Clean: The Revolutionary Program to Restore the Body's Natural Ability to Heal Itself (3 page)

CHAPTER TWO A Doctor’s Journey

I was born in Uruguay in 1964 to Jewish parents who survived World War II. My mother left Germany days after she was born. My father survived a concentration camp in Hungary and went to Uruguay after the war, looking for his sisters. He found them, and my mom.

Life in Montevideo and Punta del Este was slow-paced. We shopped at the local farmers’ market and almost always had lunch or dinner sitting at the dining-room table, all together as a family. Our city was safe, and children played in the streets without supervision.

Early on I knew what I wanted to do when I grew up: I wanted to become a doctor and help alleviate people’s suffering; help them become healthier and live longer and better lives. I went to medical school and fell in love with medicine. Our family doctors used to do house visits, spend hours with us, and teach us all kinds of interesting things. I wanted to be like them.

When I graduated, I decided to become a cardiologist. Something about the heart attracted my interest. The fast thinking necessary, the life-saving decisions made in a split second, the satisfaction of saving someone’s life without having to wait for months to see if the pills were going to work—all these things left me with no doubt of my choice of specialty.

After graduating I wanted to study in the place where my medical school textbooks had been written. I got a position as an intern at New York University’s Downtown Hospital in Lower Manhattan and moved there a week after my graduation to complete three years of training in Internal Medicine. At the end of the three years I was twenty-six years old.

Life in Manhattan moved at a lightning-fast pace, very different from my home. Medical training was tough. Being on call for up to three days in a row, always busy, I had no time to prepare meals. My main sources of nourishment were takeout, vending machines, nurses’ pot-lucks (lots of them), and the hospital cafeteria. If I had some extra time, I visited the nearest supermarket. I was fascinated by all the packages, the colors, the smells, and the fact that with a microwave oven, anyone could have a dinner in minutes. I felt like an aboriginal who finds himself in the magical modern city, and I often found myself thinking, “Boy, these Americans really know how to make things easy.”

But life as a trainee doctor in one of the busiest cities in the world started taking a toll on me. I was gaining weight and started sneezing like crazy with every change of season. I was exhausted, but could not get much sleep. Overall I still enjoyed the experience of learning from doctors, some of whom were considered the top in their field. As to the deterioration in my well-being, I figured, “Once I graduate, things will change.”

After three years of internship and residency, I moved to Manhattan’s Upper East Side and started my training in cardiology at Lenox Hill Hospital. Running the Cardiac Intensive Care Unit, admitting patients from the emergency room, and consulting all over the hospital added the weight of responsibility to my shoulders and the weight of bagels to my belly. In those second three years of training my allergies got so bad that I had to take antihistamines and use steroid inhalers several times. My digestion was turning into a nightmare. I was often bloated, and I had abdominal discomfort and alternating bouts of constipation and diarrhea. This was alarming.

I decided to ask one of our attending gastroenterologists for help. Within minutes of listening to my story, he ordered an upper and a lower endoscopy, abdominal sonogram, and full blood work. Every test came back absolutely normal. The specialist’s diagnosis was “irritable bowel syndrome.” Not much could be done, I was told, except try to control symptoms with antispasmodics, antiflatulence pills, painkillers, and antidiarrhea medication alternating with laxatives. Nobody asked me what I was eating—which was not surprising, since I had never had a nutrition class myself.

A few months before finishing my fellowship I started waking up with chest pain. If I hadn’t already been a cardiologist myself by then, I would have gone to see one, but I knew the heart muscle and its arteries were not the problem. That other aspect of the heart, the one I had not had a single class or discussion about in all my years of training, was the problem. I was sad. In fact, I was depressed.

This to me was unbelievable. There was no history of depression in my family. My life was busy, but I liked working hard and I was good at what I did. Something was very wrong, because my feeling of impending doom was not justified by whatever difficulties I had at that time.

And soon I started noticing something even more alarming: from the moment I woke up until the moment I went to bed, my mind did not stop thinking. There were always thoughts rolling through my mind. It was not me choosing to think them. In fact, if I had a choice I wouldn’t be thinking 90 percent of the thoughts that were happening day in and out. Sometimes there were dialogues in my mind. I noticed that there was only one difference between crazy people talking to themselves in the subway and me: they were doing it out loud.

The thoughts were louder at night. I could not sleep. Which only led to more thoughts. If I was not choosing those thoughts, who was? Where were they coming from? Was I going mad?

At one point it got so bad that I decided to seek help from a top psychiatrist in New York. After one session of questions he solemnly said, “You are depressed. You have a chemical imbalance.” He explained that my brain was not producing enough serotonin. He wrote me a prescription for Prozac. In the elevator on my way out of his office building I looked at the piece of paper in my hand and wondered, “How did my cells forget to do their chemistry? How did they become imbalanced?”

I didn’t like the idea of taking a medication for the rest of my life, so I decided to get a second opinion. It took the new psychiatrist two sessions before he declared, “You have a chemical imbalance in your brain,” and wrote a prescription for Zoloft, a cousin of Prozac. This doctor talked a little longer, saying that a chemical called serotonin, a neurotransmitter, is responsible for the feeling of well-being, of happiness. He said my serotonin was low. Zoloft would ultimately raise the levels of serotonin in my brain and resolve my symptoms. When I asked him what had caused my cells to reduce the production of serotonin, he answered that it was not well understood, but that I was not alone. He was starting to see depression in almost epidemic proportions.

Instinctively I rejected the idea of being on prescription drugs for the rest of my life. The psychiatrists had no answers to my questions. Neither did a number of other therapists, social workers, teachers, and friends whom I asked. I wondered if anyone else would be able to satisfy my need to understand what was happening. So I started going to bookstores. I quickly discovered that New York has amazing bookstores (even more impressive than its supermarkets) where a person could sit and study for hours without buying a thing. I took full advantage, starting my research in the psychiatry and psychology shelves. “Thinking” … “thought” … “the mind” … I read everything I could get my hands on to answer my burning questions: Where are my thoughts coming from? How are they affecting my feelings to the point of despair? How can I stop this madness?

Every time I read something that resonated with me, I made a note of the reference, and immediately I’d go look up the book that was referenced. In this way I found myself shifting from the psychiatry section into the self-help section and then into the New Age section of the bookstore.

One day, following the trail of references, I found myself looking for a book in the Eastern Philosophy section. As I was browsing the shelves, a book literally “fell” on my hands and opened up to a chapter titled “Meditation: Silencing the Mind.” As I read the first few paragraphs, it was as if the skies were opening up. It said that through the practice of meditation one could slow down and even stop the incessant habitual thinking process. The mind was described as the “monkey mind,” always moving from one thing to another, always busy; some people also call it “radio playing.” This information was exactly what I was looking for.

I laughed at how close the names of these two approaches were: medication and meditation. So close and yet so far apart. I immediately made up my “monkey mind.” I had to meditate.

Finding a meditation teacher was not easy. After a couple of awkward experiences, my friend Fernando offered to take me to a specialist. We drove upstate to a school of meditation that same day. It’s a monastery of sorts, where seekers can come to study and learn. This meditation school was led by an Indian meditation master. As soon as I met her there was no doubt in my mind she would have some of the answers to my questions. She was fully present to such degree and so profoundly calm within that it was felt by everyone around her. I had such an intense experience from simply being in her presence that my thinking brain fell completely silent for some time. When my mind started the incessant radio playing again, it was different: I could remember the experience of silence. I had a reference point. I had a sneak preview of what was possible—and I resolved to acquire that ability, to silence my mind, to become present. The course of my life changed at that moment, and it has never been the same.

I started reading all the books that this Indian teacher had written, and the ones her teacher had written before. I also drove every weekend to the meditation courses offered at the school of meditation at that time. On one of these weekends, an announcement was made that a volunteer doctor was needed for the medical clinic at their meditation school in India. A series of magical synchronicities ended with a firm decision: I would go to India. To the shock of my colleagues and family I turned down all the offers I’d had to join very lucrative cardiology practices, packed my bags, and left.

In India I studied yoga. I learned how the physical movement routines that were starting to be a great fashion in America were only one aspect of yoga. There are eight “limbs” of yoga in total: yamas, personal attitudes toward the world and others; niyamas, attitudes toward self; asanas, body postures; pranayama, breathing exercises; pratyahara, control of the senses; dharana, concentration; dhyana, meditation; and samadhi, enlightenment, firmness in the present moment. It is an expansion of awareness and opening of the mind. And that was exactly what happened to me.

As my form of service I directed a team of volunteer health practitioners from all over the world. There were Ayurvedic doctors, Chinese medicine doctors, chiropractors, nurses, massage therapists, hands-on healers, meditation instructors, and many other practitioners, all with different philosophies and all practicing different techniques. Our mission was to treat the meditation school’s large population of students and to take our traveling hospital—a converted school bus—to the surrounding villages, some of the poorest places on the planet. We took on every case as a team, discussing each patient’s condition from everyone’s point of view. It was a truly integrative approach. I had never heard of “integrative medicine” before, but suddenly I was practicing it.

As I heard the other doctors explain their views on patients and diseases, I was blown away by how much sense they made. Even more impressive were the results I was witnessing from using herbs, acupuncture, diet, massage, chiropractic care, and hands-on healing. These were being used in a subtler way than Western medicine knew—to find the root cause of imbalance in the body and mind, not just put out the fires of symptoms. It struck me that what we were practicing could not be categorized as “alternative” or “traditional.” It was, simply, common sense. On certain occasions a Western medical approach using drugs or surgery was absolutely necessary, and the advanced technology available was life-saving. But this was rarely needed. Given the right support and conditions, the body’s natural healing ability was restored without drug intervention. My mind, which had been rigorously schooled in the paradigm of conventional medicine, was cracked wide open. And meanwhile, my own mental and physical health, though far from optimal, were getting better by the week.

By the end of my year of volunteering at the meditation school I had erased many categories of medicine from my mind: “alternative,” “traditional,” “Western,” “allopathic,” “Eastern,” “Ayurvedic,” “Chinese.” All these medical traditions and practices blended into one integrative category that I called “openminded medicine.” It was, I decided, the process of bringing the best of Eastern and Western medicines to the table without judgment in order to best serve each and every patient as a unique individual. By the time I returned to the United States, I was determined to bring this new style of practicing medicine into the hospital system—to change it from within. I returned to the States and took a job as an attending cardiologist in a busy practice in Palm Springs, California, with admitting privileges in the four local hospitals.

Before I knew it I was back in the all-American rat race—personally and professionally. It was much harder to maintain peace and well-being here than it had been at the meditation school. Constant commuting in the car, responding to beepers, and inserting pacemakers and IV drips became my reality. The pressure was on to make the rounds of wards and intensive-care units as fast as possible, to keep the practice profitable. On paper the job was enviable. If I stuck it out, in three years I’d be a partner in a very successful practice. But treating patients this way was killing my spirit. I had no time to listen to my patients’ symptoms or even recognize their basic humanity. They received, on average, seven minutes of attention, and the system treated them like commodities: a way to do more tests, write more prescriptions, and make more money. The patients who came to me were often taking five or more prescription drugs. Neither I nor they completely understood how all these chemicals interacted in their bodies. The system was set up to encourage someone in my position to add more medications to the already full load. This was not the dream of healing I’d grown up with.

Not surprisingly, the effects of stress, cafeteria food, and late-night dinners piled up again. My own symptoms of irritable bowel syndrome (IBS) and the foggy mental state that before had made me sad now returned. In private moments I had to ask myself if my health was much better than my patients’.