Years ago I learned that to have new things come into your life, you must make room for them. If you want a better relationship, end the bad one. If you want a new job, quit the old one. If you want to be productive at your desk, clear it completely and put only the thing that you wish to work on there. If you want to have new ideas, do something that requires no thinking at all.

About 3 days ago forgot my phone at home, and my work computer had been replaced so I had no passwords saved on it. I could not access my own email. For a few hours I had no tech distractions at all. It was a good reminder of how much I enjoy my coworkers, the garden, the view of Mt Hood from the school. It was time to think again without wordle or whatever to tempt me into the screen. I realized fully then what has been lurking just beneath the surface of my mind.

As of yesterday I emptied out my doctor's desk and changed it to a writing desk. I'm not going to see patients anymore. I gave being a naturopathic doctor a solid try. What I learned is that practicing medicine when you are outside of "the system" is a Sisyphean push. I learned that I do not want to be a business person. I learned that it is really hard to help people adjust their diet and lifestyle when they would much rather take a magic pill. 

It's pathetic and sad that a nation as rich as ours can't find a way to do a better job at preventive care. It's even more pathetic and sad that poor people and especially poor elders are basically written off. We are so obsessed with money and social issues that we fail to be kind.

Another thing I learned is that being a scientific naturopath is a very small needle to thread. It's oxymoronic. People don't expect those two words to be connected. Even the word naturopath is an oxymoron; it's a combination of Latin and Greek that clashes. Naturo = nature, path = disease. Nature disease? Yeah, it was a mistake to go down this path. As of today I'm done.

With that said, this blog is not done. I may continue to post. Depending on my job situation, I may post more instead of less. We shall see.

Recently I had an extended text conversation with a paddling friend who wanted to know what I thought about hormone replacement therapy for post-menopausal women. I answered her questions when I was able. My life is quite full and long text messages are an awkward approach to medical communication.

At the end of our text conversation she thanked me and said that the "medical professionals" in her life had been unwilling to discuss it with her. My response was that I am a medical professional. I am licensed (#1944 if you want to look it up), and the licensing board has requirements. I can diagnose and prescribe in the state of Oregon. I have a tremendous debt from my medical education. My practice as a naturopath is unlikely to pay enough to even dent it, much less pay it off.

I know that I am somewhat casual in my manners and speech. Some of the supervising physicians during my education thought me unprofessional and told me so. I remain the same person with a somewhat raunchy sense of humor and a direct way of speaking. My intention is to connect and communicate, not to show off my years of training and fancy medical vocabulary. Even in these blogposts I work hard to explain things in language that most people can understand. This is my goal.

After I told this friend that I am a medical professional, the lengthy text conversation abruptly ended. It was as if she didn't think I was a professional. Or perhaps she wants my advice as a naturopath but doesn't think it's worth paying for. I don't really understand her reasons, but I can tell you my reaction. 

I'm steamed. I'm mad. I'm tired of people wanting all that I know for free. I invested years of my life in an exasperating educational setting and continue to study so that I know my shit. I carry a burden of debt. I try to help people by working around the for-profit medical system that has cut me out of the profits. I teach them how to get what they need out of the for-profit system, and how to avoid needing things from it. My heartfelt goal is to help people. I especially want to help people that connect to my personal life. Even this desire can be described as unprofessional. Apparently to be professional you need to be cold, calculating, and profit-driven. Screw that.

The most gratifying thing in the world is when a person pays me cash for my services, and then says "your time must be worth more than this". Well, yes and no. I will do it for free. I will stay in the conversation. If my patients who are often my friends are able to pay me, I ask that they do. When they do, I know that they truly value what I have to offer, and that is a gift. THANK YOU.

One definition of intelligence is the ability to hold two conflicting ideas in your head at the same time. Sometimes the evidence doesn't all point in the same direction.  Sometimes it takes gathering a great deal more evidence before the complex big picture comes into focus.

In fact, that ability to say "I don't know" can take years to learn.  But when you know that you don't know, you become ready to learn.  And I would say that learning is part of healing; it is when we discover what we were doing wrong, and how to do better.  This learning is the process of growing up.

Here are the 2 true things:

1. You are the foremost authority on yourself.  Nobody knows more about you than you do.  You are the only one who can feel what it feels like to be you on the inside.  

2. There are things about you that others can see, and you cannot.  This is part of the human condition.  Even when we are provided with a mirror, we can avoid looking into it.  We might avoid people who will tell us things about ourselves that we do not want to believe.

I interact often with people who want to self treat for what ails them.  They look it up on the internet.  They study the herbs or remedies and pick what they think will help them.  Sometimes they do pretty well. 

More often, people fail in their attempts to self-treat because of #2.  The reason why they are unwell is something that they are unconscious of, or in denial about.  When this is the case, there is no replacement for seeking help.

I see this so much that I am redirecting my practice toward helping people with this process.  It is a shift toward energy medicine, toward spirituality, and away from science and evidence basis.  I understand things about people from being with them.  I know things from what they say, and what they don't say.  And I have neglected this part of my practice.

From this day forward I dedicate my practice to helping people, myself included, to see into the blind spots and dark corners of our psyches.  From this day forward I dedicate my practice to bringing us all home to a spiritual center where we can begin to integrate all the parts of ourselves, and recover true health.

He told us that we should not be using Osha. The herbalist explained how hard it is to grow Ligusticum (that's Osha's Latin name), that it has to be cold enough, that the leaf litter has to be just so and the moisture steady. It was a moral quandary because to harvest the medicine you dig up the plant's roots.  It's not sustainable.  And the plant was rare to start with. 

Twenty years later, I'm working in an herbal medicinary where we sell Ligusticum root in bulk form and tincture.  And we can't find it anymore.

Somehow this last batch of Ligusticum was amazing.  Maybe the plant always was.  As we try to replace the herb with something different in various respiratory formulae, we learn how hard it is to replace. There are lots of great herbs but nothing has the same clearing pungency. It's a shame.

This last batch was also very expensive.  Someone got top dollar for some minimally processed root, and here it is smelling like the best medicine anyone ever had.  I just made a 4 ounce tea formula with only 24 grams of Osha in it and the tea cost over $70.

My message to herbalists is to say goodbye.  Stop prescribing this wonderful plant, unless you can figure out a way to cultivate it.  I believe you can still purchase the seeds from Strictly Medicinal.  It's in the carrot family and lots of plants in that family are poisonous, so be careful!

Many of us use herbs.  We use use use, and rarely say thank you or try to help the plants.  Let us not be so selfish.  Use what grows near you, learn to propagate it.  Encourage it.  Protect it.  Help plants migrate to higher ground and cooler exposures if they need the cold.  And be grateful, because these wonderful plants are a gift.

The big news right now is the nearly 75,000 healthcare workers who are striking in the Kaiser Permanente system. What is Kaiser Permanente? It's an American integrated managed care consortium. What is managed care? It's the system by which mega-businesses corner people into using only particular healthcare services based on their insurance. In other words, you buy X insurance, you can only see X care providers and on X schedule. And the staff at KP say it's not working for them anymore, they're being squeezed and the mega-biz profits. They also say it's not working for patients.

The vast majority of Americans get their healthcare through managed care. What this giant system in effect does is leave out providers like me, who can't get a job there. They need care providers, but they won't hire naturopaths UNLESS we have another degree in something more conventional. What's especially insulting is that virtually everyone thinks that they know more about holistic healthcare than a naturopath. As if the years I've invested were for naught. In retrospect, it was clearly a mistake.

I went into naturopathic medicine because the conventional healthcare system failed me. An N.D. was the first person to actually help me, and another N.D. was the first one to actually understand and diagnose my problem. I didn't know that this credential would get me exactly nowhere in the "modern" medical system in the U.S.. I didn't know that chiropractors and acupuncturists have better luck getting paid by insurances.

There has been a lot of writing about the Art of Medicine. And there's also a lot of noise about the Science that underlies Evidence Based Medicine. Which evidence will you accept? All this noise tends to bypass the question of truth in all its complexity. In today's post-modern culture, truth is a fuzzy thing, unclear, unknowable, subjective and slippery. In today's culture, the only evidence that counts is either double-blinded placebo-controlled studies done by pharmaceutical companies, OR your personal experience.  It's nonsense.

What is true? It is true that we are each individuals, with different genetics, environments, and behaviors. We humans all share some basic physiology, and our anatomy maps to our species. It is also true that to be truly healthy we need more than what our commercialized medical system can offer.

A true student of medicine knows the magnitude of the challenge. There is more to know about human health and illness than any one person can know. Humans are inherently biased and susceptible to a wide range of delusions and denial. Businesses are not human and do not care about health. Profits are their motivation. Whether you think of medicine as an art or a science, you probably know that our modern money-grubbing mega-businesses are failing us. What you may not realize is that by paying for a particular insurance, you trap yourself in that dysfunctional system. If you have no money for other kinds of self-care, you get what managed care offers, regardless of how inhuman it might be.

Insurance is not healthcare. Insurance is a gamble, a bet. Insurance is paying in advance for what you hope you don't need. Seeking the care of a human that will listen to you and actually cares about your wellbeing, well, hardly anybody does that. It is beyond me why people place their trust in mega-businesses instead of each other.

This morning I talked to a friend of mine who is a pediatric ER doc, and she has covid.  She got it from a kid who came to the emergency room with a rash--it's a hazard of the job.  She at least tested herself for covid when she got symptoms, whereas a nurse that she works with is sick and didn't test.  My doc friend's husband also didn't test, and these folks are out in the world sharing the virus with you.  It will be with us forever now.

The FDA would like to increase the availability of a range of home-testing options, not just for covid. Now that the emergency use authorization for previous covid tests has ended, there's been a shift in who can do what, and in how the money flows.  The Cue brand home test is FDA authorized to be marketed to you using a "traditional premarket review pathway".  It's a NAAT test which is short for a molecular nucleic acid amplification test (NAAT)--it tests for DNA of the virus in your nose.

The kit will contain a "reader" that is battery powered, and cartridges which are disposable.  There is also an associated app.  It will give results in about 20 minutes.

The accuracy of the system is similar to prior testing options.  "In a study reviewed by the FDA, this test correctly identified 98.7% of negative and 92.9% of positive samples in individuals with signs and symptoms of upper respiratory infection."

https://www.fda.gov/news-events/press-announcements/fda-permits-marketing-first-covid-19-home-test-using-traditional-premarket-review-process

Anti-vaccination sentiment is still spreading in our communities. People have lost faith in the authorities and in the medical field, and they are finding their own way. Unfortunately for them, the decision not to vaccinate their children will backfire.

Just this morning I read that there is a Measles outbreak ongoing in Ohio. For months now I've been reading about a resurgence of polio in New York. And of course Military personnel will no longer be required to take the Covid vaccine. The backlash against vaccination (what people perceive as an assault on bodily autonomy) will result in an increased death rate from vaccinatable diseases.

It's not an easy question, when and how to vaccinate. I don't exactly trust the official recommendations either, because I know that the guidelines are created by a council packed with representatives of Big Pharma. I am sympathetic with those who are skeptical. And I see the writing on the wall. If you don't vaccinate smartly, you are destined to be diseased.

There are a lot of anti-vax media personalities and websites that are spreading a bunch of BS. You can't believe everything you read on the internet. Of course you know that. But you also can't believe everything you read that you already agree with. If you seek "information" that supports your current position about ANYTHING, you could be allowing Confirmation Bias to steer you into a trap.

Rather than seeking supportive information, seek out the information that tries to prove your belief wrong. Test your belief. Check your understanding against what the experts say. Check your medical knowledge against the CDC, or come bounce it on me. I am not parroting anyone's sound bytes, I am a true student of medicine. I am interested in scientific studies or background information that sheds light on the hard questions.

The problem with the anti-vax craze is that a lot of the so-called "information" is coming from people who have zero science background and very little understanding of the actual risks and benefits of vaccination. Unfortunately for the anti-vaxxers, their sources are misguided and downright wrong about a lot of things. And they and their kids will suffer and die as a result.

I am always one to look for silver linings, and this particular situation has just one, which is that a reduction in the human population would be a quick way to reduce our impact on the planet. We are destroying habitat and polluting air and water at such a rate as to cause massive suffering and death in the not-so-distant future. Anti-vaxxers are offering to remove themselves and their children from the human population which will be a boon to future generations who survive diseases because their ancestors were vaccinated.

It is unfortunate that simply saying the above headline to a person of color is now considered RACIST. Unfortunate because in the pursuit of health, it is helpful to understand a person's genetic makeup. You learn a person's genetic makeup by exploring their deep history. "Where did your people come from?" is a question I have used for years to begin to understand this. I get very interesting answers and stories.

It would be so much easier if everyone would do genetic testing like to assess their origins. If someone were to ask me "Where are you REALLY from" I would answer "I am a Euro-mutt."  If they pressed me further, I'd say I'm from "Northern and Western Europe, plus a trace of Polynesian islander". In spite of family lore and my blood type, I know that I am not descended from the native tribes of North America--unless 23 and Me (the gene testing I used) has mistaken Native American genes for Polynesian. I have no way to assess that.

Discussing people's origins and genetics is important in medicine. To really understand a person's evolutionary predispositions and needs, we need to know where (or better, WHO) they are "from".

I understand that people of color have long been harassed by repeated questions along these lines. I know that recently a British royal employee apologized and resigned after questioning an Australian official this way. The social ramifications are playing out as they must in this time of high sensitivity. As medical professional, I maintain that we need to be allowed to talk about our evolution and genetics, because if we cannot, we are deprived of a huge and growing resource.

Genetics and epigenetics will be part of the Future of Medicine. There is no avoiding it. Learning about a person's evolutionary origins is not racist in this setting, it is humanist. It is an attempt to understand, and to help.

Please be kind to each other. Regardless of variations in genetics and in appearance, we are all human. It is my opinion that all humans deserve a certain base level of respect and dignity. Give it. Without question. Work to recognize and deprogram your biases. Accept that not all words that hit your buttons are "racist" or sexist. Your buttons are YOUR biases, your programming, and only you have the ability to do something about them.

Image below: Skin with low melanin, and its layers.

The NIH (National Institutes of Health) has a website up where they are tracking people's home tests.  It's here: https://makemytestcount.org/ .  Many people, myself included, have taken a home test from time to time and reported it to NOBODY except my friends and family.  That does not help the public health people track the virus and provide for areas that are getting hit hard.  So I will be reporting self tests from now on, and suggest that you do the same.  By working together on this we help all of us!

A healthy friend of mine had Covid over the last couple of weeks.  She described it as the worst sore throat she'd ever had. When she described the testing that she had done it became apparent that she didn't know that DAY 5 is the day that you are likely to test positive--at least with the last few variants.  She tested herself during the first 4 days when she felt sick, and thought she didn't have Covid. She even went in for PCR testing.  All came back negative until day 5.

Experts say that the best way to home test is to test twice (or more) once you have symptoms, 48 hours apart. That's two DAYS apart, right?  Lots of people test just once when they get symptoms, and consider that test definitive.  It isn't. If that one test negative they think they have something other than Covid, but that could be a terrible mistake.

The message here is Don't Trust negative Covid tests before day 5 of feeling symptomatic. If you test negative after feeling sick for 3 days, and spend time with someone who then spends time with an elderly relative, you could conceivably cause the elderly person to die. 

This is why the new normal is to stay home if you feel sick.  Don't go to work.  Don't go be social.  Take the opportunity to rest and relax.  You know you need it anyway.  Take the time and slow the spread.

Oh and by the way I got my bivalent booster 2 days ago and I did not have nearly the massive response that I had to previous vaccines.  To me this means that I have not yet had the new variants that they are vaccinating us against.  This vaccine is FREE and it's available NOW and I recommend that as many people get it as possible, because it is still our best tool for limiting severe disease and death during the spikes that are going to come this winter. 

Go get your bivalent Covid vaccine, says this naturopath.  Why does this naturopath say get a vaccine?  I don't say you should get all vaccines, I say you should pick and choose.  Get this one because it will save a lot of lives. Because the benefits of the previous Covid vaccines far outweigh the risks, according to the science.  And believe me, I do look at the science.  I am even trained to recognize bogus "science" which is definitely out there.

Should you listen to the CDC?  I say yes.  They are on the comeback from a period of political distortion and I trust them more now than I did last year.