I KNEW SOMETHING WAS WRONG with Western medicine at the end of my Family Practice residency. I hefted my patient Carol’s three-inch-thick chart, filled with notes on her serial ailments and treatments over the last three years, and wondered: “Is this it? Is this what I’m going to be doing for the rest of my life—treating an endless stream of illnesses, one after the next, after the next, all the way to the grave?” It dawned on me in that moment that, while I was compassionately treating Carol’s illnesses, I was doing little to restore her health—at least, in any lasting way. So, I retreated to the Emergency Department (ED), where I practiced as a board-certified physician for nearly 20 years.

It was spectacular. Nowhere else are the benefits of modern medicine more salient and sure. I felt purposeful and right. In those days, I would challenge any and all detractors of Western medicine by saying: “Why don’t you follow me one Saturday night, just once…and then tell me what other kind of medicine you think would have been better for those sick and injured people.”

But deep down I still knew something wasn’t right. As magnificent as Western medicine is for treating emergencies and stabilizing extreme conditions, it did little or nothing to address what I was beginning to suspect were the deeper causes of many illnesses. Somewhere along the way, I had started asking my patients the most important question in medicine (that is, after the diagnosis has been secured)—namely, “Why today?” Why, when the world is bathed in bacteria, did you get pneumonia today? Why, when your cardiac lesion has been accumulating for years, did you have a heart attack today? You might have come down with appendicitis a week ago or a week from now—why today?

To my surprise, virtually every patient I asked had a plausible reason: “My mother-in-law just moved in with us.” “I need to get out this job, no matter what.” “I just learned I was conned, and now I’m broke.” Psychological reasons for physical maladies kept cropping up, again and again. And yet, my beloved science gave no ground to mental causes. Nothing in my training even allowed for the possibility. And if mental causes were excluded, what possible part could noetic (meaning: of or pertaining to the mind) factors play in a cure?

At the time, of course, I had no idea these nagging questions would lead me to hypnosis and compel me to untangle the tragic misconception that had relegated that world to “the fringe.” Nor could I have realized, then, that finally understanding hypnosis would allow me to unlock the secrets of placebo and nocebo, and more broadly, to understand the impact of ideas on health and healing.

Nevertheless, along the way I had become sensitized to the influence all caregivers possess, to the impact of our words and deeds—sometimes for better and sometimes for worse. I learned that subtle refinements in our communications—and in our thoughts about causes and cures—could be integrated into our daily practice to improve actual outcomes and convey a sense of Hope and Alliance to patients. I also discovered, to my amazement, that those very same refinements could also be used to uproot the deep causes of many diseases and bring about lasting cures.

Exciting stuff for any healer. But during my early days in the E.D., all of that lay ahead.

Fire Walking

Around the same time I began asking patients “Why today?” I took a surf trip to Bali. There one evening, I witnessed an entranced village elder dance over blazing hot coals for half-an-hour, without suffering so much as a blister. I was astounded. Not only did the fire-dancer defy the “expectations that govern normal science,” he also defied my own direct experience. As it happened, every July 5th in southern California, people would come screaming into the Emergency Department with second- and third-degree burns of their feet. Why? Because the previous day (4th July), when the celebratory beach barbeques were over, the revelers would bury their embers in the sand. The following morning, unsuspecting beachgoers would trample the coals and suffer the painful consequences. At the time, I could make no more sense of fire walking than I could of the possibility of psychological causes of illness. Both seemed somehow related to “the power of the mind.” But what did that mean? So, I consigned fire walking to the category of “religious mysteries” and moved on.

That is until Tony Robbins started coaxing “regular people” over the coals. So much for my “religious mysteries” explanation. Naturally, when Robbins brought his fire pit seminar to San Diego, I went to watch. But instead, I walked. Fire walked. I knew I couldn’t explain it, the fire walking, but now there was another equally perplexing question posed by the event. How did Tony Robbins manage to talk over 300 seemingly sensible individuals, including myself, into taking off their shoes and socks and parading over 10m of red-hot coals? During the two hours leading up to the walk, all he did was tell a tale or two. Or, so it seemed.

It turns out, Mr. Robbins was using a modeling technique known as Neuro-Linguistic Programming (NLP), which was the brainchild of Richard Bandler and John Grinder. Bandler and Grinder had managed to distill and methodize the bewildering techniques of the most eminent hypnotherapist of the day—Milton Erickson, M.D. For all my studies in Family Practice and Emergency Medicine, this was a world I knew nothing about. Quickly, I read Uncommon Therapy and realized that Erickson (who died in 1980) had singlehandedly figured out how to cure psychological maladies like no one else in the history of psychiatry or psychoanalysis. His methods were unconventional and ingenious. And Bandler and Grinder had dissected out the essential elements and were out there teaching.

So, in 1985, I flew to Philadelphia to study with John Grinder. It was the most brilliant and transformative seminar of my life. Those three days began a decade-long obsession with Erickson, NLP and hypnosis. I read everything I could; studied, practiced and eventually became Board Certified in Medical Hypnosis and credentialed in NLP. I applied the methods I was learning to virtually every situation I encountered in the ED and in the private Medical Hypnosis practice I established. At first, I “hypnotized” patients to help relieve their pain and anxiety—something I was constantly witnessing in the ED. And it worked. Kids drifted off “to Disneyland,” and let me suture their lacerations without having to restrain them. Adults settled into a quiet, comfortable repose, without requiring much in the way of analgesia or anesthesia.

Soon I was performing all kinds of potentially painful procedures without provoking so much as a whimper. As my confidence grew, I started doing what ER doctors do—winging it. I offered suggestions for more than just comfort and relief. I suggested that bleeding stop, joints relocate after dislocation, heart rhythms normalize. Much to my amazement, these suggestions also worked—sometimes with and, even more surprisingly, sometimes without a formal trance induction. It wasn’t long before I was publishing extraordinary case reports in major medical journals and national television networks were sending crews to film me. It was a marvelous time. I was witnessing miracles, even while learning how to bring them about. Things were rolling.

Non-surgical Cure

Then, I got sick. As the CT scan confirmed, an intervertebral disc between C4 and C5 in my neck had ruptured. The pain was excruciating, and the arm that was innervated by the compressed nerve was becoming impossibly weak. Unfortunately, I hadn’t yet learned how to turn the powers of hypnosis on myself. So, instead, I turned to my trusted medical colleagues. “Here is what we’ll do,” they explained, confidently. “First, we’ll cut into your neck from the front—being careful not to nick the carotid arteries, of course.” They could have stopped there, but they didn’t. “Then, we’ll spread open the space with traction and remove the faulty disc.” At that point, I’m pretty sure my decision was made. “Then, we’ll hammer in a piece of your hip bone—” Enough!

The quest for a non-surgical cure was on. I started reading, desperately, while taking pills to ease the pain. I read about homeopathy, osteopathy, chiropractic, naturopathy and much more. I tried several of these worthy disciplines—but to no avail. Finally, after finishing Michael Harner’s The Way of the Shaman and several other scholarly texts on shamanic healing, I convinced a physician friend of mine to accompany me on a trip to Ecuador.

After a few missteps, we found a guide, Jose, who claimed to be a “Brujo-in-training” (a brujo is a shaman). With him, we took a dirt road out of the small town of Macas to its terminus. Then, the three of us traipsed through boot-sucking mud, inched over furious rivers on slippery log bridges and slogged deep into the jungle. Hours later, we reached the Brujo’s encampment, where 13 puzzled patients asked: “What took you so long? We’ve been waiting two hours.”

They explained that two hours prior to our arrival, the Brujo had a vision of two white men coming toward them. “We shall wait,” he declared. And so, they did.

That night, after taking the medicine–Ayahuasca, the jungle vision vine—the Brujo treated all 13 patients. Many of them described themselves as cured on the spot. The next night, the Brujo again took Ayahuasca. As the visions commenced, he examined me by peering through a crystal as he passed it over my body, up and down. When he came to the left side of my neck, at the level of the ruptured disc, he paused. Mind you, I had simply asked for an examination, telling him nothing of my ailment. Then, he drew a deep breath and blew. It felt like an Arctic wind whose full force had somehow focused on my neck. I remember shivering. Again, the Brujo blew. And again, the freeze. Then, he held the crystal over my neck and declared: “Curado!” And cured I was. Within days I no longer needed the pills I had been taking—the pain was gone. Soon, the strength in my arm returned, and shortly thereafter I was able to recommence all my sports and work activities.

*******

The anomalies—things conventional science just could not explain—were stacking up. I had already consigned fire walking to the cabinet of mysteries. I had no explanation for the consistently plausible “Why today?” answers my patients were offering. I had the accumulating wonders of NLP and hypnosis I was, literally, witnessing every day at work. And now, I had this jungle ritual, which entailed nothing more than me holding still while an inebriated tribal elder huffed and puffed. How could his actions have possibly restored what was clearly a mechanical injury deep in my spinal column? I was hearing faint echoes from Andrew Weil’s thought- provoking Health and Healing: “I find allopathic medicine glaringly deficient in theory and philosophy of any sort.”

Of course, my surgical colleagues shrugged it off. “Placebo effect,” they declared as if to say…bogus! “It will be back.”

“Nice,” I thought. First, the meaningless dismissal of a glaring fact (i.e., I was back at work, despite not having succumbed to surgery); and then, the curse (“it will be back”). Sadly, I began to hear this pattern repeated frequently by my colleagues—not all of them, but many—most of whom I knew to be earnest and compassionate caregivers. It was as if they had been taught this quick thrust and facile parry as a defense against all things inexplicable.

Chinese Energy Healing

Not long after these events, curiosity led me to study with Sifu Share K. Lew, a Taoist priest and Nui-Gung Grandmaster. A kind and encyclopedic teacher, Sifu was also a powerful healer who explained that his cures resulted from changing body-energetics—removing blocks and restoring the flow of chi (energy). Coming from southern California, I was especially dubious of all things “energy.” I understood the energy of physics; it was quantifiable and subject to the Laws of Nature. But I recoiled at the ill-defined “energy” of alternative medicine: as in, “Her energy isn’t balanced” or “This manipulation will shift your energy.” Nevertheless, I could feel the chi Sifu was pushing out of his hands, and I had direct sensory experiences with the energies he called “yin” and “yang.”

Moreover, I witnessed many of his cures. For example, I saw and traced with X-rays, Sifu’s healing of a young man with a non-union, the navicular bone. The orthopedist had urged a surgical repair and yet, despite having persisted for more than two years, Sifu’s methods somehow knitted the fragments together within a matter of weeks. I also witnessed a woman in her 30’s, who had been branded “a nutcase” after years of cyclic abdominal pain, who was cured in two sessions by Sifu’s ministrations. And there were dozens more. As to his “energy,” I once watched him project his chi across a room, at a skeptical patient’s back, while she sat facing away from him on the floor. Within minutes, she grew hotter and hotter, her face redder and sweatier, until at length she could take no more: “Okay, okay!” she protested. “I’m a believer.”

And so was I.

Until I read an account by Dr. James Esdaile (written in 1846), wherein he induced the exact same changes in a “hypnotic subject” through the subtle transmission from his fingertips of so-called Mesmeric fluid.

********

At this point, my mind was a whirl of confusion—anomalies everywhere. There were only three things I could be sure of. First, I wasn’t about to give up conventional allopathic medicine. I had seen what it could do, and it was a lifesaver. Second, I knew from direct experience that hypnosis, shamanic healing and Chinese energy healing worked. I had no idea how they worked or what, if anything, might be their common thread, but I wasn’t about to dismiss these modalities (or other complementary disciplines) by pretending they were bogus. Third, I had seen enough in my years since medical school to know our science was incomplete. The Bard was right: “There are more things in heaven and Earth…than are dreamt of in your philosophy.”

And those “things” included the marvels I was witnessing in the ED and my private office every day: patients responding not only with relief from pain and anxiety but also with phenomenal physical changes, such as the cessation of bleeding, the normalization of aberrant heart rhythms, bloodless surgeries, relaxation of airways and the disappearance of tumors.

In the face of such stupendous anomalies, the peremptory dismissals and negative suggestions of my colleagues seemed feckless and small. Mental matters had been roundly excluded from my medical education, yet kept evincing themselves as powerful elements in the interplay of causes and cures. Without somehow factoring in the agency of Mind, modern medicine could hope for nothing better than what I had come to recognize as the blunt beginnings and endless endings of serial ailments and infirmities.

The Exquisite Art of Caregiving

HEALING: Beyond Pills and Potions is the result of my decades-long effort to resolve this confusion—not by discarding Western medicine, but by expanding it. The end result is a wider command of the Healing Arts and a deeper sense of personal fulfillment in caregiving.

We begin our journey by learning that the state of helplessness and dependency, common to many if not most sick patients, triggers a primordial survival reflex. This reflex scans for the one least uncertain, and vests that One with what I will call Authority. Not of a boss or police officer, but rather, the Authority of a newborn’s parent. The provider and protector of life itself. As such, ideas flow unimpeded from Authority to subject–from caregiver to patient. Mind Matters.

We then learn how Authority features in the rituals of all healers, from the ancients of prehistory to the Asclepians of Greece to the placebo-controlled trials of modern medicine. And we discover, therein, the first of many secrets—the implicit structure behind the Placebo Effect, and its ability to help or harm.

And so, we consider first how to avoid harm. We learn what constitutes a negative suggestion and how to avoid inadvertently hurling curses. We examine the dangers of the common Fallacies of Extrapolation and Prophecy. And we contemplate Therapeutic Restraint, in the context of reverence for the Wisdom of the Body and charitable forgiveness for our own inevitable mistakes.

Then, we turn to helping, to using our words and deeds to effect positive outcomes. This is where we begin to witness the wondrous exercise of “mind over matter”—bloodless surgeries, shrinking tumors, “chronic” illnesses (both physical and mental) interrupted and dispelled. It is also where the real work begins. Where new communication habits are formed and fashioned. But it is joyful work, rich in its rewards. For here we learn how to deliver information honestly, in a manner that leaves our patients hopeful and impelled toward health.

Soon, however, the unspoken underpinnings of conventional medicine begin to constrain us, and we are forced to reckon with reductionism’s implied notion of causality, a causality that excludes all things psychological. It is a worthy exercise, though; for at its conclusion we are left with a holistic causal model—one that includes the truncated sequences of our science, even as it expands to allow for both mental and physical causes and cures. And once again, a secret is revealed—this time the source of Ockham’s razor, the diagnostic principle that guides most conventional allopathic practitioners.

The reach of our new model is pervasive, touching literally every aspect of caregiving: from taking a patient’s history, to the formulating a diagnosis and treatment plan, to delivering a deep and lasting cure. This is a transformative undertaking–one that drives us to continually improve our communications and refine our thinking, so that our patients may reap the full benefits we now realize are possible. No longer must they suffer painful procedures or bloody surgeries. No longer must they linger under the curse of chronicity, without Hope or Alliance.

Often our goals can be achieved using simple refinements in our basic gestural and linguistic toolbox. But not always. There are times when circumstances are so dire or causes so deep that more powerful tools and more protracted encounters are necessary. Enter, hypnosis. But not the hypnosis you might think. Not the hypnosis that, for centuries, has been conflated with trance. Instead, we discover that what drives hypnotic responses are certain simple behavioral patterns we can establish with our patients. These patterns drive our suggestions to actualization. While trance can be a response to certain sets of suggestions, health and healing can be responses to other sets of suggestions. Trance, in other words, is an effect. Hypnosis is the cause. Once this is understood and clarified, a universe of salutary outcomes blooms before us.

What emerges from these various considerations is what I call the Exquisite Art of Caregiving—using words and deeds to help and heal. No matter whether you’re a well-meaning relative assisting an ailing loved one, a chiropractor or surgeon, midwife or naturopath, emergency physician or acupuncturist—I am confident the skills and teachings in this book will enrich your practice and enhance your love of caregiving.