Swagat Varanasi

Assi Ghat, Varanasi

Varanasi is the oldest living city situated on the banks of the Ganga River. It is one of the oldest cities in the world, dating to about 1200 BCE of continual inhabitance. It is also one of the only cities on the Ganges where the river flows south to north. It is cradled around the tributary rivers of the Varuna and the Asi traveling into mother Ganga.

A city of many names over many millenia, Kashi is the abode of Lord Shiva and a great center of learning, music, religions, and textiles. It is the place where Lord Buddha acquired spiritual enlightenment, where Sant Tulsi Das wrote the Ramcharit Manas, where Adiguru Shankaracharya received the knowledge of Brahma, where maharishi (maha=great, rishi=seer) physicians studying under Charaka wrote the primary textbook of Ayurvedic Medicine, where alchemy was perfected by Nagarjuna and colleagues, and where Sushruta, the true father of surgery, developed and practiced various surgical procedures. Benaras is also famous for the world’s best silk sarees, carpets and a pageantry of culture and arts.

Banaras Hindu University, known in Hindi as Kashi Hindu Mahavidyalaya, is the largest campus University of India and of Asia. Founded in 1916 by the great visionary Pt. MadanMohan Malviya, it imparts teaching in almost all branches of Science, Technology and Humanity through 3 institutes, 14 faculties and 140 departments. Currently, it has 1300 teachers and 18,000 students.  BHU is the Cambridge/Oxford/Harvard/Stanford of India, but it is the only world-class University that has a devoted Faculty studying the oldest knowledge that mankind has produced on medicine.

After arriving on a flight with the little drama of a brake failure, we land safely and step into the shiny new airport of Varanasi (VNS). Some political candidate must have built this before his elections.   I make my way quickly to the hotel, drop my bags and run to the campus, intent to register in the month of July for classes that begin on August 1.  I am greeted first by Mr. LB Patel at the International Centre and then by Dr. Jha and taken to an impromptu MD-Ayurveda graduation ceremony, where I am asked in Hindi to make my first speech.  The year has begun.

Arrival

Barakhamba Road,
Connaught Place, New Delhi

Delhi receives me gracefully.  I arrive with no complications on Air India, my airline of choice. A non-stop 15-hour flight of 3 films, some audiobooks, some work on the computer, 3 meals, some dozing, and I am in India.  A friend close to the diplomatic corps has carried a piece of luggage for me and meets me at baggage claim.  We leave the airport, he in his VIP car, and me in the Fulbright van.  The Fulbright guesthouse has flooded in the rains, so I will be staying at a hotel.

A day later, I am at the Fulbright campus, tucked away neatly on a street facing one of the spokes of Connaught Place. The orientation is a packet, some conversation, some fact-checking about me. Then I run off to the US Embassy for a tour, and a presentation on how to stay safe in India.  I comment that his hints are true for any city. The fear factor and paranoia of the rich is apparent in his talk.

The thesis of the presentation is that Americans are thought to have more, so people will try to steal from them/us.  I wonder if the police officer knows that a 1000 sq. ft. apartment in Delhi starts at INR20,000,000, which is about $333,000. I wonder if he knows that there are more millionaires in Bombay than in any American city.  Anyway, it is true:  Americans are perceived as rich to Indians.  Some of this is because we don’t hide our wealth. As a society, we leave our valuables on display in our homes, and we wear our nice jewelry on the streets to show our status, and we travel with lots of stuff.  This makes us look wealthy. 

What makes us wealthy, really, is that we have the freedom to think and to explore. We can study what we want. We can travel. We can talk with people of other creeds easily. We can even sleep with them, marry them. We can do business as we please, stealing from the world without much consequence.  As Americans, we are assured that we can make mistakes on our bodies and have society pick up after us, in the form of medical insurance. We can make mistakes and explore our own dim-wittedness with little consequence.  But what really makes us wealthy is that we have the freedom to make our dreams come true, once we find them. 

So, I sit and listen to the officer quietly as he drones on about the dangers of Indians and hands me an emergency card to flash in case of danger. At the end, I politely exit the locked room and follow him out.  He cares for my safety: that is the main message I choose to take.

As I leave the grounds, I notice that the US Embassy has encroached on a huge amount of land in the prime real estate of Delhi. I wonder what their rent is for these hectares, all behind tall walls.  There is a huge fountain, fancy grounds, lots of walkways and buildings. 

Next stop: a meeting with the Executive Director of the India Fulbright program. A fellow grad of UPenn, I meet Adam an hour late due to traffic and Embassy timings. He lived in India during college and learned tabla in Varanasi. He is very good friends with one of my good friends. He is deeply devoted to higher education and cultural exchange.  He loves Delhi life.  We chat and I share with him about Ayurveda and my goals for the upcoming year.   He likes to know each of the awardees. I am sure I will see him again. With that, the India briefing is done and I go back to my room. 

Professor Jha calls to welcome me to India. He is the Dean of the Faculty of Ayurveda at BHU. He brings greetings from another Dean at a school in Delhi and a Principal from Bangalore, both good friends of mine. Jha has seen the articles which have suddenly appeared in all the newspapers on Sunday and Monday about my arrival at BHU. His warmth and enthusiasm light up my jet-lagged heart. 

The Doctor is

The Doctor is  In  Out

Lexington Avenue, Manhattan
New York, NY

Closing down the clinic space in New York has been a big decision. The space has been the home of healing a thousand souls. But, for their sake, and for the sake of future patients that will come hopefully, upon my return to New York, I must take a break, to heal my own soul.

People can see it. Occasionally, patients exhibit the audacity to mention it. The good doctor looks unfit. Weight gain. Hair loss. Imperfect skin.  While many doctors my age look this way, I know I have a different challenge.  Ayurveda must prove to me its validity through its work on me.  I want to learn the deep lessons and then transparently show them through the laboratory that is my body.  To do this, I have to leave the stress of running a private practice, a school, two households and a clinic space that costs me $2500 a month, entertaining countless visitors, writing two books, having no time for my relationships, and running all the errands that are required to clean out my life and keep it clean. The time for exercise, fresh food, and routines is deferred on many days.  Admittedly, I love the fast lane. But it is making me wilt.

It has been decided that the clinic furniture will be put into storage. I look around, and talk to my chief counsel, my power attorney, quick-thinking, sharp, and straightforward.  She is also my sister.  “Pay it forward,” she says. “Give it to the Universe and allow it to come back to you in another form.  The clinic’s value is not the couch, the cabinets, the heavy furniture. The value is in the faith of the patients, the invaluable collection of books, the herbs, the knowledge. Let the rest go back to the Universe.”  I wistfully agree to return the material wealth to the Universe and give away as much as I can. My tendencies to collect and hoard are facing a welcome challenge.

A few pieces go to use by friends and students. The books cannot be disrespected by putting them in the dead space of storage: they go to the willing bookshelves of students who will enjoy them.  The herbs come to my home apartment, which bulges with fullness. All else goes to storage.  After three weeks of packing and cleaning, the clinic closes on July 15.

A doctor colleague asks me the next day if I would like to share a clinic with him in Manhattan upon my return. Somewhere in the same area. Am I interested?  I smile. The Universe is responding. Onward and upward. 

Pigtails and Parinama^

July 8, 2013.

Now that the Universe – and the F* Board – has agreed the project on Ojas is worth funding, I have a budding inner girl jumping up and down, pigtails and wide grin, bursting with an excitement that a mature physician-scientist must never show. 

Those of us who manage to keep our minds young know we hold great secrets. One secret is that we are just children trapped in bigger bodies. We have learned how to position the 43 muscles in our faces to get our way (known as authority) by moving them subtly.

I suspect I will finally get to mother the little girl that was pushed to achieve because I could do the work of American 7-year olds when I was four.  She wants time to tell me all the things she learned while I was tied to books and backpacks. 

India rips our veils and exposes our soul: it shatters some, and is heart-opening for others. I know it will smash many walls of my adult self and expose parts of me I suppressed in order to survive the life of a self-reliant physician. 

That little girl is the ever-curious, benevolent sweet one that guides the research. She teaches students from a space of knowing what it means to not know. She is the winner of the Fulbright. My adult body will write the reports, monitor what good work is, and make it all come together, not just for my discipline, and several fields interested in immunity, public health and medicine, but also for my patients. But the little girl is really the one who will do the work of unearthing knowledge from the deep corners of Ayurveda; she is ready to show me what I can do when I finally spend some time with her.

^ Parinama is a Sanskrit term. In Ayurveda, it means the changes with time and season.

Inner Compass

July 1, 2013

New York, NY

Life is more difficult when we are forced by the inner compass of integrity and truth demanded by the Hippocratic Oath.

Today’s physicians do what the others do, because they can, …. and because it pays for their lifestyle.  Am I cynical? I have seen this with thousands of physician colleagues, and openly challenge any MDs to complete their patient advocacy scorecard.  Even the 20 celebrity physicians I know.  Or those from or at the best schools.

The issues are time and patience. Cardiologist colleagues quickly recommend angioplasty, rather than Dean Ornish’s medically-proven diet and lifestyle reversal of heart disease. One tells me he is heart-broken at what he has to do, but has worked hard for his chairmanship. He has to do procedures to keep the numbers up, for the rating of the department.  

Gynecology colleagues do coloscopy but throw in a cone biopsy “just to be sure,” rather than use vigilance and patience to watch clinical symptoms or consider the risk factors for infection from having an open wound for 4-6 weeks in the cervix.  One blindly tells me that she must follow the standard of care, else her practice colleagues will discontinue her from the practice. 

Of course, oncology colleagues insist on chemotherapy even when they have not a clue about maintaining the health of the healthy tissue surrounding the cancer. One tells me he only does what the literature recommends. 

My obstetrician colleagues do too many ultrasounds, too many cesarean sections, too little observation. They says it is a game of time management.  My friends blame it on “the system:” not enough time to see patients, ridiculous rates of payment for thankless, heart-wrenching work, and little support from administration, nurses, or those who “support” the system.

Their own unwellness is the source of this, Ayurveda suggests. When a physician is not healthy and clearly connected in mind, body, senses and soul, s/he will make decisions about others that are not of the highest use to the patient. 

Thus begins the journey to explore what Ayurveda prescribes:  how do I make myself healthier, stronger, more clear, so that I can serve my patients more fully?

Routine as an Anchor through Winds of Change

The early morning routine in Ayurveda is a sacred opening act of its treatise called DINacharya (din=daily, charya=routine, that which walks forward).  As I prepare my digestive fire and try desperately to rekindle it through the winds of change that are blowing heavily on me this spring, I decided to engage more actively in my daily early morning routine. 

The Early Morning Routine

rise before dawn: 96 - 48 min prior to sunrise (use

lay still in bed & assess digestion

thank Mother Earth before placing feet down to walk on her all day

morning ablutions: go to the toilet & check for your "daily news"

wash hands

wash face with water

wash eyes with COLD water

rinse  nostrils with cool water

swish & spit water from mouth

brush teeth (tooth powder is ideal)/ (floss)

scrape tongue (elongated Silver spoon optional) then rinse mouth

look at face in mirror, present self to self

go to sacred or auspicious object, look with intent

chant or listen to sacred sound

go to kitchen space, prepare and drink first glass of freshly boiled water

This routine has been written in two classic texts, the Caraka Samhita (circa 1000 BCE) and furthered by Vagbhata’s Astanga Hrdyam (circa 800 BCE).  My dog-eared copies have been read intellectually, and now it is time to make it work in this body, this mind.

The first couple of days I re-assess what I am already doing each morning, moving around a couple of rituals to get them into the order given.  Then each day, I add in one or two new things until the 15 steps are on auto-pilot.

The hardest ones to remember are the symbolic blocks in our lives. Sometimes, I have forgotten to look intently at the sacred object, activity being more comfortable than Being-in-the-moment-with-Auspiciousness.  This is my clue that I need to be perceptive of the auspiciousness I have in my life now.  Santosha, the art of being consciously content, learning to want what we have over having what we want manifests more and more each day.

Other days, the hardest one is looking in the mirror and presenting myself to my Self.  Why is that so hard? I just forget.  So, do I appreciate who I am?   When I stop to look, I usually find a girl and have to search for the woman. The girl is easier to see: she has made less mistakes. But the woman has compassion and victory over years that have worn over her. 

Each day I step out of the bathroom and as I boil my water, I realize how much this Routine is truly a cornerstone of building Trust in my physical world: taking care of me, cleaning my senses and getting into my body. Why was this not taught in medical school, I wonder, as I sip my hot boiled water and step into my day.

Papa-Centered Care

June 23, 2013

Why do I care so much about patient-centered care, when most doctors seem not to give it first priority?

Perhaps the fact that my father was chronically being treated for his declining health also contributed. His excellent insurance predisposed him to whimsical testing by doctors who never coordinated their testing or medications with other specialists.

He was tested for every disease that could be billed by insurance, had 17 medications, which increased every time I left the country and was unable to supervise. For example, his doctors refused to discontinue his Coumadin for years, despite the scientific, evidence-based medicine that prescribed it unnecessary. My sisters contributed with their fear and their blind trust of what the “real” doctors advised. Wars broke out at home over what should be done.  My mother was exhausted with all the routines, all the pills, and all the testing.  Her cooking and care kept him alive much more than any of their drugs. 

Three years before he died, he insisted that he wanted to stop all the drugs. My mother panicked, aware of the rage of physicians who depend on the visits for their income.  It took three months to help him discontinue all his medications, even those that doctors insisted were life-sustaining: he did fine. We substituted them with herbs like Triphala for his constipation instead of Dulcolax, gave him brahmi and shankhapushpi instead of Lyrica, Wellbutrin, and Aricept. Many of his conditions disappeared, and his memory and functionality continued. He died peacefully just before his 83^rd birthday.

Lesson learned:   physicians who are not centered in their own souls practice medicine that is not evidence-based, not patient-centered, and not in the best interests of the medical ecosystem surrounding the patient.

Leaving the Road More Travelled

June 16, 2013

In 2008, a series of hospital cutbacks forced our senior administration to a series of closed-door meetings. Physicians, who had the official power of medical decision-making, were asked to use more hospital resources to keep the doors open. Fear of liability was driving up the hospital’s liability coverage of physicians.

In English, that means – order more tests. Increasing suggestions were made to order those procedures that had high reimbursement rates.  Medical liability and need to observe the standard of care was emphasized. Uninsured patients were to have what was medically necessary, of course.  But the message was clear: order more tests with high DRG codes, decipher the reimbursement rate languages, known as medical coding,  and bill more. 

Nowhere was patient-centered care ever mentioned in these meetings.

Perhaps because I believe in the inalienable right of each of us to make our own choices for our own bodies, I found these meetings to resemble medical bullying.

Of course, I had experienced it since medical school, but things seemed to be turning toward the slippery slope of corruption.

I made the decision that staying in the system in my salaried role would make me victim to the corruption and bind me to the politics of games of selfishness that fuel the medical-industrial complex and keep it from being an institution of healing.

The first step was to leave the hospital weeks after my student loans were paid off.  My medical director had made a practice to take me out quietly for drinks every 2-3 weeks, and had confided in me about certain decisions.  He had urged me to start a private practice so that I could develop independence, a sense of entrepeneurship and creativity in my own business, and ultimately not depend on others for income.

The hospital had already forced all physicians on payroll to start our own practice, “to help us.”  It was actually so that they could unload us from their books and thereby decrease the time we spent under the hospital medical malpractice insurance.  Of course, we still had to do all the administrative work in the hospital, but we were paid less.  After a few months, I quietly departed, just before the 2008 financial crash.

Ultimately all these events and observations led me to yearn for a way to observe the elderly excellent physicians who practice a timeless science of medical wisdom, where we practice medicine to actually help people and advocate using our intelligence on their behalf.      

It took me five years to get here, and now I begin to try to practice the real art of medicine.

Redefining Tradition

June 9, 2013.

Twenty years later.

On June 9, 1993, I delivered a speech that changed my life. In it, the activist and precocious physician-to-be  spouted philosophy about Redefining Tradition – the title of the Oration ­– and gave us an earful on my views on tradition and its purposes and propagations.

The faces of the men sitting behind me are a symbol of what I would go through for the twenty years that followed….!
 

https://www.youtube.com/watch?v=gdEawXyyho4

That speech was one of my greatest achievements at Harvard, because I had the courage to do something I was warned not to do: Dean Cassandra Simmons (a black female) warned me not to apply for the competition because ‘they only pick white boys.’  I was the first Indian, and woman, to have that podium, to write my name in the Harvard Big-Leather-Book-of-People-That-Give-Commencement-Speeches-at-Harvard. 

That fall, I applied for a Fulbright and was rejected because Harvard forgot to mail my transcript to them and because I was less meticulous and less meticulously-intuitive than I am now.  Here I am twenty years later, on the precipice of another thing I was warned not to do:  go beyond conventional medicine, since I was trained in conventional medicine. All the laws are against my work both here and in India, since Indian conventional doctors cannot teach or practice Ayurveda … but laws are meant to be … evolved.

the new F* word.

7/24/12.

It was a hot, empty day in late July. My email had a reminder from Fulbright: since I had been on their website in February 2012, if I wanted to complete an application, I had to do it by August 1.  

In fact, instead of being empty, I had planned to fly to India with a group of my Ayurveda students in mid-July. But the unpredictable had happened. On July 13, all semblance of peace had disappeared as one student after another reported death and destruction in their lives, backing out from the journey, and leaving me with a non-refundable ticket and a bunch of train, plane, hotel, and car bookings….  I had decided to cancel the trip and eat JetAirway’s cancellation fee of $995, a fee that was only possible because AirIndia was on strike, leaving other airlines to price-gouge freely.  My mother had experienced her own destruction, walking into her home and finding that the guy living above had an exploded water pipe that made her ceiling fall into her bathroom tub and floor.  With the week suddenly free of flights, I spent the time in Princeton, overseeing renovations, and spontaneously upgrading her bathroom significantly, since the guy upstairs had his insurance pay for it. 

The email reminder came at a time when renovation of life was in the air.  As we stripped away the protective plastic sheets in her apartment and the new bathroom emerged, I decided to renovate my life too. 

For many years, I had been yearning to study abroad.  Shortly after residency, I had received an award from the Clinton-supported America India Foundation-AIF, but had declined, as my student loans needed to be repaid.  With the $401,000 paid off now, I was itching to do some much-awaited research in India.  My hospital was in trouble, downsizing from budget cuts and corruption.  I had left in 2011.

Two decades before, in 1993, I had applied for a Fulbright fellowship and was devastated when they informed me that Harvard had not yet sent my MPH transcripts, so my file was disqualified. Harvard’s holy Office of the Registrar was filled with people that …..well, did not attend Harvard….!  They had “forgotten” my transcript in a To Do pile that was Not Done.   So my file was ignored, my life path disrupted, my whole world interrupted by their neglect.

Lesson of Life Learned: smile at others, but always check their work when you are the one that will benefit from their labor.  

After a strong meditation, and several deep dharana sessions as I had grouted tile in my mother’s new bathroom, I dreamed up a project I loved, that would benefit the people who assisted me in the field, and that would help the Americans that paid for my grant.  In a week, I had an essay. Then three letter of recommendations promised, then reminded, then chased, then begged, then done by three benevolent angels of change who believe in the work of explaining Ayurveda in medical language. An essay, a language competency verification letter, a slew of demographic questions, a summary of the field, with references. Then I sat on July 31, reviewing and satisfied before hitting the SEND button. 

The Fulbright Scholar grant is a long application, and my sincerity in finishing all the research and writing and compiling was an exercise in self-confidence. The biggest reward was the realization that I still have the focus to complete long applications. I also got a lot of credential papers organized along the way. I threw out a lot of old papers while hunting for things they requested, like transcripts and technical articles. Whether or not I received fruits from my labor, I knew that my idea to conduct interdisciplinary research on Ojas in Ayurvedic pockets in India would be a great clinical tool. If I did not get funded, I still wanted to go to India and try to finish the research with the elders over several years.

Anyway, I argued, it was a good way to spend the empty last days of July.

In the late summer, my diksha guru told me NOT to mention the application to anyone, not to even utter the F-------- word. Not even to my mother. Food cooks better when the lid is on the pan; things can simmer quietly without outside interference. I had to keep the lid on!

When my referees asked for status updates, I referred to the application as ‘the F* word,’ determined to value the magic of cooking, and the command of my guru. Through silence over the 6+ months, until the F* Board agreed the project was worth funding, I learned about the space, the abyss, between the words, where personal hopes and determination mix with surrender and resignation, where decision occurs.

The biggest lesson to learn from ‘the F* word’ is that the true victory is to survive the rigor of the application process. It will remain as a very personal growing experience that belongs to noone else.

heat transfer, kleda and pace

In my practice, which combines allopathy with holistic medicine and a backbone of Ayurveda, I use a combination of herbs with great success for immune issues.  I use the good clinical reductionistic biomedicine I learned. I frame the care with the holistic attitude I developed traveling to ancient teachers. I include time for building healthy awareness of the mind-body-senses-spirit. This seem to be a great recipe for interfacing with today’s patients who want to heal.     
 
For example, for skin issues, I use herbs which have an inherent lack of heat transfer energy, known as cooling virya.  Herbs like Guduchi, Shatavari, Kutaki, combined with the principles of Ayurvedic structural physiology and emphasizing the role of our mind, our senses, and our choices makes a great combination. Patients are often cured of diseases they were told would be lifelong.  
 
For cancer patients, and those with growths currently benign by modern medicine, but classified as purvarupa, or premonition-ish symptoms of Ayurveda, I use a set of herbs produced widely.  The formulation includes the smooth, sweetish root of shatavari (Asparagus racemosus); the horse-odoured rough, tough root of ashwagandha (Withania somnifera), the accumulation-removing, channel-cleansing, heart-livening rhizome of the small mighty Himalayan kutaki (Picrorhiza kurroa); the spiky, hoof-catching fruit of Tribulus terrestris; the phallic, penetrating srotamsi-srodhana fruit of Piper longum; the round, rich, heating and phlegm-reducing, lipid-bilayer shrinking fruit of black pepper, Piper nigrum; the heat-transfer increasing rhizome of ginger, Zingiber officinale; and the thin-barked Sri Lankan cinnamon, Cinnamomum zeylanicum.  
 
Hungry opportunists will jump with this combination to their labs, analyzing and blending the whole plants, their alcohol extracts, or their essential oils, trying to find the active ingredient through a spike of their expensive equipment. They will try to copy its effect in rats and quickly apply for a patent before I do. They will apply for research grants to the NIH, and get funded by review section scientists who know just as little about the root vs. the stem and have never dug a rhizome without killing the plant, who spent three weeks interviewing natives on a root in the south Pacific and extrapolate their knowledge to the entire botanical Universe. 
 
They will try to replicate what I do, in the name of science, never thinking to learn the pattern of discovery from me or from my teacher. We use these herbs but we increase or decrease their amounts based on the qualities of heat transfer and kleda (excess mucous) and pace in the body of the person we will give the medicine to. We see how each patient processes food, indicating their ability to take in nutrients across their intestinal wall.  We ask about fatigue patterns, sleep, appetite, bowel movements, cravings, and mental focus. We feel the energy in their pulse, look at their tongue, their skin, and their eyes.
 
Then we dose the herbs singly or in combination at a time of day that correlates with the level of heat transfer energy they will have in their body, called Bhaisajya Sevana Kaala. We put the herb in different form, liquid, solid, paste, gel, depending on the strength of the body, the time of year, the person’s age and constitution. We adjusting for meal patterns and routines. We give the same medicine with one food vs. another, and it changes the rupa/color of it, just as two cans of paint mixed vs. applied side by side. With certain liquids, called anupana, it has different penetration. With certain carriers, the nutrients head to a particular organ for which the liquid has affinity, called yogavahi. The patient tries the experiment and comes back to us with a report of what worked and what did not, called upasaya, and we make adjustments to optimize the experience for the patient.
 
This may seem complicated, but it is a set of well-repeated patterns that have been replicated over millenia by minds that can handle the details and have the passion and curiosity for watching what can happen to the human body.  In fact, just knowing the herbs in the cancer formulation  is enough for a good Ayurvedic physician who studied Dravya Guna and Kriya Sharira, who can easily unravel the combination and why they are used together. 
 
For those who think in terms of pills and LD50 curves, they will not understand. They will reject the energy combinations that lie in the formula.  Ayurveda teaches about the body in patterns. These herbs work to reverse, or balance those digressive patterns. 
 
I have learned through live clinical learning, how to use it from my teacher, who made it.  I have used it with lymphoma patients, ovarian cancer patients, thyroid cancer patients, kidney tumors, uterine fibroids, lung cancer, and sarcomas. With great success. Documented in CTs, MRI, blood reports.  I have used it when the physicians cannot make a diagnosis and fail to see the trend in 8 tumors (“all benign”) and a failing kidney.  I have used it when the histology in the slides were interpreted screaming cancer, and later screamed inflammation, and finally went silent. I have used the formulation alongside chemotherapy and radiation and pre-surgery and post-surgery.  But these results are only in individuals. The sample size is insignificant, chimes in another parrot of evidence-based medicine, and the discussion stops as he opens his NEJM journal to read the regular column, entitled, Case Records of the Massachusetts General Hospital. 
 
Yet, the bottom line for those same materialistic, prove-it-to-me physicians who challenge yet hungrily visit my practice, is that the formulation works. They look down their noses at me when they sit in their white coats, as they were trained to do.  Later, they come quietly, sheepishly, when their bodies fail them, and they are afraid to use the same medicines with which they have poisoned their own patients. Straightening their spine, and claiming that they are also part of the fraternity of healers, they ask for that same formulation of herbs that they could not, would not, give to their patients because it was not evidence-based. They tell me of the tumors that have gotten hold inside of them. I pause, knowing the tumor started long before, when they had closed their mind to what evidence really is.

just after midnight

2/21/13.

It was two minutes after midnight. "Barota beje geche," my mother would say. 

When I visit her on weekends, we stay up chatting into the night, though we keep prodding each other to go to bed.  We rose from the couch. As she headed to lock the doors and turn off lights, I compulsively turned to my computer to check my emails.  "Do that tomorrow," she insisted. "You will disappear into that thing if you start now.  Let's go to bed." As she stepped into the bathroom to complete her pre-bed rituals, I took the quiet moment to disobey her request, as courage-afflicted daughters do to bossy mothers, as I had often done since adolescence.

The subject line was official: Your 2013-14 Fulbright Scholar Program Application

but the first words of the message were kind, peeking out in gray - Good news! Congra...

I clicked and it continued: Good news! Congratulations on your selection for a 2013-2014 Fulbright U.S. scholar grant. An official letter of selection from the J. William Foreign Scholarship Board (FSB) is attached...

"Maaaaaaaaaaaaaaaaaa!," I heard myself scream as the world went blank for a moment.  She came running into the room, frothing toothpaste from a clasped mouth, holding her toothbrush like a drawn sword. I grabbed her unspectacled body and pulled her toward me. She could not see and stuck her nose inches from the screen, as I expanded the window.  "February 21, 2013,  On behalf of the J. William Fulbright Foreign Scholarship Board (FSB), I am pleased to congratulate you on your selection for a Fulbright award to India....," she seemed disturbed.  

"Wait." She reentered the bathroom and moments later - the quickest I have seen this 76-year old move in a while - she emerged with eyeglasses, clean mouth, and wet face. She grabbed the laptop intently, and read aloud, in the thick Bengali accent we loved to imitate as rowdy children, "As a Fulbright grantee, you will join the ranks of distinguished participants in the Program. Fulbright alumni have become heads of state, judges, ambassadors, cabinet ministers, CEOs, university presidents, journalists, artists, professors and teachers. They have been awarded 43 Nobel Prizes. Since its inception more than 60 years ago, approximately 300,000 Fulbrighters have participated in the Program."    She looked at me sternly. "How did this happen?"

I smiled, too changed to be devastated by her inquisitive judgment and everything her question implied.  There was noone else in this world who would have shared this moment, and the weeks after, with me with such benevolent, youthful elation than the woman who birthed me and gave me the fire and drive to set out to do what I am doing.