An Integrated Life
By Genevieve Morgan
Photographs by Peter Dennen
There’s a healing Eastern wind swirling through hospital corridors and exam rooms, buffeting the Arctic blasts of impersonal Western medical care–and its source may surprise you. Meet three faces from a new generation of physicians trained at Maine Medical Center who are practicing at the crossroads of alternative and traditional medicine and wholly enjoying the breeze. Forget health care reform, this is health care (r)evolution.
Craig Schneider: Native Healer
It’s not often that a man realizes his life calling while jogging beside a horse in the remote villages and high plains of the Himalayas, but that is exactly how Craig Schneider decided to become a doctor. And why he came to Maine to do it.
As an undergraduate, I thought I would be an anthropologist, says Schneider, now the director of the Integrative Family Medicine Program at Maine Medical Center and a busy family doctor with an integrative-care practice in Falmouth. Back then, I was interested in Tibetan medicine as a potentially vanishing form of existing culture. I went to Mustanga remote area in Nepal with strong cultural ties to Tibetand knocked on the door of a local healer. He took me in, and I became his apprentice medicine-maker, grinding herbs and seeds between a big rock and a little rock. There were no roads, so he took rounds on horseback. Sometimes he would use herbal medicine to treat patients, other times he used relaxation techniques, and sometimes he would use moxibustiona technique by which acupuncture points are heated to stimulate healing. I got inspired to do what he didthe way he did itin my own culture. I had that romantic, old-school notion of how a general practitioner could work in a community.
Schneiders vision survived the overwhelming experience of medical school in the United States, where romantic notions tend to get squashed by the sheer volume of information students must remember. He kept his interest in alternative medicine alive by experimenting with self-treatment and by organizing meetings with a group of like-minded students. He received his MD from Columbia Universitys College of Physicians and Surgeons. When it was time for his residency in 1999, Schneider, already a big fan of Maine from his experiences during childhood vacations, came to Maine Medical Center, where he was pleased to find himself among residents and attending physicians with similar interests. As Schneider tells it, in the late 1990s the allopathic (Western medicine) and alternative-healing worlds were collidingwith explosions and screams coming from both sides. The two might never have found peace had it not been for early pioneers such as Dr. Andrew Weil and a growing market for different kinds of health care experiences.
Its one of the great things about this movement: the patients really want it. They like it. And they are dragging their more traditional doctors behind them, Schneider says. In fact, they are dragging them along in droves. A 1998 report in JAMA (The Journal of the American Medical Association) pegged the percentage of people seeking complementary and alternative therapies at 42.7 percent. More recent data from a 2007 survey by the National Institute of Health found the numbers holding steady at about one in three adults, or 38 percent of the population.
As a physician, its a trend you cant ignore, Schneider adds. If you want to be a responsible doctor, you have to be knowledgeable about this stuff because its very likely your patients are doing it. Even better, you should become a clearinghouse for itthat way you can advise your patients on what treatments and which providers they can trust. Schneider pauses for a moment and smiles. Thats the kind of doctor were training in our program: one who gets to know their patients, understands them, and provides the most suitable options for their care, whether its a medication, an X-ray, a referral for body manipulation, or a stress-reduction technique. They all count.
The Integrative Family Medicine Program was established in 2001 with a grant from the National Center for Complementary and Alternative Medicine, an agency of the National Institutes of Health, and it has already graduated five fellows. Four more are currently in the pipeline. Residents coming into the program hail from all over the country, but so far all of the graduates have chosen to remain in Maine. On average, these physicians will care for between 2,000 and 3,000 patients across the state. During his fellowship at the Arizona Center for Integrative Medicine at the University of Arizona, Schneider acted as a grant-writing consultant. After he returned to Maine, he became the director of the program, where he is responsible for designing the curriculum, raising private funds, and personally educating the fellows.
Will these homegrown, hybrid docs truly be able to change the face of national health care? Schneider grins before he answers, I dont know, but I sure hope so. Were certainly going in the right direction. Outside his window, snow falls across an empty field of ice. A patient is waiting to see him. It may not be the Himalayas, but it is close enough. Schneider has become the doctor he set out to beonly tonight, hes happy to be driving home in his all-wheel-drive Subaru.
Lisa Belisle: Life Support
The renowned Zen monk Thich Nhat Hanh wrote, “You are here for life; and if you are here for life, life will be here for you.” If Lisa BelisleÑa family doctor, medical acupuncturist, and Qigong teacherÑwere to rewrite that line (which she could do, and well, because she is also a talented writer), it would read: If you are here for yourself, life will be here for you. And by “life,” Belisle would mean a vibrant, joyful, connected existence free of pain and illness that honors the ever-changing nature of being human.
Im here to poke peopleliterally and figurativelyto wake them up and reconnect them with themselves, Belisle explains. I want to move them from a sense of being passively transported through their lives to being actively engaged and feeling well. Lets face it: we all have health concerns and periods of serious stress and discomfort, but for me it comes down to how able my patients are to handle their personal challenges without losing their balance. This is the kind of healing Im interested in, but its not the way I thought I would be practicing medicine when I first got my degree.
Back in 1999, the year Belisle completed her residency in family medicine at Maine Medical Center, she was following in the very traditional footsteps of her fathera beloved local physician who, along with his wife, raised her and her nine siblings in Yarmouth. She soon followed her MD with a fellowship from the University of Massachusetts in preventive medicine and then pursued a degree in public health from the Medical College of Wisconsin. In 2000, Belisle spent a year and a half treating inmates at the Cumberland County Jail, which led to a decadelong teaching stint at Maine Medical Center and an appointment as a medical advisor for the MaineHealth integrated health care system. Belisle simultaneously established a solo practice in her hometown to provide the prescriptions, routine examinations, and procedures that are the meat and potatoes of Western medical practice. In her spare time, she wrote and taught and looked after her three children. Life was unspooling exactly the way it was supposed toexcept for the creeping sense that something fundamental was missing in the way she had been taught to deliver medicine.
As I was doing my family medical practice, I would talk to patients. I began to find patterns of disease that went far, far beyond the time I had to talk. Even with longer visits, I wouldnt necessarily be able to get to the end of a problem or I would get to the end and I wouldnt have a solution. I was looking for a tool to help me. At the time, I saw acupuncture as an extra technical skill. I liked it because it achieved identifiable, measurable results. Very Western thinking. Then I started my training [at the Academy of Pain Research in San Francisco and at Harvard University], and thats when I discovered that it encompassed so much more. The Eastern modalities attract me because they are metaphors for something bigger. As a creative person, this makes sense to me. Almost everything has meaning, so why shouldnt medicine have a larger meaning, too?
Belisles life path veered from the straight and narrow, and with that turn came a deepening and expansion of her medical approach. Today, she provides medical acupuncture and teaches weekly Qigong sessions at Aerie River, her new practice, which is located in the old Sparhawk Mill overlooking the Royal River in Yarmouth. She dispenses nutritional counseling and something less tangiblesome might call it life coaching, but it feels a lot more like simple caring. And not just for her regular patients. She hosts a weekly health program, Dr. Lisa, which airs on both radio and television, and she writes a popular blog through which she shares her insights into the complexities of being human, along with recipes and unique life prescriptions derived from her personal experiences.
Belisle is the first one to admit she has willingly given up all preconceptions of what her role as a physician should be. I take people where theyre at. If they just want pain relief, I can do that, but if they are interested in peeling back other layers, I can do that, too. No one can solve every problem, but I can work with patients to adjust to whats going on in their lives in a healthier way.
This concept of wellness as a lifelong practice, in which physicians serve as collaborators and guides, is pivotal to the new breed of integrative doctors being trained in Maineand it could help move our states health ranking from number eight closer to that of our sister state, Vermont, which is currently number one. Nothing would make Belisle happier.
My goal is to see my patients out there making healthy personal choices and thriving in the community because their well-being has a ripple effect. Everything
is interconnectedone persons health is my health, and yours. If we want a better world, thats where we have to begin: with ourselves.
Matt Hand: Gentle Touch
Let’s get one thing straight: Matt Hand is not particularly interested in talking about disease. He’s a doctor of osteopathic medicine and an expert in pediatric nephrology, but for the most part he doesn’t waste time with statistics or probable outcomes. Hand is more interested in the health of his patients, in whatÕs going right in their bodies and how to amplify it, even when the odds look grimÑand he has faced some pretty tough odds. (Hand was a team leader in providing care for a Kennebunkport-born girl with sirenomelia, or mermaid syndrome. Patients rarely survive infancy; Hand’s patient lived to be ten years old.)
In the 1990s, Hand was the only kidney specialist in the state able to treat children with severe renal conditions: dialysis and transplants for kids whose ages ranged from newborn to twenty-five. It meant long hours, emergency phone calls late at night, and a road-warrior existence that made him physically ill from stress. There was no one, and I mean no one, taking call with me, he remembers. But make no mistake: as a former professional lacrosse player, Hand still has the endurance of a world-class athlete. For the past seventeen years, he has carried the banner for the introduction of health-affirming, life-sustaining alternative medical techniques to in-patient pediatric care. This is pushing-the-envelope stuff that is advancing integrative medicine beyond preventive care or office visits and into the hospital and the treatment of seriously ill children.
Hand was raised in upstate New York. He didnt come from a family of doctors and never had any real interest in becoming one until college. His lacrosse experience sparked an interest in sports medicine, which led to a decision to ride shotgun in an ambulance during collegean experience that sealed his fate. His family was perplexed at first, since he had been an environmental science and forestry major. When he told his mother about his decision, she said, Dont you have to be kind of smart for that? Hand paid no heed. He prefers a challenge. At first, he contemplated an MD, but after four people in one week told him to look into osteopathy, he decided to listen.
It comes down to complexity theory, as opposed to reduction theory, which is how most MDs are schooled, Hand says. In other words, if you have this condition, you take this pill or have that surgery and youll hopefully get such-and-such result because thats what the best models indicate. But that never made sense to me. Just by having a mind and a history, a persons condition is automatically complexso why, as a doctor, would you consciously decide to narrow your approach?
Osteopathy has an illustrious history in the state of Maine. The University of New England has been training doctors at its College of Osteopathic Medicine since 1978, which might help explain why our state has become something of an osteopathic hub. Osteopathy was developed in the 1800s by an American frontier doctor named Andrew Taylor Still. It promotes the idea that the body is an integral unit with a structure and functions that work together interdependently and are supported by built-in repair and regulation processes. A doctor of osteopathy works with these processes to boost health and remove disease by gentle manipulation of the muscle and bones. Chiropractic adjustment, massage, and other body-manipulation techniques work along these same lines, but DOs are first and foremost licensed physiciansmany opt to complete an extra year of medical school to learn osteopathic manipulation. Despite the rigors of the training, some patients (and MDs) still question the medical authority represented by those two letters.
I learned a long time ago not to get hung up on the initials after my name, Hand laughs. Honestly, its about taking care of people the best way I canat least thats what its about for me. And his best is extremely good. Hand completed his residency at Maine Medical Center, and like many others, he never left. He helped build the Barbara Bush Childrens Hospital. He consults for the Maine Chapter of the American Academy of Pediatrics. His work has been lauded on the Discovery Channel and the Oprah Winfrey Show. Today, he leads the division of nephrology and integrative medicine within Maine Medical Partners Pediatric Specialty Care and continues his efforts to redefine the pediatric health care model from disease to wellness. Currently, about 60 to 80 percent of the kids with chronic illness he sees receive alternative forms of healing in addition to their traditional medical care.
Its important for peopleand their doctorsto understand the concept of integration, Hand stresses. Nobody is talking about getting rid of traditional care; its about adding other things into the mix for the benefit of a patient. My goal is to have a kid who is sick be seen as a person first, not a disease entity. And its happening. Were creating a patient-centered pediatric program that covers the entire state.
Will that mean a return to the hectic on-the-road professional life for Hand? Not really, he thinks, but even if it does he wont mind. The champion in him will never quit.