Journey and Realizations

Computer ScienceMy professional education and work experience started with studying Computer Science at the University of Michigan. As I was entering my final year of undergraduate studies in 1999, I co-founded an Internet-based market research company, imyst, Inc. (www.imyst.com), which I am still involved with today. Simultaneously I applied to medical schools and was accepted into Tufts University School of Medicine’s combined MD/MBA program. Through medical school I continued to work on my company. Ultimately, I chose Anesthesiology as my specialty and matched into my first choice for residency training at Baylor in Houston. That year was a seminal year for me, as I moved to Houston, got married, entered residency, and experienced the loss of my father-in-law to cholangiocarcinoma. This series of significant life events, combined with the memory of my father’s untimely heart attack and death at age 45, stimulated a serious introspection. It spurred me and my wife to take a leap of faith and “reset” our lives. She left her corporate litigation firm where she was on a partner track and I left my residency program. We moved to Austin to be close to family and redefine our priorities. In the process we reconnected with nature and a simple way of life.

After a year and a half in Austin, my heart was pulling me back towards medicine. Serendipitously, I met a program director for a Family Medicine program in Dallas while on a medical mission to Guatemala in February 2009. I applied outside of the match process and because they did not fill their positions that year I was given one of the six spots. Out of the hundreds of applicants that had been vetted I was fortunate to enter the program.

In the Dhauladar Mountains, India

In the Dhauladar Mountains, India

In June of 2012 I completed my residency program and then set off on a year of world traveling and self exploration with my wife. We spent several months in South America, trekking and mountaineering our way across the Andes. Then we shifted to Asia, spending the next six months in India, Nepal, Thailand, Australia and New Zealand. Wherever we went, we practiced our yoga. Through daily dedicated journaling, and reading authors like Bharat Aggarwal, Dean Ornish, Bernie Siegel, and Joan Borysenko I practiced Svadhyaya, or self-study.  The following are a number of important realizations I had:

1) Medical school and residency trained me to be excellent at treating acute conditions and practicing hospital medicine; but when it came to chronic disease there was something lacking. My institutions focused on pharmacological interventions for treating disease versus prevention and lifestyle change—lifestyle and dietary changes are very effective but require time and counseling. So there was always an elephant sitting in the room (or in the back of my head) saying, “I need more time with people if I am going to help inspire them to wellness.” The year I spent away from medicine motivated me to listen to the elephant and make two major changes. The first was changing myself, and the second was changing my practice. I realized I had to be an example and practice what I preached. Also, I decided that the current insurance-model of medicine would not enable me to practice the best medicine for my patients.

White Willow

White Willow

2) To understand the nature of a system and what it promotes we have to look at intentions and motivations. In western systems of health care, innovation and treatments are driven by capitalism which promotes profit from innovation. It is a system driven by making money, which directly relates to controlling resources. If resources are plentiful and cheaply available, then economics dictate that that item will be inexpensive. The corollary is that if resources are scarce, then prices can be raised or controlled in a fashion that increases profits. In a capitalistic system such as ours, the incentive is to promote and push those products which generate profits, not ones that are readily available and inexpensive. For example, the tea of white willow bark is readily available and cheap, having been used as a fever and pain reducing agent for hundreds of years (since the time of Hippocrates at least). It appears to have less risk of toxicity than its pharmacological counterpart, aspirin, which can cause kidney and stomach problems. However, in a healthcare system such as in the United States, the public is unlikely to see a large scale head-to-head trial of a standardized extract of white willow bark versus Bayer aspirin. This is because the ingredient white willow bark cannot be controlled as readily as the manufacturing of aspirin, hence the pricing.

3) Individual cases of healing, though not statistically significant, are nonetheless valid observational data points that should be respected, even if the mechanism cannot be understood. The gold-standard of having a randomized controlled trial is the western medical paradigm and is not the only one of value.

4) Chronic conditions like diabetes and high blood pressure do not develop overnight. Similarly, effective non-pharmacological holistic and integrative treatments take time to work. Meditation, yoga, tai chi, and progressive relaxation are among many techniques that are very effective in lowering blood pressure, but the process of learning these practices takes time and dedication, like any other skill. Use of these practices has been shown to lower stress, improving the hypothalamic-pituitary-adrenal axis which regulates the cortisol hormone levels in the body. Improving cortisol regulation in the body has far reaching consequences from improving diabetes and immune function, to reducing weight gain in the belly area.

Herbs5) Cultures around the world have been practicing well established healing traditions long before the advent of western medicine. Two of these traditions which I have familiarized myself with, Ayurveda and Traditional Chinese Medicine, emphasize prevention and well being rather than treating diseases after they have taken root. They utilize ‘slow’ approaches to successfully treat chronic medical conditions on a regular basis. In general, these traditions overlap in a few very important ways—focus on digestive health and diet, reduction in stress through a myriad of different approaches (synchronizing sleeping patterns with Nature, meditation, integration into community), and increasing internal energy through specific practices (yoga, chi gong, acupuncture). One notable similarity between the two traditions is approaching disease with cleansing through fasting or dietary restriction. To better understand the nature of this type of treatment I voluntarily underwent a 7-day detoxification program, twice. Though the initial experience was intense, the results were well worth the effort.

6) Love is the most powerful healer.

The journey still continues and I appreciate all the lessons and experiences it has to offer. Sharing it with people makes it that much more enjoyable.

Darshan Shah, MD, MBA, ABFM, ABIHM, RYT

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