When you’ve been around longer than 2/3’s of the folks in the United States, everything begins to look a little skewed.  My new periodontist, for example, makes the neighbor’s  children look almost middle aged, and the fact that I have a periodontist allows me to finally understand the expression, “Long in the tooth.”   This afternoon, the waitress that brought me my sandwich at the Diner seemed to be checking over her shoulder periodically to see if the truant officer was coming to take her back to the eighth grade.   Oh, yeah, and the kid who checked my battery?  Except for the tattoo on his neck and that pierced eyebrow, I thought the only batteries that he would be familiar with might have been removed from his Star Wars light saber.  

Everyone tells me that age is relative and I completely agree with that, but this isn’t really about age; it’s about wisdom and experience.  Don’t get me wrong.  Plenty of folks get older and never seem to wise up.  In fact, it seems to me that Fish Oil should be built into our cereal, milk and pancakes because lots of people today need to have something to give their brains a boost, any kind of a boost.    It has been my experience , however, that those of us with enough battle scars seem to have had to either gain that knowledge or perish. What’s the expression, we all age, but not all of us grow?

Once, after being verbally attacked by a somewhat unstable man who, unfortunately, was one of my superiors at the time, a great silence fell across the room.  He had yelled and screamed that I should be fired, but it was clear that, had the gun laws been just a little more lenient, his real desire would have been to eliminate me from the human race.  Anyway, after his tirade, an outburst that only Judge Judy could have matched, a lone voice rose from the group of people in the room who had heard his accusations and demands. 

The person who spoke up did so in a very deliberate manner and said the following, “When I was a kid, my father told me that I would be lucky in my life to end up with six friends.  When I met Nick, I felt that friendship instantly, and he has proven to be one of my six.”  (Or something like that?)  Then he said to the ranter, “Maybe you should leave.”  It’s not often that someone has the guts or the heart in a tense moment like that to stand up for a friend in the midst of a dozen or so very powerful people.  As it turned out, he was supported in his request, and my life and job went on, but that moment will never be lost.  (Thanks, Ron.)

Well, today, one of our sixth friends left us.  When I got the E-mail, my heart sank, not just a little, but a lot.  You see, today, the person who passed took a piece of me with him because, like my hero above, he had been a cheerleader, guardian, and supporter from the first minute that we met.  He was one of those special people who, no matter how bad the lightning was flying from the storm overhead, would run out to support and protect you from the elements with his very personal umbrella. 

I’m sure that his family knows how much he was loved, respected and will be missed, and I’m positive that mine does. 

In the words of Kahlil Gibran, “Only when you drink from the river of silence shall you indeed sing . . . And when the earth shall claim your limbs, then shall you truly dance.”  

We will miss you, Jake, and your presence will always be felt among those who loved you. 

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Today, I received an article from a friend written by Nicholas Kristof, a New York Times op-ed columnist, titled “New Alarm Bells About Chemicals and Cancer.”  Having lost my father from cigarette smoking related lung cancer (They’ve identified4,000 chemicals in tobacco smoke and at least 69 of those chemicals are known to cause cancer), the headline really didn’t surprise me very much.  After all, we have gone from eating cupcakes made with flour, sugar, baking powder, salt, shortening, milk, vanilla and eggs to eating faux cupcakes made with niacin, iron reduced, thiamine mononitrate, riboflavin, palm oil interesterified, palm kernel oil, partially hydrogenated cottonseed oil partially hydrogenated with TBHQ, emulsifiers, sorbitan monostearate, mono and diglycerides, sodium stearoyl lactylate, propylene glycol monostearate polyglycerol esters of fatty acids, sorbic acid and a little bit of flour, sugar, eggs et al.  You get the point.

Some of the low-lights of the article included facts like, 300 contaminants have been detected in umbilical cord blood of newborn babies which means that these babies were already polluted when they were born!  The other very disturbing detail that came out was a quote from the report which says, “Only a few hundred of the more than 80,000 chemicals in use in the United States have been tested for safety.”  Just think of it.  Only about 79,800 other chemicals MIGHT BE DANGEROUS.  Heck, the food industry is already screaming because there is a bill before the Senate to ban bisphenol-A, commonly found in plastics from food and beverage containers.  Right or wrong, BPA has been on the endangered drug list for years.

Okay, unless you make your living from treating these folks, here’s the really bad news.  About 41 percent of Americans will be diagnosed with cancer at some point in their lives, both Republicans and Democrats.  So, the issue shouldn’t be a political issue, but, because it is also an economic issue it is not being addressed equally.

As a healthcare professional, it is tough to see the new statistics involving the cancers that are becoming more and more common with children.  Could these cancers be happening because of chemicals in our food, water, air and   household products, or is it just Mother Nature trying like heck to keep the seven billion of us from destroying her planet?  You know kind of a guaranteed thinning of the herd?

The good news about the report was that it was filled with suggestions for us common folks relative to self-preservation from these chemicals.  For example, filter your drinking water.  That would seem simple enough, especially if you didn’t store it in heated plastic containers after filtration.  Then there were suggestions like remove your shoes when you enter your house.  Truthfully, I grew up in a house that was not unlike any respectable Japanese home, EVERYONE was expected to leave their shoes at the door upon entry.  I always hated that.  (Primarily because my socks were darned or had holes in them, but it was the law.)

They suggested storing your water in stainless steel instead of plastic and to microwave in ceramic or glass containers.  They also embraced organic foods and suggested that you not eat meats that are too well done.  (They must have seen me bar-b-que.) Oh, and finally they said, “Check radon levels in your home.”  They probably should have gone on to say, and do something about them, too.

Well, today, I met an 89 year old man who had been on the ground in Hiroshima seven days after the bomb was dropped, and he told me that his secret to longevity was never to think about any of this stuff, to hang out with young people, and to drink a lot of high quality alcohol.  He was particularly fond of moonshine?  We all have to die from something.  I guess CEO’s of  the manufacturing companies who use known carcinogens figure they just wanna die rich!

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When Clayton Osbon, the pilot of that Jet Blue plane lost it a few weeks ago, the entire world stepped back and asked what was wrong?  Did the weight loss shakes that he sold somehow impact his neurons?  Was he so sleep deprived that he became in-congruent?  What made him snap?  Everyone described him as a rock solid, non-controversial human being, and all of his neighbors, friends and family were shocked by his actions.  

Interestingly, while listening to a talking head about the soldier, Staff Sergeant Robert Bales, who was accused of killing 17 Afghan citizens, the commentator indicated that, sleep deprivation and stress can turn any human being into a moral moron. “Your decisions become so clouded and incongruent that anything becomes possible,” he said.

As a hospital CEO, one of my saddest physician practice memories occurred when one of our top docs began speaking in incomprehensible sentences and acting erratically.   The result was an agreed upon early retirement after which he came back to his full, normal functional capacity.  In a casual conversation with him months later, he believed that he had embraced a personal diagnosis.  You see, he had been working, taking calls, and visiting patients late into the night and was back on the floors by 5 AM every morning.  He attributed his incoherent activities to his sleep deprivation.

Now to a very disconcerting Pittsburgh meltdown; last week a highly respected, top CEO in this area cracked and was arrested for fighting with the husband of his mistress.  His listed salary was about $4,000,000, but more importantly, he was working to lead his organization in a new direction that could literally be a prime example of what may be possible in the new health care arena of these United States. 

Dr. Ken Melani was leading the way in the creation of an Accountable Care Organization that would cover all aspects of healthcare from cradle to grave.  His path was truly one of great risk, amazing strength, and deep understanding of the new Healthcare Reform legislation. It meant taking on the UPMC juggernaut while preserving choice in healthcare in the Pittsburgh region.  It also meant managing numerous very strong personalities who either agreed, disagreed, or thought they could do whatever was to be done in a better way than their leader. 

 Literally at stake were millions and millions of dollars and a $1.2B debt was also knocked into the risk portfolio because of Dr. Melani’s meltdown.   More importantly, however, in this “Battle of the Titans” was the two million or so patients who would be blocked out of the competitions health system when Highmark stood its ground. 

Many countries regulate the work week by law, such as stipulating minimum daily rest periods, annual holidays and a maximum number of working hours per week.  During a conversation with the wife of the Finance Minister in the Netherlands, I told her I would see her in August to which she replied, “You really don’t understand, do you?   We threw out the Pilgrims and Puritans and you still live by their standards.  We have 54 days off a year, and no one will be here in August.” 

It’s a well known fact that US workers put in the longest hours on the job in industrialized nations, and we are spending the most on our health in the United States with some of the worst outcomes, and we are the ONLY nation that does not provide health coverage for its population. Bottom line, maybe Dr. Melani,   Staff Sgt Bales  and Capt Clayton Osborn all needed a break.   Battle fatigue can be a dangerous enemy, and the results can be both economically and physically lethal.  We can’t turn back the clock for any of these individuals, but we can learn to carve out 20 or 40 minutes a day to nurture ourselves, to breathe deeply and to rid our minds of the unnecessary.   Change or DIE. 

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In a New York Times Op-ED by Theresa Brown on March 15^th entitled Hospitals Aren’t Hotels, she clearly articulated the company line regarding the new patient centered care requirements being imposed upon hospitals by previously the Bush and now the Obama administrations through CMS.   Although Ms. Brown is most probably a world class nurse, she echoes the sentiment being expressed by many healthcare leaders regarding the realities of current thinking in hospital care.  In her op-ed, she writes that “A lot of what we do in medicine, and especially in modern hospital care, adheres to this formulation.  We hurt people because it is the only way we know to make them better.” 

Having been in senior management in healthcare for over twenty years as an officer and for the last dozen years prior to my retirement as a CEO, this type of rationalizing was a constant symphony.   My experience was very different because it was from the patient’s point of view.   Almost ironically, prior to entering the healthcare field, I was the CEO of a Convention and Visitors Bureau, and I saw firsthand what could be done in healthcare.   The irony for me was that, once I was in a position to introduce a more patient centered environment in hospitals, the push back was relentless and unending.  That was until I became a CEO and took an unmovable stand on this issue.

You see, this is not a situation where patient centered care resulting in higher acceptance wouldn’t work; it is a situation as so aptly described by Ms. Brown where “We hurt people because it is the only way we know to make them better.”   Once while observing a young child being treated in the Emergency Room I heard blood curdling screams.  After the treatment was complete, we brought that team of care givers together to discuss what had happened.  During that conversation, we asked if any type of topical pain killer could have been used.  Their response was, “Yes, of course, we just never did it that way.”  It was done that way from that day forward.

What we are missing here can best be described by reading the poem “Calf Paths,” by Sam Walter Foss in which he describes a walk taken by a medieval calf that ended up being the foundation laid for what later became a road, then a primary street through a medieval town and finally a major highway.  Healthcare is based on conservative tradition, and it is well known that, as stated by a seasoned VA nurse at a presentation that I gave, “We are famous for eating our young if they don’t follow the traditional path set out for them by our healthcare ancestors.”

Our hospital offered massage, stress management, music, aroma, pet and all other types of therapy.  We had 24 hour visiting, beds for our visitors beside their loved ones and double beds in the OB suites.  We baked bread in the hallways, had popcorn machines and live music in the lobbies, but most importantly, we provided our employees classes in emotional intelligence and sensitivity.   We provided them with the knowledge that every aspect of what we did we did as a Good Samaritan.  We embraced the philosophy of “Doing unto others what we would have others do unto us,” and then we capped that with a commitment to provide unconditional love to our patients and their families.

The result?  This hospital had the lowest restraint, readmission, lengths of stay and infection rates of it 18 peer hospitals.  But most importantly, even though the patients came from the same pool of humanity, we had the lowest mortality rates. But here’s the real irony for this lesson, our employee and patient satisfaction rates were in the highest possible percentages.  Treat people with kindness, love and respect.  Explain to them when they will hurt and why and then respect their needs.  That’s not a hotel.  It is a center for healing.

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His room is a virtual wonderland of enjoyment and entertainment.  It is a kid’s world of both toys and secret stuff.  Hanging from the underside of his top bunk are helicopters, at least four of them, filled with miniature GI Joes or WWE figurines ready to rappel and hit the bottom bunk bed to engage in a toy war or a wrestling match unprecedented in scope and dimension anywhere in this galaxy.
The floor of the room is covered with cat’s eye marbles from his race game, a DSI, his Harry Potter books and the white cardboard from my recently laundered shirts.  On these cardboard canvases, are incredibly complicated and elaborate drawings of pirate ships surrounded by sharks, whales, a dingy  or two and either soldiers or pirates from other ships poised to sword fight their way to ownership of the booty hoarded within the bowels of these terrorist vessels.  There are cannons firing into the sails of the enemy and bearded men with patches, hooks and peg legs fighting across the decks.

On his desk, which is a worn antique procured from the estate of his great grandparents, sits a wooden box that his father bought for him during his time in Iraq.  In that box are many of his most prized kid treasures: decorative coins, an arrow head, the tiny jaw bone from some skeleton found in the woods near his house, and multiple folded dollar bills of various denominations that had come from either his birthday party or various other celebrations.

On the dresser is an aquarium with two chameleons, neither of which are usually discernable with the naked eye as they disappear on either the brown piece of drift wood or the decorative green plastic leaves that had been carefully placed in the glass container.  The exhaust fan and light/heater are on 24/7 as the chameleons are fed a stable diet of crickets and more crickets.

On the window sill above the desk are several kid trophies from his numerous athletic accomplishments such as wrestling, horseback riding, football, soccer and baseball.  They say things like, attended wrestling camp, or participated in the horse show; you know, trophies that sometimes are more indicative of one’s capacity to breathe than to actually win any given sport, but they are his treasures.

There is a baseball autographed by the entire Pittsburgh Pirates team that someday will probably be worth less than the $12 paid for the ball, and beside that is a small statue of his favorite retro football star, plus a bobble head of what could only be described as a Thor-like figurine that is most probably representative of some other wrestling dude.  Finally there are pictures of him and his sisters from various Easter Bunny, Santa Claus visits.

Under the bottom bunk of the bed is a virtual arsenal of Nerf guns,  fake plastic knives, a flintlock pirate gun,  a toy compound bow with no arrows, and numerous Dollar Store plastic hand guns and automatic AK-47’s.   He carefully explains to me that, should an intruder make it past his dog, Chipper, and up the stairs to his room, he will be comfortably positioned under his bed and armed to the teeth.  (I pity the fool.)

The cupboard is filled with both new and hand-me-down clothes, and on top of the end table is a clock that consistently flashes the wrong time, no matter what time of the day or night you visit.  Finally, in the top dresser drawer is a collection of his poppa’s old cologne and a beaker where he carefully mixes his own, sometimes overwhelming fragrances.

It’s a virtual womb of comfort, practicality, and fantasy where everything is in place to imagine and dream his way through childhood.  I’m sure someday soon, he will add his own microwave and refrigerator. Oh, yeah, that would be college.

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STATUS OF THE FUTURE

The ABIHM was incorporated in 1996 with a vision to establish and maintain the highest standards of medical care, ignite and sustain the joy and passion of physicians in their work, establish the role of unconditional love as the basis of healing and support, and to recognize the importance of the health of the planet as integral to human health. Since 2000, the ABIHM has provided the only peer reviewed, psychometrically validated certification process in comprehensive integrative holistic medicine to over 1600 Diplomates.

When the ABIHM was incorporated, educational opportunities in integrative holistic medicine were scarce. The past 15 years have brought tremendous growth to the field, and training programs in integrative medicine now abound. Many residency programs are offering integrative opportunities, and fellowship training programs in integrative medicine are becoming increasingly available.

The leader in the integrative medicine fellowship arena is the Universityof Arizona(U of A), whose directors have initiated a relationship with the American Board of Physician Specialties (ABPS) to develop a new board of integrative medicine. For more information about the ABPS, please see www.abpsus.org. The ABIHM has been invited to participate in the development of the new board, as have a number of representatives from academic institutions. Many have historically inquired about the possibility that board certification in integrative medicine might be recognized by the American Board of Medical Specialties (ABMS). Both the ABIHM and the U of A have explored this prospect, and all indications are that the ABMS is not interested in recognizing such a specialty. The ABPS is currently officially recognized in 33 states, and it is our hope that more state medical boards will rapidly follow suit in recognizing the ABPS.

It is important to explain that the new board plans to require a fellowship level of training as a prerequisite for board certification. The number of required hours has yet to be determined.  However, at least during the first few years that the new board exam is offered, the fellowship requirement will be waived for active Diplomates of the ABIHM.  Nonetheless, ABIHM Diplomates who wish to pursue certification through the ABPS will need to sit for the new exam.  For ABIHM Diplomates who do not wish to undergo ABPS certification, the ABIHM intends to continue to offer its maintenance of certification process into the foreseeable future.

The ABPS anticipates offering the new certification exam as soon as 2013. Therefore, the ABIHM plans to stop offering its certification exam after January, 2013 (though these dates are not fully established). The ABIHM will offer the certification exam several times over the next year, as a means to offer more robust opportunities for those who do not wish to pursue a fellowship to become certified by the ABIHM and/or to be forgiven the fellowship requirement by the ABPS, should they wish to sit for the new exam:

1. January 22^nd, 2012, at the conclusion of the Scripps Natural Supplements Conference inSan Diego (paper and pencil exam);
2. May 7^th-18^th, 2012; this is a computer based exam offered in 200 cities within theUSA andCanada;
3. November 2^nd, 2012, following the ABIHM/Scripps Annual Review Course, The Science and Clinical Application of Integrative Holistic Medicine inSan Diego (paper and pencil exam)
4. January 28^th-February 9^th, 2013; computer based exam

The ABIHM supports the development of the new board as a natural progression of the work we have done over the past 15 years to establish the standard for knowledge in integrative holistic medicine. We see the new board as part of the evolution toward a higher and more broadly recognized standard, and we are proud to be a part of the process.

Feel free to contact our office by phone at 218.525.5651 or email at admin@abihm.org if you have questions about these plans. Please recognize that while we have described the current nature of the situation accurately, the process is still under development and subject to change.

Yours sincerely,

The Board of Directors of the American Board of Integrative Holistic Medicine

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As some of you may know, I’ve been on a journey for almost a decade and a half to find the connections between music, vibration and health or healing.  We have studied the works of indigenous man, listened to the quotes of comparative mythologist, Joseph Campbell on the power of music, read Nancy Shute’s article about a study, published by the Cochrane Collaboration which looked at 30 clinical trials of music therapy, both those led by trained music therapists and ones where patients listened to recorded music on their own. Both methods were found to reduce anxiety and pain, and to improve mood and quality of life for cancer patients.  Music may also improve heart rate, breathing and blood pressure in cancer patients, the review says.

While at the Windber Research Institute we engaged in a study commissioned by the Yamaha Foundation to determine the genetic nuances of music as a stress reliever and a few weeks ago we passed around a story from NPR where a musician  and teacher named Holland performed sound studies on various cancer cells and saw a 50% reduction of cancer cells in pancreatic cancer . . . but this is still a work in progress.

We have known that indigenous man has used music as a part of healing ceremonies for thousands of years, and we know the impact that music can have on us emotionally.  In fact, back in the early part of the 21st Century we spoke with scientists and leaders from the University of Hawaii and the University of Pittsburgh who were doing studies regarding the bending and folding of proteins within our bodies as they responded to music.

There are also numerous studies demonstrating that music provides some relief from Autism, and from an undocumented Autism blog we read the following:  Autism is a neuro-developmental disorder that affects children, and its effects can be seen as early as infancy. Symptoms may appear at the age of six months, and the disorder is established before the child reaches three years of age. Typical symptoms of autism include impaired communication and social interaction, repetitive behavior, and limited interest. Autism is considered a disorder because it prevents the affected person from being self-dependent and leading a normal life. Most autistic people are unable to take care of themselves, even after they reach adulthood, but there are a number of them who have succeeded in becoming independent after they received proper guidance during their childhood.
Music therapy helps in treating autistic children, but it has to be applied with kids in mind. It should not be too complicated for them to follow. Music that engages autistic children in dancing and singing works very well in helping them communicate and develop social skills. Autistic children respond to music by singing in the same note, and some of them may even start communicating through singing. They may take up an instrument to play, and this will help them gain interest in acquiring a certain skill. Music therapy can help different autistic patients in different ways, but generally, it is beneficial to them because it makes them more responsive to things around them.

The reason behind such great response to music is that autistic children do not engage in normal social activities, and music sessions give them an opportunity to express themselves. Music therapy for an autistic child starts with learning how to play a musical instrument, as he or she may get intimidated by human contact. Slowly, the therapy moves on to include singing and even dancing, if the child shows interest for such activities. This gives the child an emotional outlet as well as a sense of fulfillment, which were lacking in the past because of limited social activity.

I’m still not exactly sure where this is all going, but today, I heard a segment on “The Splendid Table” on NPR in which an Austrian wine maker has successfully applied music to the craft of making wine.

Sonor Wines    December 10, 2011
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December 10, 2011

Episode Rundown

19:36 – 25:03 Sonor Wines of Austria

Markus Bachmann uses a unique fermenting process with his wines: He drops a speaker in the tank, plays music, and “the yeast starts doing total different things.”

The speakers have magnet and not membranes which makes the wine fluid  the membrane.  The vibrations mix the yeast . . . and the movement of the sound waves determines the type of mix.   Consequently, the yeast doesn’t have to move to get its food.   This effect is referred to as glycering and produces high end and enriched aromas plus it causes the yeast to use all the sugar.   The result is that it produces a very dry wine and sometimes sweet flavors.  Through this method the wines taste very rich and very mature, but it is actually a new wine, a new wine that tastes three years old.  It also tastes wooden but has never been in a barrel.  Mr. Bachmann describes it as a very oily wine that when tilted against the side of the glass creates sheets and not legs.   Finally, he says that the key in the music is that it depends on frequencies, volume, pulse.  It is like mixing the wine and keeps it more alive.  He has discovered that there is 30% more yeast that is alive at the end of fermentation than in regular fermentation processes.

http://splendidtable.publicradio.org/listings/111210/

Music for Grapegrowing
by Angela Ricci on June 28, 2011 – 12:47 amNo Comment

Sonor Wines is the brainchild of Viennese food and wine expert and horn player Markus Bachmann. This pioneering method exposes the wine to music during fermentation – a process that, according to its Austrian inventor, refines the finished product.

Bachmann explains that once in the steel fermentation tanks, a biochemical reaction is set into motion by tiny vibrations triggered by the sound. He also believes that varieties of wine that have been treated using this technique contain less sugar, have a fuller flavor and are more drinkable.

Different genres of music are also said to give the wines different characteristics. In principle, any type of music can be used, from symphonic works to hunters’ classics, waltz and polka melodies and even Viennese folk sounds such as Schrammelmusik. The process has been put to the test at the Wienbauschule Klosterneuburg on a Grüner Veltliner white wine. A number of leading growers have put the new approach into practice, including Vienna-based producers Peter Uhler and Franz-Michael Mayer, who have already bottled the first generation of Sonor Wines.

So, I’m going to keep on keeping on as I look for music/healing answers and would enjoy hearing from scientists and healers alike as this journey continues.  Seriously, folks, we know that the vast majority of our pharmaceuticals come from the rain forests or the oceans . . . why isn’t it possible that all of the cures that we need for everything are right here within our grasp?  Hmmmmm or oooooooooooooM?

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