10 Things I Wish I’d Learned in Medical School

Introduction This book is a compilation of the most helpful things I’ve learned since finishing medical school and residency: practices and concepts which have proved invaluable to my patients in the form of better health and better quality of life. Healing isn’t simply the absence of illness or pain and is almost never instant. Healing is facilitated by carefully examining the conditions that give rise to your current state of health, and discovering what actions can be taken in order to remove the obstacles that are preventing your body from returning to its natural, balanced, optimal state of health. These ideas are helpful no matter what stage of life or health you find yourself in, whether you have just been diagnosed with cancer, a more chronic illness like diabetes, or simply don’t feel as healthy as you might. Because living in greater health and peace is possible—no matter how many illnesses are plaguing you, and no matter how close you may be to death. The key I have found comes in two parts. First, we need to make sure we understand when Western medications and treatments are necessary. Second, we need to know when evidence-based alternative approaches might do a better job over the long term, and how to implement them alongside Western treatments. These are things not currently taught—or at least not well—in most medical schools, and they are outright rejected in many. When I first found myself in private practice, I discovered that most patients in the outpatient setting don’t have the classic symptoms or disease processes that are described in medical textbooks. Attempting to work around patients’ insurance (or lack of it), issues with access to care (or lack of it), and the side effects and cost of medications was frustrating for everyone. And because I often saw sparse results from the usual “best practices” I’d learned in school and residency, I became curious as to whether I could implement other methods of healing alongside the tools my training had given me. I wanted to find a way to practice a better form of medicine. I spent years studying several “alternative” modalities outside my regular realm of practice, and started integrating this knowledge into my patient interviews and treatment plans. My earliest successes showed me the superiority of some of these concepts for reducing patient symptoms and the amount of medications necessary, for patients with issues ranging from pregnancy-related weight gain to brittle type 1 diabetes. Tailoring my treatment plans to individuals and building trusting relationships with my patients took time; it required working with them over months or years on their diet choices, exercise practices, and tapering or changing of medications. I learned that of the 80 percent of general practice patients who have chronic lifestyle diseases, many of them can reduce dependence on medications and begin to heal themselves—but they need a great deal of support with very good medical supervision, practical straightforward advice given in manageable doses, and encouragement. Essential for success is persistence and excellent communication in the challenging work done by both patient and doctor. When I started this project, I intended nothing more than to write down the things I wish I had learned in medical school but had to learn on my own through successes with patients and extra post-residency schooling. The reason I continued writing this book was to communicate the vision shared by my patients and fellow practitioners who understand the interconnectedness of all things: whole person and whole planet health. I am continually inspired by my patients, many of whom have had trouble navigating both alternative and modern medicine but have persisted and are learning to create conditions for their own improved health. I am also inspired by the hardworking scientists and advocates in the social justice and environmental movements, and would like to provide a bridge for people to understand how our own health is inextricably linked to the planet’s health, right alongside social and economic justice. The changes I am working toward all intersect: social justice, health justice, environmental justice, and economic justice. At least 60 percent of the determinants of health are economic and social factors; the medical system needs to take these factors into account and work with social and economic justice movements to fix the structural problems that make and keep people sick. Racial and economic disparities are direct causes of poor health and correlate with the worst areas of environmental pollution and toxic agricultural exposures. The trauma experienced by whole segments of our population, including refugees and immigrants who have an even harder time navigating our medical system because of language barriers, makes people sicker and is not taken into consideration by most of our medical system. When we know that a black trans woman’s life expectancy is only around 35 years, it’s even easier to see the direct harm injustice causes our patients. The medical community needs to be more aware, more vocal, and politically involved; we all need to work inside the system to remedy the structural problems that lead to people’s ill health. We must integrate these concepts into the practice of medicine. We know our bodies are not separate from our minds or our spiritual selves; we are not separate from each other; and we are not separate from the soil and air and water we depend on for survival. We aren’t even separate from the animals and plants and fungi that share our home—we can’t live without them. Our microbiome, living in and on us, proves that beyond any doubt. We can no longer behave as though we are a species apart, looking to technology or other planets to save us.