Arizona Center for Integrative Medicine

Transcript

Episode #1 Body of Wonder with Dr. Andrew Weil & Dr. Victoria Maizes

Victoria Maizes: Hi Andy.

Andrew Weil: Hi Victoria. 

Victoria Maizes: It's so beautiful here in your house today. 

Andrew Weil: Yes. Lots of plants. Sunshine. The garden is outside, and my three canine companions, Ajax, Juno, Kango. 

Victoria Maizes: And they're so well behaved, haha.

Andrew Weil: They really understand podcast and don't move until we're done recording.

Victoria Maizes: But listeners, if you do hear just the little bit of sounds, you'll know what that is. I'd love to have the chance to introduce my colleague and mentor, Dr. Andrew Weil, who is founder and director of the Andrew Weil center for Integrative Medicine at the University of Arizona. Also a professor of medicine. He's internationally known as the father of integrative medicine, and he's written 18 books.

Andrew Weil: And I'm delighted to be here with Dr. Victoria Maizes who was a graduate fellow of the University of Arizona Center for Integrative Medicine. She's a family physician and has become an expert in women's health, with great interest in environmental medicine as well. You've also written books and, are on the lecture circuit, and she has been for a long time now, Executive Director of the Center for Integrated Medicine.

Victoria Maizes: I am really excited that we are launching a new podcast called Body of Wonder. 

Andrew Weil: Well, podcasts seem to be the way that most people are getting information these days.

Victoria Maizes: And we have a lot of information that we want to share with the world.

Andrew Weil: Yeah, I really knew nothing about podcasts. I haven't listened to a whole lot of them, but I've been invited to be on them a lot and I just can't believe the numbers of people that have heard them. I think what I say has reached many more people than I have through one written work.

Victoria Maizes: It is amazing.

And what I hope for our podcast is that it'll be a conversation that we will get to have really interesting, thoughtful conversations with people who we think of as thought leaders in integrative medicine. 

Andrew Weil: And I'd also like to see to not be too long. I can’t imagine listening to a two- or three-hour podcast, and I think if many people would like to have, you know, shorter informational bits.

Victoria Maizes: Well, I agree. Would you do me a favor. Would you please define integrative medicine for our listeners? 

Andrew Weil: I think integrated medicine is the way of the future. You know, it is a system that is based on understanding and emphasizing the human organism's potential for healing and self-correction. I think that's generally ignored in conventional methods. When I sit with a patient, always the question in the back of my mind is, why is healing not happening here? Because that's the rule, not the exception. I think, also integrative medicine sees people as not just physical bodies and that, we teach that you have to understand the mental, emotional being, the spiritual entity, the community member, and look at all those dimensions and trying to understand and help them. We place a great deal of emphasis on lifestyle. And I think that emphasis on lifestyle medicine puts us in a very strong position to offer real preventive treatment. and by since being diseases of lifestyle or epidemic in our society, hypertension, diabetes, obesity, conventional medicine can't. And then there's major cost burden on the healthcare system.

And I think we have ways to have better ways to manage those conditions. And, I think, you know, an aspect of integrative medicine that attracts a lot of attention is that we're willing to look around the world and throughout history, to find remedies, treatments that are not going to cause harm, that show reasonable evidence for advocacy and bring those into the mainstream.

So in a short definition of integrative medicine is the intelligent combination of conventional and alternative medicine, but I think it's much more than that. It's, as I said, healing oriented medicine that takes account of the whole person and emphasizes lifestyle and is willing to use all remedies.

Victoria Maizes: Thank you. I know that for many years as you traveled the globe, people would say, but how do I find someone who practices this way? Yeah. And one of the things I'm most proud of is that, our center, the Andrew Weil center for Integrative Medicine at the University of Arizona has major training programs for physicians, nurse practitioners, physician assistants, nurses, registered dieticians, acupuncturists, physical therapists. You name it, and, we probably have a program that you could join us and deepen your learning and your ability to help patients. and now we are developing a range of ways to educate the public, including this podcast.

Andrew Weil: Well, I'm very proud the fact that our center is the world leader in greater education in this field. The demand for integrated practitioners is huge, the supply is small. But we are turning them out. We've graduated over almost 2,000 fellows from our very intensive training program, and these are physicians and allied health professionals who know really the basics of nutritional medicine, mind-body, medicine, and the strengths and weaknesses of alternative medical systems like Chinese medicine, you know, all the things that are left out of conventional training.

Victoria Maizes: And when you talk about the strengths and weaknesses, I feel like one of the things we really help, the, physicians and allied health professionals who train with us do is be discerning. And we want to do that with the public as well. 

Andrew Weil: Yeah. And a very important to stress it integrative medicine and no way rejects conventional medicine. We're trying to make conventional medicine better. So we're building on and trying to, you know top down access and remedy its deficiencies and build a new system of medicine. I've always said that one day we'll be able to drop the word integrative and it'll just be good medicine. 

Victoria Maizes: So how did you first become involved with the University of Arizona's College of Medicine?

Andrew Weil: My car broke down in Tucson in 1973 it was an English land Rover that I had driven to South America without incident.

I shipped it back, and had it overhauled of the Land Rover in Laguna Beach. They forgot to packed one of the wheels with grease. I drove to Tucson. I was just going to stop here for a couple of days and I was on my way to Southern Mexico to deliver a baby of a friend of mine, and the wheel bearing shattered, almost causing a major accident.

And it took six weeks to get the part. It was February of a warm, wet winter. I fell in love with the desert and it was in full bloom. I met people I loved and I never left. Baby got the delivered by itself. As they do.

Andrew Weil: Now, you know, I would never imagine that I would be living in Tucson, Arizona. I've been here for 40 some years. It also turns out, I think this is the only place that I could have done what I had done with integrative medicine.

You know, I was educated on the East coast. I did an internship on the West coast. Integrative medicine could never have taken root those places because the conventional medical establishment was so conservative and powerful. Arizona. First of all, the medical school here was fairly new, the licensing laws in Arizona are kind of “wild Westy” and freewheeling. There was already many alternative practitioners who were licensed to practice here. There's a long history of sending people to Arizona for health reasons. You know, remember “send your sinuses to Arizona.” 

Andrew Weil: People with asthma were sent here to recover. We have the leading spas in the country. And this beautiful natural environment. So I think all of that, it really supported, my initiative to try to change that. 

Victoria Maizes: So there's this philosophical openness, this willingness to allow you to experiment and, to do things a bit differently

Andrew Weil:  When the University of Arizona approached me I was living in a fairly remote area at the mouth of the Canyon outside of Tucson. I had dropped out of medicine. I was making my living as a writer. I wrote articles for magazines. I had written a couple of books.

People had heard me speak on the radio or talk, and patients began showing up at my door. It was not an easy doorstep. And I found myself gradually drawn into practice, which surprised me. But in the meantime, the University of Arizona contacted me and asked me if I would lecture to first- and second-year medical students about cannabis, because there was a great deal of interest in it. This was about 1974 or five, and they had no one on the faculty knew anything about it. I had done the first studies with marijuana back in 1968. So I went in, I gave that lecture was very well received and this is the course that I did it for human behavior and development, asked me if I'd give it another lecture on addiction in general.

I did that. And for a couple of years, I gave those two lectures each year. And then I said to them, you know, this is old stuff for me. And, currently my interests are in about alternative medicine. Nobody even knew what that. So I gave a lecture on alternative medical practices, talking about things like osteopathy and chiropractic and naturopathy.

And then I asked to add another lecture on mind, body interactions and healing. And those lectures became the basis for my first book about healthful health and healing, which really lays out the philosophy of integrated medicine. I ha, you know, I enjoyed having a. I know what has some sort of adjunct faculty appointment and was paid and what we fill those lectures, but I could use it.

And, you know, I had this tenuous institutional connection, but I had no illusions or interest in trying to change anything down there because the College of Medicine here in Arizona, like I suppose most colleges of medicine are monolithic, frozen, business as usual, not open to change.

So I really felt like a man from mars down there. And then in, I think it was about 1992, or three, my best friend from Harvard medical school, Joe Albert, a cardiologist, was named chief of medicine. And he came with a new Dean, Jim Dalen, who was also a cardiologists, the two of them had been a team at the University of Massachusetts Medical School.

And they had been instrumental in getting John Kabat-Zinn's program on mindfulness and meditation set up there. So I had dinner with Joe shortly after he arrived, and he said, “Well, now you have friends in high places. What do you want to do?” And I said, “Well, I'd like to change all the medicine.” He said, “How do you want to do that?”

And I said, “I'd like to start a residency in a field I want to call integrative medicine.” He said, let's talk to the Dean. So that's when Jim Dalen said, “You can't really start a residency in a field that doesn't exist. Why don’t you think about doing a fellowship.” So that's how it began. And you know, I have to say for many years, the University of Arizona very much capitalized on my celebrity, you know, using my photograph in all of their fundraising materials and stuff, but really never supported our center financially.

You know, they gave us minimal space. We've got no money from the State of Arizona. We were dependent on private philanthropy, some federal money. And then gradually we became self-sufficient through tuition, but it's only been fairly recently that we've had a university president and a vice president of health sciences who strongly favors what we've been doing until they couldn't believe that some years the University [of Arizona] didn't see what an asset it had in our center for integrative medicine. So it's been a great change. 

Victoria Maizes: I know, when you first conceived of training doctors and integrative medicine, you were warned away from training, medical residents, by our Dean.

Andrew Weil: Well so he suggested, backing up and taking people who completed residency training to do a fellowship. So, the first thing that we did, it was the program in integrated medicine then, was to offer a two year residential fellowship. People came and lived here for two years, and we took four people at a time. And you were the second class.

Victoria: I was.

Andrew Weil: The main criticism that I got in those early years was how possibly are you going to change anything by training four people a year. But over the years, we've graduated something like 35 people from that residential fellowship, and some of them are now in very significant position of change in medicine.

But more importantly, this gives a chance to really refine a curriculum translated into a distributed learning format. And we began an ongoing fellowship program with some residential time in Tucson, and that has now really grown exponentially. We train about 160 people a year. It might be the largest fellowship program in the world, and we've graduated, as I said, 2,000 people from that.

Andrew Weil: Victoria, coming into the fellowship and those early days, that was a fairly risky decision. You know, we were a new enterprise and a very new, untested field. How did you come to do that?

Victoria: I had been in practice in Northern California for nine years before coming into the fellowship. And, in those years of practice, I studied at UCLA for medical school and then I did a family medicine residency and I was really interested in this question of how you help people be healthy, stay healthy, return to health, which I think is one of the fundamental questions that we ask in integrative medicine.

When my patients in Northern California found out, I was interested in that I ended up with this practice of people who took vitamins, paid attention to different kinds of diets. We had John McDougall, who was an early proponent of vegan diets. They were going to chiropractors and using acupuncture.

And so I started learning along with my patients. And, I would say that over the years I was in practice I had some amazing opportunities, but I also became deeply dissatisfied with what I would call the fast-paced treadmill. And the treadmill kept getting faster and faster, until I felt that we were just putting band aids on serious problems and I was very unsure that I wanted to go back to school.

But when I came and interviewed at the fellowship, I felt that the mission of, the program in integrative medicine and my own personal mission we're so well aligned that I convinced my husband and three children that we had to move to Tucson for me to do this. 

Victoria: So The fellowship, is an amazing training program. It's two years, as you said, mostly online with three residential weeks in Tucson. And, we've trained about 1,700 doctors and nurse practitioners in it. But our goal was really to get into the fundamental foundational training of physicians. And the average age of our fellows is mid-40. So that's a bit late. We were delighted to start a program in 2008, that we call Integrative Medicine in Residency. And this embeds a 200-hour curriculum within the residents training itself. And we started this at eight family medicine residencies. We're now up to 88 residencies, and they're in family medicine, internal medicine and pediatrics, psychiatry, OB GYN, preventive medicine. So it's really grown very substantially. And in that program alone, we're training about 1,500 doctors a year. So it's exceeded the capacity by far of the fellowship.

Andrew Weil: And, you know, in the early years, we were seen as radical anti-scientific, you know, the enemy of conventional medicine. Now the term integrated medicine is totally accepted and academic discourse. There are textbooks of integrated medicine. Some of them produced by our graduates. There’s a national student medicine held conference on integrated medicine.

Oxford university press asked me to be the general editor of a series of volumes for conditions. At any rate. And now, it's just wonderful to watch this, this change. I think everybody now has heard of it. 

Victoria: I would think it would be deeply satisfying to be in your shoes at this point of your life. Not that many people get to witness, something they hold dear, have argued for, written about for decades come to full fruition. 

Andrew Weil: You know I think for the early years of my work, I was way ahead of the times and I didn't get much reinforcement for it. And it's been amazing to watch the mainstream catch up with me. But I hope I never ceased being controversial haha.

Andrew Weil: You know the “controversial Dr. Weil”. But I think if I'm not controversial enough to do my work.

Victoria: Well, you still seem to be willing to hold that up.

Yes. I think that part of the work of our center is very much to ask, the people who train with us to think about, “What criteria would they use as they are approached with something novel?” and there are novel things all the time, like for example, STEM cells, when do you decide there's enough evidence to send a one of your patients to have a STEM cell transplant?

Andrew Weil: So we're in touch with a lot of interesting people that have novel ideas. And, you know, I think our hope was to bring some of these people on our podcast. And acquaint listeners with some of these new ways of thinking about medicine. 

Victoria: So I'm really excited to announce our first six guests. They will include Deepak Chopra, who's been like you writing for a very long time about these concepts. And, we'll speak with him about consciousness. we have a nutrition and the brain researcher, especially focusing on the micro nutrients, the vitamins and minerals, Bonnie Kaplan, a wonderful science writer, Donna Nakazawa, who will focus on the immune system and the brain. We will have Paul Stamets, who's a longtime friend of yours.

[00:18:18] And, also I would say a bit of a disruptor who we'll be talking about mushrooms. We have a pioneer in the field of interactive guided imagery, Belleruth Naparstek and then we have a scientist and researcher, Valter Longo, who has been one of the leading researchers on fasting, fasting mimicking diets and intermittent fasting.

Andrew Weil: We are constantly thinking of new guests.

Victoria: And we want to hear your thoughts about who you'd like to hear from and who you'd like to have Andy and myself have a conversation with…we have set up several ways for you to ask us your questions.

You can call us at (520) 621-3950 that's (520) 621-3950 or you can submit a question by going to our website azcim.org/podcast again, azcim.org/podcast and, we look forward to getting your questions and bringing them on the show.