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(RW) Integrative Medicine: Chiti Parikh
21 Plays29 days ago
(REWIND) Season 1, Episode 14: Dr. Chiti Parikh is an author and integrative medicine physician at New York Presbyterian – Weill Cornell Medical Center. Listen to Chiti talk about the definition of integrative medicine, the types of patients who seek out integrative care and the importance of addressing spirituality during patient visits.
Check out Dr. Parikh's book Intentional Health here.
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Transcript
Introduction to 'The Wound Dresser' Podcast
00:00:09
Speaker
You're listening to The Wound Dresser, a podcast that uncovers the human side of healthcare. I'm your host, John Neary.
Meet Dr. Chidi Parikh
00:00:21
Speaker
Today, my guest is Dr. Chidi Parikh. Dr. Parikh is the Executive Director of the Integrative Health and Wellbeing Program at New York Presbyterian Hospital, Weill Cornell. She received her MD degree from UMDNJ Robert Wood Johnson Medical School and performed her residency in internal medicine at New York Presbyterian Hospital, Long Cornell.
00:00:42
Speaker
Chidi, welcome to the show. Thanks, John. Very excited to be here.
What is Healing?
00:00:47
Speaker
So first, I just wanted to ask you in your own words, ah what is healing?
00:00:54
Speaker
So healing in my, from my perspective, is just allowing the body to do its job. So very often diseases and symptoms happen because we often get in the way of this immense intelligence our body has inherited over years and years of evolution.
00:01:13
Speaker
and often things that we do to our diet and lifestyle just gets in the way.
Healing in Palliative Care
00:01:18
Speaker
I know even work in palliative care. So is there healing that can happen ah sort of when you're not necessarily guaranteed of ah and a good outcome?
00:01:30
Speaker
Absolutely. so just like you know Just like we talk about healing that can have multiple definitions, so does health. So healing also takes on a new meaning for each individual at different stages in their life.
00:01:44
Speaker
There's always an opportunity for healing. There's always an opportunity to have a conversation about health. So I think that's a door that's always open for everyone. It's just a matter of how we approach it and what it means to the person in front of us.
00:01:58
Speaker
So I'll give you an example. so for instance, you know we see patients, I see personally see patients anywhere you know, people in their late teens, early 20s who are otherwise healthy. And also see people who are towards the end stage of their life.
00:02:12
Speaker
And I always have a robust discussion and lots of things to talk about when it comes to health and healing. So I don't think, um you know, sometimes we end up thinking about outcomes in the sense are material objective outcomes, you know, as to can I get the blood test under you know blood pressure under control? can i ah Does this chemotherapy make someone live longer?
00:02:35
Speaker
When we talk about healing, you have to expand the conversation beyond just the physical, objective, tangible outcomes. And you really have to start the discussion of what does health really mean to the person that we're healing?
00:02:49
Speaker
Because their definition really dictates what that healing journey looks like. And it doesn't always have to be objectified in, you know, lab tests and sort of tangible things.
00:03:02
Speaker
Could you expand on you know, when you're having those, like you said, robust conversations about what health looks like? um I imagine, like you said, age might be one factor that kind of steers that discussion. But what are some other things that will, i you know, sort of give you more direction?
Patient Goals in Treatment Plans
00:03:21
Speaker
So one of the first things in my you know visit with a new patient, the first questions I ask is, what is your goal? You know, what is the patient looking for? Because it's great that you know patients, you know I have my own set of ideas based on my medical training, what the patient should be doing or what they should be focusing on.
00:03:42
Speaker
But ultimately, the patient drives the discussion. So always start the conversation by asking the patient, what are they looking for? What is the goal that they would like to set for us to focus on? And the discussion is far more comprehensive besides just saying, you know, talk to me about your, um you know, medical history, surgical history, things that we learned sort of checklist in medical school. It goes way beyond that.
00:04:08
Speaker
So conversation often indicates, you know, it includes, the goal for the patient, but also looking at the whole biopsychosocial model of
The Biopsychosocial Model in Patient Assessment
00:04:18
Speaker
health. So the questions will pertain to um from childhood history to psychological history, to talking about their diet, talking about their stress level, talking about their coping mechanisms, their support system, exposure to environmental toxins.
00:04:34
Speaker
So it really goes far beyond just asking you know what hurts today, what you know what brings you into the doctor's office that can be fixed, ah you know sort of set into a box of ICD-10 codes.
00:04:47
Speaker
it The conversation is really all encompassing because we know health is not just absence of physical disease or symptom. It's really a balance between all of these components of health, whether it's you know emotional, psychological, spiritual, ah community, environmental, all of these aspects play a big role in health and healing.
From Alternative to Integrative Medicine
00:05:11
Speaker
For our listeners who may not be too familiar with integrative medicine, can you just describe what it is and what tools you have at your disposal? Yeah, so the definition of integrative medicine, it has really evolved over the last, i would say, at least a decade.
00:05:26
Speaker
So before, this field of medicine was often referred to as alternative medicine. So, the The image that conjures up is always, hey, someone, let's say someone is diagnosed with diabetes or high blood pressure. And instead of taking a medication, they chose not to see a Western medicine doctor.
00:05:45
Speaker
Instead, they did something on their own, whether it's diet changes or seeing an acupuncturist or whatever it may be. So it's really your you're avoiding the Western medical approach and choosing an alternate.
00:05:57
Speaker
So that's how it always was viewed upon as. Then they people realized that, again, there is more and more scientific evidence backing up some of these modalities. um And then the terminology shifted from alternative medicine to complementary medicine.
00:06:11
Speaker
What that entails is, let's say someone is diagnosed with high blood pressure, they see their doctor, they start a medication for high blood pressure, but on the side, they also end up, you know, doing a lot of research and starting some sort of a diet or start exercising with the fitness trainer, right? But the doctor doesn't really know that the patient's doing that. the doctor who prescribed the medication is not necessarily the one who's recommending some of the other things that are evidence-based.
00:06:37
Speaker
So now integrated medicine brings all of this under one roof. So if I see a patient who I'm diagnosed with high blood pressure, I'm not simply just prescribing a medication, I'm also trying to look at the root cause and understand what is contributing to the high blood pressure, doing a very detailed you know history taking when it comes to diet, lifestyle, stress factor, a family history.
00:07:00
Speaker
and recommending things beyond just the medication that we know through research that these things work, whether it's a DASH diet, whether it's encouraging patients to exercise, lose weight, um maybe addressing stress by ah through meditation. All of these have shown to help with hypertension in research, right?
Therapies in Integrative Medicine
00:07:17
Speaker
So this is a true integrated model where you're combining the best bodies of research, whether it's from the Western medicine world or whether it's Eastern medicine, and you're combining that really to bring and support, to bring the best medical therapies to the patient and really give the best chance for the patient to succeed along their health journey.
00:07:38
Speaker
Could you talk more about some of the therapies you employ? One of them is nutrition, which is obvious. The second is psychotherapy. We also have acupuncturists as part of our staff. We also have a meditation instructor.
00:07:52
Speaker
We also have yoga ah therapist, Reiki therapist, massage therapist. um all of these are working together for the patient. So very often a patient will see the physician, but they also end up seeing a lot of these other providers.
00:08:07
Speaker
And all the providers are discussing the patient's case so that everyone is on board and everyone's sort of working together in a team um that's supporting the patient's journey. So hypothetically, let's say I'm interested in um reducing stress by doing yoga.
00:08:23
Speaker
Mm-hmm. Should I, in theory, it seems like you could either a go to a yoga studio and kind of take that up ah independently or do it through this integrative model where you're kind of bringing your physician into how ah would you go about advising patients like on on what way to choose to do that?
00:08:47
Speaker
So I always recommend a more integrated model for two reasons. First of all, very often, you know, patients come across some of these therapies because they heard about it ah by reading an article or heard about it through a friend or family member.
00:09:02
Speaker
So So they don't they might not really know exactly what that treatment is, but you might not exactly know what yoga is, but you heard that it really helped your friend and you heard it's really good for you, right? But you might also not know where to find the best ah you know therapist or someone that's gonna suit your needs.
00:09:21
Speaker
So I always recommend trying an integrative model because then you cover all bases, especially for patients. Usually, patients who are otherwise healthy, It's not that big of a deal, but when it comes to patients who do have a complex medical history, I always recommend going through a physician consultation first so that all of the treatments can be in a supervised setting and in a more coordinated setting.
00:09:46
Speaker
And second of all, um even patients who are otherwise healthy, they often come to us for guidance because they might have heard of yoga, but there might be other modalities and things that could also help them.
00:09:58
Speaker
So it's always good to go through the integrated model because then you know you're checking all the boxes and you're doing it in a safe and effective manner.
Is Integrative Medicine Primary Care?
00:10:08
Speaker
So to be clear, though, um seeing an integrative physician like yourself isn't considered a primary care visit. It's it's sort of a specialty of sorts, correct?
00:10:18
Speaker
Yeah, it is. In most places, i mean, there's a hybrid model. So some integrative practices do both. They act as a primary care physician and also add the integrative model, where some practices like our practice chooses to just focus on the integrative piece.
00:10:33
Speaker
But we work very closely with primary care physicians within Cornell, New York-Presbyterian, or any other primary care physician that the patient already has a relationship with. So looking more at the patients you treat, what are what are some of the most common conditions you see?
Common Issues for Integrative Treatment
00:10:50
Speaker
So I would say about top five, and this is this is common across most integrative centers. There was a survey that was done for top integrative so centers across the country, and they all found a similar theme that...
00:11:02
Speaker
The main reasons patients seek and are given care, number one is mental health. So when patients are suffering from depression, anxiety, or stress, um second tends to be chronic pain.
00:11:13
Speaker
Third tends to be more GI symptoms like IBS, IBD, or irritable bowel syndrome, inflammatory bowel disease like Crohn's, also colitis. um Then followed by patients with a history of cancer and also followed by patients who are looking for more sort of cardiometabolic, so whether it's trying to lose weight or address heart disease, diabetes, and things like that.
00:11:37
Speaker
So it's really very sort of comprehensive in the sense you, and again, you know, we always think about in integrative medicine is we treat patients, not diseases or symptoms, right? So the same patient could have a manifestation of many of these different diseases, but ultimately the treatment approach for that patient might vary um from someone else who has sort of the same diagnosis as labels.
00:12:02
Speaker
So do you see it as ah like a lot of those conditions you mentioned are just saying is that the Western that Western medicine hasn't done so well what yet that for a lot of people, just like mental health care hasn't really advanced enough in the Western context to to be satisfactory.
Why Choose Integrative Medicine?
00:12:17
Speaker
So they look elsewhere. Yeah. It's sort of kind of like a pivoting to look elsewhere, i really That's a very good point. So one of the reasons why patients come to us, because they know they could be doing more. It's not necessarily that they haven't tried the Western Medical Approach. Often these patients have seen multiple specialists and kind of done what they're supposed to do from Western Medical Approach, whether it's medications or whatever it may be, they've already tried those things.
00:12:41
Speaker
So either they're not having full results just from that approach, or um some of the patients are interested on not having to take medications. so Before they try medications, they want to see what else they can do.
00:12:53
Speaker
so So it's either they're in early stages and they want to explore other options that they know um can work, or they want to do more than just take a pill. so So those are the patients we typically see.
00:13:06
Speaker
And unfortunately, a lot of these conditions that I mentioned that patients come to us for tend to be more chronic and tend to be not very well addressed from Western medical approach, right? So not everyone benefits from just a you know ah antidepressant. And like you mentioned, not everyone has access to mental health care, whether it's psychotherapy or even medication management.
00:13:29
Speaker
And when it comes to GI symptoms, we often just focus on the symptoms and try to prescribe pills when we know a lot of these GI conditions are very intimately tried tied to diet and lifestyle.
00:13:40
Speaker
So often the focus is just medications, but no one is really addressing the big, big root cause of a lot of the GI symptoms, which is diet and a lifestyle. Same thing with chronic pain, especially nowadays, being everyone becoming more and more aware of the problems with the with taking opioids in the long run, the opioid crisis.
00:13:59
Speaker
ah More patients are seeking to do things that are really going to help them in the long run rather than just taking opioids. So it's really, and again, integrative medicine is not necessarily for everyone um because a lot of the patients that come to us are sort of looking to go the extra mile. There are no shortcuts in integrative medicine. There's no magic supplement. There's no magic diet, right?
00:14:22
Speaker
This is a commitment. This is a journey. So patients who come to us are often ah willing to dedicate ah their time and and be disciplined about following this path because they know that that's going to give them more long term, you know, better outcomes than just taking a pill.
00:14:43
Speaker
I want to ask you ah little more about, I guess, just the philosophy of ah integrative medicine. And you've you've kind of touched on this already, right? That, you know, we steered away from this alternative, ah you know, attitude. But as I understand, everything you do is is pretty much evidence-based. So why bother to kind of make this?
00:15:00
Speaker
Why are you integrating anything? why Why isn't just kind of like one medicine? Exactly. So that's often my answer to a lot of integrative medicine questions. Like, this is just how medicine supposed to be, but unfortunately it's not.
00:15:12
Speaker
Right. So like you said, ah all this is evidence based. In fact, um most of the diseases that we treat in Western medicine, most the chronic conditions, the first line of therapies often diet and lifestyle changes.
00:15:26
Speaker
And to give an example, in medical school, I probably learned about four hours of nutrition in four years. Right. so so the it just doesn't make sense that when we have this robust data,
00:15:38
Speaker
when it comes to just diet and lifestyle management, and we're not really teaching physicians the tools they need to combat majority of chronic conditions, that's where the gap is. So if 80% of the conditions that most Americans suffer with are preventable, then how come not 80% of our efforts are not focused on prevention?
00:15:57
Speaker
Less than 4% of all the healthcare care funding actually goes into prevention rather than, you know, everything else just goes into treatment, which is very reactionary approach. So this is honestly at what, i when I was going about to go into medical school, this is how I thought medicine was practiced. It just makes sense. It just, you know, would it, you know, any, anyone you ask, they'll say, you know, I'm surprised that not other doctors are doing this. I'm surprised that not other medical centers are doing this because first of all, we embracing preventive medicine approach. Second, we're incorporating, you know, evidence-based medicine techniques that are far safer, less invasive, cost-effective.
00:16:37
Speaker
And third, we are talking about making a time you know a commitment to our patients in making sure that we support them throughout their health journey. It's not just incidental, accidental into encounters when something goes wrong, patient comes in, we give them a medication and we see them a year later.
00:16:55
Speaker
This is more of a commitment and understanding what health means to that patient, investigating, and also investing a lot of time and effort in understanding what the root cause of the disease is rather than treating all these symptoms in isolation.
00:17:08
Speaker
So when you can actually do this in a team-based approach in a more holistic model, it's really it really is a win-win situation for both patients and for the provider.
00:17:19
Speaker
I do want to ask, though, about just like science, I guess, as a philosophy. I think we often forget that science is a philosophy, that it's and it is you know, especially and like at the end of the 19th century and the 20th century, science has kind of become the king of medicine and like rightfully so. But are there um I just sort of feel bogged down in this idea of you know, you just sort of accumulate a bunch of data and like plug and chug and figure out whether there's some sort of statistical significance. And that's supposed to help you, you know, with the patient in front of you that is very, very likely different than all the people that you analyze in your study. So is that something that's kind of going through the back of your mind when when saying things are evidence-based and maybe saying,
00:18:11
Speaker
all right, yes, science is like obviously very important and in you know maintaining the integrity of medicine, but also... you know, taking it with a grain of salt. Absolutely. So when we talk about evidence-based medicine on the research studies, we are practicing the science of medicine.
00:18:27
Speaker
But first and foremost, medicine is an art. And when
Balancing Art and Science in Medicine
00:18:30
Speaker
it comes to art, you know, you you really have to bring in this more abstract concept of tailoring and customizing treatment to the person in front of you.
00:18:41
Speaker
Because like i said, two people can walk into my door and both have the, you know, diagnosis of diabetes. But what I'm going to do for these patients and what these patients are looking for will be very, very different.
00:18:53
Speaker
So ah sometimes that gets lost in the science of medicine. medicine And I think a lot of the success we've had is really because we combine the art and science of medicine. And I think as we go forward, we're looking at, you know,
00:19:08
Speaker
more and more recent studies are now starting to focus on patient reported outcomes rather than just objective findings, whether it's the lab results or you know um or just how many you know extra days the patient lives with chemotherapy.
00:19:20
Speaker
So I think as we shift more focus and and a good amount of focus on patient reported outcomes, hopefully we'll pick up on this variation um And we'll finally acknowledge the fact that no two patients are the same. And I understand we do have to group people together for their but the sake of research, but we don't always have to do that when we see in a one-on-one encounter with with a doctor-patient relationship.
00:19:44
Speaker
We can practice art of medicine just as robustly as we practice the science of medicine. And I think that will really ultimately determine the success. And the future of medicine is taking into account this holistic model. It's not just looking at patient organ organ system in isolation.
00:20:03
Speaker
And I think it was William Osler who said, it's more important to know, um you know, what what patient has a disease rather than what disease the patient has, because that will ultimately determine what treatment you choose.
00:20:18
Speaker
So I think we need to shift the focus from treating a disease to treating the patient. I definitely like what you're saying, right? The art, the the combining of the art and the science, but like, I imagine at times those can kind of feel like they're butting heads and you sort of need to favor the science side because that's maybe deemed more culturally ethical.
00:20:40
Speaker
So that's what most people think when it comes integrative medicine. And that's what I thought before going into the field that very often ill i will stand at crossroads where I'll be forced to pick um you know, which way to go, whether to go with the conventional approach or whether to go sort of the alternative approach.
00:20:59
Speaker
And I can tell you in the last several years I've been practicing integrative medicine, there's never been a case where I had to do that. So if I see a patient who yeah I've seen, let's say I'll give you an example of ah of a patient i had I have, I still see, you know, young man in his 30s, athletic, very healthy, but has severe, you know very high blood pressure.
00:21:20
Speaker
had seen the best doctors you can think of and an entire workup. And he tried some blood pressure medication, had some side effects, he just completely gave up on it. And he saw multiple specialists and no one had any luck in, you know, getting him to take the medication.
00:21:35
Speaker
When he came to see me, you know, his focus was, I want to do, i want to control the blood pressure, but I really don't want to take any medicine because they make me sicker. um So I don't wanna do that. So after developing a good relationship with the patient, really working on, you know then we said, okay, fine, we won't approach the topic of medication just yet.
00:21:54
Speaker
Why don't we focus on the diet and other there things, stress management, other things we can do in the meantime. And as you develop that rapport, you know the patient has trust in you and I say, you know and We've tried all of these things, which is great. This is the foundation, the diet and lifestyle.
00:22:08
Speaker
But I do think given you risk factors and everything, I do recommend a medication. And I'll work with you to find a good fit for you. Let's figure out what medications you've tried. Let's try the ones you haven't and see if you tolerate them better.
00:22:21
Speaker
And now he's on two different medications, right? so My approach was a little bit different. He had seen some of the best doctors, blood pressure, you know hypertension specialists. But it's not that patients are coming to me because they don't want to take medication.
00:22:36
Speaker
Often because they're it's just that they're not educated in the right way or their goals were not heard. right So again, the art of medicine in this case was to work with the patient, identify what's important to them and bringing every option to the table.
00:22:53
Speaker
and developing that rapport. And that rapport ultimately determines the success, the therapeutic success in any relationship between doctor and a patient. So it's not so much about a patient saying, I don't want that. And a lot of time that I don't want this Western medicine approach often comes because they had a bad experience with the provider or the treatment. They don't really understand it completely.
00:23:16
Speaker
So when you establish the trust with the patient, they are far more open to every option you bring to the table. so So again, that's a testament to really combining the art and science of medicine. Because when we do just science, we leave a lot of people out.
00:23:32
Speaker
Yeah, what you're saying definitely reminds me of of what one of my friends has reiterated to me on multiple occasions, that when she just goes to see a doctor, it just sort of, at times, can just feel like rushed. And like, we need to spend more time like listening to, you you were saying, the patient's goals and and kind of what's going on.
00:23:52
Speaker
And I think obviously like looking at more as an art will allow you know that doctor and patient relationship to build more of that ah trust. Another thing I was going to ask you about is in your practice of integrative medicine, I think one thing that is unique, ah a lot of the therapies we talked about earlier have been around for you know hundreds if not thousands of years.
00:24:19
Speaker
ah What's it like sort of in a lot of ways, looking back to the past ah to find some some like wisdom and um you know insight for for your medical practice when a lot of your your peers are likely you know looking forward towards towards the new breakthroughs in medicine.
Modern and Traditional Methods for IBS
00:24:44
Speaker
that's a That's very interesting you say that because often when I explain to patients or you know anyone, all my family members, when they ask to me what I do, I often say I combine the best of the East and West. So it doesn't have to be one or the other.
00:24:56
Speaker
So in my practice, I say a patient comes in with IBS, they might walk out with a treatment plan that includes testing their gut microbiome. um And it might also include some herbs that are based in Ayurveda and some diet changes, right? so So it really is the best of both worlds. And the more time I've spent learning things like Ayurveda, which traditional Indian medicine that goes back thousands of years, and traditional Chinese medicine. So I learned acupuncture and learned that there's a lot of, know, a correlation between these ancient techniques. So whether you look at traditional Chinese medicine, whether you look at, you know, Ayurveda, or whether you look at some of the more indigenous ah medicine practices um or shamanic practices, a lot of the concepts are very, very similar.
00:25:45
Speaker
And the reason why these modalities and these, ah you know, these traditions have survived because they've really stood to the test of time. So it's just fascinating to see how things have been practiced for thousands of years and they're just as relevant as they are, they were thousands of years ago as they are today.
00:26:05
Speaker
And in my experience right now in my practice, I would say I practice about 20% Western medicine 80% sort of Eastern medicine I've up sort of eastern medicine because Most patients who come to me have already gone through the Western medicine route. And so when they come to me, my job is to think outside the box and really see what else can be done.
00:26:25
Speaker
And when I learned Ayurveda, when I learned traditional Chinese medicine, it it just blew my mind how refined, how advanced um these these ancient, um you know,
00:26:40
Speaker
these ancient ways of practicing medicine have been. so when you learn about it and you find parallels with Western medicine, it was fascinating think that, oh, they knew about this 5,000 years ago. so for instance,
00:26:53
Speaker
you know In Chinese medicine, the idea is that if patients are very anemic or they have any sort of blood disorders, so hematological abnormalities, it's often, you know sometimes it's often related to the kidney meridian being weak.
00:27:07
Speaker
So the kidney meridian often includes you know the kidneys and also the adrenal glands as well. um So sometimes, so it just makes sense if you strengthen the kidney meridian, which also produces orthopoietin, that it can often help with anemia, right? So things like this, that you, you know, when you find these correlations, just fascinating to see how much they knew about the body.
00:27:30
Speaker
And I feel like learning about Eastern medicine has only deepened my understanding of medicine in general and made me a much better doctor. So because these ancient um you know traditions often rely very much on the art and the science.
00:27:46
Speaker
And when you add thousands of years of experience, that's just a cherry on top. So it's just been fascinating to see ancient tradition to see how advanced, how detailed, um you know how elegant they are.
00:28:02
Speaker
um it really it is humbling and it just feels sort of foolish not to take advantage of that.
00:28:10
Speaker
Was it like, do you think those things were were sort of lost and are being rediscovered? Or are they only isolated to, you know, geographic regions? How come this wasn't, you know, more on the radar, especially, ah I guess, for instance, just people in the United States far before and now?
00:28:29
Speaker
Yeah, I do think, I mean, these... ancient traditions have been around for thousands of years ago, and they still to this day are practiced in certain parts of the world. I think over the last 20, 30 years, as we've seen a tsunami of chronic diseases, patients have started looking for more, right? So if you think about the incidence of, you know, cancer going from one in four people 40 years ago to now one in two people have cancer to the epidemic of obesity and hence the consequences of obesity, um whether it's heart disease, diabetes, again, cancer, autoimmune conditions, when these have skyrocketed and we realize the limitations of Western medicine, there is a renewed interest in learning more about Eastern tradition.
00:29:13
Speaker
And as more and more evidence starts supporting the efficacy and safety profile, I think more and more people are eager to incorporate that into their practice. And again, you know getting more media attention with social media and everything, these isolated areas in the world, they're practicing the medicines have become a lot more, they've received a lot more limelight in recent years.
00:29:35
Speaker
So it's just amazing that you can be in New York City and you can have access to, you know, acupuncture, to Ayurveda, to um to meditation classes, to all of these things. It's just fantastic.
00:29:51
Speaker
And I think this is sort of we're heading into the best age of medicine where you really have the best of both worlds.
Spiritual Journeys and Medical Practice
00:29:59
Speaker
After college, you embarked on a solo spiritual journey throughout Southeast Asia. Can you tell our listeners about this experience and some of the insights you gained? Yeah. and So I grew up in India um and my parents, thankfully, were very open-minded and embraced this holistic approach. So I was yeah i ah you know i always joke that I probably learned to meditate before I learned to walk.
00:30:25
Speaker
So a lot of these modalities were new to me. So when I moved to the US and when I went through medical training, you know, I often put those, you know, things that I i grew up with sort of on the back burner um and focus a lot on the Western approach.
00:30:43
Speaker
And it was fascinating to learn about that. And when I came to practice, mean, as a resident, as an attending, you very quickly realize the limitations of Western medicine. And then,
00:30:56
Speaker
I realized that this is so important that we really bring all modalities to help our patients. And having done that year between, you know, between college and medical school, I literally just decided to defer for a year um and just pack my bags and travel through Southeast Asia by myself for six months. And it was an eye-opening experience because I really, at that time,
00:31:19
Speaker
delved very deeply into a lot of these traditions. So i did, you know, just give an example. I did a 10 day silent meditation retreat when I was 22. And most people think of backpacking as, you know, you party or on some island in Thailand when you're backpacking at that age.
00:31:34
Speaker
um But i you know, I said, let's do this. And ten that 10 day meditation retreat was basically you don't speak for 10 days. um They take your phone, your wallet, everything.
00:31:45
Speaker
um And you're just in complete silence for those 10 days. And you're literally meditating 12 to 16 hours a day. And it was just one of the the most incredible experiences of my life.
00:31:58
Speaker
And that just opened my eyes that there's so much more um out there. And as I traveled through different countries in Southeast Asia, I learned more and more about the local traditions and healing modalities and experience them firsthand.
00:32:11
Speaker
Because a lot of things about integrative medicine comes from a place of authenticity. So if I'm recommending anything to a patient, it's something that I have tried, that I have practiced and I have deep, because knowledge has its limits, right?
00:32:27
Speaker
um you know I can read all the books in the world, but what experience brings to the table really adds that element of authenticity when when it comes to the patient relationship.
00:32:40
Speaker
Because that's when I can develop that trust relationship um in a very short period of time. Because patients can see that it's coming from a place of genuine, you know that I really care about my patients and what I'm recommending, um I really believe it's going to help them.
00:32:57
Speaker
And that effect is so powerful. It's far more powerful than any medication or treatment ah I will prescribe. So if I don't have that relationship, I could have the best medications for the patient.
00:33:09
Speaker
It just won't have the same effect as having that trust relationship. So anytime I recommend something to a patient, I always talk about my personal experience with it. And that just adds more to that.
00:33:23
Speaker
that art of medicine that I'm talking about. And having done that year really was life changing in so many ways, not just for personal growth, but also professional growth. But that time has served me to this day and continues to serve me because that's when I learned that, you know, when you experience it, it completely, it can never take place.
00:33:43
Speaker
You know, it can never replace all the books that I'm going to read in the future. So to this day, I've kept that lesson and I continue to practice. And as we're speaking, this week, I actually took a week off at extra vacation time. And I'm actually going through um a very detailed Ayurvedic detox called Panchakarma.
00:34:03
Speaker
um There are a lot of patients I think that would really benefit from it, but I wanted to personally experience it. So i'm actually doing it um right now to see what it entails. It's not easy, but I wanted to experience it firsthand so I can share my experience and be authentic when I suggest that to my patients.
00:34:22
Speaker
So again, this is, that's a lesson I learned during that year. and it's probably the most valuable lesson has served me very well until this day. And hopefully, you know, in the future too.
00:34:33
Speaker
How do you conceptualize the the spirit and in like mind, body, spirit? And how how do you see spirituality? what What role does spirituality play in someone's health?
00:34:46
Speaker
I think it's one of, and if you talk about Eastern medicine, spirituality is one of the most fundamental aspects of health because, you know, when spiritual health um is out of balance,
00:35:00
Speaker
it's it has a domino effect. So spiritual health and out of balance manifests itself as imbalance in psychological mental health, and that manifests in the physical health. So often the physical symptoms we're seeing comes from psychological imbalance that was because of the spiritual imbalance.
00:35:18
Speaker
So one of the questions I often ask my patients is um what brings you sense of joy or purpose in life? It seems like a very... um like a frou-frou question to ask, it probably one of the most powerful questions out of all the questions that I ask my patients. And that tends to bring the most tears, I would say.
00:35:39
Speaker
um i would say more than half of my patients typically cry within the you know when I see them for the first time during our initial consultation. And I don't think it has anything to do with my demeanor. I'm not scary. I don't bite.
00:35:50
Speaker
um But it just goes to show you that A lot of times we just don't ever contemplate these questions, let alone have a doctor ask you this question, because the doctor thinks that this is probably one of the most important things that I can learn about the patient in front of me.
00:36:05
Speaker
So that's where the spirituality comes into play. It doesn't have to be religious. it It's just something um that what makes us human. One of the fundamental questions we ask as a human being is, why am I here?
00:36:19
Speaker
What is my purpose? What may it brings me joy? And I find that if that question is unanswered, there will be an imbalance in psychological health and physical health.
00:36:30
Speaker
So I can do everything to fix up the physical health. But if I don't address this fundamental question or encourage a discussion, a conversation about this, um then I'm not really practicing holistic medicine.
00:36:43
Speaker
So i find spirituality to be a very, very fundamental thing that has to be addressed and often completely ignored um in a more modern Western sense of medicine.
00:36:56
Speaker
So you're kind of saying though, the essence of those, those big questions you ask your patients, that kind of is how you tune in to their spirit. Absolutely. And that's how I really get to know the person in front of me. Right.
00:37:09
Speaker
So i can have them fill out a form and tell me about, you know, the family history and allergies and the medications they've taken surgeries they've had. But for me to really establish a connection with the patient,
00:37:21
Speaker
um That question really opens so many doors. And, and sometimes it shakes people. And my job is to shake people and start the
Spiritual Health and Wellbeing
00:37:32
Speaker
discussion of health. And I cannot have a discussion about health, unless I address the spirituality, the the psychological aspect and the physical, because people often come to me for physical symptoms and diseases.
00:37:45
Speaker
um And they're often sort of shocked when I ask about these questions. But no one has ever questioned me on those questions because the everyone understands and recognizes that is it is instrumental in but in any discussion pertaining to health.
00:38:03
Speaker
Want to finish up with a lightning round? series of fast-paced questions that tell us more about you. Sounds good. um So you were on the Dr. Oz show. i I recommend that all our listeners check out the clip.
00:38:17
Speaker
It talks about identifying your digestive type. So what was the coolest thing about being on that show? I think it was great to recognize how hard it is to be on TV and how Dr. Oz does it effortlessly. he must have incredible memory because he, you know, you think when you think about shooting a movie, it's like retakes and retakes with shows like that. There are no retakes. You just go.
00:38:44
Speaker
So I have incredible, you know, incredible respect for anyone who does live television or and you any TV shows like that. I will say i thought you were very ah refined and eloquent. So kudos.
00:38:55
Speaker
i ah other I felt like for a while I associated Dr. Oz and Dr. Phil. So I didn't, I i didn't know too much about his legitimacy legitimacy, but then I looked him up. He's like a very, he's like a, he's like a cardiothoracic surgeon, correct?
00:39:11
Speaker
Yeah. Yeah. So ah I guess I should maybe pay a little more attention to what he has to say. Um, What's a go-to fun activity in New York for you? For me, it's eating. I love exploring different cuisines, so I think that would be my go-to for sure.
00:39:30
Speaker
have a running list of all the restaurants I want to check out. What's your favorite genre or like ethnic food or whatever? ah i can't pick one. I just can't.
00:39:41
Speaker
There's just so much. Can't do it. It's so hard. All right. Best movie or TV show you watched during COVID? god now this is really embarrassing 90 day fiance nice
00:39:57
Speaker
what's your one uh shameless indulgence or like i don't know do you have any like yes um i love to travel and whenever i can i try to fly business class, first class. This is my treat. It sounds ridiculous, but I just love that experience.
00:40:20
Speaker
Nice. What's your go-to self-care technique? ah for For me, go-to self-care technique, hands down pranayama, which is breathing exercises based in yoga.
00:40:32
Speaker
um Most powerful thing in the fastest. Awesome. Last question. What's the biggest misconception about integrative medicine? that it is not evidence-based.
00:40:47
Speaker
And it's it's completely opposite. It's actually actually the most evidence and what we're often doing is actually not evidence-based.
00:40:58
Speaker
You heard it here. Start meditating, start doing yoga, reach out to your local integrative medicine physician. Dr. Chidi Parikh, thanks so much for joining the show. Thank you, it was a pleasure.
00:41:18
Speaker
Thanks for listening to The Wound Dresser. Until next time, I'm your host, John Neary. Be well.