Transformation in Medicine

Introduction

Janet Lynn Roseman-Halsband, PhD, MS, R-DMT, REACE™, REAT™

When I think about my experience of transformation in medicine, it brings up many things both personally and professionally. I have worked in the field of medicine since 2010 immediately after the death of both my parents, Sid and Toby. I have them to thank for my career since I envisioned that I would be a scholarly academic in the world of spirituality and dance and even wrote a few books on that topic. When my mom was diagnosed with a rare cancer, I witnessed a lack of empathy and compassion from too many health providers and I was not afraid to call people out on their behavior. She deserved humanistic medicine as all patients are entitled too.

I found some wonderful allies at the Warren Albert School of Medicine in Rhode Island and my mentor, Dr. Gowri Anandarajah, was key in my future career. I created the Sidney Project in Spirituality and Medicine and Compassionate Care™, a medical education program for residents that I am proud to say has been in existence since 2015. After my dad's needless death in a hospital, I wanted to make sure that no daughter or person would experience what I did.

My transformation in humanistic medical education has been profound, and I am so grateful to my mentors who took the time to help when I needed it. The countless medical students and residents that I have taught give me hope for the future of medicine, and I envision a time when health care, compassion and empathy is a triad that can't be broken. My personal life has changed significantly, and I am now happily married because of a chance meeting when I was teaching. In the spirit of transformative experiences, I invite you to reflect on the rich and compelling essays in this issue.

Janet Lynn Roseman-Halsband, PhD, MS, R-DMT, REACE™, REAT™, is an Associate Professor in Integrative Medicine at the Dr. Kiran Patel College of Osteopathic Medicine, in Ft. Lauderdale, Florida, USA. She specializes in teaching Spirituality and Medicine and Art in Medicine and is the Founding Director for the Sidney Project in Spirituality and Medicine and Compassionate Care™. She is the author of several books, including If Joan of Arc Had Cancer: Finding Courage, Faith and Wisdom from History's Most Inspirational Woman Warrior (New World Library).

Digital Spectres: The Intersection of Technology and Emotion in Medicine

Amanda Furiasse, PhD

The idea of digital transformation is everywhere, nowhere more so than in medicine, where researchers continue to explore digital technologies' transformative political, economic, and scientific impacts on medicine. The impact of digitization on the emotional states of medical researchers and practitioners, however, remains a relatively underexplored area of study. Medical researchers and health care professionals exist within emotion-laden environments wherein the heightened affective states of fear, anxiety, hope, and grief play a crucial role in informing clinicians' subjective experiences and encounters with patients. Digital technologies are not immune to emotion, but as researchers have previously explored, digitization exerts tremendous influence over human emotion. ¹ How are digital technologies impacting human emotion? How might these emotive encounters with our technologies be transforming the contours of medicine?

When it comes to answering these complex questions, I believe that the medical humanities offers a unique vantage point. The medical humanities uses interdisciplinary methods in an effort to merge the history of medicine with global cultures of healing, bioethics, and subjective accounts of health and illness. Among the medical humanities' primary methodologies includes the practice of ethnography. Generally, ethnography involves observing people in their everyday environments to better understand their subjective experiences. In the case of digital technologies, medical ethnographers have brought particular attention to the way in which digital technologies' emotive power is grounded in their unique ability to transform the way in which people perceive and relate to time.

In Ethnography as Commentary, Johannes Fabian draws particular attention to the way in which digital technologies can throw a researcher back into their past. ² This temporal transformation is largely the result of digital media's active reliance upon memory, since digital media must use human memory as a conduit for meaning-making. This temporal transformation is important when it comes to research, since much of academic research is often framed as future-facing when it is, in fact, unavoidably stuck in the past. As Fabian explains, this temporal situation is achieved through what he refers to as a “schizogenic” use of time whereby researchers and their human subjects are represented as existing within different times, one in the future and the other stuck in the past. ² It creates a literal rupture in the fabric of space/time that is ultimately predicated on the “denial of coevalness” or the denial of the fact that the subject and researcher exist in the same time. In research, there is thus a propensity to treat human subjects as the Other who exists in a stable and older time set apart from the researcher's own, more progressive future. ²

Digital technologies, however, undermine this temporal framework by redirecting both the researcher and human subject to the past with the two converging around an increasingly tangled web of digital artifacts. Likewise, Christine Hine warns in her landmark monograph, Virtual Ethnography, that digital technologies demand our participation in their creation to the point in which we find ourselves relentlessly involved in the construction and reproduction of digital media. ³ Building upon this insight, Josh Postill and Sarah Pink argue that digital media tends to situate people into a “thread sociality” or a torrent of asynchronous exchanges of highly-charged emotions. ⁴ Digital media, thus, relentlessly hounds us or more specifically demands that we remain stuck within an unrelenting torrent of e-motion.

Although this radically new experience of time induces a certain sense of fatigue and heightened anxiety, it also and perhaps more importantly induces the feeling of being haunted. In her monograph on technology's impacts on spirituality, McGarry argues that this feeling of being haunted is induced by our encounters with machines, since machines can only process information from and in the past. ⁵ Yet, machinic interfaces project this past out at human beings as if it were a vision of their future to come. McGarry describes this temporal inversion of time as a “haunting” whereby the past suddenly intrudes into the future, revealing a potential future to come. Twitter, for example, takes tweets posted in the past and reorganizes them into future trends, which in theory is supposed to allow advertisers to better predict the future desires of consumers.

According to McGarry, this temporal inversion facilitates a certain fixation around the assumption that our past can yield renewed revelations about our future. Thus, the black screens of our digital interfaces haunt us with the “ghosts of our futures past.” ⁵ Ultimately, this unique experience of time induces a certain degree of grief as we invariably find ourselves returning to our past over and over again, feeling as though we can never escape the painful and traumatizing memories of our own past.

Grief, as Chun ⁶ explores in her analysis of new media, is fundamental to the experience of using digital media. According to Chun, this emotional sensation of grief is produced by programming languages themselves. Source code facilitates a repetitive encounter with the dead whereby machinic languages' discrete yes-no commands transform the living remnants of memory into the dead, making the images, texts, and tags that memorialize the living into public spectacles of mourning. Moreover, this experience often feels ghostly to the human user, since the computer interface veils the logic undergirding its animating codes. As she explains, “Source code as technê, as a generalized writing, is spectral. It is neither dead repetition nor living speech; nor is it a machine that erases the difference between the two. It, rather, puts in place a relation between life and death, between present and representation, between two apparatuses.” ⁶

While computers help us remember the past, they also simultaneously force us to repetitively encounter it in our future with the visual remnants of our past routinely projected out at us via our interfaces as if they are visions of our future to come. The digital interface operates as a space of ghostly encounter, whereby the living must routinely encounter the most painful and emotion-laden memories from their past. Digitization, consequently, transforms our perception of time and redirects us back to our past. In the process, we often find ourselves overwhelmed by stress, anxiety, exhaustion, and ultimately grief. On its own, grief is not necessarily a negative emotion, but if overlooked, it may evolve into a debilitating condition that can fundamentally erode institutional trust and undermine social relationships.

Reports of burnout and depression among health care and medical professionals may, in fact, offer an early glimpse into the widespread effects of digitization's transformative impacts on human emotion. According to a 2021 study in Mayo Clinic Proceedings, more than three in five physicians experienced at least one manifestation of burnout. ⁷ Moreover, a systematic review and meta-analysis of 38 found that the pooled prevalence of depression among health care workers during the COVID-19 pandemic was reported at 37%. ⁸

Medicine has made tremendous progress over the years in terms of developing new treatments and technologies, but there is a growing sense that medicine is becoming increasingly exhausted and rudderless without a clear future. It is possible that this growing sense of fatigue and depression is partly the result of an over-reliance on data analytics and computational methods that have the potential to constrain the practice of medicine to the patterns of the past and consequently induce a feeling of being mired in the mistakes of the past.

Digital technologies might be marketed and sold as future-facing technologies, but the reality is that they cannot provide us with a clear sense of direction or purpose. In this context, spirituality becomes an essential component of modern life, offering a vital source of hope and possibility for the future. Spirituality is especially critical in health care, where it can help individuals refocus on the future and counterbalance technology's tendency to look backward. By integrating spirituality into health care, patients and health care professionals alike can develop a deeper understanding of each other's needs and experiences, leading to more compassionate and personalized care.

Additionally, spirituality can serve as a powerful tool for health care professionals to manage the emotional toll of technology and stay motivated to provide the best possible care. A recent study on the effects of spirituality on health care professionals and patients, for example, found that during the COVID-19 pandemic health care workers and patients who engaged in daily spiritual practices, such as daily prayer and meditation, experienced an overall reduction of stress and anxiety and also reported an increase in feelings of hope and resilience. ⁹ By engaging in spiritual practices, such as meditation and self-reflection, health care professionals can find greater meaning and purpose in their work and feel more connected to their patients and local communities.

As digital technologies continue to shape our understanding and experiences of the world, spiritual practices will become more critical to helping redress technology's emotive effects. The integration of spiritual practices into health care has the potential to empower patients and health care professionals, fostering a deeper sense of meaning and purpose in their work while also paving the way for innovative and groundbreaking approaches to patient care. Ultimately, balancing the benefits of technology with the insights of spirituality can mitigate digital media's emotional toll and forge a path toward a future full of possibility.

Amanda Furiasse, PhD, is Assistant Professor of the Digital Humanities and Medical Humanities at Nova Southeastern University in Fort Lauderdale, Florida, USA. She is co-founder of the Religion, Art, and Technology Lab and co-host of the Political Theology Network's Assembly Podcast. She also served as the co-director of the Contagion, Religion, and Cities project at the Center for the Study of Religion and the City and was a 2021–2022 fellow at Sacred Writes: Public Scholarship on Religion Program.

Gaps and Opportunities in Postpartum Care in the United States: A Personal Reflection

Jia Jennifer Ding, MD

By now, the poor performance of the United States in reproductive and maternal health metrics as compared to other high-resource countries is well known. ¹ We rank abysmally in maternal mortality rates with drastic health inequities, with a large proportion of deaths deemed preventable, and have relatively minuscule parental leave policies that are often unpaid. Though pervasively in the background, a recent headlining case of postpartum psychosis highlighted the lack of appropriate referral and follow-up care for pregnancy-associated mood disorders, which impact a significant proportion of birthing people. All of this, coupled with increasingly restrictive reproductive rights, has the United States seemingly headed to a crushing nexus of reproductive coercion, poor maternal and neonatal outcomes, and societal neglect of critically needy postpartum people.

There is a large movement to redefine the postpartum period as “The Fourth Trimester,” a term that, even as an obstetrician gynecologist, I had not heard of until I was in the weeds of postpartum myself. This perspective shift attempts to further align the critical period of physical and emotional postpartum recovery as an integral part of pregnancy itself, and it views the birthing person as not just a vessel for fetal growth, but rather as a valued individual whose worth does not stop with delivery. However, my personal experience with motherhood has shown me that this refocusing on the postpartum period needs to come hand-in-hand with societal and economic support in the form of expanded health access, psychosocial support, and paid parental leave.

Working as a Chief resident physician in obstetrics and gynecology on the labor floor while in my third trimester of pregnancy, I received no lack of advice and commentary on my impending transformation to new motherhood. I was told that my 24-hour in-house calls were excellent practice for the sleep deprivation to come, and that I should be well versed in the postpartum warning signs of heavy bleeding, intractable headache, and postpartum blues. I was grateful to have had a smooth pregnancy and ultimately delivery, and we were fortunate enough to have plenty of family help in the immediate postpartum period, so what more could I ask for?

Though I remember those early days of being at home with a newborn fondly—the first sponge bath, the first smile, the first dress with the matching headband—what I recall more viscerally was the all-encompassing anxiety and crippling sense of loss of control. As someone who has built a career on optimization—how to perfect this surgical procedure, how to improve this patient counseling—I was struck by the randomness with which our lives were now held captive. Every time I felt like we had any semblance of a routine, my newborn daughter would be up all night or cry uncontrollably from gas pain, and I'd feel like a complete failure. Compounded with the physical toll of nursing and extreme sleep deprivation, I found myself constantly crying and then overwhelmed with guilt for feeling anything less than grateful for my new role as a mother. As someone who had previously not experienced a mood disorder, my postpartum anxiety and depression left me feeling helpless, adrift, and frightened.

Through the utter exhaustion, searing nipple pain, and throbbing perineum bound together by stitches, my only reprieve during those days were the nourishing meals painstakingly assembled by both sets of grandparents. In Chinese culture, new mothers undergo a period of confinement during the month following delivery. I had always found this tradition outdated and strange—no bathing, lay in bed all day, and have all your food brought to you? But as I averted my mother's look of disappointment at my leaving the house to go on a walk so soon postpartum, I was also daydreaming about my next meal. The aroma of flavorful broths overspilling with ginger and herbs, soups with enough fats and collagen to form a glistening film, and millet congee with chestnuts and goji wrapped me in a warm embrace. As my milk came in, my incessant hunger said yes to seconds and thirds. It was as if our village was pouring all of their care and love in the form of food into me, and my body transformed this love into nourishment for my child. Around three weeks into our postpartum leave, the suffocating bleak sense of hopelessness transformed into an exhausted sense of reassurance and pride for not giving up during our hardest days, though I shudder to think what would have happened had I not had the wealth of support and network that I immensely benefited from.

During those days and weeks surrounded by family who cooked, cleaned, and overall kept us new parents afloat, I often thought about a patient I had taken care of who delivered around the same time I did. She had just graduated high school and birthed twin boys via cesarean. As a single parent, she had planned to stay with her dad for the first week postpartum, but then would not have stable housing. Due to her high-risk pregnancy, she had painstakingly presented to dozens and dozens of prenatal visits and ultrasounds, but if she missed her solitary postpartum visit at six weeks, there would be minimal effort to contact her and connect her to any resources she may need within the health care system. Compared to her circumstances, I felt rich with resources and support. But at the same time, I have since realized that postpartum care in the United States is threadbare at best and shockingly negligent at worst.

However, perhaps all is not lost. Though slow, progress has been made in the last several years, largely due to the perseverance of those of us who face firsthand the disproportionate physical, emotional, and financial burden of reproduction on birthing people. The American College of Obstetricians and Gynecologists (ACOG) tirelessly advocated to Congress the merits of expanding Medicaid coverage from 60 days to 12 months postpartum, citing the rise in maternal mortality, with a significant portion of deaths from overdose or suicide occurring weeks to months postpartum, when many patients were no longer traditionally under our care. Under the American Rescue Plan Act, the State Plan Amendment (SPA), which became effective on April 1st, 2022, is a federally supported pathway for states to extend postpartum Medicaid coverage for 12 months postpartum. At the time of this writing (May 2023), all but nine states have expanded postpartum coverage or committed to expansion pending approval from Centers for Medicare and Medicaid Services (CMS). ³

Recently, while corresponding with a colleague in Montreal, I received an automated message from her university email stating that she was on a 12-month parental leave and to expect delays in communication. I smiled, seeing this “delay” as room to breathe, growth, and replenish for this hard-working friend who will, like myself, return to her work in maternal health with even more vigor and attentiveness as new mothers ourselves.

Jia Jennifer Ding, MD, is a third year Maternal-Fetal Medicine fellow at Yale University in New Haven, Connecticut, USA. She completed her residency in obstetrics and gynecology at Brown/Women and Infants Hospital in Providence, Rhode Island. Her interests include maternal complications of pregnancy, ultrasound, and impact of periviable birth.

Transformation Through Listening: Ourselves and Others

Nina “Anin” Utigaard, MFT, REAT

When I was young, I used to look at health professionals as gods, wizards of sorts, who could fix us when we were ill, damaged or in pain. They help birth us at the beginning when we are new to this world and they continue to guide us in our last minutes alive, or most of the time. As I launched into adulthood, I still viewed health professionals in the same way. Clearly most doctors, nurses and those in the helping professions know more than the average person on the street about our body, its bones, heart limitations, the brain, and all the intricate functions working simultaneously to keep us alive. I still honor their knowledge and skill. However, in my early thirties I became aware of some limitations too.

My son was born at home with the help of a midwife. It was a very spiritual and memorable experience with a few friends, his sister and brother present, while I listened to my favorite music, watching our tree sway outside, and hearing the mail lady knocking on the door wondering if today was the day. Then, when he was three months old, we discovered he was not gaining any weight, even though I was breastfeeding him multiple times a day, and adding formula milk to make sure he was getting enough. Still nothing was working. The Western doctors provided many tests, trying to figure out what could possibly be going wrong. He weighed less than when he was born at three months old. As I stared down at my thin baby, sitting in a local coffee house with tears in my eyes, after a doctor's visit, I knew I needed to find alternatives to save my son. I turned to homeopathy and was advised that we were symbiotic, my son and I, and that what was happening to him was related to me.

The clinician worked with me for over an hour. She determined he was burning more calories than he was receiving. We both began treatment and received a dose of homeopathy medication and she suggested I begin feeding him mashed bananas and rice three times a day. After one week, he gained eight ounces. By the time he was six months old, he was at the weight and height he was expected to be. I was deeply relieved.

A couple of years later, I found out I had thyroid cancer and was told it was a very slow growing form of cancer and that I could have had it for several years. I had my thyroid removed, but I began to wonder. What if my son while in utero was creating more thyroid hormone for both of us since mine was low? And then, once he was born, had too much and was hyperthyroid? When I brought this forward to doctors as a possibility, they declined this hypothesis, but I still wonder about this possibility.

Then, following a back injury while working on a movie as a costume designer, I attended chiropractor meetings daily, then weekly and monthly for over two years before one of the specialists suggested I see an acupuncturist to assist in my recovery. I went three times and my back issue began to improve rapidly. I was amazed at what a difference it made.

Just a few years ago, when I developed a rash on my breasts that wouldn't go away, I asked for a mammogram or tests to see if there was something going on and was advised by the nurse practitioner that I should just put lotion on the rash. I pushed and finally received a test in which it was discovered that I, in fact, had early stage breast cancer. I knew something wasn't right, but the health professionals weren't listening to my concerns until I pressured them.

In each of the above events, it required me to listen to my own health concerns and sometimes, if I was lucky, a professional truly listened to me about my experience and what was going on. Each time I took an alternative path: the midwife, the homeopathist, the acupuncturist, and a caring woman at the women's clinic, and each time it worked and was successful and maybe saved a life.

As I moved on with my life as an artist and musician, seeking a profession where I could combine my skills and abilities that I'm passionate about, I discovered the field of Expressive Arts Therapy. It is a fairly new field that combines psychology and expressive arts to address the many mental health issues plaguing our communities. It's an alternative therapy that allows individuals to explore, express and gain insight about the issues challenging them: grief, depression, anxiety, past trauma, low self-worth, relationship problems, hopelessness and isolation. When I first began this path, I was fortunate enough to be welcomed into this field by none other than Natalie Rogers, Carl Rogers' daughter.

Many of you may be aware of who Carl Rogers was. ^{1 –3} He began his education wanting to become a minister, doing some pastoral counseling, but then moved his attention to the arena of psychology, going on to teach, nationally and globally sharing his thoughts and philosophy on what he called, client-centered therapy, a non-directive approach. He was very involved in developing the Humanistic branch in the field of psychology. His approach to counseling was built on honoring the person or group in front of you, being fully present and listening with an open mind and an open heart. What were they experiencing? What do they need? What does it feel like to live their lives right now? The pillars of this approach were: (1) Unconditional Positive Regard, (2) Empathy and (3) Congruence. This approach has been widely honored and many subscribe to this approach in education, psychology and even in some professional organizations. In his later years, he was nominated for the Nobel Peace Prize in 1987, the year he died.

My mentor and teacher, Natalie Rogers, combined her father's approach with creativity and was one of the pioneers in the field of Expressive Arts Therapy. ⁴ Like her father, she was very involved in the global picture, teaching here and internationally about this new approach—Person-Centered Expressive Arts Therapy. Again, based on Carl's approach, she followed the needs of the client or student. Do they want to move the stress in their body? Do they want to paint the disturbing dream they had last night? Do they want to drum or sound the feelings they're experiencing? Such options or choices provide the client with the power to choose what feels right for them to process, release, express and gain new understanding with what is going on.

I feel a great deal of gratitude that I found a way, with incredible guidance on how to provide psychotherapy and expressive arts therapy to clients, families and groups. I explain that my position is similar to being a co-pilot, following the lead of the pilot or client, to make sure we're headed to their desired destination. We focus on what is important for them when they are ready to focus on the issues. Knowing that sometimes it's difficult to find words to express what's happening with the body or mind, we can instead find the expression and sharing with a stroke of paint, or a drumbeat, a movement, a sound or letter to some part of ourselves or another, or combining these to gain new understanding and awareness to begin the process of healing.

It has been my learning during the 25 plus years of providing counseling and expressive arts therapy that directing a client about what to do and how to be, without hearing or considering what our clients share, does not necessarily work in the field of psychotherapy. Listening, truly listening and following their lead, empowering them to create the path that feels right, with me as a witness to this journey, holding the space, and offering a menu of tools for clients to choose from, is what eventually gets us to a healthier place.

So, this is my learning and personal transformation with regards to the helping professions and our role with our clients. I have learned to trust the inner wisdom, strength, intuition and needs of my clients and the groups I work with. If I am present and truly listen with my eyes, ears and heart without judgement or critique and actually honor and accept what clients or others are offering, I can blend it with my own skills and begin the process of healing. I now know that if I offer therapy in this way, it is much more likely that a positive outcome will come from our collaboration. Yes, I have skills, expertise and knowledge to assist those who seek help for mental health issues, but if my clients are not fully heard and understood, or I'm not listening to their needs, I'm not sure they will derive the same benefits from our work together.

Nina “Anin” Utigaard, MFT, REAT, is a licensed Marriage Family Therapist and Registered Expressive Arts Therapist and has a private practice in San Francisco, California, USA. She works with individuals and groups of all ages and cultures. She was a founding Executive Co-Chair for the International Expressive Arts Therapy Association (IEATA) and continues to be on the Advisory Council for the organization. Anin was a faculty member with Natalie Rogers' Person-Centered Expressive Therapy Institute for over 10 years, and uses the person-centered approach in her work with clients and students. She is adjunct faculty with the Northwest Creative and Expressive Arts Institute in Seattle, Washington, and was adjunct faculty for the JFK University until moving in 2017. She has taught and presented her work nationally and internationally since 1992. She was also the clinical director for an assisted living facility from 2007 to 2010 and trained interns and staff on the benefits of using expressive arts with elders. Anin has a fine arts and professional music background, which she combined with psychology and the humanistic approach in psychotherapy. She believes that the arts are a transformative power that can change the world we live in.

Changing Tides: Spiritual Dimensions of My Journey as an Immigrant Medical Educator

Arkene Levy, PhD

As a medical educator, mother, and woman of color, I have always leaned heavily on my spirituality to sustain myself in academia. My spirituality has impacted both my pedagogical approaches in the classroom as well as interactions with my peers and students, primarily from the perspectives of building resilience, helping others grow and heal, and self-healing. For me, spirituality is complex. It is the manifestation of many beliefs, the expression of many emotions, and it is an effector of social change. My personal concept of spirituality resonates with that of Hill, which posits that “spirituality can be understood as a search for the sacred, a process through which people seek to discover, hold on to, and, when necessary, transform whatever they hold sacred in their lives.” ¹ Throughout my journey in academic medicine, my spirituality has been a personal quest for illuminating the things that matter the most in life.

A Paradigm Shift in Medicine

Judith Thompson, ND

As a young practitioner, I, like many new doctors, was hopeful for the future and believed that improvement of human health was a collective desired goal. Through interactions with people within the health care system, insurance companies, and state and federal government, I learned that the system in place was not always built to improve human health, but rather to maintain a paradigm of medical management.

It surprised me that low cost, low intervention therapies were not used more often to help patients. Natural therapies and remedies such as herbs, homeopathy or acupuncture were disregarded, while high cost, high risk therapies and medications were favored. It didn't make sense. Why would economical, sustainable and low side effect remedies not be the therapies of choice?

If the body could heal on its own given the right nutrients, restful sleep, movement and supportive stress management, why wouldn't we correct the impaired physiology before prescribing medications with side effects that oftentimes require more medications and create dependencies in people? If we corrected those imbalances with dietary shifts, vitamin and mineral supplementation, individualized exercise programs and coping strategies for stress, would a need exist for many medication prescriptions or surgical interventions? If medications or surgical interventions ceased being a first line of treatment when appropriate, how would the people involved in the delivery of health care as it stands today make a living? Could the system withstand a change in paradigm?

When the pandemic happened, it exposed the cracks in the system. It showed how little the general public knew about practical and fundamental ways to care for themselves. More importantly, it displayed how the conventional model of medicine is insufficient to meet the needs of all people, how unsustainable it is and how we're on the verge of a paradigm shift that will disrupt the whole system.

As a Naturopathic Doctor, I saw how the health care system managed disease. It did not promote health. The pandemic years were the first time people in the general public recognized the way health care operated. They realized they were left without options and took it upon themselves to research what healthy living really is. They relied upon internet sources to figure out how to eat better, exercise, implement sleep hygiene and learn coping and stress management techniques. They decided it was time for a change in their own lives, and it was this switch that stirred the embers of hope in my soul. The paradigm shift was upon us.

The pandemic forced people to go inside, literally and figuratively. With every day that passed being stuck at home, some people focused on physical health. They exercised, ate better, slept well and found their stress and bodies improved. They felt physically better. Yet, not being used to spending time with themselves or in close proximity with family members, their mental health declined. Anxiety and depression rose in record numbers. As people's mental health declined, their emotions took a dive and their spiritual life became empty. They no longer searched for a connection to something greater than themselves. Many saw no point in it. However, it was this lack of connection that fueled my curiosity in asking, “What exists that is not a medication that will help people heal?” Enter courage.

Choosing to heal by any means other than a pill or surgery requires courage. It means stepping out of the road well-traveled to an unknown place where science may or may not have speculated. This act requires humility to say, “I don't know.” It requires vulnerability to say, “I don't know and I am willing.” This is not an easy path to take because taking that leap means risking rejection, being ridiculed or called ignorant. The people who were willing to take that risk had usually run out of options to heal their pain and had nothing left to lose.

I was happy to help the risk takers because they stepped out of their comfort zones. I could provide the confidence they were looking for. I could show them the studies that discussed the efficacy behind various natural remedies or talk to them about the many other people who had taken the risk and transformed their lives back to health. I could support them through the stages of healing—which weren't necessarily easy or pretty—and get them to the other side.

As the pandemic continued and censorship arose around the successes of natural therapies and remedies, I found myself getting quiet about the “miracles” I had witnessed. I call them “miracles” because they happened to people who suffered for decades and got better within a short amount of time after implementing remedies from nature that supported their wellbeing. I saw it happen regularly as did my colleagues who practiced in the same way. Yet, as the messaging got stronger against practitioners of natural therapeutics, more of us became silent.

The silence continued until doctors started talking to each other. We shared our clinical successes with treating chronically ill patients and we regained confidence in the oaths we had taken. We built strength in our collective voices to speak out against a medical paradigm that wasn't helping every person. News outlets and podcasters created an avenue for trusted and accomplished professionals to start talking to the public about how to stay healthy, what actions to take to maintain their health and how to prevent disease. As the professional voices gained strength, I could feel my own courage building as I rediscovered the power in the natural therapeutics I had been using all along.

The world of medicine is changing. Medical technology is advancing at lightning speed. Artificial Intelligence is already able to diagnose illness correctly 95% of the time. In a short amount of time, the medical and health care environment before us will be unrecognizable and still, the laws of nature, will continue to exist on this planet. We will continue to be bound to forces like gravity, the order in which the body heals, the unrelenting move toward homeostasis in biological systems, and the understanding that we are not separate from anything on this planet, but rather an intricate component of the web of life.

The paradigm shift will come in recognizing the forces around us that influence our wellbeing. We will see that as we do onto this planet—either take care of it or pollute and weaken it—we will receive its fruits or nutritionally devoid and toxic foods. Similarly, if we maintain unsustainable practices in medicine as opposed to health promoting modalities, we will all suffer. If we embrace an integrative model where all disciplines of medicine can have a seat at the table in an open conversation about the state of health of our planet and ourselves, we stand a chance to take actions that better our health and the health of our planet.

In the two decades I've been in clinical practice, I recognize that my role is not simply to help people find physical relief, but also mental and emotional freedom to express their soul's desire while living within a planet that governs biological function, a society that impresses upon its members assimilation and a medical paradigm that fights for its survival through the people who have something to gain from it. It's not an easy road, but it is an exciting path that is being created and shaped every day.

Judith Thompson, ND, is the immediate Past President and current Director of Special Projects of the Florida Naturopathic Physicians Association and the former Executive Director of the Naturopathic Medicine Institute. She served as the Florida representative for the House of Delegates of the American Association of Naturopathic Physicians and has presented to legislators in the Florida State congress and in Washington, DC, USA. Dr. Thompson has lectured in osteopathic, naturopathic, pharmacy and physical therapy schools in the United States and abroad and has been teaching at Everglades University since 2007.