By Jack Temple, MS IV
For the past two months I have been on the road and in the air. It is “interview season”. I, like many other fourth-year medical students, went shopping for a new suit, learned how to act as my own travel agent, and zig-zagged my way across America visiting as many Internal Medicine training programs as possible. My hope, and the hope of all the other US and foreign medical grads, is to match with my dream residency program.
Last week, I sat down with Dr. Edwards in a Spartan office, the kind of multi-purpose room that has certainly seen its fair share of interviews. He was sitting across from me, flipping through a folder containing my CV, application and letters of recommendation. I watched as he traced the page with his index finger then stopped with a slight “Aha” reaction.
“What is this LEAPS Program?” he asked looking up at me over his reading glasses.
“Ah, the LEAPS Program!” I sat forward on my seat, eager to share what I had described in countless other interviews.
“LEAPS stands for the Leadership and Education Program for Students in Integrative Medicine. It is a one-week immersion into Integrative Medicine for medical students that takes place at the Kripalu Center in the Berkshire Mountains. This was hands down the most important, and the most enjoyable, week of my medical training. I collaborated with 20 passionate, like-minded students. I was taught by an amazing faculty of physicians who practice with an integrative approach. Most importantly, I was inspired to become a leader in this community.”
Dr. Edwards glanced up skeptically and kept shuffling. “Integrative approach? What is that?”
I went on to tell him that, during nearly all of my interviews, I have been asked how I define Integrative Medicine. The vast majority of my extracurricular work throughout medical school has focused on Integrative, Complementary and Alternative Medicine.
He stopped me right there. “I’ve been hearing about such things during the past few years. At first I dismissed them. But it’s becoming more and more common to hear people saying that they are going to an acupuncturist, or getting massage, or doing yoga … not my patients, mind you, because they are poor. But others in the community, my wife’s friends, for example. I still think it’s a bunch of hooey. But you seem like a serious young man. You are calling it Integrative Medicine. What is that?”
“I prefer to call it Integrative Health. Integrative Medicine implies that this practice is focused on providing alternative or complementary therapies to work with or substitute for allopathic medicines such as pharmaceuticals. Integrative Health, on the other hand, describes a holistic approach, focusing on the root-cause of imbalance and illness in a person and working within his or her entire psychosocial context to create real change. The main focus of Integrative Health is on movement, nourishment, mind/body/spirit disciplines and allopathic medicine.”
Dr. Edwards looked thoughtful and gazed at me. “As you can see, my patients are poor. Most of them can’t afford such things.”
“Integrative Health has been around for millennia, and has been used by people from all walks of life,” I replied. «In fact, it is the only type of healthcare available to a large portion of the world’s population. Many elements of Integrative Health are inexpensive or even free. For instance, movement therapies such as Tai Qi, yoga or dance, for that matter, are free. Mindfulness, meditation and breathing exercises are free as well and can be very effective.”
I paused, but decided to keep talking, because he had stopped shuffling and was listening intently. “Just a couple of months ago, I was caring for an otherwise healthy 50-year-old woman who presented to the emergency department with back pain. Tests revealed she had multiple myeloma (this is a serious bone cancer).
“I was with her when she was told she had cancer. I saw the fear in her eyes accompanied with denial and pain. I pulled up a chair, placed my hand over hers, and guided her through the process of becoming aware of her breathing, to feel her breath in three parts: belly, ribs, chest. Through the simple act of conscious breathing for a few minutes her initial shock began to dissipate.
“Then I held her thumb in the palm of my hand. I started a basic Jin Shin Jyutsu finger hold progression that I learned at LEAPS. I spent two minutes on each finger progressing from the thumb to the pinky on each hand.
“I explained that I was guiding her through an ancient Asian energy medicine technique that helps move energy. She could do this on her own anytime she felt stressed, worried or anxious. I told her it has helped me with pre-test anxiety and frustrating moments on my medical rotations. I printed her off some more information about Jin Shin Jyutsu then offered her privacy to digest all that had transpired.”
Dr. Edwards was still attentive. I was surprised, and decided to keep talking. “This is just one example of Integrative Health. A noticeable shift occurred with this woman in the 20 minutes I sat with her. She seemed calm, collected, and like she was able to face this new and terrifying diagnosis. Her inner healer, the intangible drive for a body to recover, seemed ignited. Related to your question, this entire process cost nothing more than 20 minutes of my time and 10 cents worth of paper. Integrative Health is not synonymous with affluent medicine.”
Dr. Edwards and I spoke for a while longer about this story. He had many questions and, at the end of the interview, he thanked me for our conversation. That was a first for me, and it gives me hope that his program will look favorably on my application for residency.
Now that my interviews are finished, I can turn more of my attention to two upcoming Integrative Health retreats that I am facilitating.
I am currently planning the “Humanistic Elective in Activism and Reflective Transformation” (HEART), a four-week-long immersion experience for fourth-year medical students held in the Redwood Forest of California.
HEART’s program has some similarities to the upcoming International Integrators Living Whole retreat. We learn to cook whole food, plant-based meals and serve the community. We engage in movement through hiking, yoga and other disciplines. We explore our mind/body/spirit connections. We draw inspiration from the redwoods. One main difference that is important to me is that Living Whole can be attended by anyone interested in Integrative Health, whether or not a health professional, and certainly not only by medical students.
For me, Integrative Health is the process of deeply understanding ourselves. As health care practitioners, we focus also on understanding our patients, their motivations and unique health beliefs, working within this context to provide the best quality care. The approach, as always, needs to be a well-considered one. To quote Dr. Andrew Weil, I am an “open-minded skeptic”, and if the therapy is not likely to harm the patient, has shown reasonable efficacy and is not prohibitively expensive, it is worth considering.
I am now finished with interviews. During the next month I will carefully construct my “rank list” of my favorite programs. March 20th is Match Day for residency programs, an event with tremendous pomp and its fair share of circumstance as well. Undoubtedly I will be very anxious and excited, and will take a moment to turn to Jin Shin Jyutsu and work though my finger holds. Then, I will open an envelope revealing the program where I will train and the city where I will live for at least the next three years. I know that Integrative Health will underscore my entire approach to residency. Even when I am on a night shift in the intensive care unit, I will find a scrap of time to sit and hold hands with my patients, offering them Jin Shin Jyutsu, whether they are conscious enough to realize it or not.
Jack Temple is nearing graduation in his fourth year as a medical student at Rush University. He will be a facilitator at Living Whole, an immersion retreat in March in the Redwood Forest of California, sharing his experiences with mindfulness-based stress reduction, hiking and other passions. Jack and his fiancée, Nabeelah, live in Chicago.