Tuesday, December 2, 2014

Becoming the Teacher

Just sat down for breakfast with mother-in-law and we were talking about -purpose in life.  I was actually trying to reveal to her a new "teaching job" that she is symbolizing  by having the grand kids witness the respect and care we give to our elders.  She was a servant of the church and with current physical limitations, the feeling is that with no further means of self care and transport, there is no further service to be offered.  (I think letting go of independence is difficult for anyone; in addition when one transitions from 25 hours a day of work to hanging out and watching Church TV, self worth can be broken down to being more of a burden than a servant).  Discussion made me think back to my grandmother.  I only remember one time in my youth (about when I was 3 year old) when I was in the back seat of my Dad's car and grandma let me place my head on her arm (my Lola Mac had chubby arms and compared to 1960's car upholstery she was my comfy pillow!)  I remember the love my parents showed toward Lola and although she wasn't in my life much, I had great respect for her.  This observational lesson relates to my mother-in-law now and the unconditional love and respect I give to her even if she is not able to contribute to covering bill paying or reliable babysitting.  Hopefully my kids experience their memories that stick for life as I age and lose independence.

In residency training, we rotate through all the departments of the hospital to learn application of medical school didactics to real world patients.   I translated that to "stealing techniques" from  supervisors and building my repertoire of knowledge.   As I progress up the ladder of learning, I am privileged to sit and speak with some of the worlds greatest minds in medicine and healing.   With the death of my mother in 2009, the feeling of being bullet proof with no time for being sick had quickly dwindled away.   My doctor skills self diagnosed reactive depression to her loss so I did what any family medicine doc would do, I prescribed therapy for myself.  (But I did it in the disguise of taking courses to satisfy state requirements for continuing medical education!!)  So here I am sitting in front of guys like David Simon and Deepak Chopra, Andrew Weil, Tierona Low Dog, Wayne Dyer and listening to these present day sages speak in modern medical terms but translate ancient information on the power of the body to heal on it's own.   The information presented is very empowering and I feel a great urgency to share knowledge with patients.....only problem is that the bulk of my practice is in immediate care and there seems to be no time for educating on how to maximize healing with mind body medicine and nutrition.    So I tuck the information away and continue "band aid medicine" wondering how and when can I apply all this knowledge....or even if I am supposed to do anything with it.  (I do cool video tutorials but short of a few views....the world is quiet)

Then the unthinkable happens and I am called by my Dads neighbor about the worst experience anyone is not supposed to have.  I rush to his bedside and during my Dad's last 2 weeks on earth, I was grounded by the fact that all the healing I went through while attending classes with the giants of medicine had been to support me in my journey.  The man who created me had given the biggest lesson that I was to learn:  heal myself the way I would heal others and everyone will prosper.   Turns out the guy who inspired me to become a doctor also became my greatest teacher during his final hours.

I am reluctant to take the torch of knowledge and pass it onto others....mostly due to the selfish reason that in becoming a teacher means there will be an eventual student/class/community that goes on after me to do more things (realizing my own mortality).   Seeing my teachers go through to their next summits, helps me realize that it is my duty to pass the knowledge onto anyone who is willing to accept it.   In this current dynasty of information/technology, the knowledge of healing is coming at light speed and seems fantastic and exciting.  So there is a bit of honor to know I can "handle the torch" but equal apprehension on the volume of knowledge I have to pass.   Stay grounded, eat mindfully and keep moving....
.....my time at the front of the class should be awesome!   Thank you for direction Guru's!

Andy Weil

Tierona Low Dog
Claire Diab
Herb Benson
David Simon
HMI and Joseph Helms

Deepak Chopra
Ossie and Nora Saguil

Sunday, November 23, 2014

At Peace Inside/Creating Peace for Others

It's been 3 months since I said goodbye to Dad.  Through introspection and soul searching, I was able to accept him being gone but more importantly understand that his spirit/memory/legacy is more important to my future than ever before.  I used to tap into his wisdom asking for advise whenever life was challenging.  He served as a grounding force for me.  I remember a picture he painted for me in high school when I was frustrated in fixing a car; when ever he would get flustered in surgery and what he planned wasn't working to save a patient

-he would pause/step outside the operating room/let go of the frustration/return with a sense of peace and calm.

I carried his teaching with me into my practice of medicine.  When a patient presents to me and seems complicated, frustrated, suffering without hope; I help them step back, ground, recollect strength and set goals.  No matter what the disease or how advanced it is, there is always a way to find peace again.  Medicines and surgery may help but it is up to the patient and his/her spiritual team to reconnect with the most abundant form of healing-the Universe.  I often run into people (guys especially) who see the world in concrete terms. "Life is a biological process and events that occur are purely coincidental without any spiritual connection".  I personally believe in God but don't force others to follow how my parents raised me.  I see that when all hope is erased from someone due to medical complications or a terminal diagnosis, if the person I am examining has no spiritual practice or belief....they are essentially at a very dark abyss with no light.  When that realization sets in, fight or flight is turned on every minute of every day until the adrenals are just burned out and can't produce enough adrenaline/epinephrine to keep up with daily suffering.  At that point, they are still at the abyss but just so fatigued and depressed that jumping off seems the only way to end the suffering.  My goal in the 60-90 minutes I spend with them is not necessarily to cure the diagnosis they arrive with but more to help them....

-step outside their frustration and return to a sense of peace and calm

It is proven with developing a meditative practice (or just practicing mindfulness) that brain tissue grows, DNA gets turned on, white blood cells work more efficiently and the adrenal cortical system slows down.  At the least; a patient suffering can step back from the abyss for a while.  At the most; the trillions of self repairing/designed to exist/never taking-a-break cells can function at their peak to fix what toxins/damage/trauma has been presented.  I can usually create a plan for lifestyle change that I review after printing and wonder ...."where do I get these ideas?!".  It usually comes from an article I read a few months back/or a lecture I attended during fellowship training or with a previous experience in my past.  Regardless of how answers come, I have to be in a state of peace or else my brain can't pull these ideas together and I don't get to tap into that message that resonates inside me while face to face.  (The opposite happens in most medical practices-when the doctor is flustered and stressed and hungry; creativity decreases and problem solving just reverts to an algorithm so the patient is turned into a statistic and standard therapy is prescribed).

I don't mean to say every doctor should spend 60-90 minutes with their patients.  With reimbursement the way it is now.....all medical offices would be bankrupt in 12 months.  When I work the immediate care (my main source of income) I am moving quickly (I reluctantly admit to seeing a patient every 10-15 minutes) but in this setting, I justify it as important for people to start the healing process early to decrease time off work/infecting other family members/decreasing pain/stopping vomiting......and I have to work these numbers to help show that there is a need for the hospital to keep an immediate care center open and de-fuse the ER.  (Not to mention cutting back on the spending government insurance pays for patients with no docs to be seen quickly).   Today at noon, 9 people walked in at the same time and I had an immediate wait time of 1.5-2 hours (if I spent less than 15 minutes each)....and more people continued to arrive (cough/cold/flu) pushing back the wait time further.  I could have freaked out and showed my frazzled state to each patient I greeted but I chose not to.  I sat through the 21st day of  Deepak and Oprah's Energy of Attraction and remembered the centering thought "My presence creates peace".  I had to be the beacon for the staff to stay calm and the patients to know they will be seen and attended to 110%.   (I had one patient that was coughing for 7 days, getting worse and worried she would have to cancel her breast cancer double mastectomy next week......and here I am worrying about getting out on time and having something to eat!)

During my Dad's last 2 weeks on earth, I stayed by his bedside and scrutinized every specialist, reviewed every order in his chart, made suggestions and "controlled his case".  I didn't want him to go and I saw rays of light when I reported to the family daily progress.  In the end, Dad decided to leave on his terms, at his pace....no matter how I had the medical team intervene and no matter how many hours I stayed up next to him.  Dad became part of what Lao Tzu calls "invisible forces" and his final lesson to me was:

-step away from chaos, comfort others by becoming peace....and purpose in life will find you.

Dad knew I was adopting healing traditions outside the standard medicine and I was still searching for how I could fit in with "my kind" of practice. The day I cremated him I received a call from my old medical director stating she wanted me to join her in private practice.  We hadn't spoken in 10 years!!!  I asked her why she decided to call me at that specific time....said she had been thinking about me for the last year but was "drawn to reach out" on that day.  I then heard from a physician recruiter at the Advocate Sherman Hospital....we had spoken in the past but she was "praying for an answer" to find a physician to spear head a new medical center being built!!! Whether you believe in God, a higher source....or have no spiritual "insides"....at the least, these happenings are way too coincidental.  I feel it's my Mama and Dad/the Universe telling me that when life doesn't seem to be going the right way, maintain mindfulness in the emotional tsunami and the right path off the abyss with show itself.

Tuesday, September 9, 2014

Shifting Gears

As of August/September 2014, I have been a witness to the inadequacies in insurance based medicine.  The old adage of when you have a hammer everything looks like a nail is still true.  The talents in some of the doctors graduating from medical school is fantastic.  Unfortunately, there are also some very average healers out there.  The problem is if you have someone fighting for your life, it would improve the odds of survival if that person was as committed to maximizing health as you.  On a good day, in the morning, after a good meal and sleep....most doctors will probably be "on their game" in problems solving your predicament.  But as you know, most people "on call" for the ER probably slept poorly.  Most people trying to get through Monday morning traffic to arrive on time for office hours probably have been through 2-3 episodes of being cut off before arriving at destination.   Most people running late in the office are contemplating how to apply the "care algorithm" for your 2 biggest problems and delay addressing the others down the list until next visit.  Most people by the end of the office day have not eaten properly and are saving the most urgent calls for immediate call back and postponing other messages so they can "get the hell home" and let the office staff deal with the left overs.  Note that the higher you go with medical training (the sub-subspecialists) the less likelihood a response will be.

Speak of the devil, I just got a text from my wife.  She is in Florida caring for a relative who is being released from a chronic care facility as the insurance just ran out on the 20th day.  The nurse was teaching how to give an insulin shot to a newly diagnosed diabetic.  She was also teaching last minute (right before discharge) education on high glucose foods choices.  Some of the info was wrong....see this picture for the "average diabetic hospital meal"

....if this meals looks like it is sustainable to you then you are probably very thin, meditate and exercise daily.  This will be an eventual failed nutrition change that a patient will use to fall off the wagon and go back to eating starchy salty foods ....or go back to smoking, drinking and watching TV/with no exercise.   

Thinking outside the box is very important for designing lifestyle changes.  As well it is helpful for maximizing survival if in a hospital.  I watched as my father suffered a catastrophic medical event, and then was witness to sustaining his life for his last 2 weeks while in CCU, step down unit, surgery, ICU then hospice.   The hospitalist was outstanding and listened to my concerns.  The initial neurosurgeon was hard to speak to, and gave black and white answers quoting statistics (so giving the average answer.....treating my Dad as a nail).  The neurologist and 2nd neurosurgeon were excellent.  The pulmonary doctor who we didn't need (of all people!) was the most compassionate and helped with the ultimate decision of withdrawing all lifesaving measures.   Biggest problem I have is with the initial doctor who evaluated him while the event was happening.  12 hours prior to event, Dad was a 78 year old independent "grandfather" who was complaining of double vision.  If the doc may have investigated further, the brain bleed may have been halted sooner.   (...but what do I know, I'm just a primary care doctor who thinks anyone with double vision, headache and on coumadin should be considered for a CT scan stat).  This is the ultimate slap in the face that if someone is not invested in the care of every patient that s/he greets "hello"....then you are ultimately being treated as a nail by a healer with only a hammer.   

Having been educated by Andrew Weil, Deepak Chopra, Joseph Helms I have imbibed the idea that the current paradigm of insurance based medical care is not the only way to heal.  There are "energy based" whole systems of medicine that have been in place for 2000-3000 years.  Some people don't identify with the artsy-fartsy softer science of healing but one doesn't have to be trained in it....just have to acknowledge it exists- so if all else fails, entertaining another path may get the suffering expedited.   (suffering of the patient in pain/suffering of the family in sorrow/suffering of the community in loss of productivity/suffering of the nation in the burden of medical bills for procedures).  I love what my gurus have taught me about being more than just a hammer.  I believe it has helped my family stay safe.  Followers of my suggestions/videos can attest to a happier level of functioning.  They can also witness the disease that presents in others who don't follow my suggestions (got some 30-40 year olds that are the living embodiment of what happens when you don't exercise, don't eat mostly a plant based diet and don't learn to meditate/be in nature/practice yoga-pray for them!please!)  

Sometimes the only way to help people realize the changes they have to incorporate in their lives is the threaten.  Like any fight or flight response, threatening a heart attack or cancer will be effective only for a short time - until the f or fl response is extinguished.  It is then up to the patient to grasp the great feeling living with a springier step, faster injury resolve, better digestion, better sleep in order to keep lifestyle changes going.  More recently, one of the bigger ways for lifestyle change maintenance has been to have a little taste of the catastrophic event.  Perhaps this is where modern medicine is good.  With all the surgical techniques and expensive medicines available, we have been able to reverse some events temporarily.  So some people get to feel what a heart attack is like, what a round of chemo therapy does, what getting around with a handicap placard is like.  For them, maintaining lifestyle is inevitable or they go back to the same negative experience.  But what of the 500,000 people that will have their first heart attack the the last thing they feel?  This is where family can come in handy.  What ever the way, your average American will have a catastrophic event occur before 50year of age.  Shifting gears before the event happens is so crucial to improve survivability.  If the patient doesn't care-the family might; if the family doesn't care the community might; if the community doesn't care the nation should.  The burden of the sick is on the backs of the surviving.  

Sunday, July 27, 2014

LUCY (spoiler alert)

Just finished this movie written and directed by Luc Besson.  I went for the action and CGI but was amazed to experience the emotion he was trying to convey.   The previews were "tasty" to movie goers looking for car chasing, guns, drugs and human blood.  Weaved into the scenes was this recurring theme of enlightenment. Watching this made me feel validated on my search for deeper healing/medicine with some of our modern day sages (Andrew Weil, Deepak Chopra, Herb Benson).  I had been on a journey to quench a thirst that the standard 200 year old texts we use for learning health are not the answer to understanding the healing power of  inherent human energy.  This energy is replicated and passed on via DNA in efforts to improve the vessel that is doing the passing.  If the vessel evolves, the universe benefits from the improvement in energy shared.   When the universe benefits, the vessel is supported to "do more".  A win win scenario to this existence.

First scene was bloody involving Asians underworld and drugs.  Innocent American  thrown into a frenzy of killing and contra ban-typical opening action movie.   The twist is when a man made substance used to bring a depressed society (with rotten teeth and poor health) into a few seconds of high/happiness- actually unlocks the path to the ultimate existing in infinite bliss. The rest of the movie was a roller coaster  used to carry viewers to the directors message of universality.  The reason most dont experience it- we have not learned to apply the true power of the mind.  Humans have just created a scaffolding of science and math to help teach knowledge and intelligence.  The problem is when the vessel passing on the information cant continue to grow/evolve due to the limits of the language the vessel created.

Knowledge is empowering, teaching is fulfilling.  I think we get too bogged down by the concept that we are all individuals and "I have a better concept" instead of "how can I can help".  We are hardwired to be heard, to be acknowledged, to feel good about being part of something (contribute).  This built-in message in our individual DNA proves we are all connected.  Ultimately we are all vessels built by a universe to contribute to its constantly flowing energy.  I believe society has destroyed this message of wanting to be acknowledged (to be liked on facebook).  The social media has taken us away from the beauty in finding our strengths and purpose in life and instead has cultivated the urgency of going for the fast reward of posting or creating what ever gets people to say WHOA!!!   Creating what is in your heart takes effort and energy.  Shooting a gun, crashing a car, stealing is has high shock value but doesn't chisel out the reward that is hidden in the bolder of a sculpture, in the paint brush of an artist or the soil of a gardener.  Our modern use of the internet has united a world separated by continents but has also stagnated growing artists healers and nurturers.

The proof to my contemplating: in listening to the moviegoers discuss what they just watched, I heard one gentleman saying to his younger texting companion:  "if you get uncomfortable with the emotion the director is trying to convey and go straight the your smart phone to feel comfortable again.....you will just have to start all over again in building up an emotional level the actor/story teller is trying to bring you to."   I liken it to computer games and ADD- if young people are constantly bombarded by speed, sound, visual experiences that demand focused attention, it will be hard to "unplug" and experience the true rewarding power of nature/the universe/existence.  That part of the brain that is getting the the stimulation programed into a computer code is small compared to the part of the brain responsible for creation, happiness, love.   Thing is, the computer programmer has found a way to deliver the "caffeine rush" to the fight or flight brain-parts that bypasses traditional "unlocking" of the reward system built in our DNA.  If given a choice to effortlessly get a caffeine rush vs read, learn, interpret, create....most people will choose the proverbial apple in the garden.

The point I was able to arrive at with Lucy: when we only go for the apple in the garden, we don't learn to utilize the massive gift created by the universe.  The vessel we exist in may have evolved from homosapien to modern day Prada wearing creatures of plastic surgery and hormones but our minds are still functioning at a little higher than cave man status.   Bottom line with Luc Besson's creation; it delivers the visual reward for Hollywood but also has the hidden lesson that we are all interconnected not only to each other but to nature/the universe.  "I am everywhere" (I give it 2 thumbs up)

Wednesday, July 2, 2014

The Duality of Healing and Healthcare

I just got tagged for 4000.00 malpractice insurance payment and a 700.00 license renewal.   I spent 2-3 hours on a "mandatory" online education that was supposed to take a few minutes.   Multiple meetings to make sure all doctors are "on the same page"- making diagnosis and treatment plans universal.   Yet my malpractice climbs every year (even though in 20 years I have never been sued); reimbursement falls every year; my paycheck is the same as a 27 yearold just getting out of residency training (since the Kelly Blue Book says all family practice doctors should be practicing and making about the same all over the US).
Most of the doctors I know went straight from college to medical school to residency (a few of us to fellowship and a handful to a second fellowship).  Suffice it to say, most of my colleagues have not been trained in business so running an office is a tough learning curve we don't have time to do the correct way - going back to school.  This is why many choose to be an "employee" of a large corporation so you can practice with "autonomy" and leave the business to the hospital administrators.  But your med school guru didn't teach you that if your practice is run by a non medical human, compassion and time are not in the formula for turning a profit.  If a director has to answer to a board, he won't be saying "our doctors are very loved by the community, one of our physicians gave a great lecture at a local high school, we had a doc interviewed on television".   The director report is real time paper/graph generated results with prospective graphs for the future and comparison statistics to local competition.   I will never forget working for a Hospital in the Center of Dupage, the immediate care centers in the 90's closed doors at 9-10oclock to save on electricity and payroll.  All the centers except one; this Convenient Care just happened to be in the neighborhood of several board members in Wheaton!!!  (the rumor was it was closer to the Wheaton-ites than going to the hospital so they were advised to stay open later)    Alot of hospital high ranking administrators will want their employees to streamline, follow protocol, not give away anything but yet whenever I hear a COO/CFO is bringing his kid in or a board member wants to be in and out quick....it sounds like the people that make the rules of how doctors are supposed to heal, follow a different set of rules.
If you look at how much sacrifice was spent in school, how little reimbursement is given for invested problem solving, how much time is lost away from children and spouses/ waking up answering phone calls in the middle of the night and seeing sick people in the hospital.....and compare to a business major finishing college, starting a company, hiring employees (doctors) and starting another business-it doesn't compare.  It used to be an honorable and guaranteed business in the 70's and 80's ....but not now, in fact the stressors of being brought up to "do great things" but then being told that you are "standard and should be practicing in the mean average of doctors" is so heart breaking.
This is where the schizophrenia of medicine exists.  We are groomed to heal others, give back to the community, continue learning since it will help humanity.....but at the same time, don't used intuition, don't listen to your heart, follow protocol make sure you don't deviate from policy.  Isn't healing a dynamic thing that varies from person to person, from country to country, from harvest to harvest?

The Saguil Approach is to take a regular paying job (so the kids can get a great education and walk home safe).  At the same time-Sow my Healer oats-take a chance with practicing medicine from the heart, outside the wallstreet paradigm without worrying about following hospital protocol, government restrictions and getting reimbursed for healing lives and not just making pharmaceutical industry wealthier.  I joined several groups to increase chances for 40 hours a week of steady income, I also have a twice a week consulting service where I practice "no holds barred" medicine (weaving between western and alternative medicine, educating and empowering, making suggestions for relaxation practice, hand picking herbal supplements and embracing physical changes to help immunity/recovery.)
This is my duality = DrRicOnDemand-using modern technology to administer old fashioned healing.   

Tuesday, June 17, 2014

Monday, April 28, 2014

Pushing buttons

Had a long Sunday at Immediate Care.  Seems that the people coming in were not interested in getting healthy, they were more interested in getting back to the way they were before getting sick.  (What they don't get - they are sick because of the unhealthy lifestyle....may not seem obvious now but I can wait, when ready, I can help)  So I buzzed through the walk-in patients....kept the wait to 15-30 minutes and handed out a lot of prescriptions.  Kinda easy to agree with a diagnosis of infection and just write a prescription.  Another symptom, another prescription; another trauma, another xray.  This is "cook book medicine", if your symptoms fit the ICD9 code, you will get the predetermined treatment algorithm for that code.  I detached myself from the need to educate and empower and just picked up charts and discharged patients.  After work, I was looking forward to spending the remainder of Sunday with my family so we took a walk at a local forest preserve then looked for a place to eat.  Son wanted Japanese food so we drove to a local place..  After reading through the menu, I asked to waiter about the portion size for some soup.  He said "it was big".   I wanted to make sure it wouldn't be too much to eat.  He said "I don't know how much you eat".  Finally I asked how many scallops come in an order/dish and he said it was "alot of scallops".....(perhaps his full time job was at a Japanese comedy club so I went on to decide my order by just reading ingredients and guestimating portion size by price point.  We all ordered and received our food....except for my scallop order which seemed to take a long time to come out.  I ended up having some of my wife's sushi order and asked for the check and some boxes.  He came with the check and the missing order.  He said scallops take a long time to cook and he mentioned it to me (of course it was probably between the fantastic descriptions he arduously built up of the menu choices when taking our order)  I took the price of the scallops out of his tip and left saying the food was good but service not appetizing.  Then it started raining on the drive home.  I usually drive the right lane and during downpour make sure I watch my periphery and rear since people underestimate wet stopping distance.  (dry = 1 car length for each 10 mph  or follow using the 4 second rule)  Regardless, if someone is tailgating me in the right lane, they have the option to use the left lane for passing.  If they don't take the option I slow down both of our cars and increase the distance to the guy in front of me so in the event of a sudden stop, I have ample braking distance and the tail gaiter will hopefully do the same.  So on this day with windshield wipers going full speed, the only thing I saw in the rear view mirror was a very 3D looking set of headlights.   I let up on the throttle to "gently" indicate that he should distance himself or pass (not sure if male or female -too much rain).  Headlights got even closer.  I continued to focus on the scene in front of the car while my son was making fun of me pretending he was the waiter from the comedy club/sushi place we just left.  (I didn't want to invite wife and sun into this movie that was taking place behind us -reminded me of a 70's film by Spielberg called Duel where Dennis Weaver was being stalked by a relentless big red 18 wheeler villain)  The narrow right hand turn into our neighborhood was fast approaching and he was intentionally getting closer so I had to slow to a crawl to navigate the intersection/the rain/his front bumper.....and while my son was laughing from the reenactment, the car behind me started wailing on his horn.  I did the civilized thing and made the turn waving my finger to him saying you are driving to close.  I couldn't make out if male or female as my eyes were on the road hazards during the peel off.  I always like to memorize the driver and license of reckless drivers thinking that one day I will be able to discover an amber alert fleeing vehicle.  My son immediately says this is the worst day ever, then my wife say poor Daddy "so stressed".   I then calmly say...I'm not stressed....that guy is.
This is one of the reasons why it is important to practice relaxation exercises daily.   To remain calm in a fight or flight situation will help with problem solving/be a beacon for others in the frenzy to emulate me /and I believe if you react to anger or a stressful event with more stress, the options for moving forward will be limited. Think of the typical ER star- cool calm and collected physician that runs the recusitation, leaning back against the wall, calling out orders, controlling the chaos erupting over the dying patient and having everyone work in unison to bring the patient back from death.  The human body can only exist in fight/flight or unity/procreation.  If the only way you know to live is fight or flight, adrenaline/epinephrine/cortisol will be the dominant hormones and inflammation will be the dominant reaction in every cell.  (FYI....inflammation = heart disease, autoimmune disease, Alzheimer's, diabetes and cancer.)     If you develop/practice a relaxtion response regime, you can choose to be proactive/calm before an event.....(the opposite would be reactionary to all events).   Having a healthy life practice doesn't guarantee immortality but at least you did what you could to shape the future.  

Monday, April 7, 2014

Multi Level Happiness Marketing

There is something about helping (contributing) that gives satisfaction.  Humans are hardwired to be a part of "the whole".  In it's most basic sense, we can generate a good feeling (high secretion of serotonin/oxytocin hormones) when we are part of something bigger.  Think of the rush you get to see how many Likes a post on Facebook gets.  Studies measuring hormone levels in people having an act of kindness done to them show highest hormone levels as expected.  Same study didn't expect high levels in the person giving the act of kindness.  Further studies went on to find out how far this extended and documented the same hormone levels in people witnessing the act of kindness being done!

Humans have a built-in brain pathway (like a service road) that certain electrical impulses get prioritized to go from the 5 senses witnessing the event straight to the pleasure center.  The end result is a reward system that makes you feel good if you are doing good.  It gives you such a great "high" that you want to seek out doing it again-even if you witness an act of kindness.  Just see what being in nature does to you.  No matter how stressed out a parent is while traveling with the family, when you get to the destination beach; stress just melts away.  Nature has it's own beauty that acts like a beacon to draw you to it and involve yourself with it.  You get to a pristine national park and notice trash-you pick it up to keep the memory pristine.  Louis Schwartzburg filming nature. The sum of energy in the universe is meant to be everlasting and all the lives that exist within the universe live in happiness when in harmony.  The opposite can be felt as well, when you live to destroy and not contribute- life is lonely, painful and unrewarding.   Witnessing bad energy also leads to an uneasy feeling.  When you watch the morning news and see deaths that occurred overnight, every new story ends with a feeling of fear or hatred (toward the bad guys).  Watching an uplifting movie, an act of kindness or the beauty of nature will bring a sense of calm and awe.  Nature in particular expresses itself to make lives want to "join in" and be part of "the whole".

For those of you stuck in a rut, trying to change with a push or detox......try to surround yourself with positive energy.  I remember buying paint at a local store (now out of business) and the guy mixing looked and sounded like a KKK member.  Every other work in his vocabulary was F@#$.  As I was waiting for my can to be mixed, I noticed when there was a new customer, the customer would acknowledge the conversation and answer in step to the KKK guy with F#%$.  (Kind of like joining in on the mob mentality topic which was all small talk about current hot button topics).  I paid my bill and didn't join in as he seemed to bait me when it was my turn to the counter.  The opposite also happens under rain sheds when in a national park, I was in the Grand Canyon solo hiking and needed a break from the elements.  The 7 mile mark of a 14 mile hike had a shelter and others were there.  I stopped, changed my gear, re hydrated and the conversation with 3 other parties was so cool.  The topics seem to be superficial but the people that day were sharing without fear of judgement.  Soon without an uncomfortable feeling of the conversation dwindling, we all wished safe journey and carried on.  One positive experience (received, given or witnessed) generates another positive experience and so on.  Like multilevel marketing, if your down line is strong and happy, you to will exponentially manifest strength and happiness.   Seek it out!!!

Friday, April 4, 2014

Happy (Unhealthy) Doctors Week!!!

Got a nice gift for Doctors Week this am with a bag of "goodies" from one of the hospitals I belong to.   It was a container filled with colorful decorations and snacks.  I opened the bag and started pulling out the snacks and wondered.....wheres is the gift? (Mama taught me to say it's the thought that counts).   Then I got to the bottom of the red paper filler and found some golf tee's.

So I just finished my morning loose leaf green tea (Genmaicha from Adagio Teas), toast and fruit (banana) and thought good thing I'm not hungry.  If I didn't have my morning ritual, I may have been tempted to pop open the Special K breakfast bar.  The design of the "100 calorie" bags is deceiving; packaging says 100 but it's flat, small and carries about 20-30 pieces of mini size edibles. (I would not be satisfied with 1 package unless I intentionally ate one at a time and allowed the wafer to melt on the roof of my mouth then worked it with my tongue-sounds sensual but this is mindful eating - (see Jon Kabat Zinn Mindfulness for Beginners-The Raisin Story) and allows for satiety with changing blood levels of ghrelin/leptin/cortisol/serotonin/oxytocin/IGF1.   Mindless eating comes when stressed, hungry, tired, thirsty, overwhelmed, sick....and I just described every American I see in clinic.  Obesity is an epidemic and it will carry heart disease, high blood pressure and diabetes along with it for 1in3 people -excluding Colorado.  (Cool to watch on my lecture link by advancing from slide 12-slide 39 and you will see the evolution of obesity in the US.)   I calculated the total calories from all these snacks

to be 1010 calories.  (This would be in addition to 2-3 regular meals in a day!)  The downside is the glycemic index for the snacks is very high and in 30-120 minutes I would crave more fast food due to the hypoglycemia response after fast food I refer to as the "insulin dump".

In comparison, the bulk of my packed food for the day is about 1300calories- good enough for me!  I am working a 14 hour shift today so in anticipation of hunger this evening, I will plan on a pre-emptive strike to cravings with an order from local veggie restaurant if necessary.  My food looks bland compared to what I ate 20 years ago but across the hallway is a physical therapy place.  My excitement/satisfaction will come in the endorphin rush from getting on the treadmill during down time and cranking out a mile or two.  (unless the physical therapy police tell me the equipment is only for patients).  Speaking of police, if an officer of the law is found doing anything illegal the news will chastise him/her and suspend without pay until decided by a judge. No one is above the law but I am sure some law enforcement officers break rules every once and a while.

So what should we do with health care workers that are unhealthy.  Or healers that don't know the law of letting "food be thy medicine".   After prescribing medicines, most doctors would apply some anecdotal stories of what they have tried personally which is honorable but not usually deep enough to build individual templates for the wide variety of people/diseases/ethnicity/tastes/ages.  In the 90's, insurance used to cover visits to a Registered Dietitian but not now.  With some insurance companies- after you have been diagnosed with Diabetes, you will get 2 visits to an RD in the first year and then 1 visit annually (lifechanging right?).  Most diabetics I speak with roll their eyes when I ask "how informative was your visit and why are you not taking advantage of what your insurance covers?"  Looks like patients are on their own when it comes to nutrition....unless you find someone locally on EatRight.Org.  A friend told me it would be better to see someone for counseling that you know versus a stranger, at least make sure they have been through credible training.  Be your own policeman!  (Or attend local lectures like mine at Advocate Sherman Hospital April 26th!)

Friday, March 14, 2014


Meet Cory

Cory is 56
He was very close to his brother
His brother died tragically
Since then, he would go into anxiety when ever he was alone, contemplating the solitude
He was introduced to a 16 year old girl
She ended up adoring him
They both love "hanging out" together
When she is around, he forgets about his lost brother and times are spent running, playing, walking in the park...
When she spends time with him, she bubbles with energy, no longer shy, offers help to others....
According to her mom, she is a different person with Cory
According to his caregiver, Cory no longer goes into anxiety when left at home.....(chewing on wood)
The two are inseparable, together the happiness exudes to unsuspecting people caught observing the two together
There is sense of calm that takes over when you play the part of observer to the unlocked love between these two lives
Like the plume of smoke from a nuclear bomb, you can feel love when these two pause( in one of the terminals of San Antonio International Airport), kids ask to come over to pet Cory, adults stop and watch the kids, more crowds start to form seeing a large gathering...
The dynamics of what ensues is amazing, I witnessed the same parents of the first kids start to smile (a few seconds before, the dad was told the flight was overbooked and they could not fly together)
I was also told my family couldn't sit together and although I had thoughts of child predators sitting next to my precious cargo, the longer I observed Cory melting the hearts of this previous zombie circle, the more I was reassured this flight was full of people that cared and someone would give up their seat for me (and someone did!!)
I watched some in the crowd smile, some start to tell jokes, a few of the stoic adults placed their bags on the floor and sat down to pet Cory as well....I even witnessed two people exchanging pictures on their phones of pets they owned....
Cory, his 16yr old companion and her mom lingered enough to change the dynamic of more than 51% of the people at United Airlines Gate 1 that day
Cory got his belly scratched and received love, the kids gave love, the bystanders witnessed love being exchanged.....there was an explosion of positive energy that overcame the majority of the travelers on that flight
What had changed that day?- the flight was still overbooked, delayed and heading to a snow covered Chicago.....but my interpretation of the time was through the eyes of empathy and not anger
All this because a 16 year old girl had the feeling years ago that what she shared with her 8 year old (dog years) pet could potentially be of service to others.

Tuesday, March 4, 2014

Choose wisely.....

You are in control of the choices you make.  Doesn't matter about finance, available resources, health status, relationship, age......the one freedom we are given as humans is to make a decision.  Sometimes the ego will accumulate multiple opinions and develop a conclusion that the journey you are on- has no waiver.  True living is: we set our goals / let go of the attachment to the goals / and live in the journey.   Staying too tight and worrying about destination makes you de-focus on the daily events that are placed in front of you to support your journey.  As my teachers at the Chopra Center told me, the beauty of having an intellect of higher function is the revelry in happiness and love (more so than the fact that you can calculate and interpret) A reptile can problem solve how to get away from danger-a human will embrace the event and appreciate the contribution that they just went through to make the universe a better place.
If you seem to be going through rough times, "sh_t happens" and you learn for next time to take a different path.  If the event keeps on happening....perhaps an outside opinion would be helpful to figure out how your life can be dialed-in to support the universe and continue its everlasting existence. Life went on before you were born, as you live and after you die.....if you live your life to not coexist with nature, life will be painful, lonely and end fast.  If you live supporting what is around you with a goal of contributing to the benefit of "life"....you will probably have happiness come to you and your immediate circle.  (see the Chopra Center)

Smoking, overeating, cutting people off, gossiping, fighting ...always leads to something bad.  If we learn early about how our lives are intertwined with the Universe- disease as we know it will be postponed until 90-100 years of age.  (There are currently about 70,000 centenarians in the US)  If we are 50 years old and just never were aware of the "messages" life sends us- you will accumulate alot of damage.  The more damage you carry, the less your options for changing life. Taking off an ill fitting jacket is easy when it's your only layer. If you have a t shirt, a base layer, a mid layer, an outer layer, a water proof layer..... you will have to fix alot of things to get to the underlying problem that needs adjustment.

This is hard to fathom when you are knee deep in bad surrounding/events.  The concept of epigenetics states if you wait on taking the healthy choice, DNA will be the backbone of coat hangers that holds onto all those bad layers of clothing.  If you don't feel the wrath of damage, it will be transferred to your family decades down the line.  Studies on smoking teens have shown gene mutation to the children of the young smokers.   (for those of you who don't subscribe to the preceding concept and make bad choices you probably don't care about your future family....but guess what...you will have to take care of that burden!!)   Ultimately there will always be a choice to make every hour of every day, if you choose a short trail to follow, it will just be a longer hike to get to your pinnacle. 

Wednesday, February 19, 2014

The Calming Power of a Shoe

As I train for this year's pilgrimage to Zion National Park, there are only a few places that present with elevation changes in Illinois.  Training weekly around local forest preserves gives the feel of nature and allows my mind to quieting down.  When one becomes used to the speed of the Internet, the speed of rush hour tailgaters, the speed of getting taxes done right before deadline-you learn to always do things with speed.  It may be good for applying CPR but you can't apply speed to waking up, eating, spending time with loved ones....these activities are meant to be slow so the brain can secrete serotonin.  This hormone then bathes the trillions of cells to reset DNA, mitochondria, allow other hormones to cycle on, allow brain tissue to perform abstract thinking, problem solve.....or just fall in love.
Fight or flight hormones are useful for escaping danger.  The human hormone feedback loop is well established to start even as an embryo.  I remember watching the ultrasound of my son in utero when we had to get a sample of amniotic fluid for testing.  We localized where he was floating in mom's bag of water; as the doctor inserted the needle through moms abdomen we could see the needle tip pierce the wall of the uterus and immediately my son moved out of the field of vision on the machine!  When Antelope are born on the plains of Africa, within minutes, they can run with the herd if danger is sensed.  When a science frog has been pithed (inserting a needle into the brain to destroy higher function) it will still lift a foot up and away when held over a fire.  (sounds barbaric but this used to be how physiology class was run in college premed).   All this thanks to the reaction of every cell to adrenaline!!!
But this was not meant to see secreted every day of the week.  When rats get electrical shocks every day in a cage they tend to ignore the pain and withdraw into a depression like state.  When children are abused every day with no hope of a respite in sight; they too withdraw, become zombie like with no emotion and a very altered interaction with the world.  A study in the 90's on adult immune diseases went back and found the patients that experience Adverse Childhood Events where at higher risk for triggering disease later.  The big buzz word now is inflammation as the trigger for 80% of all the diseases treated in a doctors office.
A little inflammation and stress response is good (think of Robot from Lost in Space- "Warning, Warning!!!" alarming the crew of impending danger), too much inflammation and stress is not conducive to a peaceful life. (think of Dr Smith from the same black and white TV series throwing the crew into turmoil after every challenge).
One really has to practice the relaxation response since it is not part of American culture. Reflection/introspection in it's most popular form used to be practiced when you sat in the corner in silence as an act of penance.  Or if you fish, hike, pray......it used to include martial arts and yoga but I see alot of hybrid yoga and mixed martial arts places that just stress the movement and not the philosophy nowadays.   Even running is broken down into managing split times, hydrating, powergels, shuffling the ipod....and not just running  to lose yourself in the cadence of your foot strikes.  I just came back from a 30 minute resistance training routine where the only thing I was thinking was "almost done"....as I worked out like a madman banging my head to Metallica's Fuel.  So my argument is even in the activities we do to keep ourselves healthy, we still turn on the stress response.
I was blessed to have experienced the classes of Herb Benson/Harvard, David Simon/The Chopra Center, Andy Weil/AZCIM and of course Deepak.  These modern day sages translated true traditional healing into modern day medical terminology.  Through hours of learning, I developed my own form of eliciting the relaxation response in myself to help during times dealing with death, sarcastic orthopedic surgeons, the difficulty of starting a private practice......and aging.  I am still finding my technique but I feel more in control of my journey now than ever before.

So here I am hiking in Starved Rock, getting ready to ice climb and be one with nature.  Just listening to my crampons (steel foot spikes) crunch the ice with every step I take approaching the frozen waterfall puts me into "the zone".  I wield my ice axe like a warrior and dig it into the solid mass like a harpoon and develop a swing/strike/pull timing.  Axe/axe/crampon/crampon....up we go.  Serotonin is flowing, DNA is healing, oxytocin (the love hormone) is bathing my heart and brain!  I looked at some pics a stranger had taken and I got pretty high! (I didn't even care)  Then it all came to a screeching halt.  One of the last crampon kicks I gave with my left foot - kicked off my spikes!!!  So here I was "in the zone", high up on a frozen waterfall with only one operating foot.  I would normally just say "who cares" and forget the feet using full upper body strength like Tarzan hitting each Axe like a pendulum and work my way down.  But my "fight or flight","warning, warning" hormones started to rush out of my adrenal glands and took over every bodily function.  Brain started thinking "I am going to fall and impale myself on an axe";  heart started to beat distractingly fast; hands became sweaty in my gloves and gave me a sense of slipping off my axe grips, my remaining crampon/foot could not for the life of me get a good hold in the ice; the viking like swing of the axes became wiffle ball foul tips bouncing off the mammoth ice cube.  Well, I paused for a second, laughed at myself and thought "my shoe will do fine"....and with a renewed focus on smooth striking like the beak of a humming bird hit each mark-I stuck my axes and remaining crampon till I returned to ground.
The power of the mind to effectively change the outcome of an event!!!  With just me getting down from a frozen waterfall being a chore, think about someone trying to battle cancer, feeling great about the fight and then being told by a trusted specialist-we can't help you, good luck (fight or flight).  Versus being bathed by the love and support of a community and beating disease with lifestyle changes (relaxation response)
....if only we could teach meditative breath work in grade school!!  Or get medical insurance to cover a week at the Chopra Center!

Sunday, February 16, 2014

Genie in a Bottle

Eyes open 430am, my brain thinks I better get more sleep.  Mind says get up, make some tea, go push some weights and get my yoga on.  500am I am ready to start the day and no sun out, no activity on the road, Facebook says a few people liked my Detox blog but no activity.  As I make my way to the local Planet Fitness, traffic lights are all in my favor....this is like a dream.  I get there thinking it would be just me and the desk attendant and there are a whole bunch of people, even this guy on a treadmill that is just jacked up.  Probably running 7 minute miles, great form, blank stare recalling floating past the 13 mile aid station at the Chi-town marathon.
So how do I get this energetic attitude, so ready to take on the challenges of the day?  How to others seem so alive at this hour?  How can I insure my adrenal gland gets stimulated like this every morning, and how to turn on the part of the brain responsible for elation?  If I could just bottle the hormone proportions floating in my blood stream at this present time; take it out and inject it when I need it!!!!   How to then inject it into others I work with, patients I see with major illness, strangers that are suffering?  If only we could pull some blood out when happy, transfuse it back in when we are challenged with daily commuting, office deadlines, hunger from not eating properly, angry insomnia from lamenting on the "asshole encounters" from the day.
Western medicine and the pharmaceutical industry thought they could about 20 yrs ago when they found receptors in the brain for serotonin where empty in people with depression.  The answer: make a medicine that allows more serotonin to be present in the blood stream and the deficiency with be cured!!!  It worked but people were a little blunt faced, emotionless, zombie like, sleepy....and heavier.  (I guess they just assumed giving medicine would cure the disease without behavioral therapy to fix the abnormal introspection...just like cholesterol medicine without changing the diet doesn't stop the heart attack, just slows it down)
So I tried to go through an inventory of my schedule/diet/activity for the last few days and found one thing. Repetition; I was waking up for a few days straight, really pushing the plant strong foods, trying to keep up with meditation in the morning (as my Chopra Center Guru Davidji says-Rise-Pee-Meditate every am and it will make you bullet proof for the challenges of the day!)  In my Detox blog from DrRic Frequently Asked Questions, I mention that if you are trying to break bad habits and begin a new lifestyle, it is easier to set the body on a ritual/rhythm with Thinking Eating and Activity.  As your hormones are thrown into the blender of an emotional tornado, forcing the digestive system/musculoskeletal system/endocrine system into a regimented 12 hour sleep wake cycle will guide the haphazard glands into a uniform secretion.
Providing a good parachute of proper nutrients, moving muscle, engaging conversation, restful sleep and a little supplementation is important.  Everyone is a little different as to what deficiencies need repleting but most Americans need the aforementioned activities. The one drawback of ritual is some people may not see that the ritual they adopt for short term change, will also act as an anchor and hold back the journey.  A goal is always important to set but at every detox (even if it's as short as a day or two) when your mind is clear-contemplate a new pilgrimage
In the end, it isn't the need for an injection during times of challenge, it is the need to inject "healthy choices" into everyday of your life before the challenges happen.  The miracle of your body/mind/soul can let loose a tsunami of serotonin but it wont just let you pull out "calm" from your adrenal gland when you don't practice a daily lifestyle of longevity.  For most Americans (myself included) challenges begin to avalanche at about 30-40 years of age.  If you wait until that time to practice a healthy lifestyle, you will always be playing catch up and eventually western medicine and surgery will step in to place a halt on damage until you decide to start reversing disease......if you still can.  

Saturday, February 1, 2014

Evil Triumphs when Good Men do nothing.....

My steady paycheck comes from working for hospitals in a few "10 minute clinics", where docs are judged by productivity and if you spend too much time with patients= waiting room gets backed up, patient complains, administration says "speed it up".....doc feels pressured, pressure gets pushed onto patient, fast diagnosis is made and pills are prescribed without treating the cause.  I can easily work for a corporation, be the face of primary care, get a salary, follow the rules and retire at 63years of age as a burned out professional but......

My calling is to empower people to heal from the inside.  Unfortunately, spending 60 minutes to learn about what makes patients "tick" and getting reimbursed 70 dollars an hour/ but having to pay 50 dollars an hour for malpractice insurance doesn't add up.  (Don't forget taxes, rent, staff, utilities).  This is why I opt out of taking medical insurance in a small cash practice a few hours a week.  If I don't send bills to insurance companies, I don't need an office clerk; if I don't draw blood in the office, I don't need a lab tech; if I don't have staff, I don't need an office manager; if I don't sign contracts with the government, I don't have to buy expensive electronic medical records and I Don't Have To Spend My Time Asking Insurance Based Questions vs figuring the reason why they came to me. I can't put into words how rewarding it is to see people come in with multiple diseases and leave with hope and a plan for change.

I see first hand how patients are given a diagnosis but not given the keys to reversing the problem.  It just takes a few minutes to empower patients to make a change.....but if you are under the gun to see volume, being 5 minutes behind in the morning can translate to 2 hours behind by evening.....and that will lead to complaints and the whole cascade of administrative events outlined above.   As dualistic as it seems, my regular hospital paycheck involves giving patients band aid medicines and my cash clinic fixes the band aids placed by my colleagues.   (....and yes by me but for each prescription I write, I always suggest an herbal supplement or "what to do next time" videos-see http://www.youtube.com/user/herbal411)

So for now I have to "keep my day job" and pay the mortgage, college tuition....and occasionally bills from my Integrative Medicine Clinic (The Center of Healing).  If I don't venture away from the mainstream medicine, some person from this planet will die frustrated, suffering, with no hope and probably pass issues to the family.

Thursday, January 30, 2014

A Warrior's Battle

What happens when you are given the news you have 3 months to live?  Like the climax of a movie when the group draws straws and the last person picks the short straw.  You never think it's going to be you.  So we shrug it off thinking "wont happen to me".  Then the universe reminds us our time is finite by giving a short straw to a close patient, relative, friend.  It is humbling to see the stages of suffering, it's heartbreaking to experience the visceral feeling of death as it approaches another person.  As a doctor I thought it was "proper" to be stoic to death so as to convey to the grieving family a confidence that the doc can still be a clear headed decision maker in the tornado of emotion that occurs during the last breath.  I have matured to learn that putting a shield up to the emotional suffering of others also blocks you from expressing your own suffering.  If you don't know what its like to hurt, how can you relate to the one that is hurting?   I am not saying we have to have cancer to treat it.....but we should learn compassion.  Not all people are born with this but luckily I think it can be nurtured out of someone.  I believe our cells are hardwired to come to the aid of others.  We feel good when witnessing an act of kindness.  It has been studied that when an act of kindness is performed, the giver develops high levels of the hormone serotonin just like the receiver.  It has also been measured that the observer to this act of kindness has a serotonin release just by watching.  So why is it that some people act so cold in the face of suffering.  And how ironic that some doctors that are sworn to "do no further harm" do just the opposite and harm with poor advise.

Standard Oncologist:     "you don't have to worry about eating....it doesn't matter in the long run"
Integrative Oncologist:   "lets teach you to avoid sugars, eat small meals more frequently...can you juice? .. fish is ok if you like it"
Standard Oncologist:   "the statistics on this kind of cancer are poor and you have 3 months to live"
Integrative Oncologist: "I have a patient who came in worse than you and she is alive and well in remission".
Standard Oncologist:   "the experimental protocol medicine says your outcome is not what we want, so sorry but good luck"
Integrative Oncologist:  "I don't want to worry about the cancer right now, lets work on the medical problems that will kill you first, then we can attack the cancer later with a healthier body"

I heard from a doctor that took care of my mother, he didn't want to give her false hope by trying something that didn't have statistics behind it.  Then again, our drug industry calculates in a 30% placebo response when formulating a new drug.  If the observation of and act of kindness gives hope and empowerment then why do we deny it to the most deserving people when they need it most?

Just with the open ears, the acknowledging voice and the comforting words of Dr Keith Block ( The Block Center ), I saw a change in color, posture and facial grimace over the course of 90 minutes with both Kathy and her husband as I came to support them during what was unfortunately her last consult.  Turns out the most powerful treatment over the last 6 months came in the gentle words and hands of a compassionate healer.

We'll miss you Kathy and I will keep my promise.

Saturday, January 11, 2014

"Meat Soup"

The holidays are always festive with opportunity to join family members and share food and laughs.  Some will go from house to house to greet elders and cousins.  In the Filipino tradition, there is usually someone who meets you at the front door with hugs and plates.  "Hello, how are you, go eat".....all before you take jackets off!  Great tradition in my opinion but it also means as a semi-vegetarian, I will be grazing some tables that have a bounty of only beef and pork.  I have to honor the host by not turning down the food offer, but have to honor my stomach to not throw it into spasm the next morning.  The political thing to do is walk around in camouflage-(holding a plate with some essential macro nutrients and "nursing the plate" for the night).  Luckily in the last decade a select few relatives have also decided to join me on the "dark side" and shop at Whole Foods, hike, meditate, and lose weight.  I find it either takes the threat of impending doom (like a surgical procedure's) or the loss of a family member to shock a person into making the switch.  Hearing "you have to lose weight, stop smoking and exercise" from a doctor check up doesn't make lasting enthusiasm to manifest change.  This is why statistics report doing routine things like breast exams or prostate checks doesn't make a difference in mortality for the American population.  believe it or not, the USPSTF suggests against teaching self breast  and prostate exams.  This could make sense to save money for the insurance agencies/government and for the multitude of SBE teaching I gave and the prostate cancer screens I ordered but for the handful of patients I saved with early diagnosis, I feel it was worth it for them there children and children's-children.  The statistics that we apply to the general population have nothing to do with the individual.  (see Ecologic Fallacy).
Another example, dentists at UIC are taught rough spots found on physical exam to the surface of a tooth are labeled as carries (cavities), the insurance industry says there is no reimbursable disease until the rough spot has punctured through the enamel (surface) and deep into the dentin/enamel junction.  Only at this point will the insurance reimburse dentists for the corrective procedure.  The problem is when the cavity has eroded deep into this DEJ, it is days away from a root canal (resulting in killing the tooth and filling it with composite)
A final example is modern day medical insurance does not reimburse the doctor for counseling patients on healthy eating, exercise or ways to lose weight,  You technically don't have disease until your BMI gets to a high number, your sugar and cholesterol reach a high number, or your xray shows a mass in your chest.  When health crests over the test threshold, then you can get treatment and doc can get payment for time spend finding and counseling about the disease.  (Like the root canal case, once the disease is "declared" you will probably be knee deep in an unhealthy lifestyle, making it close to a miracle to reverse without medicine that only treats the effect and not the cause)
Getting back to my holiday story, as I meet with my fellow herbivores at these family functions, there will always be nod and silent understanding that you have to indulge in the feast but not go overboard.  My hard core relatives will be stoic at any event and stay the course of healthy eating - refusing all "door plates".   10 years ago this would have been babysitter suicide in that if you refused cruising the dinner table for seconds and thirds, the elder that prepared the massive layout of culinary meat eater delight would be offended and return the face slap when you asked to watch the kids this week.  I listened to Rick Bayless and Andy Weil speak downtown and remember Andy speaking of the randomized controlled trials and research about food, glycemic load, plant based diets and inflammation (making great sense) and Rick chimed in (no medical degree or university teaching status) and said in human culture you cannot take away "the feast".  It is in our oldest books of man as part of survival/history.  As we develop this disdain for food like it was evil and caused your high cholesterol, high BMI, elevated blood pressure....as hate relationship starts and we minimize nutrition to scientific elements.  IT ISN'T.  It is a life form placed on earth for humans to prosper.  Eating something prepared really fast from a drive thru window; swallowing it without chewing (like a lion that eats to over gorge in anticipation that the next meal may be a few days away) and trust the food company to use healthy ingredients while trying to make a profit....you are bound for early death and disability.  But have no fear, US health care is built to administer "rescue medicine".  In other words, we wait until a disease has manifested and changed DNA, then we intervene with very expensive procedures and medicines.  Note that this style of medicine does nothing for the health of the country and is expensive.
So your choice is make a decision to keep the "meat soup" indulgence to 2-3 times a year   OR   let go of your common sense, eat crap, don't exercise, don't control your reaction to daily stress and live like you only have a year left!