three Caminos experienced in four years.  I know it’s time now to turn around and start my trip home, and I ask myself the kind of unanswerable question I always ask, “Did I get what I came for?”  This has been more of a quest than a holiday.

For almost a week, I have been bogged down in my writing, plagued by a section on anger.   Anger has become almost a defining feature of working in or being served by our health care system.  It often circles around feeling disrespected or a sense of helplessness.  We are sensitive—as we should be—to explosive expression by our patients as an indication of being overwhelmed.  For providers of health care, such expressions are regarded as a root problem itself, evidence of fixed character flaws like narcissism, rather than as a messenger.  The reaction to these outbursts is part of drawing a line around the behavior to condemn it. I am afraid, however, that without a willingness to venture beyond the “We’re mad as hell, and we’re not taking it anymore” stance, we will remain locked into a dynamic of rage. 

I’ve been dwelling with Roshi Joan Halifax’s notion of “edge states,” those places where adaptive, constructive feeling states move into personal distress and become harmful to ourselves and others that I shared in the last post, Fostering Compassion.  I reread Harriet Lerner’s rich primer, The Dance of Anger, in which she reminds us that anger is a signal, like pain, a call from ourselves that we need to hear, and at its core is often the task of defining ourselves and balancing that sense of self in relation to others—at home, in love, at work, in the world.  The work, however, begins at home.  We cannot bank on changing the world to our liking, but we can come home to ourselves.  We can discern what we can or cannot do, what we are willing to do, and in the light of this most honest appraisal of ourselves, we might be able to more comfortably accept the consequences of our choices and feel less helpless, less victimized.  Lerner also advocates and offers guidance for addressing anger productively, which she might define as ways that open the door to realigning relationships rather than perpetuating the status quo.

Then, as if on cue, my magician friend Alberto sent this, from Thich Naht Hahn:

Don’t try to force, manipulate and control others.

Become your own master and let others be what they are or have the ability to be.

Settle in the silence and harmony of the entire universe.

This, then, is the real journey home, the emptiness and totality of the 0 kilometer marker, the silence and harmony of the entire universe.

Fostering Compassion

One of the inspirations for The Seed House was to create a resource that would foster compassion in health care providers.  Being a surgeon, I have special interest in the challenges of providing care in an increasingly financially oriented medical system and rekindling the original sacred intention to relieve suffering that most doctors dreamt of when starting down this road.  My personal journey and academic inquiry led me to learn more about the constituents of compassion and understand how what seemed like a natural inclination could get utterly shipwrecked.  Most of the programs, now mandated by hospital accrediting organizations, to address and remediate behaviors that interfere with the safe and civil delivery of care are diagnostic and punitive, laying the blame on basic character flaws in errant providers.  Given that every medical student I knew had a dream and that current data shows that nearly half of all medical students have signs or symptoms of burnout by the end of the second year of medical school and before actually beginning the clinical part of training or having regular patient and clinician contact, it made sense to me that whatever process appears to swallow our ability to relate to the suffering of our patients or even to their individuality and experience happens along the way.  It’s not the result of choosing the wrong applicants.

The very best and most prescriptive work I have found comes from Roshi Joan Halifax, Ph.D., a medical anthropologist by training and abbotess of Upaya, a Buddhist monastery in Santa Fe, NM.  Her blend of centuries old Buddhist practices centered on ending suffering and neuroscience research are providing some surprising and practical guidance for understanding and nurturing compassion.  Perhaps most surprising is that “burnout” or compassion fatigue actually seems to originate not in a low capacity for caring but in the setting of hyper intense caring and taking on the pain of others without adequately separating from them.  She distinguishes empathy, the emotion of feeling inside oneself what another person is feeling, from sympathy, the state of feeling alongside another person, of being attuned to and present with another person’s suffering but sustaining awareness that it is their feeling, their pain.  This requires a kind of balance of cognition and sense of self along with the attunement to others.  She argues that empathic hyperarousal is a more accurate, descriptive term than “compassion fatigue.”  This would explain another contradictory finding in my research about disruptive physician behavior: the majority of doctors referred for counseling or remediation are actually more concerned about their quality of care and dedicated to their practices than their colleagues.

Interestingly, mindfulness practices, such as meditation and embodiment practices like yoga asana practice that refine our capacity to sense what we feel in our own bodies and modulate our emotional responses utilize shared neural pathways with compassion and can help us bear witness to suffering without moving into personal distress.  As we approach the one year anniversary of The Seed House, it is a good time to reflect on and share what inspired the creation the space.  The yoga studio and the cafe are just the tip of the iceberg.  There’s purpose and hope and intention underneath.  I am humbled, as I make my way along the Camino de Santiago very slowly this time, how easy it has been for me to slip into habits of work that were detrimental to my wellbeing as a surgeon.  This walk is a chance for reflection, removed from the immediacy of The Seed House day to day operations (capably being attended to by the other practitioners and staff there) and to have time and concentration to consolidate some of my findings into a handbook for surgeons and other care providers. Like my walking, the process is slow but steady.  And when I return, I will be on my yoga mat and zafu, practicing, exploring the mind-body connections that help build true compassion and ease suffering, always returning to home.

Spring Equinox Cleanse


Sunday, March 11
Taste, Love & Logic with John MacLeod (free event)* @ 3:00 PM (45 min)
Monday, March 12 (NOTE: no open meditation this week)*
Guided Meditation, detox beverage before, tea after @ 7:45 AM (1 hour)
(with Jon McCollum, PhD Seichō Kenzen 清調研禅)
Immerse & Emerge Spring Yoga Cleanse Morning Series* @10:30 AM (90 min)
Immerse & Emerge Spring Yoga Cleanse Evening Series* @ 7:30 PM (90 min)
Tuesday, March 13
Guided Meditation, detox beverage before, tea after (Jon) @ 7:45 AM (1 hour)
(with Jon McCollum, PhD Seichō Kenzen 清調研禅)
Immerse & Emerge Spring Yoga Cleanse Morning Series* @10:30 AM (90 min)
Immerse & Emerge Spring Yoga Cleanse Evening Series* @ 7:30 PM (90 min)
Wednesday March 14
Guided Meditation, detox beverage before, tea after @ 7:45 AM (1 hour)
(with Lauren Hickey)
Immerse & Emerge Spring Yoga Cleanse Morning Series* @10:30 AM (90 min)
Immerse & Emerge Spring Yoga Cleanse Evening Series* @ 7:30 PM (90 min)
Thursday, March 15
Guided Meditation, detox beverage before, tea after @ 7:45 AM (1 hour – with Dan Teano)
Immerse & Emerge Spring Yoga Cleanse Morning Series* @10:30 AM (90 min)
Immerse & Emerge Spring Yoga Cleanse Evening Series* @ 7:30 PM (90 min)
Friday March 16
Guided Meditation, detox beverage before, tea after @ 7:45 AM (1 hour with Lauren Hickey)
Immerse & Emerge Spring Yoga Cleanse Wrap-Up Restorative* @10:30 AM (90 min)

*indicates need to sign up online (can link through our FaceBook page or at

Please note that there are other offerings on Eventbrite.

Sign up to secure discount of $25 for one-to-one coaching sessions or demonstrations with John MacLeod (first 5 registrants), $25 discount for detoxifying lymphatic massage with Linda Moyer (first 5 registrants, massages completed between 3/12 and 3/16/2018), or Gates of Buddha individual acupuncture sessions with Anya in the week following cleanse week (since she’s out of town during cleanse week).