Bernie Siegel, M.D.: Turning Modern Medicine Upside Down

as originally published in Nutrition Science News, March 1997

For almost two decades, Bernie Siegel, M.D., has been familiar to both mainstream and professional medical audiences as one of the most persuasive advocates of complementary and alternative medicine--particularly mind-body healing. His credentials (an undergraduate degree from Colgate University in Hamilton, N.Y., a medical doctorate from Cornell Medical College in Ithaca, N.Y,. and surgical training at Yale University in New Haven, Conn.) are impressive. But his appealing charismatic style, demonstrated on Oprah, Donahue, 20/20 and scores of other popular television programs, ensured that general audiences would find him and his message especially compelling.

Siegel's first book, Love, Medicine and Miracles (Harper, 1986), sold more than two million copies and went to No. 1 on the New York Times best seller list. [His other works are Peace, Love and Healing (Harper, 1989) and How to Live Between Office Visits (Harper, 1993).] All three books document the innovative work Siegel and his wife, Bobbie, have done to encourage healing and personal growth through "carefrontation"--a variety of holistic techniques for empowerment and self awareness that includes the use of dreams, drawings and images.

In 1978, the Siegels founded the Exceptional Cancer Patients (ECaP) program, a combination of group and individual therapy in New Haven, Conn. Since retiring from clinical practice in 1989, Siegel, working with Bobbie, has focused on humanizing medical care and medical education and teaching other health care professionals about the mind-body connection. The Siegels travel extensively to speak and lead workshops, sharing their techniques and experiences. They are working on several books, one of which, Bernie Siegel notes with a laugh, is tentatively titled "Out of My Mind."

CHOWKA: I read a story this morning about a hospital in Pennsylvania that is starting up a comedy channel on its internal cable TV system for patients to watch, because of evidence that humor--and the role the mind plays in medicine--helps to accelerate the healing process.

SIEGEL: Twenty years ago I said, "Look, I'm seeing that if you help people live and alter their lives, it has a physiologic effect." I got no interest or support from organized medical groups like the National Institutes of Health (NIH) and the American Cancer Society (ACS), the medical journals, or anyone else in the medical establishment. Later, I started doing TV shows: Donahue, Sally Jesse Raphael, Oprah--all the shows. They were always about controversy. They put me on for controversy. But today, I can't get on those shows unless I have some inspiring stories. Then they put me on to support the fact that this work--mind-body medicine--is true and no longer controversial. So it's interesting that the things I had arguments and fights over in the 1970s are now becoming "scientific."

CHOWKA: What were you doing during that period that inspired you to start ECaP in 1978?

SIEGEL: I didn't start ECaP because of inspiration. It was because of pain. I had been doing general and pediatric surgery for 15 years. I was watching disaster after disaster. As a surgeon, I had post-traumatic stress disorder. There was nowhere to go and no one to help me to deal with my feelings. My medical education had left out all of the things that psychologists, psychiatrists, therapists, social workers and nurses were aware of because they actually spent time with patients and saw things happen.

I started going to workshops. Carl Simonton, M.D. (co-author of Getting Well Again with Stephanie Matthews-Simonton and James L. Creighton, Bantam Doubleday Dell, 1980) came through Connecticut. He did a positive workshop about how to deal with cancer. I thought the room would be filled with doctors. But there were only two other doctors there, and I was the only one who was practicing physical medicine. That blew my mind. Then I went to work with Elizabeth Kubler-Ross, M.D. She helped me a lot--to be able to sit for a week with people who I could not cure and get in touch with my feelings. She introduced me to the writings of Carl Jung, to the unconscious and the work of drawing. As I began to read literature of that sort, I thought, "Wow, this isn't new. Other people have realized these things for decades."

After attending a lot of workshops, reading, and so on, I began to understand that there are many issues related to treatment and survival that I hadn't been considering. I went back to my office and began to allow patients to share their feelings with me. I said, "Let's see if I can help people live." I wasn't judgmental--rather, I let people make the decisions about how they wanted to get well and what they wanted to do. I decided I would be there to help them.

And so medicine became exciting and interesting for me again. Because I was starting to help people live, helping them make choices, empowering them. What my patients needed from me was not just another operation, but help living each day when they weren't with me. They needed inspiration. There is a small group who are inspired--by what I call "survival behavior"--but medicine doesn't study them. I learned that information doesn't change people. You really have to inspire them.

CHOWKA: It seems to me that one of the lasting values of your work has been to see and help, as well as to talk to and to teach people about your patients as individuals. That said, are there common characteristics that you notice in people who get well as opposed to people who don't get well?

SIEGEL: My work with patients as well as my reading of the literature that goes back 50 years reinforced for me that there are certain patterns associated with healing, including a willingness to express feelings, a willingness to change your life and relationships--to deal with feelings and spiritual aspects. I began to ask my patients questions: "What happened during the past year or two in your life? Why are you sick now?" I'd meet identical twins. One of them had cancer, the other didn't. I'd ask, "Why not? What was going on in their lives?"

In terms of overcoming illness, things like love, family structure and the experience of illness are important. I ask people to describe what they're experiencing. Then you get into words that fit people's lives. They create metaphors or drawings--and when working with these things, you can get biological changes that improve your body.

Redirections are what troubles are about--problems alter your life and what can come out of it. How can you benefit from an illness? What does it give you permission to do? "Oh, I took my tie off, I moved, I got a new house, I quit my job." Alright, those are important things to look at. But also give yourself permission to live a joyful life without needing an illness.

CHOWKA: Did a personal experience with your own ill health influence your work?

SIEGEL: My wife and I had five children in seven years, including twins. We were exhausted. She got sick and then I got sick. I was hospitalized for a severe infection. Well, I learned a lot from being a patient in a hospital for a week. After I went back to work, people would come in with an infection. I'd ask them, "What happened in your life? Did you move, take a new job?" They'd look at me and say, "How did you know that?" I wasn't smart enough yet to use this knowledge in a meaningful way. It was just a joke in the office. People thought I could read fortunes. But I began to say to my patients, "Your body is telling you something. Maybe you ought to think about your life so you don't become vulnerable, because that's what happened to me." And then, when I got more involved and learned more from my various teachers, I began to see how to use the body and how to relate it back to people's lives, to teach them how to heal themselves.

CHOWKA: What do you think makes a good doctor and what are the impediments?

SIEGEL: First, I describe the villain as medical education. It's about disease, not about people. We are taught to think and not to feel--don't deal with patients' feelings or your own! Therefore, doctors are tourists, not natives.

Students and young physicians say that it's the people--helping people--and not the money that makes them want to be doctors. But the training ruins these lovely young men and women. It doesn't teach them about feelings and about why they became physicians. Jack Kevorkian, M.D., and I would both be a lot healthier and happier people today if someone in medical school had stopped us and asked, "Why are you being a surgeon? Why are you being a pathologist? How are you going to deal with death? How are you going to deal with pain? What are the healthy and unhealthy reasons that you're involved in this work?" All of this is important because a doctor can hurt people not only by actions but by words. A doctor can do more damage with words than with swords. If those kinds of questions had been asked in medical school, both Kevorkian and I might be helping people more today and not be involved in so much controversy.

CHOWKA: Are there still institutional barriers to making medical education more progressive, more appropriate?

SIEGEL: The barriers are the people in charge who were educated in the old system. They tend to perpetuate the same sickness that they were taught. We physicians close our minds because of our training. If we were exposed to various alternatives during training, like herbal remedies, then we'd see things differently. Are unusual healings hard to accept? No, they happen. Are they hard to understand? That might be. Are they hard to explain? That may be. Perhaps 10 years from now, we will understand these things. We don't even know how the universe started! But do we cancel it--not accept life because we can't explain its origins?

There are some students and professors making changes. Also, medical educators get cancer. And then they say, "Oops! I'm changing my lectures." They begin to write articles for the medical journals pointing out that this is a different world now. And God, family, relationships, health and time are what's important--not what's the best treatment for cancer, rather, the experience of it.

CHOWKA: I've read that you still run marathons.

SIEGEL: I am 64 and I just ran in the New York City Marathon for the sixth time. Everyone can be like me. Some of it is my parenting, some of it is me taking care of me--I'm not trying not to die, please understand that. I don't follow any rigid diet or anything else, and I enjoy life. But I learn about supplements, herbal treatments, exercise and a whole host of things. We could have healthy adults who, when they get tired of living, don't have trouble dying. If you teach people how to live, they don't have trouble dying--literally. And we can also have healthy adults who don't cost a lot. Ultimately we are going to come to what I call "the cost effectiveness of wellness"--the insurance companies will say "We need to keep you healthy to save money."

The difficulty, again, is in the system: There isn't a reward for proving that there are less expensive ways of doing things. The pharmaceutical companies are trying to cure disease because they are in business.

I'd like to see the government say to pharmaceutical companies, "If you test herbal remedies and they are effective, we will grant you the first five years of sale of these so you can make some money."

CHOWKA: You've said that the government might help to educate people with information on health promotion and that the U.S. Food and Drug Administration (FDA) could play a role in this.

SIEGEL: The government should include things like alternative therapies in their plans. Let someone from the government visit the [alternative] clinics, research them, and give people information.

What disturbs me about FDA is that when my father, in his 80s, developed cancer for the second time and was not a candidate for any more surgery, I sent for some products from Germany to stimulate his immune system. I wanted to continue giving him hope, something doctors don't know how to do. I got a call from the Postal Service saying that if I wanted to bring these products in, they could not be labeled "medical products." But if "botanical products" were written on them, there would be no trouble having them delivered to my house. The Postal Service cared about my father; they said FDA would be after them if they delivered the products to my house as "medication."

Now, if you have an intelligent human being who chooses to have God heal him, should the government be allowed to run in and say, "You're not allowed to have God heal you; you must have chemotherapy and surgery"? This is the part that disturbs me--taking freedom of choice from an individual, taking away personal rights, like the rights of my father when he was sick. That's sad, because we should have the freedom to explore, to know and to inform.

CHOWKA: You've said things that seem so commonsensical, like "We can't separate health from what's in our heads." Why do we seem to have so much trouble getting in touch with that common sense and perennial wisdom?

SIEGEL: Because people are unwilling to feel. They're too busy thinking. I say to people, if you remain logical and intellectual, you become pathological--you can't find your way in life. But if we get into the feelings and into the body, then recovery comes. Or at least the disease becomes a teacher. Some people describe life-threatening illness as a gift, a wake-up call, a blessing, a new beginning, a teacher. There's something positive in illness, in terms of what it's done for their lives. And they're grateful for the experience.

The Talmud has a line that's incredibly powerful: "He who rejoices in the suffering which is brought upon himself brings salvation to the world."

Peter Barry Chowka is a journalist, medical-political analyst, lecturer and consultant who has documented traditional approaches to healing. Chowka has been a consultant to the U.S. Congress and was appointed to the first advisory panels of the NIH Office of Alternative and Complementary Medicine. © 1997 by Peter Barry Chowka

This interview was first published in the March 1997 issue of Nutrition Science News. It is also viewable at this URL.

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