The Cab Ride I'll Never Forget

A Story by Kent Nerburn

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Twenty years ago, I drove a cab for a living. One night I took a fare at 2:30 AM, when I arrived to collect, the building was dark except for a single light in a ground floor window. Under these circumstances, many drivers would just honk once.

But I had seen too many impoverished people who depended on taxis as their only means of transportation. Unless a situation smelled of danger, I always went to the door. This passenger might be someone who needs my assistance, I reasoned to myself.

So I walked to the door and knocked. 'Just a minute', answered a frail, elderly voice. I could hear something being dragged across the floor.

After a long pause, the door opened.

A small woman in her 80's stood before me. She was wearing a print dress and a pillbox hat with a veil pinned on it, like somebody out of a 1940s movie.

By her side was a small nylon suitcase The apartment looked as if no one had lived in it for years. All the furniture was covered with sheets.

There were no clocks on the walls, no knick-knacks or utensils on the counters. In the corner was a cardboard box filled with photos and glassware.

"Would you carry my bag out to the car?" she said. I took the suitcase to the cab, then returned to assist the woman.

She took my arm and we walked slowly toward the curb.

She kept thanking me for my kindness. "It's nothing", I told her. "I just try to treat my passengers the way I would want my mother treated."

"Oh, you're such a good man," she said. When we got in the cab, she gave me an address, and then asked, "Could you drive through downtown?"

"It's not the shortest way," I answered quickly.

"Oh, I don't mind," she said "I'm in no hurry. I'm on my way to a hospice."

I looked in the rear-view mirror. Her eyes were glistening. "I don't have any family left," she continued. "The doctor says I don't have very long." I quietly reached over and shut off the meter.

"What route would you like me to take?" I asked.

For the next two hours, we drove through the city. She showed me the building where she had once worked as an elevator operator.

We drove through the neighborhood where she and her husband had lived when they were newlyweds. She had me pull up in front of a furniture warehouse that had once been a ballroom where she had gone dancing as a girl.

Sometimes she'd ask me to slow in front of a particular building or corner and would sit staring into the darkness, saying nothing.

As the first hint of sun was creasing the horizon, she suddenly said, "I'm tired. Let's go now."

We drove in silence to the address she had given me. It was a low building, like a small convalescent home, with a driveway that passed under a portico. Two orderlies came out to the cab as soon as we pulled up. They were solicitous and intent, watching her every move. They must have been expecting her.

I opened the trunk and took the small suitcase to the door. The woman was already seated in a wheelchair.

"How much do I owe you?" she asked, reaching into her purse. "Nothing," I said.

"You have to make a living," she answered. "Oh, there are other passengers," I responded.

Almost without thinking, I bent and gave her a hug. She held onto me tightly. Our hug ended with her remark, "You gave an old woman a little moment of joy." After a slight pause, she added, "Thank you."

I squeezed her hand, and then walked into the dim morning light. Behind me, a door shut. It was the sound of the closing of a life.

I didn't pick up any more passengers that shift. I drove aimlessly lost in thought. For the rest of that day, I could hardly talk. What if that woman had gotten an angry driver, or one who was impatient to end his shift? What if I had refused to take the run, or had honked once, then driven away? On a quick review, I don't think that I have done anything more important in my life.

We're conditioned to think that our lives revolve around great moments. But great moments often catch us unaware, beautifully wrapped in what others may consider a small one.

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Why do we get sick?

Why do we get sick? Answering this question can help physicians understand whether or not a treatment is palliative or curative. As physicians, we must acknowledge that what we call disease is actually an adaptive physiological response to some imbalance or stressor. The stressor can be a pathogen, an environmental stress like subzero cold, or even emotional like mania.

Often physicians mainly focus on treating symptoms. It is often very insightful to ask why does the person need this or that particular treatment? Is this treatment needed to bring about balance again, or is it being given or performed to remove or cover over a natural physiological process? There really should be no need for a medication if the person could maintain homeostasis before. Ultimately we want to re-create the natural homeostatic balance of the body.

A patient reaches an imbalance due a combination or, more accurately, an accumulation of events that move the patient away from homeostasis. The body “normally” can maintain homeostasis, yet sometimes these homeostatic events cause a build up in the body. The build up of metabolic can be due to the body’s inability to release these now toxic substances. It can also lead to the body ability to holding onto the metabolic waste and walling it off. These different responses depend upon are a person’s constitution or their lifestyle combined with their genetic make-up. The way in which people respond, or the response-ability is the result of everything that came before (all the past events and places).

Ultimately understanding how a being responds to stressors, a physician can teach a person how daily activities can create restore an optimal healthy homeostasis to the body. The physician must consider the person’s constitution, past experiences and present manifestations/symptoms into a treatment plan that can help restore balance. The treatment is unique for the disease within the context of the person. That way the cause of the disease and the way the person manifests the disease is treated simultaneously. Disease can start in any of the aspects of a whole being whether it be spiritual, mental/emotional, or physical – Healing can being within any aspects of a person’s being but wellness will require addressing the entirety of that person and restoring complete balance.

What is Holistic Medicine?

A couple of questions to begin with in an exploration of defining holistic medicine are: “How is health different from wellness and How is illness different from disease? In the modern materially based medicine of “western” society, health has become the focus and goal of healing. I would posit that even if a patient is ill they can still be well. It comes down to the “direction” of a patient’s/doctor’s intent in healing. By the same reasoning a disease-free person can still be in a state of illness.

Illness and wellness are on a continuum and intent plays the role of directing the course towards one end of it or the other.

Illness <---------------------------------------------------> Wellness

When a healer considers the whole of a patient, the intent (direction) on the Illness-Wellness continuum can be determined. In a “non-holisic” or materially based medicine, the direction towards illness or wellness could never be determined, only whether the person is diseased or not-disease (healthy). This limit is present because material medicine does not acknowledge the whole of a person’s life. It only acknowledges the materially reality. If the mental state, emotional state, spiritual state of a person is considered, then the “direction” on the above continuum can begin to take shape.

Modern materially medicine is even more “blind” to the concepts of illness/wellness because, the material reality of the concept of the patient is limited to the immediate physical body. Even further limiting is the “Descartian” view of segmenting, into tinier and tinier parts that make up the body. Modern medicine is at a point at which it cannot even determine whether the body is functioning well as a whole. In dissecting of the person into more and more parts, the discarded/disregarded aspects are loss and fall out of importance.

A good example of this is human genome project. One intent of this project, is to elucidate the genes that “control” disease processes. It could be posited that to “understanding” what “controls” disease will never be reached because with each layer into the physical world that is probed, medicine moves another step further from the whole person.

To practice a holistic medicine requires a re-membering of the person. The holistic practitioner needs to break free of the material world and begin to acknowledge and understand the patient on many different levels. This requires a taking into account all the health aspects of a person – spirit, emotional, mental, and physical. Out of this whole consideration, a direction of intent along the illness/wellness continuum can be determined.

One problem with modern day “wholistic” medicine is that the “considerations” are still physically based. While there is a consideration of the whole person it is only on the physical body and its environment. One way around this is to remember that the physical is just one aspect of the whole person. Take the word emotion as an example. From Latin, the root “emote” means to move. There are many things that make up the person, including emotions. To describe breathing we use the word inspiration. When we breath in we have stimulation of the mind or emotions to move us in the act of breathing.

Human beings are more than just a phrenic nerve signal stimulating the diaphragm to contract and causing a breath in. The flesh is one aspect of our manifestations in the world. We are multifaceted. We are not just a thing in space to be poked and dissected; we are a place that must be placed into a context. When this occurs we can once again determine where a person is on a continuum of illness and wellness. We know where there person came from and where they are headed.

You are what you wear: Organic cotton and its impact on your health and the planet!

Appearance is only skin deep…right?

Actually, the answer within our modern world is a definite, “No.”

What we wear changes not only our appearance, but also our long term health especially when what we’re wearing is cotton.

“…but cotton is all natural so its safe, right?”

Not as natural as you think

Cotton is a natural fiber derived from the Gossypium spp. plant and grows best in dry tropical and subtropic climates. The world demand for cotton is huge at 56 trillion pounds per year and keeps increasing annually. Although cotton does grow in tropical places well, the large demand for the crop and the fickleness of the cotton plant for ideal growing conditions production in non-tropical places, makes for cotton production using 25% of the worlds insecticides and 10% of the world’s pesticides^[1] while using only 2.4% of the world's arable land.[2]

During lifecycle from when the cotton first sprouts to when you purchase it in the store, over forty-six different types of insecticides are used. Of these, “Five of these are classified as extremely hazardous, 8 as highly hazardous, and 20 are moderately hazardous”[3] .

Pesticides’ impact on your health

From the beginning to end of cotton textile production, there are impacts on even the healthiest person due to the plethora of pesticides involved. Degradation to health begins in the cotton fields with the health of agricultural workers. Studies have estimated the human impact from pesticides used on cotton to be as high as 20,000 people killed and 3 million poisoned every year[4]. This type of exposure continues from the field to cotton factory mill employees as not only an accumulation of respiratory pollution, but also increasing and persistent pesticide body burden. Pesticide exposure continues into the home with pesticides that arrive on fabric from the clothing manufacturer. In fact the Environmental Working group found that just nine adult volunteers were found to have over 167 pollutants and pesticides in their bodies.[5]

Wearing what you are

So what can you do? You want to be as healthy as you can be. Wear nothing? There is a solution out there and it lies in organic agricultural practices. In organic farming, principles such as crop rotation and an understanding of pest lifecycles are used to eliminate pesticides. You can change your health by committing to buying organic cotton. As your commitment to your health increases along with your individual demand for organic cotton, manufacturers will take notice and increase their use of organic products. In 2004 an estimated 93% increase in manufacture demand for organic cotton. In fact, in 2006, Walmart and Sam’s Club bought the most organic cotton textile products of any retailer.[6] Organic cotton use can not only better your health and wellness, but also improve health and wellness for all inhabitants of the planet.

Resources:

http://www.sustainablecotton.org

http://www.planetearthgreenlabel.com

http://www.pan-uk.org/Projects/Cotton/pdfs/my%20sustainable%20t-shirt.pdf

http://www.panda.org/about_wwf/what_we_do/policy/agriculture_environment/commodities/cotton/environmental_impacts/agrochemicals_use/index.cfm

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[1] Allen Woodburn Associates Ltd./Managing Resources Ltd., "Cotton: The Crop and its Agrochemicals Market," 1995.

[2] Clay, Jason. World Agriculture and the Environment A Commodity-By-Commodity Guide To Impacts And Practices. World Wildlife Fund 2004 pp. 283-305

[3] Soth, J., Grasser, C., and Salerno, R. (1999) ‘The impact of cotton on fresh water resources and ecosystems: A preliminary analysis’, WWF, Gland, Switzerland. preliminary analysis’, WWF, Gland, Switzerland.

[4] World Wildlife Fund. Agriculture and the Environment: Cotton. http://www.panda.org/about_wwf/what_we_do/policy/agriculture_environment/commodities/cotton/environmental_impacts/agrochemicals_use/index.cfm. 2007.

[5] Houlihan, J. Body Burden: the Pollution in People. Environmental Working Group. http://archive.ewg.org/reports/bodyburden1/index.php. 2003.

[6] Volheim, E. “Next to the skin.” In Good Tilth: Organic fibers – Values that you wear. Sept/Oct 2007. p. 4.

What is natural medicine?

Natural... is...Overused. You will find it on anything and everything from toothpaste to sugar...What, sugar!? Yes, I even saw "all natural" on a sugar package the other day at the supermarket. The entire sugar industry is disappointed that the FDA refuses to define the word "natural."

Sugar is natural and is derived from nature, but nothing in nature is ever that sweet. This brings me a bit closer to my current thought of what natural medicine is. Today I had an interesting discussion with my Chinese medicine colleagues on imbalance. In Chinese medicine, there is a line from a classical text stating that "Imbalance is treated with imbalance." What this means is that disease is basically an imbalance of yin and yang and so to bring a predominantly yin disease or yang disease back into balance, the equal but opposite imbalance is needed to restore equilibrium. The more out of balance and further from our equilibrium or true natural state, the more un-natural the intervention has to be to restore balance.

So although sugar is "natural," there is no "natural" high concentration of sweetness like that found in the modern refined white stuff. [side note: researchers find "Intense sweetness surpasses cocaine as reward."] This is how people become can "addicted" to sugar and gain weight from sugar.

The closer we are to nature, the more healthy we are. When we are further from being "in harmony," with natural processes, we are less natural and thus disease starts to develop. Sugar is more natural than Nutrasweet, but sugar is less natural than honey. As I wrote in the last couple of blogs, getting to sleep by 11pm is more natural than staying up all night and sleeping during the day. On the other hand, getting to bed an hour or two after the sun sets is much more natural than staying up until 11pm if the sunset was at 6pm.

Iatrogenic diseases are diseases caused by a medical intervention - especially a physician's. These are often called "complications" or "side-effects" in modern medical jargon or a "healing crisis" or "healing reaction" in natural medicine. Iatrogenic diseases could be interpreted as the side-effects of interventions that are farther from nature than say a more natural intervention. Many modern pharmaceuticals fall into this category. Its used to be that in all pharmacopeias (list of drug actions and chemical make-ups), all the pharmacological substances listed the plant, bacteria, etc that they were derived from in nature. That is no longer so because drug companies can now molecularly characterize the exact shape of a receptor site and synthetically create a drug that can fit the exact shape of the receptor.

Yes, modern pharmaceuticals are very powerful, but since they are in fact very refined and precise yet distant derivative of some substance in nature, they often have many associated undesirable side-effects (The side effects are then treated with more drugs). The same trend holds true for the supplements.

Often times people think that because this or that supplement is "natural" it is free of any side-effects that would be seen with a drug. Supplements are becoming more and more refined as well. A good example of this is "red yeast rice extract." This supplement is used to lower cholesterol and works as well as Lipitor...because red yeast rice extract is, as the name describes, an extract of yeast. This is basically a drug labeled as a supplement. Red rice yeast extract shares many of the same side-effects as Lipitor because it acts exactly the same - as a HMG-CoA reductase inhibitor.

So is a supplement that acts like a drug natural? I would say not if its a refined to an extent like the sugar example above. Remember the ultimate goal of natural medicine is to bring people back into balance in a manner that is the least harmful and thus the closest to a natural physiological process and the rhythms of nature. If we take our cholesterol example, food and exercise can often lower cholesterol significantly. Lifestyle change may be slower, but there are less side effects to eating fiber containing fruits and veggies and exercising daily.

So in order to get better and heal, should we all sell our possessions and live in the woods with only animal pelts to cover us? Not exactly, the ultimate job of a natural medicine practitioner is to guide the patient back to his or her natural state and life rhythms. If you are a child, is it good to sit inside all day and play video games? If you are an adult, is it best to stay up until 2 am watching the "Late Show?" If your a woman in menopause, should hormones be used to create the hormone levels similar to that of a teenager? All of these questions should be answered on whether or not this substance or that habit restores natural physiology and rhythms of life.

The body develops disease because it is trying to adapt and bring itself back into a natural balance. The farther we are from nature, the more imbalanced our physiology becomes and a more diseased state develops.

Natural medicine is restoring a balance back into human beings' lives. Natural medicine is restoring our strong connection to nature and its rhythms.

Until next time,
Gibran

Sleep tight...How to get a good nights sleep.

As I mentioned in the last posting, sleep is one of the most important ways to optimal wellness. In my clinical experience, I have yet to see a person "recover" and "heal" from disease and move toward wellness without good sleep.

Lack of sleep contributes to many diseases such as diabetes, hypertension, and obesity. It is no wonder these diseases are considered now to be at epidemic proportions. Sleep can help us not only prevent many chronic illnesses, but also recover faster from acute diseases such as the common cold.

So on to the how to part...

Routine. After committing oneself to sleeping an adequate amount, the next step is sticking to a routine. Go to bed at the same time every night and wake up at the same time every morning. What? No sleeping in on weekends? Exactly. When our sleep wake cycles are on a routine, our bodies physiological processes also become more rhythmical. We will have an easier time falling asleep and waking up. Think about times when you get hungry at work. Its probably about 1/2 hour before you have your lunch break. Your body starts to secrete digestive enzymes and hormones to prepare for food. The same holds true for sleep. Your body starts to secrete evening hormones and begins the repair and regeneration process if you are on a routine. Your dog or cat wants to go to bed at the same time every night...listen to them and listen to your body. To accompany and reinforce the routine, be in bed by 11pm at the latest.

Getting ready. A good nights sleep begins before bed. How many of us do email, work, or watch tv right before bed. To be in bed by 11pm requires some preparation. Ideally when 10pm rolls around we would turn down the lights and start the evening routine of washing up and brushing one's teeth. Even in the bathroom, try to brush your teeth with only a night light on as this low light level signals your brain that it is time to turn off and turn-in. I have notice when I am camping, I am tired within an hour of the sun setting and am zipped up in my sleeping bag soon after. Don't eat within 1 to 2 hours before bed as it can stimulate your mind into thinking its actually time to be awake. Also avoid fluid intake 1 hour before bed so that you can avoid waking at night to urinate.

The Bed. When in bed either sleep or have sex. Do not do other things associated with waking activities in your bed. Avoid using your laptop, watching TV, eating or even reading. This way your mind will associate bed with sleep and sleep with the bed. Make sure your bed is comfortable by getting what you need to be comfortable at night. Invest in the pillow, bedding and mattress that you want. You will spend the more time in your bed than on any other piece of furniture in your house. Splurge.

The Room. Quiet. Eliminate as many possible distractions as you can. Find ways to make your bedroom more sound proof - Area rugs, wall hangings, etc. When you wake at night even for a moment, your mind and body resets itself and starts the sleep cycle again. It takes almost 2.5 hours for the first sleep cycle to be completed. When sleep is interrupted, we start the sleep cycle from the beginning. According to numerous sleep studies, we function best with about 4 sleep cycles, which works out to an average of 8.25 hours.


The Room. Dark. Also sleep in complete darkness by having light proof window coverings and getting a non-continuously illuminated alarm clock. Melatonin requires complete darkness for its production. It is a very powerful anti-oxidant that mops up free-radicals in our brain produced by our daily mental activities. Melatonin is also a hormone that resets our circadian rhythms so that we can restore during the night and be active during the day. Sleeping eight hours in a completely dark room is one of the best ways to have amazing energy the next morning and to even regulate the menstrual cycle.

Sleep tight and sleep well,
Gibran

Good night!

I'll just check my email one last time after clicking that stumble upon button one last time...you struggle to keep your eyes open...

All the while we get the latest news report on the Center for Disease Control study finding that "Sleep Deprivation, a Public Health Problem."

Do we have less hours in the day than before? It sure feels that way sometimes.

Although it seems like we can make it through the day just "fine" on 5 and 1/2 hours of sleep, we were never meant to function, to live and to thrive with these habits. The effects of our sleeplessness go beyond the perceived drop in alertness. It may not be all that important to catch every single word during your company's budgeting meeting, but there are many more things your body is missing out on.

Repair begins at night. It is the time of not only rest, but also of renewal. It is the time for your cells to regenerate and to remove toxins, and for your mind to process all the day's events and release stressful events.

In Chinese Medicine nighttime is understood as a key to preserving the vital life force. Nighttime is a time when the Yin of the body replenishes itself and the Yang of the body goes inwards to repair the internal organs. It is a time to be still like the natural world around you.

So as long as the news reports keep coming out stating that a "Lack of Sleep Increases Childhood Obesity Risk," or that "Lights at Night Are Linked to Breast Cancer," it may be good to listen to that yawn and call it an early night.

More in the next post on sleeping soundly.

Good night,
Gibran