Frank Lipman, MD, did his medical training in South Africa. He imigrated to the United States in 1984 and did his residency at Lincoln Hospital in New York City. He became board certified in internal medicine. During his career, he has studied acupuncture, Chinese medicine, functional medicine, nutrition, herbal medicine, biofeedback, meditation, and yoga. He believes that true healing involves a blend of Western medicine and these other healing philosophies. Dr. Lipman now practices in New York City. He is the founder and director of Eleven-Eleven Wellness Center and the founder of the Be Well brand.
Robert Rountree: Can you let us know how you got the initial inspiration to go into medicine? How did that impact your development as a physician?
Frank Lipman: When I was growing up in South Africa, the smart kids did medicine. At the time, my brother, who is five years older than me, was at medical school, so I went too. I was not that interested in medicine when I first started, and there was no real inspiration. I only really started enjoying medicine much later, after medical school. To understand my training and background, it is important to know that it took place during the apartheid regime in South Africa. At that time, the hospitals were segregated by color into white hospitals, which were more like an American hospital and more sophisticated, and black hospitals, which were rougher. In the latter hospitals, training was much more hands on. The motto was “See one, do one, teach one” because there was not enough staff, especially physicians. This meant that even as students we were assisting with caesarian sections during a gynecology and obstetrics rotation. We were doing a lot of stitching up. There was so much volume. It was always more interesting working at the black hospitals for many reasons, one of which was that we got so much more experience. Another benefit was my exposure to nontraditional medicine, which later would pique my interest. When we could not help the patients, they would call in the sangoma, the local healer. And I noticed that some of these patients actually got better. At the time, I did not have a direct interest in it, but it did open my eyes to alternatives.
Growing up during apartheid, I always knew that I did not want to stay and live in South Africa. There was a sadness, and guilt as a white person, and I felt like there was nothing I could do to change it. In fact, this may have been one of the reasons why I went into medical school because my mother would always say everyone all over the world wants doctors. She said it was a safe profession. At that time, if you had any awareness of what was going on, it was hard being black or white. I still feel an obligation to go back and do something because South Africa gave me so much. I love South Africa, and to this day, I go back often to help.
Dr. Rountree: Can you describe some of the work you currently do in South Africa?
Dr. Lipman: I work with a nonprofit group in South Africa called the Ubuntu Fund. Ubuntu is a Xhosa term that means “What makes us human is the humanity we show each other.” It is a beautiful term and a great organization. I brought some of my philosophy and skills to the table there. We started organic vegetable gardens—first at schools and later at a hospital. The area where we work is very poor and plagued with human immunodeficiency virus (HIV), so nutrition is extremely important. We have seen great results with the kids at school. They were not getting proper nutrition before we started our projects. In addition to HIV, a lot of them were having medical problems, as well as attention deficit hyperactivity disorder (ADHD)–like symptoms. Since we put the gardens in and the children are being fed with vegetables from the garden, the principals are ecstatic because the kids are focusing better and not getting sick as much. The beauty of working in those situations is that you get to see how these little things that we take for granted, like just getting some basic nutrients, make such a big difference.
Dr. Rountree: Do you think that you were able to get a model from South Africa, perhaps of a simpler life, that has been a good model for you? Perhaps a model that has helped you to focus on a wellness-oriented practice?
Dr. Lipman: Yes. Looking back, I think I learned a lot of things. But at the time, I was still struggling to work things out, as it was during my first couple of years of being a doctor. However, there were a few things that I experienced there that have been very influential in the way that I think. One important example was when I worked in the “bush” after my residency. I went up into a very rural area and worked in KwaNdebele, which was a homeland. And in those days, there was not much electricity in those areas. This meant that people went to bed when it was dark, and they woke up with the sun. For the most part, they ate whatever was local and seasonal. In other words, they had to live with the seasons, and they had to live with the rhythms of day and night. The diseases that we saw there were very different from the diseases that I see today. People were coming into the hospital with appendicitis, pneumonia, or severe infections, or they had broken bones. We were not seeing diabetes and heart disease or obesity and irritable bowel syndrome. In other words, we were not seeing a lot of the problems we see today in what we now call a civilized society. When I stopped working in the bush and went back to working in the city, in a white upper-middle-class practice, people were coming in with similar problems to what we see today—irritable bowel syndrome, fatigue, and migraine headaches. They could not sleep, and they could not poop and they had back pain. I came to realize how lifestyle, or the way we live, the stresses we live under, the lack of sleep, or not living with the cycles of nature, all play a part in the types of diseases we experience as a society.
Dr. Rountree: I think you have a unique perspective. A lot of people talk about the paleo lifestyle or a simpler lifestyle. They talk about it from an intellectual perspective. You have actually lived it and seen it.
Dr. Lipman: Absolutely. Another very important thing I came to realize is the importance of cultural perspectives in health and healing. I think it is also relevant to us today, but we take it for granted. No matter where someone works, beliefs and cultural perspectives are very important. In South Africa, I observed that if someone believed in the sangoma, they often got better. The culture is set up for the sangoma to play an important role. In the West, we have the same thing. People believe in their doctors, they believe in medicine. Because of that belief, I think a lot of people are getting better—not so much because of the medicines that they receive but because they believe that doctors know what is going on. We assume that doctors know so much, rightly or wrongly, without realizing how important these cultural beliefs are. I once read that the Dalai Lama said, “The three most important aspects of healing are the belief of the patient, the belief of the practitioner or the doctor, and the karma between the two.” So, that is really important—what you, the physician believes, what the patient believes, and your connection, your relationship. As practitioners, we often know that a patient will get better before they even leave the office. We know that because they believe in what you are doing, they believe in what they are going to do. This suggests to me that although it is clearer to see in a different culture, where the medicine may not be as powerful as modern Western medicine, it is happening in our culture and society too. This doesn't mean that science is not important, just that other things such as beliefs and the relationship between a doctor and a patient are also important factors in healing.
Dr. Rountree: Can you tell us about the importance of music in health and in your life?
Dr. Lipman: This is another thing that I picked up in South Africa. Music there is so ingrained in the culture, not necessarily just as entertainment but as a natural aspect of culture. There is music for weddings, for funerals, for initiation ceremonies, and for all types of ceremonies. Music is playing everywhere. In South Africa, in particular, music is used by the black community to uplift them. This means that black South African music is very happy and upbeat, and it is very catchy. I would guess the development of music in South Africa would probably be similar to how gospel music developed here in America—it was something to lift up spirits. As a child, I grew up listening to this upbeat, catchy music playing in the kitchen by our maid. At the same time, my parents were playing classical music, which I could not really relate to. I got drawn into this African beat and became a music freak early on—I have loved music from an early age.
Because of this, I think I see music as another way of helping patients. Earlier, I mentioned the rhythms of nature, talking about waking up with the light, going to bed with the dark, and living with the seasons. Well, we also have internal rhythms. This got ingrained into me when I started studying Chinese medicine, and the whole concept of our bodies changing throughout the day (and year) with the rhythms of the outside world, and ultimately the association between rhythm and health. There is a concept of entrainment, which involves a change in our body's internal rhythms synchronizing with a larger external rhythm in the surrounding environment. For instance, while at the beach, our heartbeat slows down and gets in sync with the sounds of the waves. However, in traffic in New York City, our heartbeat will speed up. We can use music that way too. For example, reggae music or the music of Bob Marley, which I love by the way, tends to pulse at about 60 beats per minute—the same as a slow heartbeat, so it slows you down. Salsa, on the other hand, is more upbeat, which makes you want to move and speed up. Your internal body rhythms tend to entrain to, or synchronize with, the external beat. Music can also alter moods—it can lift you up or calm you down. So, I use music or recommend music to people depending on what I think their needs are. Music by Leonard Cohen, for example, is wonderful for soothing but won't snap you out of a bad mood or stop you from feeling depressed. I am a big believer in music, or the ability of music to change mood and probably do more.
I also use music during my acupuncture treatments. During treatment, I give the patient headphones and play music with certain frequencies that stimulate the brain into entering specific states. This brain-wave entrainment basically helps to relax people deeply. The brain entrains to the beat that has similar frequencies to a meditating or relaxed brain. This is a similar concept to the whole-body entrainment I mentioned earlier, but it's a brain entrainment. This method can get someone into an alpha or theta state for relaxation. So many people are stressed out, especially in New York, and when they finish their treatment, they feel so relaxed. It allows people to have that subjective experience of relaxation. This feeling is very powerful—once they get that, they understand their level of stress in normal situations and how it may not actually be that difficult to calm down the nervous system.
Dr. Rountree: Can you discuss your relationship with Gabrielle Roth and your latest book, Young and Slim for Life?
Dr. Lipman: Gabrielle Roth was quite a big influence on me. We originally connected through music, as she was doing a variation of what I just mentioned. Gabrielle was an incredibly smart woman, and she had developed a movement system where there were these different rhythms. In her classes, the idea was to move your body to the different rhythms, which she would change throughout the class. The idea is the same as what I already mentioned—as the body gets entrained to different rhythms, this results in the awareness of different emotions. She had developed a specific formula out of it and taken it to another level. I used to go to her classes and love them. I found them very powerful—the combination of music and movement, and the different feelings that would come up with different rhythms and movements. She called this The Five Rhythms®. In my book Young and Slim for Life, I quote her, something she always used to say: “The quickest way to calm the mind is to move the body.”1 Her classes were a moving meditation. It is so hard for most of us to sit on a pillow and meditate. However, with movement, we get caught up and we forget. It is focused concentration—a meditation. Personally, I have also found that it is easier for me to involve movement with meditation. Now, after all these years, I can meditate more easily. However, in the beginning, it was impossible for me to quieten my mind. So, I found yoga and t'ai chi and the Five Rhythms. Moving meditations were my entry point. I think that is probably true for a lot of people. It is very hard for most of us to quieten our minds, and people do not realize that movement can be used to do that. Now, I am not saying that it is the only way or it is an either/or. Sitting quietly can also be a way in.
Dr. Rountree: In some ways, I think you are a missionary for a healthy lifestyle because you are taking this message out to the public. You take part in TV shows and the media. You are involved in changes in hotels. Are you able to talk about how other doctors can get this message out?
Dr. Lipman: I am definitely a missionary for wellness because it works, it is simple, and for the most part it is relatively cheap or free. And I see so much unnecessary suffering and disease because often people just don't know better. I am so disgusted by the medical system. Like so many of us, I have seen too many patients screwed up by a narrow-minded medical system, with the limited tools of drugs and surgery, causing more harm than good. Too often, they are just treating the symptoms with a band aid and are not treating the underlying causes of the problem. Very commonly, the treatment of the diseases we see today involves just changing the way we eat and the way we think, moving a bit, and sleeping better. I am a strong believer that simple lifestyle changes can make a huge difference to people. There can be so much less disease and discomfort. People do not have to suffer so much. And it would save the country a whole lot of money.
So how do we turn people on to wellness? The way I see it is that there are different entry points for different people. Some people can get it by lying on my table and just realizing that they can relax. Other people can get it by listening to music. Other people will get it through nutrition. Other people get it through working out. If we can expand the entry points, we make it easier for people to understand.
As an example, I am working with the Hyatt Hotels Corporation. The Hyatt approached me because they wanted their guests to have access to healthy options in their hotels. In other words, how can we turn people who come into a Hyatt Hotel on to wellness? Entry points in this case might include sleep, exercise, a change in menus, and so on. We are working with a large restaurant group to bring healthier fast-food options to the public. We need to get people to feel better, because if that happens, then we have got them. So how do we bring in the broader population? In my opinion, part of the way to do it is to partner with different groups, for example travel people, restaurant people, and industries that have an audience. Wellness is hot, so there is partnering with different companies who see wellness as something to grow their businesses. This is part of my philosophy. How do we increase the entry points beyond our practices? How can we turn other people on to wellness, not just those that come to us as patients?
We know that when people get hooked, they get hooked. Once they have had that subjective experience of feeling vital, they do not want to go back to the old way. Most people think that it is normal to feel puffy and tired, to experience insomnia, to have back pain, headaches, and constipation. They think that it is due to aging and that everyone else has it. They think it is normal. Once people feel vital and healthy, they are hooked. So, whether it is Gabrielle Roth's Five Rhythms class, a yoga class, an exercise class, or a group meditation—anything that makes someone feel good—this is what will make someone want to get back that feeling of vitality. It is one thing telling someone that they should not eat sugar or that they should exercise. It is another thing, and so much easier, when that person experiences that feeling of vitality. We need a hook for wellness. It is a practical way of looking at the human condition and the way we are.
Dr. Rountree: One of the things that you do well that I would like you to discuss is your work with health coaches. How many health coaches do you have in your clinic, and how do they play a role in your promotion of wellness?
Dr. Lipman: Overall, I have trained about eight or nine health coaches. All have worked with me in my practice, and some have branched out and help me in other wellness-related projects. Most of the health coaches have been trained at the Integrative Institute for Nutrition. They initially work in my office, and sit down with me and new patients. They learn the way I work, we come up with a plan with the patient, and then the health coach helps the patient implement the plan. Until I had health coaches, I really did not understand why people could not adhere to a plan on their own. Before, I would just give my patients a piece of paper with instructions and send them on their way. I had no idea how difficult it often was for them. Once I started working with health coaches, I realized how important it is to show people the how to's, and not just the why's, of the plan. So, now with health coaches, my patients have the support and help with practical advice on how actually to implement the changes I am recommending. We help them choose healthy food options, we help with restaurant choices, and we suggest things to have in the pantry. This helps people have available healthy choices so that their default choices become healthy. They eventually don't even have to think about it.
The health coach also teaches the patient breathing exercises and other practical tools that can help support them through the changes that we encourage, and help implement those changes. The help of the health coaches is priceless for me now. I wouldn't have the time to work without them. The health coach is able to sit down with the patient for as long as needed to help the patient really understand what they need to do, what they need to eat, where to get the food, and so on.
In general, health coaches are very passionate about what they do. They all live this lifestyle. Much of the information they provide, I do not even know. It is fascinating to hear them give information on what to cook with to add flavor, changes that can be made, where to get the ingredients, or what can be swapped out that patients happen to be eating. They deal with the specific changes that folks need to make in their diet—such as telling the patient to stop using Splenda® and replace with monk fruit or stevia when needed, or try some cinnamon as a sweetener instead, or use coconut oil as a cooking oil instead of the typical vegetable cooking oils. They help patients with simple cooking ideas if they do not cook. We take these things for granted, but we do not realize how helpful those little day-to-day lifestyle tips are.
Most of my health coaches are in their late 20s or 30s, and it is wonderful to see this next generation so into wellness. They are so passionate about it, and they really want to help people. For them, it is exciting to work in a medical office because most of them came from the corporate world or another vocation. It is wonderful to work with people who really love what they are doing and really want to help people. And it is great for them to see people getting better. They have taken a huge load off my plate because they are managing the day-to-day stuff. This leaves me more time to do my doctor work. All in all, it has been a wonderful experience working with health coaches, and I highly recommend it to other doctors.
Dr. Rountree: When you send people to your coach, do you write very detailed recommendations? Or do they know your program? How does this work within the confines of insurance?
Dr. Lipman: There is always a health coach that sits in with a new patient, so each patient will have a particular coach as support. While I meet them, they are taking notes, and I will write out the program. From the discussion, they will know that a patient eats out a lot, meaning restaurant recommendations are needed to help maneuver a restaurant menu. If the patient only cooks a little bit, they will provide simple recipes. If the patient is having problems sleeping, they will provide sleep tips and/or a meditation app. So, they are going by my recommendations, but they are also seeing what is needed in the consultations.
With regards to insurance, the health coach is part of my fee. In the end, this is a problem with the medical system because it does not pay for these services unfortunately. There should be a way of doing it through insurance, but I do not know how it could be done.
Dr. Rountree: I wonder if this goes back to the experience you had in South Africa? There were fewer doctors, so people could not rely on doctors. They had to rely on the sangoma.
Dr. Lipman: Exactly. Especially out in the bush, there was only a nurse at a clinic, and the nurse saw everyone. The clinics were in outlying areas, and I would go with a driver on sand roads, and drive to at least three or four clinics a day. Each clinic would probably have a doctor coming once, maybe twice, a week. The nurses at the clinics in the outlying areas saw the patients first, leaving the problem cases for the doctor. If the doctor thought the patient may need to go to the hospital, then they would call the ambulance to take them to the hospital.
Dr. Rountree: Can you discuss your books and how they help you get your message out to both patients and physicians?
Dr. Lipman: Yes, I have four books now: The New Health Rules, Young and Slim for Life, Revive, and Total Renewal.1–4 These books all talk about the many ways of staying healthy—music, laughter, kindness—the many things that we just take for granted. It's what Larry Dossey calls the extraordinary healing powers of ordinary things. So, yes, we need to cut back on sugar and try to eat a clean diet. However, other factors are also important, such as how we sleep, how we move our body, how we think, whether we have community and support. We need to get this message out to people. When people realize that they have much more control over their health than they were taught to believe, it is very empowering. I find people really get empowered by it, which is great because our medical system is fear-based, which is very disempowering. We are not encouraging people to stay healthy and we need to.
For me, the fun part of writing a book is that I am often looking for signs or research to confirm what I know or see clinically. While researching for my last book, I learned about the glymphatic system, which suggests that sleep is necessary for the garbage in your brain to be disposed of.5 I did not know about that. I am looking at all the research, and I am finding out amazing things. This is always quite exciting. I usually work backwards. So, if I know that sleep is helpful, I try and find out what the research says to explain why it is helpful. I find these amazing nuggets. I do not normally look at the research, but I am always fascinated by the nuggets that I find when I am researching for a book. Interestingly, I often find nuggets on music or laughter or compassion. I look for the science behind things that we think are non-scientific. They are hard to study. However, there is often research on these things, which I find quite intriguing. While I was writing my latest book, I started with the big things that I knew helped people feel young and lose weight. Then I worked backwards. So, in the book, I talk about things that we normally talk about: the microbiome and why fat is not bad—standard stuff. Then I get into more specifics about stress, movement, and sleep. In the last chapter, which I call “Ubuntu,” just because I wanted the term there, I talk about the ordinary things we take for granted, I talk about music and laughter and community—finding passion and meaning. These are the non-tangible aspects of healing that we do not really think about, which I think are very important. I see this every day in my practice. People who are passionate about life, who have some meaning, and who feel strongly about something tend to do better than people who hate their jobs or who are in an unhappy marriage. We know these things, but we do not really place as much importance on these issues as we do on nutrition, for instance.
Dr. Rountree: Nutrition is a natural thing to gravitate to because we can present science. However, part of the problem with nutrition is that we seem to spend years debating fine points, such as whether there are problems with specific food groups or carbs or fat. In your book, you give more details. It is not about carbs, fats, or proteins. It is about the type of carb, the type of fat. Can you discuss this?
Dr. Lipman: Yes. It is about the type of nutrient and how each person metabolizes them. That is what I find quite fascinating. Personally, I became prediabetic by eating what I thought was a healthy diet. I was sort of pescetarian. I hardly ever ate meat. I was eating tons of whole grains and tons of fruit. However, I found that this diet was not healthy for me. I had difficulty eating that amount of carbohydrates, and I ended up with prediabetes. I see this a lot. I should have known, in a way. My father died early from heart disease, and he was an early diabetic as well. Obviously, I have the genes for it, and I just cannot metabolize the amount of carbohydrates or sugar that my wife can. While she does much better eating more carbohydrates, I do better eating much more fat. This means we both just need slightly different diets. For her, eating a lot of fruit is not a problem—for me, it is. It suggests that everyone's needs are slightly different. We need to tailor our diet to our specific metabolism and needs.
One of the big issues that we do not pay enough attention to is cooking oils. They are ubiquitous and are extremely unhealthy. Whenever we go to a restaurant, or eat processed foods, we are getting food cooked in these oils, which are heated, causing problems. In my practice, we encourage people to cook with coconut oil, avocado oil, or extra virgin olive oil, and we suggest a lower heat when using the olive oil. But unfortunately, these recommendations are much more expensive. Avocado oil, for instance, is one of those oils that has a high heat point and is great for high-heat cooking, but it's expensive. So, one needs to be creative. For instance, I am working with the group at Hyatt Hotels to try to come up with creative ways of not having as many unhealthy fats in food. It is wonderful working with these people because they want to serve healthy whole foods. They want to come up with creative ways of making food tasty and healthy at the same time. I love intersecting with other experts in their fields and trying to come up with something practical and workable.
Dr. Rountree: I am curious about palm oil. When I was in Ghana, everybody used palm oil for everything. Is it good or bad? It seems like there was a lot of hypertension there and heart disease. Was it the palm oil or something else? What is your feeling about palm oil?
Dr. Lipman: I never use palm oil because it's not so readily available here. Theoretically, it is not a bad oil to cook with. It fits into the same category as coconut oil. However, I am not sure. What I can discuss is what I saw in South Africa when the black South Africans moved from the countryside to the city. In the rural areas, they did not have heart disease, diabetes, or obesity. Once they moved to the city, they started eating corn and white rice—the white man's diet. They then started to get all these diseases. It is a huge issue in South Africa now, with major epidemics of heart disease and diabesity. Interestingly, there is a big movement in South Africa now called Banting, sort of a mix of a Paleo- or Atkins-type low-carb diet. It is based on the name of a man, William Banting. In the 1700s or 1800s, he lost a lot of weight by eating more fat and less carbohydrates. This low-carb movement there has been made popular by a doctor, Tim Noakes. He is receiving a lot of flak for it from the medical system. However, a lot of people are doing well with it. Now, those white man's diseases are being reversed by going back to eating more healthy fats and fewer of those refined carbohydrates.
Dr. Rountree: You work with a lot of very successful people, and you are saying that even people who are prominent personalities or high-powered executives can benefit. Do you have any closing advice for our readers?
Frank Lipman, MD
Eleven Eleven Wellness Center
32 W 22nd St
New York, NY 10010
Phone: (212) 255-1800
E-mail:drfranklipman@gmail.com
Website:www.bewell.com
Dr. Lipman: Just do what really turns you on. Do what makes you happy. It is really not difficult to help people get healthy. Some people might need to be inspired or motivated. Some might need to be a bit scared about possible consequences of unhealthy choices to make the changes. They might need to hear someone say, “Do you not want to enjoy life with your grandchildren?” This is the way I work. A little bit of fear, just to give them a bit of a nudge. Then I motivate them, inspire them, and support them. I think if they have the support, it makes it so much easier. For the people who have to be on top of their game, I tell them that. I remind them that they need to be on top of their game because there are younger people coming up. These young people are sharper. They are quicker. I let them know what will happen if they keep eating the sugar, don't get enough sleep, or don't find the time to exercise. If a person is getting older, I remind them that if they are going to continue to eat the way they do, they will not look as good. Or they will feel puffy. This is a little bit of fear. It is not telling them that they are going to get cancer. It is telling them that their functioning is not going to be as good as they would like, or they are not going to look as good, or they may not be able to enjoy their children or grandchildren. If it is done in a very nice way with encouragement, they will see that it is not that difficult. So once again, if you can get them to have a subjective experience of that vitality quickly, then you have got them hooked. ■
References
1.
LipmanF. Young and Slim for Life. Carlsbad, CA: Hay House, Inc., 2015.
2.
LipmanF, ClaroD. The New Health Rules: Simple Changes to Achieve Whole-Body Wellness. New York: Artisan, 2014.
3.
LipmanF, DoyleM. Revive: Stop Feeling Spent and Start Living Again. New York: Fireside Books, 2009.
4.
LipmanF, GunningS. Total Renewal: 7 Steps to Resilience, Vitality, and Long-Term Health. New York: Penguin Group, 2003.
5.
JessenNA, MunkAS, LundgaardI, NedergaardM. The glymphatic system: A beginner's guide. Neurochem Res, 2015; 40:2583–2599.
