Prevention is not the best Cure.

BHU, Varanasi

The head of one of the departments is engaged in a deep debate with me about the value of Ayurveda. He decidedly states that Ayurveda is only preventative, but cannot intervene on diseases: that is why modern medicine has succeeded and is superior.

It is a well-paved argument, one I was taught at Columbia and Harvard: the power of modern medicine is in its speed and scientific precision.  He cites the advent of antibiotics as the cure-all since WWII.  His colleague is seated with us, did a fellowship in New York, and willfully agrees.  

They discuss fever and diabetes. “You will have to admit that paracetamol (aka acetaminophen/Tylenol) works much faster than anything we have in Ayurveda. When you cannot wait for the fever to come down, you have to get it down. If my son has an exam tomorrow and he develops fever in the night, I can’t risk him taking Ayurveda which will take 2 days to take effect. Paracetamol will have his fever down in 2 hours, and then he can take his exam. This is the way of modern life.”

Indeed. Modern life.  The long term effects of paracetamol are not cited, but the short-term action is celebrated.  I ponder, as I cannot deny his truth. 

“And there are no drugs in Ayurveda to lower blood sugar. Modern medicine uses insulin very effectively to lower blood sugar, quickly and effectively.”  My mind echoes the same thought: what is happening to the body while we are precipitously countering its actions and reactions, pretending to understand its ecosystem by analyzing a few molecules and proposing a mechanism? 

I pause, waiting for my turn for rebuttal. The rules of academics in India require that we listen and never debate with persons much senior than ourselves.  The Fulbright faculty status has exempted me for these months: I am allowed, expected to engage in debate, in the activity of “faculty interactive discussions.”

As I begin to cite some biochemical mechanisms, patient cases, and some Ayurvedic roga nidana (pathophysiology), he rocks suddenly in his chair, calls abruptly for tea, and stops the conversation.  It is an indication, another indication that when someone is ready to hear, only then can he hear.   I politely leave, actively engaged in this example the Universe has provided for debate. I have to get sharper, more deep, more able.  Down the marble steps, I walk across the length of the yellow-painted megalith, pondering.  Are there really no drugs in Ayurveda for fever and for diabetes?

The issue is diagnosis and keen observation and examination. All the clues are there and only need to be perceived accurately. This requires that we have a still mind, acutely clean senses.  There are many modalities in the ecosystem of Ayurveda: herbs, surgery, metal medicines, pranayama, mantra, gemstones, marma, yoga, ahara (diet), lifestyle,….  The most potent, according to the wisemen, is Pathya, or appropriate and clean intake of food.   Diet is not only what you eat. It also includes where the food comes from, how it is cultivated, how it is prepared. The detail required to teach this to each and every patient is what prevents Ayurvedic doctors from doing it, well. 

Vrana-ropana^

Around the corner from the expansive, dilapidated Ayurvedic Hospital is a courtyard made of sand leading like a ghat to three new marble stairs. Inside the wrought-iron accordion gate at the top is an entry hall freshly-painted, covered on one wall with a beautiful mural of Ayurvedic surgery, and as elegant as any Manhattan office building …. except ….. that it is teeming with people in every corner,

A rusted, L-shaped wheel jack handle

One of the professors in our department sends out articles from time to time.
Usually they are on metals, or policies in Ayurveda.  Sometimes they discuss health care.

But today, he sent out a link to a column that gnawed at me very deep inside. It was a blog of a guy discussing his intentions to teach his growing child how to look at women. 

Plays Well With Others

Annual Teachers Day
BHU, Lanka, Varanasi

Since I can remember, my aunts and uncles have been arguing with each other and with my mother, vowing never to speak again with each other, over important issues such as colors of cars, and lending money, and who took who to America. The tiffs have lasted for decades among the siblings, but never with my mother.  They will argue and insult her. She will forgive them. They will come running back, calling her as though nothing had happened and forgetting their shame of bad behaviors. 

My mother is my biggest Teacher. She forgives them for all their petty hang-ups, biases, lies and blasphemic vows, and she embraces them again and again.  

living.... simple

Ganga-ji arrived at our doorstep and entered that day. (This means that the river flooded and moved inward onto the streets, and into the land, and into our homes!)

We saw water rising suddenly on Sunday around 7am. It focused on the forests around the house, and the park. But mainly it filled the street that led directly to the Ganga, as though she had decided to talk a walk and come to our houses.

To Clean or Not To(o) Clean

Shivpuri Colony

near BHU, Varanasi

I am on house arrest.  Not only from leaving India (Fulbright contract does not permit grantees to leave during the grant) but from leaving my house.  Since yesterday, the waters of Mother Ganga have moved inward and now they have come past my doorstep to the first step up.  Floods happen. In this part of Varanasi, the last huge flood that entered into homes here was twelve years ago.

Ganga-ji

Shivpuri Colony
Lanka, Varanasi

My morning tea was accompanied today by a smile and “Ganga-ji aaye!” Respected Ganga has come.  I replied, “Kya matlab?” What does that mean?
The house butler walked over to the edge of the veranda, beckoning me with his eyes.  Two stories below, the water was filling the streets, travelling steadily inward. It was now waist-deep outside our house walls.
I am glad I refused to take a ground-floor apartment.
Apparently, this last happened over ten years ago. Noone knows why she comes to visit our doorstep. It did not rain profusely upstream or here. 

The Reyaaz of Tabla

Shivpuri Colony
Lanka, Varanasi

The waft of the taal of tabla spills tears from my heart suddenly as I am washing the dishes from lunch in this intense breezeless heat in my open-air kitchen.  The house next door, or someone living below, is a musician.  He is practicing a tekha, with the same rhythm playing again and again in cycles of 16. The bayan is soft and accompanies the darts of the tabla, pulling me back to an all-night spontaneous concert by drunken Ustad Shahid Pervez and Pandit Kumar Bose a decade ago, in the living room of a student settled in the foggy hills of Jharkhand.

The tabla is a percussion instrument, created by stretching cowskin over a conical cylindrical frame of teak and rosewood, and securing it with leather stitches.  A central black area, called the syahi, is created with flour and iron fillings, rubbed with stone onto the skin, and placed slightly off-center to give it different tones. The brass or copper drum, larger and more round, is called the bayan, baya meaning left. The tabla was introduced only recently in the 1300s by polymath Amir Khusro and popularized in the courts of the kings to add a rhythmic sensuality to voice, sitar, or dance. 

Music is an integral part of Bengali and Benarasi culture. It is rare for a family not to have some member who cultivates music.  In my family, my mother sang Rabindrasangeet, my father played violin, my sisters played flute, my niece the clarinet. I believe I was cursed in an earlier life: I am surrounded by music but have yet been unable to maintain proficiency. My flute of life has too many odd holes to hold a tune.  Krishna’s disappointment in me in obvious. 

The tabla continues to beat over the hot afternoon air as I head back to the office for afternoon classes. When I return in the early evening, after a strong rain has flooded the streets, he is still practicing, the sign of a strong reyaaz.  My many musician friends who came to Benaras to devote a portion of their life to authetic study share their stories of daily 8-10 hours of practice.  This is the way of reyaaz:   dedication and discipline, living the adage that practice brings perfection.

Diplomatic Pouch

Shivganga Express
Train from Delhi to Varanasi

The lull of the train rocked me through a strong eight hours of sleep. I had awakened at my usual 4:30, but the cabin was full of snoring neighbors which lulled me back to silence and a three extra hour doze.  Aakri, the end of the month of Sravan, is celebrated in Benaras today with pujas and rituals of color. As I make my way back to Lanka, I smile. My trip to Delhi was eventful and productive, but I am excited to be home.  My workout after a long, lazy night on the train is to lug 2 suitcases and 4 boxes of books that arrived by diplomatic pouch to the Delhi Fulbright office to my rooftop apartment.  Hansraj arrives and smiles and easily lifts the last 40lb box up to the room, as I stand with sweat on my brow, determined that my biceps and core muscles should look more like his. 

My books complete the apartment and make it mine. There is a sense of guidance and mentorship I feel with the books here.  My elders are with me.

Rain and Raga

Delhi

The rain starts around 4:45pm, and I am due at Gita’s home by 5pm. I call to say I will arrive from the 30 minute drive a few minutes late. At 5:30pm, the rain is not stopping, and Sachin, my expert Delhi driver, is weaving past soaked auto-rickshaws, mopeds, bicycles, drenched cows, motorcycles, SUVs, and other cars. At 6pm, we encounter a HUGE traffic jam, and 25 minutes later inch past a fallen tree with a live electrical wire soaking in a large lake of roadside water, which people are slowly traversing with great care. A large-bellied executive is standing knee deep in his white collar, volunteering and directing the one-lane passage and 5 lanes of awaiting traffic until officials can arrive.  I feel very pleased to see an MP with a twirling red light sitting in his car helpless, and can only fantasize his electric execution if he were to push ahead like a bulldozer into the wires, as he does in his daily corrupted life of activities.

We pass the crowds and slowly edge toward Gita. She knows there is no time for a leisurely Saturday evening dinner, and she hastily enters the car as we turn back for a drive through the waterways to the India Habitat Centre, where she has tickets for the four-day concert celebration of India’s independence. 

We settle into seats, slightly drenched and entirely humidified, and wait for the air-conditioning to suck the extra water from our bodies.  Both of us love Indian classical music. We have made the effort, as is customary, to create the proper ambience for imbibing this medicinal music of the Ragas by dressing sensuously. She is in a Madhubala printed kameez, and I am wearing a simple khadi kurta and lots of jewels. 

We arrive amidst the alap, the first interface of one’s being with something in the Universe. Alap is the term “First Contact” from Star Trek.  Hindustani vocalist Bharathi Prathap is giving us parichay with the raga she will be singing. The alap is sensuous and still, yet quaking in its eagerness to be seen.  We are called to the green room to meet my friend, so we take a quick escape from the main hall, and arrive behind the stage, only to hear the vocalist even more resound and colorful.  In the green room, several people are crowded around the reyaaz of Tejendra-Narayan Mazumdar and Mohammed Akram Khan.  We greet him then return to our seats voyeuristically during the intense jhal or climax of the vocalists.

Mazumdar is probably the best sarodist today, technically and in character. Several other sarodists are on the scene, but most of them use politics and other nefarious techniques to edge others out. Mazumdar just plays.  His technique is excellent, and his hands precise. Like an auctioneer that can keep each sound distinct when announcing bids at miles a second, Mazumdar keeps his notes clean, with no reverberations or echoes on the strings, which one can commonly see in other sarodists during the jhal. 

With a polite introduction, he plays four pieces, of which one is Raga Jhinjhoti. One can visit http://www.itcsra.org/sra_others_samay_index.html and get a nice introduction to the Ragas and when to play each.  Jhinjhoti is a raga for late night, but can be played at any time. It captures the essence of warmth and exudes a magic that envelops the room.

Mazumdar and I are connected by sound. His wife, a PhD in music and current principal of Bengal Music College, is a scholar and a singer.  He and I have been discussing the ragas intimately for years, as I try to feel a world in which deep secret medicinal magic is locked.  Mazumdar has some working knowledge of the medicinal effects and tries to converse in these terms, awkwardly trying to speak a hybrid language from his native tongue of fingers on strings.   
He and I are bonded from one reyaaz on a late night in Calcutta in 2010, when I witnessed him develop a few notes, inspired by my stories of love, aspiration and longing for Ayurveda. The way he interpreted my heart and played it on the strings bonded us, as I knew he knew that I knew what it is to be lonely yet entirely fulfilled. He played it for me and my long-lost love, who was in the room. Of course, destitute-hearted people will interpret such intimacies inappropriately, but the land of music knows what was shared.

Mazumdar continues into the alap of the last piece. I see people move to the edge of their seats, some sit rocking with eyes closed, some are tapping feet, hands, shoulders.  Everyone is affected.  In India, expression of the audience is part of the energy of the room and contributes to the live piece. In contrast, western classical music captures and recaptures sequences of notes created by dead people long ago: the audience reflects it.  At the end of the jhal, Gita takes a deep breath, “Wow.” 

We enter the cool, wet, post-rain evening, look at the moon as it moves toward fullness, and drive home through sweat-filled streets.

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.