Transcription of East Meets West #28
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Dr. Lisa: This is Dr. Lisa Belisle, and you are listening to the Dr. Lisa Radio Hour and podcast, Number 28: East/West. Airing for the first time on March 25, 2012 on 1310 AM, Portland, Maine, WLOB Radio, streaming wlobradio.com. Or perhaps you’re listening to our podcast available on iTunes.
This week’s show is a pretty special one for me because it talks about something that is near and dear to my heart, which is the bridging of Eastern and Western medical therapies. Joining me in the studio today, I have my cohost and wellness editor for Maine Magazine, Genevieve Morgan. Hi Genevieve.
Genevieve Morgan:Hi Lisa. I’m really excited to hear more about this topic because I know it’s been really important to you.
Dr. Lisa: This really has changed my life. Our first guest is an individual that… it’s one of the most important teachers I’ve ever had and this is Master Nan Lu of the Traditional Chinese Medicine World Foundation out of New York. This is going to be a great interview. And then we brought in Dr. Robert Eckert, who is a cerebrovascular neurosurgeon who is featured in Maine Magazine, and the article was written by, yes, Genevieve Morgan.
Genevieve Morgan:Well, in a funny way, we’ve done our own little East-West bridging with the two wellness issues at Maine Magazine. The first wellness issue was last year, 2011, and we featured integrative practitioners such as yourself, and this year we are featuring three conventionally trained physicians who could be practicing anywhere in the world, but have brought their extreme medical know-how and talents and just superstar status to our state. So it’s been really interesting for me to do that and cross that line.
Dr. Lisa: I think I heard you refer to them as rockstar Docs.
Genevieve Morgan:Yes. We’re calling the article Super Docs, and it’s in the current issue that you can pick up at your newsstand today. I think it just came out. Really great.
Dr. Lisa: Talk about East-West – on the cover, we have Steven Anderson of the Body Architect up on the east end here in Portland. Stephen was in one of our original shows, Light, and I don’t know what number that is, but if you go to the podcast site on iTunes, you can find it. And Stephen practices Qigong.
Genevieve Morgan:Yes, and he had his own East-West transition, because he was an athlete who trained very conventionally as an athlete and then suffered burnout and injury and trauma and then came to Chi gong and Eastern medical training and Eastern physical training and it changed his life. So it seems like everybody who is interested in these topics has these moments when they understand it doesn’t have to be either/or – it can be both. And that certainly happened for you.
Dr. Lisa: That has happened for me. And it continues to happen for me. Sometimes in our lives when we find ourselves at a point of, maybe I’ll call it deep despair … I hate to say I was in a point of deep despair, but everybody gets there, or many people do. You really question where you’ve been before. You really wonder “Did I follow the right path? Did I go in the right direction? Is all of this for naught?” And I found myself there.
What I learned by going in a very different direction, so I had trained as a Western medical doctor and I just knew that it wasn’t quite right for my patients, and it wasn’t quite right for me, and it’s not that what I learned was wrong. It just wasn’t quite healing enough. It was the tools that were missing out of my toolbox. So I went and I trained in traditional Chinese medicine, acupuncture, and medical Chi gong. And realized I had never been going in the wrong direction. I went in one direction. I went in the other direction. And then the key was to bridge them. And this was what I needed to do.
When we talk to Dr. Robert Eckert, we’re going to find out that he actually had training over in Japan, which was I think offered by a fairly Western trained physician.
Genevieve Morgan:Yes, he was at the Mayo Clinic and and still maybe some time he was on a military scholarship to medical school and he still owed them some time so he went over to Okinawa, and scrubbed in with some of the most successful and impressive neurosurgeons in Japan and learned their techniques.
Dr. Lisa: And we hear these stories over and over again. So it’s not as if over in China they’re just practicing traditional Chinese medicine, or in the United States, we’re just doing Western medicine. And we’re finding that there is a certain sort of global element that is going on. People are borrowing from ancient traditions, from modern traditions all over the world. So I think a lot of people, even though we call it East-West, I don’t know that there is that distinct delineation anymore. It really is people everywhere trying to find ways to bridge therapies and bring the best to the patients in this world.
Genevieve Morgan:Well, I’m hoping Master Lu will talk about that.
Dr. Lisa: Master Lu will talk about it, and Dr. Eckert will talk about it. We really think people are going to enjoy this show.
The Dr. Lisa Radio Hour and Podcast features a segment we call Wellness Innovations, sponsored by the University of New England. This week’s innovation is about integrative medicine and is featured in Prevention Magazine. Across the country, more and more doctors are embracing complementary and alternative medicine, prescribing therapies such as acupuncture and yoga, and dispensing advice on the right way to breathe and eat. 38% of Americans already use integrative practices, and now countless researchers are proven their benefits.
One study on acupressure, out of the Department of Psychology and Neuroscience of the University of Colorado at Boulder, followed individuals who had suffered a mild to moderate brain injury. At the end of the study, which was published in a recent issue of the Journal of Neurotrauma, those who received acupressure had better memory and attention, and less stress and anxiety.
For more information on integrative medicine as a wellness innovation, visit doctorlisa.org.
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Dr. Lisa: Today’s featured guest is an individual who I hold in very high esteem and wanted to interview despite the fact that we would be making a phone call rather than our usual practice of doing it in person. This is Dr. Master Nan Lu who is the founder and director of the Traditional Chinese Medicine World Foundation in New York. I know you’re going to enjoy this interview.
Good morning Master Lu. How are you?
Master Nan Lu: Good morning. How are you?
Dr. Lisa: I am doing well. Thank you so much for agreeing to come on the Dr. Lisa Radio Hour and podcast with us today. The show that we’re doing this week is called East-West, and we will also be having a more traditional Western trained physician on with us. As a Chinese medicine physician, we are interested in how you came to be doing what you are doing, and we wanted to get a little bit of background about Chinese traditional medicine from you.
Master Nan Lu: Let me start it this way. Try the Tao way. We know that Western medicine, any kind of medicine, always has theories, has basis, has the science behind it. So the Chinese medicine is a different kind of framework. They are not based on the Western medicine, that kind of framework. They are based on the other kind, which is, as of today modern science has discovered, what you call a quantum information system.
If you look at the quantum information systems, they tell that everything are connected to each other. That is at the basis of quantum theories. So these kind of theories have been applied and used in Chinese medicine for thousands of years. One of the famous theories in Chinese medicine, we call the 5 elements theories. There are five basic elements, which means we can say one is the wood element, one is the fire element, one is the earth element, and the metal elements and the water element.
Generally speaking, the Chinese believe that the whole universe, the Earth, can be simply divided into these five basic elements. All of these elements are communicating and connect to each other. In this system then, the Chinese medicine applies for the human body, human organs, and the natures, everything into this system. Everything is connected to each other.
For example, if we say you have a liver function disorder, if you think of a way you go to the Western test, they say ‘Oh, your liver may be better to live with. Okay. The tests show you’re pretty okay.” But however, you have many different kind of symptoms associated with the liver function disorder, for example. Like menstrual system may experience the breast tenderness, major cramp, and emotional mood swings, all of these are symptoms. According to Chinese medicine, they are associated with the liver function, so that’s why the Chinese medicine will say “Because if the liver function disorder will cause you to have these symptoms.” So to eliminate the symptoms, or treat the symptoms, you have to treat the liver function. Otherwise you just cover the symptoms.
Let me give you another example, called a relationship problem. Like today, we see so many people suffer acid reflux. That’s one of the common conditions. In Chinese medicine, when we look at these symptoms, we would diagnose this as a relationship problem, which means its the stomach and the liver function relationship problem. Generally speaking, the liver function disorder that causes the stomach function disorder. So in order to eliminate these symptoms, you have to treat both organs. Making these systems function in harmony can allow… symptoms can be eliminated.
That is generally speaking about Chinese medicine. They use a different framework to look at the relationship.
Dr. Lisa: Chinese medicine can really remedy people’s chronic ailments in a way that Western medicine hasn’t really achieved at this point. Not the acute infections and disasters that happen, but chronic illnesses that seem to be taking such a toll on Americans.
Master Nan Lu: Chinese medicine, I think we cannot say that because Chinese medicine only can deal with acute conditions. But also can deal acute conditions. Like for example, if you did a heart attack in the middle of the street, you get a heart attack, I think Chinese medicine is better than any kind of medicine with acupuncture needles. So if you like, before the end you come here, and go back to the hospital, get the heart needle, you might die. Right?
Dr. Lisa: Right.
Master Nan Lu: If you look at this kind of concept, but the most important thing we have to look at them, is another what medicine is, what kind of framework do you use to look into the human body? That’s what today’s science, science already proves, already shows us, everything is about energy up to date. At the atomic level, or the subatomic level. Everything are changeable. Everything is about energy. So therefore it doesn’t matter what kind of medicine, it means who can understand the relationship with energy, who will be able to have a good result.
Dr. Lisa: Dr. Lu, one of the things that I know that you focus on is the practice of Qigong. As a medical Qigong student of yours, and also a teacher of the Dragon’s Way class, I’ve found great benefit of this, for this to my patients. How did you come to be a Qigong practitioner and master yourself?
Master Nan Lu: Well, I had been trained by many many masters, and the thing we heard about Chi gong is one kind of energy property. Which means basic special energy properties will allow us to discover who we are, allow us to connect to the life force. Generally speaking, we all have energy, so we all know inside it has a life of force. And how can we use this life of force wisely at the body-mind-spirit level. So through my many years, the experience I rediscovered, which my Masters tell me, that I have to practice and find Qigong – it is one of the Chinese ways to discover the life force. In use of this kind of life force, you can help the body achieve the balance, and also you can using these energy properties to deal with many different kinds of physical conditions.
Dr. Lisa: Dr. Lu, what have you seen are the indicators of a healthy balanced human being?
Master Nan Lu: Well when most people come to me they aren’t in balance. If they are in balance, they are not going to come to me. So that’s why I haven’t seen a good one yet.
Dr. Lisa: Are there any indicators of imbalance?
Master Nan Lu: Sure, they can see, there are so many signs. As of today, we know everything about the signs. The most important thing as of today, the people listening, if they are listening, so they believe the modern science, you have to believe energy maps are interchangeable. And whatever will we see is the energy. So therefore, energy will have a sign. Let me give you an example. If you see your nail is not as shiny, it has many lines. Your nail is difficult to grow. You have a nail problem. The nail condition is associated with the liver function – that’s the sign. And also I see the breast tenderness – that’s the sign of the liver function disorder. That also is the sign. I can give you other signs.
Okay, suppose you have osteoporosis, high loss of bone loss. And many people might take some calcium pills and try to eliminate the bone loss. However, in Chinese medicine that’s the sign of kidney function disorder. Even the simple way, where we say that you have a knee problem, suppose you have a knee pain and are suffering and you might need a knee replacement. You might need a knee surgery, whatever you need. That’s the sign of kidney function disorder. There are many signs in our human body. You just have to understand the relationship between the human body and the organs and the mind and emotions.
Dr. Lisa: Master Lu, I know that a focus of your practice has been on women, and you’ve done work with breast health, and there are a lot of women that have done the Dragon’s Way, and other programs that you have put forth. Why is it so important to work with women and their energy levels?
Master Nan Lu: Let me make a joke. In the Chinese culture, the woman is 50% of the heaven. The woman is the most important one of the group of people, and also particularly in the Western society, women have more stress than the men. In my opinion, that’s what I think.
Because most of the women carry many masks. They have to carry the perfect mother, the perfect wife, the perfect job, so they wear so many masks they have to carry on. So that is difficult for women. And also, on the other hand, the Chinese medicine states all women’s health directly or indirectly are associated with the liver’s function. Which means if you can treat the liver function, you can treat almost all the woman’s problems, such as gaining weight, headache, PMS, menstrual cycles, breast cancers. So many conditions are associated with the liver function disorder.
And also women are very sensitive. They are more sensitive than the men somehow, so if they can understand their emotions cause their physical disorders, so if they can control their emotions, or understand how to use their own emotions to deal with conditions, they can achieve total health.
Dr. Lisa: And you believe that Qigong is one way of working with one’s emotions, is that right?
Master Nan Lu: I believe that Qigong is self-revealing truth. So when you learn of something, you can heal yourself, you can help yourself getting better. You can almost like everyone needs to take a shower. Then you have an external shower. But can you do an internal shower?
Genevieve: Can anyone do Qigong?
Master Nan Lu: In my opinion, anyone can do Chi gong. Just as anyone have a depend what kind of physical condition. Some people have a better result, some people have a lesser result.
Dr. Lisa: How many classes do you generally need to take? Is it something that you need to do every week, or…
Master Nan Lu: You need to do it every day. You just have to think of this.
Dr. Lisa: Every day.
Master Nan Lu: Because Qigong is a different kind, unlike any kind of physical exercise. Qigong is a slow motion movement. This movement is trying to stimulate the body to a specific energy frequency. 95% of people never have a chance to restart it.
Genevieve Morgan:Someone can go to one of Lisa’s classes and learned the movements and do them themselves.
Master Nan Lu: That’s right. They have to learn it. It is very difficult to just quit the way and say “Hey, let me do something and just go to the video.” I think that someone can learn a different way. But generally speaking, you have to learn it, and you have to practice every day. And on top of this, it depends on how sensitive you are. And also depends on the stage of your health.
Genevieve Morgan:It sounds like what you’re saying is that the consistency of practice of taking care of oneself is important in maintaining one’s health. That you can’t just go to the doctor once a year and expect yourself to be healthy. That it’s a daily practice.
Master Nan Lu: Well you can go to the doctor once a year, because going to the doctor once a year, do not think the doctors going to fix you. You have to look at and go to the doctor once a year to do the physical test, the physical exam, to check on how much improvement myself. Looks like that is the improvement, that’s the test to show how good you are. Real health is reliant on your own hands. It is very important everybody has to realize you are capable, you’re able to control your own health.
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Dr. Lisa: Master Lu, you’ve been doing the traditional Chinese medicine World Conference for more than a decade now, is that true?
Master Nan Lu: Yes.
Dr. Lisa: And what challenges have you found in bringing traditional Chinese medicine and the 5 element or 5 phases approach to the United States?
Master Nan Lu: It’s a challenge. It’s a bridge – how to build this bridge. Because the Western mind is the way – it’s the Western concept – Western mind, most of the Western mind is built on classical signs, and they believe everything that they see. The whole scientific, whatever is called the scientific mind, is based on the classical science which is a Newtonic science of 100 years ago is an old science.
However today, everywhere you go, you go to the hospital, all the tests are based on the modern science. It’s not of the classical signs. So the bridge is the to say hey, the classical signs, yes, make sense. However, the model of science today shows you everything is connected to each other. Now the Chinese medicine is just one of the oldest of continuous properties of medicine that has existed for decades. It has existed for thousands of years, and it is just coming to use.
And even today as the modern science already shows here, that kind of concept, that kind of principle makes sense.
Dr. Lisa: And this is why you’re calling your conference ‘Building Bridges’ because that’s what you’re attempting to do is to bridge the different types of science, classical and modern.
Master Nan Lu: That’s right. That’s why I tried to say it’s the bridge, so use the modern science as the bridge. So that everybody can cross, because if there is a bridge, we are comfortable, we understand. So that’s why I say yes, you go to the hospital, you get an MRI, you get an x-ray. Do you understand what kind of frequency an MRI and x-ray use? They are at the atomic level, so therefore to read this result, you have to be at the atomic level. That is the quantum physics – to understand everything is connected instead of saying everything is disconnected, is individual.
Genevieve: Master Lu, how important are our thoughts and state of mind in maintaining health?
Master Nan Lu: I think the mind is very important and the belief is very important because if you believe you can heal yourself, if you believe, you can maintain health and you’ll be able to turn on your body differently. So your own belief, your own emotions take a major impact for your health. That’s what I see for the most of my patients, and particularly if you deal for the quantitative conditions, you deal with the acute conditions, and it’s very important.
Dr. Lisa: Master Lu, you just returned from China, where you go on a regular basis I think to spend time with your own master. Is that right?
Master Nan Lu: Mmhmm. (Affirmative)
Dr. Lisa: Does this help you maintain your own energy and balance and sense of perspective?
Master Nan Lu: I believe everybody has to continuously learning, because to discover the whole universe is unlimited. To grow is unlimited. So if you have a chance, it means it has to be continuous studies. And sometime in life, you come out of different conditions and its complicated. Being a doctor is the most difficult. I think it’s more difficult than any kind of art, different kind of any kind of taking initiative. Because every patient is an individual. So I often make a joke that the patient comes in. “Have you treated this kind of condition before?” I say ‘No. Because God has only created one of you. How can I duplicate it?”
Dr. Lisa: If some of our listeners have been going to a traditional Western doctor their whole lives, but they’re interested in now going to a Chinese medical doctor, can they do both?
Master Nan Lu: Yes they can do both. Because it’s not to say you can only go Chinese, you cannot go to the West. Because the patient tries the Eastern and the Western way, they just have to understand Eastern and the Western is a different kind of focus. Both ways are right. In the Western way, when they look at the world, they have a way to see, which just means that they are absolutely right from their point of view. The diseases, the illness, the infection – that’s absolutely right.
However, if you go to the Chinese doctor, they changed the different kind of frequency, they change the different kind of point of view. It’s the same condition, but they look at it a different way. They are right too. So the way the patient tries to deal with these kind of conditions, they may have to understand. Some way they may be cooperated together. So for example, if during the chemotherapy, some patient, okay, during the chemotherapy, how can you prevent the immune system from being shut down? How can you prevent the system being destroyed by chemo? So you have to change to a different kind of diet. You have to change a different kind of lifestyle. You have to even if possible do some simple Chi gong exercise. Do the simple breathing. And peace for your mind. And take some different kind of herb.
Dr. Lisa: Is there a place for a spiritual practice, or even a religious practice in maintaining health?
Master Nan Lu: I think a spiritual practice and a religious practice is very important in health. Because in the spiritual level, and the religion practice concept of religion, true religion is spirit. It is to understand you are not just a body. You have to have a fate. You have to have a belief. You have to have compassion and the love. So the love is in all disease, and it’s caused by lack of love. So if you can start loving yourself, then you will be able to deal with any kind of disease and illness.
Dr. Lisa: What are the common health ailments that occur as a result of the Western lifestyle?
Master Nan Lu: The Western lifestyle today causes liver function disorder, the number one is stress. Physical stress and emotional stress. That’s the number one. Today, almost all of the modern disease are associative the liver function disorder. You have to love yourself. We say today a lot of conditions, a lot of disease are associated with genetic problems. Yes that’s true. You know you do have some kind of genetic problems.
However, if you turn on the genetic code, according to the modern science, past connects at both times. Disease and health is the same event on both sides. So if you have disease, you definitely have the wisdom of how to control the disease. Maintaining the healing processing, your job is to find where you can start the healing programs. That’s called loving yourself, if you have to believe yourself, you have to trust yourself, that’s very difficult. That kind of concept has not been taught in the Western society. So even we say you love yourself doesn’t mean doesn’t mean you’re going to buy the car, expensive car. You go out to shop and you do this. You do it. That’s not called love of self. That’s just one angle to feed your emotions and desires. To love yourself means to trust your own inner peace, trust your inner strength, trust your own body.
Dr. Lisa: And it sounds as if loving yourself also means first of all getting to know yourself. And Qigong and some of these things that you’re teaching can help people get to know themselves.
Master Nan Lu: Yes, they can through the meditation, they can even go through the simple breathings, they do. They can lead you to understand they are all connected each other. The energy is, it is their life force.
Dr. Lisa: And when people connect with themselves, is it true that they also become better at connecting with people around them as well?
Master Nan Lu: Yes. That’s right. So if you can connect to yourself, if you are understanding your self, and then you’ll be able to connect to others. Because always they say, you want to love others, but love yourself first.
Dr. Lisa: Well Master Lu, it’s really been a privilege to have you on today. I think anybody who’s talked to me about medical Qigong knows how much esteem I hold you in, so I appreciate your coming on as our first national guest talking to us by telephone. Also thank you for coming on with us right after your trip to China. It’s been a great interview. Thank you.
Master Nan Lu: Thank you.
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Our bodies are often the first indicators that something isn’t quite working. Are you having difficulty sleeping? Anxiety or chronic pain issues? Maybe you had a job loss, divorce, or recent empty nest. Dr. Lisa specializes in helping people through times of change and inspiring individuals to create joyful, sustainable lives. Visit doctorlisa.org for more information on her Yarmouth, Maine medical practice and schedule your office visit or phone consult today.
Dr. Lisa: I’m especially pleased to have the chance to introduce this individual for Maine Magazine Minutes. This is Dr. Rob Ecker, and he is profiled in the upcoming April wellness issue of Maine magazine. This is the second full wellness issue of Maine magazine. The first one was the one that Genevieve Morgan and I did, well she interviewed, she actually did all the work, she just interviewed me last year. I continue to be impressed with the fact that Maine Magazine has such a focus on health and wellness. And impressed with the fact that we have, Genevieve has called him a Superdoc, people like Dr. Ecker, here in the state of Maine, who are practicing Superdocs. So I’m going to let Genevieve … I shouldn’t say let … Genevieve, please take over now.
Genevieve Morgan:Thank you, Lisa, and welcome, Dr. Ecker.
Dr. Rob Ecker: Thank you for having me.
Genevieve Morgan:It’s such a pleasure to have you here and have our listeners listen to what you have to say. We had a great interview for the Maine Magazine wellness issue. I want to give a brief bio of you just because you’ve moved to the state relatively recently and I wanted to let people know that you studied undergraduate at Harvard and received top marks from the Virginia Commonwealth University School of Medicine on a military scholarship. You did your residency at the Mayo Clinic and you were trained as an endovascular surgeon, is that correct? At the University of Buffalo?
Dr. Rob Ecker: Yes, Nick Hopkins who’s an endovascular neurosurgeon is kind of the grand daddy of bringing endovascular techniques to neurosurgery. And endovascular techniques are similar to the way that cardiologists will put catheters either in the arteries in the wrist or the groin and bring them up to the heart to treat heart disease. That can now be used to treat vascular disease in the head, so for acute stroke, ruptured aneurysms, unusual vascular malformations in the head and neck, we can actually in the same way go up through the arm or the leg to the neck into the brain itself and treat these disorders.
Genevieve Morgan:And you came to Maine Medical Center to be the only cerebrovascular surgeon with endovascular training in our state.
Dr. Rob Ecker: That’s correct. I’m the only dual-trained. So I do open surgery to clip an aneurysm or take a blood clot out of the head, or address a stroke in some way, and also to be able to actually go up through the vessels themselves to be able to treat them. So I’m the only dual- trained person in the state of Maine.
Genevieve Morgan:So what you do every day is go inside people’s brains?
Dr. Rob Ecker: Of sorts. That is broadly speaking what I do. I sort of view myself sort of as a body plumber. If it’s bleeding, I stop it from bleeding. And if it’s plugged, I open it up. And there are lots of terrific tools and techniques to do that, and I think we’re building a really nice team of people to help take care of these patients, who are often very very sick and need acute care basically from the emergency room to their post-operative care.
And as much as mine is sort of the technical part of it, these folks need really a good team put together and Maine Med provided really the opportunity to build a program that didn’t exist elsewhere. And that’s a rare thing even in the US. I looked all over the US, and there weren’t a lot of opportunities to build something that didn’t exist, and then also to be able to support taking care of these sick people.
Dr. Lisa: Well, you’re very modest about your skills, but but I know that it takes a lot of training and a lot of work to do what you do. In fact, you’ve described it to me as and art as well as technique. What is the artistic part of your job? How do you view that?
Dr. Rob Ecker: Neurosurgery as a whole has been described as essentially a three dimensional physical exercise. So when you are, from looking at a scan of a patient, to then deciding how you are going to treat them, from open surgery, opening up the head, to be able to even position the head, to orient the head to be able to find the sick blood vessel to be able to treat it, that sect of brain is kind of a three-dimensional exercise to safely get there.
And that requires some training or some art to figure out the most efficient way to do that. And then, endovascularly speaking, there’s not… you know, it’s almost like a game of chess. There’s sort of not one solution necessarily to get there, but trying to figure out the most efficient and safe solution often requires different tools, techniques, trying different things even if one doesn’t work to try to have a plan B or plan C to get there. I think that is often the art form to it.
Dr. Lisa: That three-dimensional exercise you’re describing, it requires the ability to visualize on a very high level, at a level that most people probably aren’t called on to do.
Dr. Rob Ecker: I think so. I think some people may gravitate, maybe it’s something I’ve just gravitated towards. And I know some who have a better three-dimensional sense than others. You can actually have them have done it for a while. I suspect like an artist watching someone paint, you kind of get a sense of watching someone work, and who seems to get there efficiently. I think that is a skill you develop. I think it’s also something you can work at to get better at over time by just doing a lot of cases and attempting to watch a lot of people who are very good at it do it. I’ve gone out of my way to try and find people I view as very very good and watch them work and see how they do what they do.
Dr. Lisa: And that’s appropriate to our theme of East-West, that journey took you to Okinawa, Japan, correct?
Dr. Rob Ecker: Yeah, right out of training, the Navy stationed me in Okinawa, Japan, which is for many neurosurgeons, considered a sleepy place. But I, in a bid not to lose my skill set, went out of my way to really partner with a Japanese neurosurgeon who was there. The Okinawa island itself is some part of the Ryukyu Archipelago, and there’s a university there, a university hospital there, and actually a very well cerebral vasular surgeon in his early 60s – Dr. Akio Hyodo was there. Had spent some time at the Mass General as a research fellow, so spoke pretty good English.
And I tried to work with him a couple of days a week, and he was a wonderful teacher. Almost a sort of second Japanese Fellowship. And he would go all the way around the islands to different hospitals to do different cerebral vascular cases, and he’d call me up and we’d go in his car, and we’d go do something else. And I think simply by having had enough, he knew that I had had a lot of experience taking care of these patients. And most of his fellows hadn’t. So I think he enjoyed having me around as a second set of eyes. And it was wonderful seeing him work. I learned an enormous amount.
Dr. Lisa: And then you went to Finland last year, so you went to the other.
Dr. Rob Ecker: Contingent on actually anywhere where I was interviewing after the military, there’s a man named Johann Ernest Neambi who’s at the University of Helsinki who I’ve always viewed as, of the generation in their early 60’s, the most cerebral vascular surgeon, so open, not endovascular surgeon. I always wanted to go watch him work, so I made it contingent on every job offer when I interviewed everywhere that I would go spend a month with him, and the guys at Maine Med and my partners let me go for the month of May last year. And it was spectacular.
Watching him work has actually improved my technique already. I never had a patient be able to have a clipped aneurysm, so an open surgery and be able to leave the next day, and not all my patients do, but I’ve had a handful now who I’ve operated on who have left the next day. And it’s simply by modifying that technique.
Dr. Lisa: I have so many questions for you. Let me to start with a very simple one for the people who are listening who aren’t doctors. Just tell me what an aneurysm is.
Dr. Rob Ecker: An aneurysm is a weakness in a blood vessel in the brain that can be something that is familial and genetic and it can be something that comes from a lifetime of smoking. They are, when they rupture, associated with a horrible morbidity and mortality. 20% of patients will die with a rupture. Of the remaining group who get to the hospital, nearly half of them will have major morbidity and mortality.
Genevieve Morgan:So it is a stroke of sorts.
Dr. Rob Ecker: It is. No, it is considered a stroke. So it is a hemorrhagic version of stroke. In fact in the young, it is the highest cause of morbidity and mortality of strokes. So if you group all strokes together, in the younger patients, subarachnoid hemorrhage, which is the kind of hemorrhage from an aneurysm, is the greatest cause of morbidity and mortality.
Dr. Lisa: Just talk for a minute about the prevalence of stroke amongst people in the United States and is that growing?
Dr. Rob Ecker: It is. Currently right now, it is the third most common cause of major morbidity and mortality in the US. And that also tracks in Maine similarly.
Genevieve Morgan:And you think that has something to do with the smoking piece?
Dr. Rob Ecker: It’s general health issues. Obesity, diabetes, smoking, all those pieces put together.
Genevieve: We talk a lot on the Dr. Lisa Radio Hour about preventative medicine and holistic health, but what you do, you treat people very often in emergency situations. And you have been trained allopathically, conventionally and that has such an important role in our health that I’d love to hear you speak about your view of Western medicine. Not versus Eastern medicine, but as part of an overall health care plan for somebody.
Dr. Rob Ecker: This is a funny dynamic. When you’d asked me to be on this show, sort of East versus West, but I think most of the conception of East versus West is one of alternative medicine strategies. So be it in opposed to surgery is someone who needs medicinal therapy, some sort of form of yoga, some other thing in order to help them get through whatever that process is that might otherwise be surgical.
My version of East versus West is experience with Japanese neurosurgeons, in fact I visited a number of others. I visited some guys in Kobe, in Osaka, in Tokyo. Up near Mount Fuji, another fellow who is very good at bypass, which is actually taking a face artery and plugging it into the brain artery for certain indications. These are all allopathically trained surgeons. The fellow I visited in Finland is an allopathically trained surgeon. So it’s not really East versus West. Its East and West.
We’ve talked a little bit about it before. I get involved when preventative medicine hasn’t worked. That’s really my main role. When all things have been tried and haven’t worked, and someone’s having a stroke or having a hemorrhage that needs to be addressed.
Genevieve Morgan:And everybody’s very happy that you’re there.
Dr. Rob Ecker: God willing.
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Dr. Lisa: Are you able to work with people who are further upstream? So, say you have a stroke patient who has come in and they now need rehabilitation. Do you go back and maybe work with somebody who does Chi gong or Tai Chi? Do you refer out to other practitioners who can help create a more holistic picture for that patient?
Dr. Rob Ecker: I do. So much of the work we’ve done with rehab has actually been through new England Rehab and they have strong ties to a lot of the different communities that run a lot of these programs for stroke. There’s even music programs for folks who’ve had brain injury – never mind East and West, but alternative therapies for them.
Dr. Lisa: So you are about integrative medicine?
Dr. Rob Ecker: Yes I think they are. But so much of that is, to some degree, a peripheral part of my practice. With those patients, it’s a matter of knowing where to refer them, but not actually, that’s not something I myself do. So as far as referring them in this community, it is something the stroke patients have an opportunity to be involved in.
Dr. Lisa: I wouldn’t discount that. You may not be directly involved, but there are some practitioners who are very high level surgeons, for example, who don’t want to refer out to a holistic practitioner. It doesn’t sound like you’re averse to that at all.
Dr. Rob Ecker: Not at all. My opinion is if it works, it doesn’t matter what you call it. It can be allopathic, it can be homeopathic, it can be, I mean, chiropractic care and spine care is another one. I think we send a lot of patients toward folks who do care like chiropractic care, and if they do, I think that’s terrific. I really have no inherent intellectual aversion to anything that works.
Dr. Lisa: But I would point out that this is a new view. You’re relatively young, and I think that older practitioners, and I don’t want to put all older practitioners in the same bucket, but I think people who are trained many years ago sometimes are not open to this idea.
Dr. Rob Ecker: I think that may be true. One of the sponsors I heard lecture once went “For the most part, a surgeon should judge his outcomes by how happy he is to see his clinic.” Especially in taking care of neurosurgical patients, I think it gives patients a good sense of ease, especially if they’ve come to surgery and they’ve tried everything else. So I’m a big fan of if a patient has some thought to try any other therapy as long as they don’t view it as something that will necessarily hurt them in the process, I’m absolutely delighted to have them do it.
Dr. Lisa: That’s great. A surgeon who doesn’t always prescribe surgery. I think that there’s a lot of fear out there that that’s what surgeons just want to do is cut into people. So the fact that you’re willing to go and recommend other practices before. But ultimately, sometimes you really do need surgery. And that’s when the advances in technology come into play. I know you’ve been around the world. You’ve looked at many different practices across the nation, and you are here in Maine, and relatively recently. You’re helping build a practice that is at the cutting edge technologically speaking in the country.
Dr. Rob Ecker: Right now there’s only one technology that we don’t have available in Maine that is available everywhere else in the world, which is a particular kind of stent for reconstructing very large aneurysms, but as of April 9th, that won’t be true anymore. It’s a stent that’s probably similar in how it delivers and in its indications to other stents, it’s just in the way it’s designed.
Dr. Lisa: And a stent is just a backup.
Dr. Rob Ecker: Right. A stent is just a small metal tube that is used usually to repair a hole in a blood vessel associated with an aneurysm or some other vascular lesion. There are a number on the market now that are approved for aneurysm work. There is only one of him that we don’t have here now. They deliver in terms of how they are used in very very similar manners, so it’s not that that first patient should rest assured they haven’t already done a couple hundred, that it’s not a uniquely new device. But it has some certain properties, especially it’s the amount of … They’re all woven a bit like chain mail and they’re not just solid metal pipes. Most of them, the amount of metal in them is very small, because you want them very flexible in the brain.
There are some though where you want to primarily put a stand and have more metal coverage to be able to occlude an aneurysm, and this is a stent that has more metal in it than the others, so that’s really it’s fundamental difference.
Dr. Lisa: So as of April 10th, we will have …
Dr. Rob Ecker: It’s called the pipeline stent. There will be nothing actually in cerebral vascular surgery and endovascular surgery that we will not have available here in the state of Maine.
Dr. Lisa: Which is pretty incredible, because for a long time, we’ve referred patients out to Boston for example, or New York, or other parts of the country because we haven’t had this. But now, in your particular field, we have the technology.
Dr. Rob Ecker: That’s correct.
Dr. Lisa: And we have, you said nine people in your practice here in Portland?
Dr. Rob Ecker: There are nine other surgeons in my practice. I have one radiology partner, Dr. Chris Baker who can’t be on call all of the time for acute strokes, so right now we are on call every other day. We’re probably going to need a third partner as we develop forward. I really don’t think there’s any other institution that has developed as much as we are the technicians. Like I said, there needs to be a whole background to getting these patients cared for. And I think we’re building that team now.
Dr. Lisa: And there are other conditions that your team treats aside from aneurysms, stroke. There’s the spinal issues.
Dr. Rob Ecker: Essentially, we cover all of neurosurgery; brain tumors, there’s a level I Trauma Ctr. That we staff, so all the trauma gets staffed through us. That includes spine trauma, degenerative spine is a huge part of our practice. There are also some specific other problems. There is some pain syndromes, like trigeminal neuralgia, which is a face pain syndrome we take care of. Pituitary disease, some people split out differently from other tumors, we take care of pituitary tumors. So the whole sort of complement of neurosurgery between nine of us, and there are likely going to be a few more of us in the years to come as we build the program. We’ll be taking care of it. We also have a pediatric neurosurgeon in our group, Dr. Jim Wilson, who’s been here for a number of years, so a good group of people.
Dr. Lisa: How did you become the doctor that you are? Why did you do decide, when you were in high school, “I want to go to college. I want to go to medical school.” What was your background? I’m interested in that.
Dr. Rob Ecker: If you told me in high school or college that I’d be doing what I’m doing, I’d tell you you were crazy. Actually this was not even on the radar. I originally had interest to get, I was interested in healthcare policy, I had actually worked a little bit on Capitol Hill along the way – I don’t know if Genevieve and I had discussed that before, but I had some issues of getting an MD and an MBA, but everything has a nexus. I’m a third generation surgeon – both grandfathers and my father were surgeons. But I apologized to my dad when I started medical school. I had no interest in being a surgeon. He laughs at me a bit now.
That being said, when I was a third-year medical student – the Medical College of Virginia has a very long history with trauma. It’s one of the leading level in trauma centers in the country. It developed some of the early thinking about how one treats raised pressure in the brain with head trauma, and it was a spectacular group. But I hadn’t really intersected. I did neurosurgery as a third-year medical student, and I interacted with a couple of patients who had ruptured aneurysms. And another patient who had a syndrome called the locked in syndrome. There is an artery that runs in front of the brain stem call the basilar artery, and when it gets occluded, patients literally can be wide awake, but move nothing but their eyes.
Dr. Lisa: There was a book about that – The Diving Bell and the Butterfly.
Dr. Rob Ecker: That’s exactly right. Beautifully written book, and a movie made about it too. And having seen a patient locked in, and I thought “Boy, there has to be better treatment for that.” I saw a patient after and they couldn’t be helped anymore. They’d already had their brainstem stroke, and seeing some patients with aneurysms, I was interested in both, and I was also interested in open technical neurosurgery. So I had this plan that I wanted to do open neurosurgery and endovascular, but wasn’t exactly sure how it would mete out. I really discovered that as a third-year medical student, so prior to that, I didn’t have particular interest in it.
Dr. Lisa: What were your interests in high school?
Dr. Rob Ecker: Oddly enough, my original interest in life related to a few different things. I always loved the ocean, so was interested in marine biology. As a kid, I had some interest in being an actor actually. I did a fair amount of acting in Boston Children’s Theatre in Boston.
Dr. Lisa: Do you think that this ocean thing – did that lead to the Navy piece for you? Or did they just put you where they wanted you?
Dr. Rob Ecker: No, I’m of a family type that will pay for whatever college you go to, so I went to Harvard. Cost my parents an arm and a leg with that, and after that, you’re on your own. So with that, both my grandfathers and my father had been my, one grandfather was in the Army, the other grandfather was in the Navy in World War II. My dad was a corps member in the Korean War. So joining the military to pay for medical schools like a natural fit.
Dr. Lisa: I just want to ask one last question about that. You did spend some time in Maryland with the Wounded Warrior project.
Dr. Rob Ecker: Right.
Dr. Lisa: Will you just described to listeners what you did there, because it’s really interesting.
Dr. Rob Ecker: For the first year and a half of my military service, I took care of the folks in Okinawa, which is about a half million people west of Hawaii, and after the last 2 1/2 years of my service, I spent taking care of the Wounded Warriors in Maryland. So taking care of all the guys from Iraq and Afghanistan who had neurologic injuries. There were 11 neurosurgeons there.
There were three guys who were similarly trained as myself with cerebral vascular taking care of the majority of the folks with head injuries. We had a great group of guys taking care of most of the spine injuries we’re in our group, but a bit separate. The best example is during the Icelandic volcano when the planes couldn’t land in Germany. Literally, you could get shot in the head in Iraq and you would be in Bethesda, Maryland 48 hours later. So a tremendous experience.
A lot of critical care experience – taking care of guys with injuries you just don’t see anywhere else in the world. You may see them anywhere else in the world, but the inability to care for them. So really, a group of dedicated military surgeons of all sorts of medicine doctors taking care of a great group of patients. I learned an enormous amount from that group. We had a fellow here I took care of, probably about six weeks ago, who had a tire explode in his face. A big truck tire – usually they’re done in cages – exploded. He had an injury that was awfully like a lot of the guys from war and that experience helped take care of this guy here. Great patient population. Really great group of guys.
Dr. Lisa: Rob, we’re so lucky to have you in the studio today. And lucky to have you in our state. Thank you very much for coming today.
Dr. Rob Ecker: I thank you for having us, and helping build and support this program and that we’re trying to build here.
Dr. Lisa: This is Dr. Lisa. You been listening to the Dr. Lisa Radio Hour and podcast number 28, airing first on March 25th, 2012 on WLOB Radio, 1310 AM, wlobradio.com streaming, and available for download, as are all of our past podcasts on iTunes, Dr. Lisa Belisle.
This week’s show featured Dr. Nan Lu of the Traditional Chinese World Foundation in New York, and also Dr. Robert Eckert, a cerebrovascular neurosurgeon from Maine Medical Center who is featured in the April, or most current issue of Maine Magazine. These individuals spoke on the ways that they have used both Eastern and Western medical knowledge in their practices and in their lives, their personal lives. I think they give a pretty good representation of the type of thing that we are doing all around the world these days. Matching the old with the new, matching East with West, and really trying to find what works with people from a healing standpoint.
We hope that our listeners have gained some knowledge and will perhaps be inspired to go out and bridge some of their own knowledge gaps, or bring together things that perhaps seem incongruous, East/West, old/new, and really create a healing strategy for their own lives.
This is Dr. Lisa. Please do become a podcast subscriber on iTunes/drlisaBelisle, and be sure to like our Facebook page. For more information on our guests, go to doctorlisa.org. Thank you for being a part of our world. May you have a bountiful life.
Announcer: The Dr. Lisa Radio Hour and podcast is made possible with the support of the following generous sponsors: Maine Magazine, Mike LePage and Beth Franklin at ReMax Heritage, Robin Hodgskin at Morgan Stanley Smith Barney, Dr. John Herzog of Orthopedic Specialists in Falmouth, Maine. Tom Shepard of Shepard Financial, Booth, UNE, the University of New England, and Akari.
The Dr. Lisa Radio Hour and podcast is recorded in downtown Portland at the offices of Maine Magazine on 75 Market Street. It is produced by Kevin Thomas and Dr. Lisa. Editorial content produced by Chris Cast and Genevieve Morgan. Audio production and original music by John C. McCain. Our assistant producer is Jane Pate. For more information on our hosts, production team, Maine Magazine, or any of the guests featured here today, visit us at doctorlisa.org and tune in every Sunday at 11 AM for the Dr. Lisa Radio Hour on WLOB, Portland, Maine, 1310 AM or streaming wlobradio.com.
Show summaries are available at doctorlisa.org. Download and become a podcast subscriber of Dr. Lisa through iTunes. See the Dr. Lisa website or Facebook page for details.