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THE PATH AHEAD

Brilliance versus . . . Blinders (?)

Joseph Pizzorno, ND, Editor in Chief

s I listened to Bruce Ames, PhDwhose many contributions to medicine had been recognized in 2001 with the first Prize for Health Research from the Linus Pauling Institutetalk about his insights and discoveries during a special roundtable event at the 18th Annual Symposium of the Institute for Functional Medicine (IFM) this past April, I was struck with the question: Why? How is it that Dr Ames made such advances to our knowledgesuch as the Ames Test (a biological assay to assess the mutagenic potential of chemical compounds) and his theory of nutritional triage (which I will discuss in a future editorial) when others have not? He is obviously exceptionally intelligent and hard working. But so are others. He also likes to get his hands dirty doing real research on the bench and with animals. But again, so do others. Nonetheless, many of the others seem to have instead dedicated themselves to what I can most kindly describe as obfuscation (more below). During this IFM roundtable event moderated by Jeff Bland, PhD (who received the Lifetime Achievement in Functional Medicine Award from IFM at this years symposium), those who have been recognized with IFMs own version of a Linus Pauling award, the Linus Pauling Functional Medicine Award (the list of past winners can be seen at http://www.functionalmedicine. org/news/generalinfo.asp), also had an opportunity to say a few words about their insights in medicine (including yours truly). Along with Ames, another notable speaker was Sid Baker, MD, who spoke about his 2-tack and get in/get out rules. I strongly encourage all to listen to his Principles Based Medicine lecture presented at the 2011 IFM Symposiumtruly outstanding! (Its available from Tree Farm Communications, https:// treefarmtapes.com/default01.asp.) As I listened to one speaker after another, a possible answer as to why these individuals gained such transformative insights began to emergeeach award winner seemed to have the ability (in addition to intelligence and hard work) to step back from, understand, and apply the importance of their work in a bigger context of clinical relevancy. But that was not enough; they also had to have the courage to go against the customs and even strictures of the prevailing conventional medical system to speak the truth they had come to believe. (And if you have any doubts about the courage needed, look at what happened to the early naturopaths who were prosecuted for such outlandish ideas as the need for healthy diets and avoiding toxins.) Yet, there seemed to be 1 more criterion: Their concepts had to be fundamentally the Truth. It reminded me of John Bastyr, ND, DCs, adage to us young students back in 1973 when all looked very grim indeed for naturopathic medicine: No matter the obstacles they place, the truth of the medicine will out.

So I think this is what struck me most deeplythe ability of these special people to see and articulate the Truth of the new medicine we are creating. I realize this is not politically correct when everything is supposed to be relative and the world is seen as shades of gray with no absolutes. Well, I have never been particularly politically correct. The Truth resonates with us (at least those with an open mind) in a special way. And when a deeply wise clinician presents us with a fundamental insight, we immediately recognize it. This problem of blinders was brought powerfully to my attention a few years ago. (Names withheld to protect the innocentand the guilty . . .) A wealthy friend of mine whose life was saved by a highly skilled cardiac surgeon was asked to make a very large donation to fund a cardiac research center. He indicated his interest, but only if the proposed center engaged in integrative cardiology research. They assured him it would. Well, he did not become wealthy by chance. So he invited the cardiologist and his colleaguesanother cardiac surgeon and their fundraisersto have dinner with him and his wife, as well as my wife, Lara, and me. We had a great dinner, and they were certainly interesting people. The conversation then focused on the proposed integrative cardiology research center. I asked them what they had in mind and was told they were excited about including music therapy and perhaps some yoga along with cutting-edge cardiac procedures. I told them I thought this was fine, but that there was a lot more they could do. I first suggested that they consider supplementing their statin drug treatment with Co-Q10 as it would help alleviate some of statins potential for adverse events. The cardiologist asserted that there was no research to support this, and he did not want to waste his patients money. Those who know me probably will not be surprised when I literally pulled out of my pocket 6 abstracts documenting that statins do indeed impair the production of Co-Q10, that this results in side effects, and that supplementation prevents most of them. I thought he would find particularly interesting a study showing that, in some patients, statins cause a decrease in cardiac output, which is reversed with 100 mg/d of Co-Q10.1 I then told him I had another dozen references at home that I would be happy to email him. His response, Dont bother; I wont have time to read them. Hmm . . . The conversation continued. I then asked him about his success with stents, and he regaled us with stories of men and women whose lives he had saved. There are situations where high-tech medicine can be miraculous indeed. I then noted, But, as you know, many, if not most, of those patients will restenose within 5 years. He became quite angry and stated, But they

Integrative Medicine Vol. 10, No. 3 Jun/Jul 2011

PizzornoThe Path Ahead

This article is protected by copyright. To share or copy this article, please visit copyright.com. Use ISSN#1543-953X. To subscribe, visit imjournal.com.

restenose somewhere different from where I put in the stent! The conversation went downhill from there. He did not get the donation. Why is it that, after successfully performing thousands of stent operations, cardiac surgeon Mimi Guarneri, MD, FACC, noticed that the same people were coming back again after 5 years and started to ask questions about this phenomenon when this other dedicated physician did not? Dr Guarneris insights gained from wrestling with these questionsled her to overcome many obstacles and ultimately to found the Scripps Center for Integrative Medicine, which now provides true cures for cardiac patients. Why was this other smart and skillful cardiac surgeon content to remain in his bunker? What connects the men and women who evolve our understanding of medicine and advance our ability to assist in true healing? Certainly, all share the ability to have an open mind, to pay attention to the real data, to think outside the box, to ask the uncomfortable questions. But that is not enough. These special people must also be able to discern the truth from the wishful or misguidedand to be courageous with what theyve learned. I think that is what the new medicine is about: Seeing what is really happening in health care, understanding what needs to be done differently, and having the courage to make it happen.
In This Issue

Our readers are encouraged to submit case studies of their experiences treating real patients with integrative medicine. Weve an informative example this issue from Mohammad Amin Nezami, MD, where he describes effective treatment of a woman with multiple sclerosis using a novel nutritional protocol. In integrative medicine, we often talk about the importance of treating the whole personmind, body, and spirit. I think we often fall short on the spirit side of the equation. Helen Meldrum, PhD, approaches this challenge by interviewing 14 winners of the American Medical Associations Pride in the Profession Award to learn about how they conduct themselves when spiritual and religious topics are present in the clinical encounter. One of the challenges with the growing popularity of IMCJ is that sometimes it takes us too long to move an article from acceptance to printing. The review article on micronutrient treatment of mental disorders by Bonnie J. Kaplan, PhD, and Brenda Leung, ND, MSc, is an example of an article that I think will be welcomed by clinicians and that I wish we could have gotten to you sooner. I especially appreciate their thesis that short-term intervention and single nutrient thinking is nave and ineffective. While my area of clinical strength is primarily in metabolism and biochemistry, I am fully aware of the importance of biophysical approaches. Therefore I appreciate the original research by Gatan Chevalier, PhD, and Stephen T. Sinatra, MD, FACC, FACN, CNS, on the effect of grounding on emotional stress and physiological parameters. Statins are an interesting class of drugs in that, in general, the benefits outweigh the adverse events. Wonderful to have a naturopathic doctor, Ryan Bradley, ND, MPH, write a well-balanced review supporting the use of statins when indicated.

As I have mentioned here several times over the years, for this medicine to advance we need to pay attention to the politics/economics of healthcare. Fortunately, John Weeks continues to help keep us informed. I find very encouraging the growing body of research documenting the cost-effectiveness of integrative medicine. In Green Medicine Tips, Joel Kreisberg, DC, MA, discusses the unintended danger of unused medications. I was unaware of the surprising magnitude of the problem of childhood poisoning and even death from the unsupervised consumption of prescription drugs. The problem is even worse when we also consider environmental effects and misuse when donated to underserved countries. Thank you, Joel. With the continuing increase in the number or prescription drugs, this is an important wake-up call. As our botanicals become ever-more potent, I suspect we will see problems with them as well when not properly disposed. Thank you Bill Benda, MDperhaps your best Back Talk ever. Anything I could say would only tarnish your eloquence. Last, we are again running some of our favorite articles from the first 50 issuesjhx in the section IMCJ Retrospective: Fundamentals of Integrative Medicine. Included is the 4th article in the Lens Series by Sidney MacDonald Baker, MD, Looking at the Membranes and Boundaries of Patients. We are also reprinting Are Additional Lipid Measures Useful? by Ryan D. Bradley, ND; and Erica B. Oberg, ND, MPH. This article serves as a handy primer for Dr Bradleys statin article in this issue, mentioned earlier.

Joseph Pizzorno, ND, Editor in Chief drpizzorno@innovisionhm.com http://twitter.com/drpizzorno

References
1. Silver MA, Langsjoen PH, Szabo S, et al. Effect of atorvastatin on left ventricular diastolic function and ability of coenzyme Q10 to reverse that dysfunction. Am J Cardiol. 2004;94(10):1306-10.

COMMENTS? CURIOSITIES? CONCERNS?

We always welcome feedback from our readers. In fact, your input is invaluable to us. If you have a comment you wish to make, an article you cant wait to write, or are just in the mood for a friendly chat, please drop us a line. Wed love to hear from you! E-mail: drpizzorno@innovisionhm.com

PizzornoThe Path Ahead

Integrative Medicine Vol. 10, No. 3 Jun/Jul 2011