Monday June 5, 2000
By Anne Jacobson
A Journey Toward Total Wellness:
Dr. Jeremy Geffen speaks with OneBody.com
Jeremy Geffen, MD is a man with a vision. As a board-certified, practicing oncologist, he sees medicine as a tool for both healing the physical body and nurturing the spiritual self. He seeks to realize this vision in his practice at the Geffen Cancer Center and Research Institute in Vero Beach, Florida; by speaking to Congress about the future of American medicine; by participating in the Comprehensive Cancer Care 2000 conference; and in his new book, The Journey Through Cancer: An Oncologist's Seven-Level Program for Healing and Transforming the Whole Person.
In The Journey Through Cancer, Dr. Geffen describes seven fundamental dimensions of human experience that individuals with cancer and their loved ones must explore for true healing to occur. The first level, Education and Information, addresses the need for an intellectual understanding of the disease and treatment options. The next area, Psychosocial Support, focuses on the need for and benefits of a strong support network. The Body as a Garden explores the wide range of alternative and complementary therapies available to cancer patients. Emotional Healing guides patients and family members to work through the often overwhelming emotional challenges of cancer. The Nature of Mind examines how patients' thoughts and beliefs can dramatically influence their journey. Life Assessment assists patients to discover and reconnect with their life's deepest purpose and meaning. Finally, The Nature of Spirit invites patients to explore and embrace the spiritual dimensions of life.
In preparation for the Comprehensive Cancer Care 2000 conference, Dr. Geffen talked with OneBody about his work and his hopes for healthcare in the 21st century.
OneBody: Dr. Geffen, thank you so much for speaking with us today. What is the primary message you will be presenting at the Comprehensive Cancer Care 2000 conference?
Dr. Geffen: One of the central messages that I will be presenting at the conference comes directly from my book, The Journey Through Cancer: An Oncologist's Seven-Level Program for Healing and Transforming the Whole Person. In fact, it is one of the most important messages conveyed in the book. Simply stated, the message is this: As human beings, we all have a body, but we also have a mind, heart, and spirit. Thus, if healing is to be complete, all the dimensions of who we are must be addressed -- with equal skill and integrity. Focusing only on the physical dimension -- as important and compelling as this is -- will never solve all of the needs and desires of human beings, regardless of whether they are sick or well. Why? Because, once again, while it is true that we have a physical body, it is also true that we are more than our physical bodies, and all the dimensions of who we are need love and attention. Thus, in my opinion, the real paradigm shift that will occur in the transformation of medicine and health care will involve going beyond the integration of conventional, alternative, and complementary therapies, into a whole new domain; namely, the genuine honoring and embracing of all the dimensions of who we are as humans: physically, mentally, emotionally, and spiritually. That is the next frontier in medicine -- and, I believe, in life as a whole. In fact, I think it is one of the greatest challenges and greatest opportunities that we have at this time in history.
OneBody: Tell me about this week's Congressional Hearing. It seems like such an important altar to step upon and such a vital opportunity.
Dr. Geffen: Yes, it is wonderful, and very exciting. I received a call about this some time ago, and was asked: "Please come and tell us what you think we should do to revamp the health care system for people with cancer. What do we need to know, and hear? What should we be doing?" In brief, this will be a 2-day hearing, on June 7th and 8th, 2000, convened by the Congressman Dan Burton, Chairman of the Committee on Government Reform. The title of the hearing is, "Integrative Oncology: Cancer Care for the New Millennium." Its purpose is to bring together experts in the fields of integrative medicine and oncology -- as well as leaders in government organizations such as the National Cancer Institute and the National Center for Complementary and Alternative Medicine, and also family members of people who have had cancer -- to have an open forum for discussion over two days about what are the most important and compelling issues that we currently face in the emergence of an integrative model of cancer care.
OneBody: Will you be telling congress primarily about your vision as it is being realized at the Geffen Cancer Center and as you explain in your book, or will you be going even beyond that?
Dr. Geffen: I'll certainly be talking about our experience at the Geffen Cancer Center and the vision of medicine described in The Journey Through Cancer. But I also intend to go beyond that and communicate my deep conviction that it is truly now time for us as a culture -- with the support of Congress and Medicare and the entire healthcare industry -- to make a genuine commitment to developing a form of integrative medicine that provides as much focus on and attention to the needs of the whole person as we focus on the disease itself. In my opinion, the biggest mistake that we make in medicine, over and over again, is to focus all of our attention on just the physical dimensions of disease. In doing so, so often, the person who has the disease, and those who love them, are left behind. Thus, as important and interesting as certain clinical trials are, for example, let's not spend all of our resources on evaluating just this chemotherapy regimen versus that one, or acupuncture versus Ondansetron for nausea and vomiting, or chemotherapy with or without shark cartilage for lung or breast cancer. I believe it is important that we spend an equal amount of attention on learning how to heal and transform patients' lives -- mentally, emotionally, and spiritually, as well as physically -- and to make that as much of a priority as anything else.
We have an opportunity now, I believe, to ask some of the deepest and most compelling questions that we've ever had the opportunity to ask in medicine and healthcare; namely, "Why are we doing this? What really are our goals as physicians and healers, and as a culture?" And, "What is it that we really want from our healthcare system?" These are issues that I explore in the first chapter of my book, entitled, "What is the Purpose of Medicine?" We have to address this question first. I believe that the creation of a truly magnificent, inspiring, holistic, effective, and sustainable system of healthcare will ultimately be dependent upon the emergence of a coherent vision and consensus about what our true goals for medicine and healthcare really are.
OneBody: What do you think Congress can do to help realize your vision and answer these questions? Is it simply a matter of funding?
Dr. Geffen: Well, it certainly will require greater funding -- for a whole assortment of subjects, including studies of a wide array of alternative and complementary therapies. The good news is that the process has already begun. In the last few years the faucet has actually begun to slowly creak open, and the flow of funding has begun to increase and is actually now beginning to approach a meaningful level. However, in relative terms, funding for this kind of research is still a miniscule percentage of the National Institutes of Health (NIH) budget. So, first of all, there has to be more funding for clinical studies on the efficacy of a variety of alternative and complementary therapies.
However, the next step -- an even more important step, I believe -- is a wider exploration and discussion about questions such as: "What really is the purpose of medicine? What really are our goals?" And, "How can we help people transform their lives -- on all levels?" We are going to have to confront these questions sooner or later, especially since the Baby Boom generation is now entering their 50s. In the next few decades, Baby Boomers will be growing older and developing cancer and a wide variety of other illnesses. They will be demanding newer and more effective treatments that often require more and more sophisticated technologies, which are in turn, quite often, more and more expensive as well. Make no mistake: the Baby Boom generation has a radically different set of expectations than the Medicare generation had about what constitutes good -- or even acceptable -- medicine. They also have a radically different set of ideas about what is expected in terms of the doctor-patient relationship, and also in terms of meeting their personal needs, wishes, and desires. It's a whole new ballgame.
OneBody: Do you think things really are changing? Do you sense a revolution coming in healthcare?
Dr. Geffen: I think it is safe to say that we are, indeed, on the threshold of a revolution in healthcare. In fact, we have already started to walk through the door. The first part of that revolution is already underway, and it involves the kinds of discussions that will be going on at the Congressional Hearings -- such as the role of alternative and complementary therapies in cancer treatment. That is the first step in a revolution which, in many ways, has already begun. However, it is just a first step.
I can tell you from my years of experience as an oncologist, and also as a family member of people who have had cancer, that chemotherapy, radiation, and surgical procedures -- as well as acupuncture, Chinese herbs, vitamins, minerals, diets, exercise programs, homeopathic remedies, all those modalities -- will never fully resolve the enormous spectrum of challenges encountered by people with cancer. This is true no matter how good those methods are now, or will ever become in the future, because they are primarily focused on the body, and the body is only one dimension of who we are as human beings. Furthermore, the body will get well today and get sick again tomorrow. If not with cancer, it will be another problem, however large or small. If not tomorrow, then eventually, at some later time. That is simply the nature of human existence. Everything is transient, and always changing. It is important to recognize that illness -- on some level -- will always be a part of the human experience. Thus, grasping constantly for "perfect physical health" is grasping for an illusion. It does not mean we should not do all that we can to be as physically healthy as we can, but we have to put it into proper perspective.
Right now, unfortunately, in my opinion, the perspective of the health care system is completely out of balance. Ultimately, we are doomed to ongoing frustration unless we open our minds and hearts and begin to embrace some of the more profound mental, emotional, and spiritual dimensions of ourselves -- and some of the more profound philosophical and spiritual issues of life. Who are we, really, as human beings? What really is the meaning and purpose of our lives? Why are we alive? To quote a well-known saying, "We are not physical beings having spiritual experiences; we are spiritual beings having physical experiences." Recognizing the full truth of this is where the real paradigm shift in medicine will occur -- not in focusing only on questions like, "What is the role of acupuncture in treating chemotherapy-related nausea and vomiting?" or "Is St. John's Wort better than Prozac for treating depression?" or "Can Chinese herbs lower the PSA faster than chemotherapy in men with metastatic prostate cancer?" or "How many milligrams of selenium a day should I take?" Once again, these are all important questions. But they are not the most important ones.
OneBody: Because most of the alternative and complementary therapies as we understand them now still only address the physical dimensions of being human?
Dr. Geffen: Exactly.
OneBody: This seems like a pretty radical position.
Dr. Geffen: Yes, I suppose it is a radical position. But it is the position I am taking because my experience as an oncologist, and as a person, has convinced me that it is true. I also believe it is what is most needed right now. This is the position of our Cancer Center, of all the work that I do, of my Congressional testimony, and it is one of the core the messages of my book. What we are demonstrating in our Cancer Center is how to do this in real life. How do you take such an expanded approach with a person having seizures because of a brain tumor, or someone who can't swallow because they have an esophageal cancer, or can't breathe because their lungs are full of lung cancer? How do you pay attention, meticulously, to the physical body, and at the same time really address in a profound and meaningful way the mental, emotional, and spiritual dimensions of human beings, and of healing?
In my book, I approach this subject in the following way. I believe there is a relativepurpose of medicine and an ultimatepurpose of medicine. The relative purpose is to take care of the body, fix the broken bone, stop the seizure, or get rid of the cancer if you can. If someone is having an emotional breakdown, of course we also want to help them get back to a balanced, functional state. This is obvious, but it is not true healing. It is simply "fixing the problem." On the big scale of things, "fixing the problem" is temporary. Once again, it is only a matter of time before there is a new problem to contend with. That is where the ultimate purpose of medicine comes in. The ultimate purpose of medicine is to help people to awaken to the truth of their own nature, spiritually, here and now. The ultimate purpose is to help them discover that the real, true, and lasting source of the love and joy and healing and freedom that they are seeking lies within themselves-- within their own mind, their own heart, and, ultimately, their own spirit -- not in their St. John's Wort, or their chemotherapy, radiation treatments, diets, exercise program, or whatever it is they are doing to try and "get rid" of their diseaseor condition. This is a profoundly important shift in focus, and awareness. And the beauty of the ultimate purpose of medicine, when understood from this perspective, is that it can always be achieved, even when the relative one cannot. It is all a question of focus, awareness, intention, and love.
OneBody: It seems the term "medicine" is almost too restricting for your message. Your perspective is so much larger than the scope of what we think of as "medicine." Have you felt much resistance from people who just do not understand your philosophy?
Dr. Geffen: Yes, of course! There is always some resistance that arises against ideas that challenge the status quo. Nevertheless, to a very significant degree, a lot of that resistance is dissolved by the experience people have in our Center, and by our reputation for providing meticulous, leading-edge medical care. My staff and I have gone to extraordinary lengths to consistently maintain the very highest standards of care in our medical practice, and this is readily apparent in everything we do. In fact, everything I am talking about is built on a solid, granite foundation of impeccable, scientifically based medicine. I am not challenging that aspect of things at all. I am very clear that you have to begin there. But once that's been achieved, once the meticulous medical evaluation has been done, a careful physical examination has been performed, the diagnostic studies have been completed, the diagnosis has been made, and a treatment plan has been recommended....typically that's where mainstream medicine feels it's job is finished, complete. In my opinion, however, that is where the real work actually begins. Making the correct diagnosis and prescribing the correct course of therapy is the easy part. The real challenge is to then say, "Okay, we've got the medical part handled. We know what to do here, medically. Now, who is the person who has the illness? What is going on in their life? What are the conditions, habits, and beliefs that may have contributed to this situation, and how can we make an impact on them? What emotional challenges may be going on inside? And, how can we help this person heal and really transform in the face of this challenge?"
It has been amazing for me, as an oncologist, to see people who have literally lost their arms, legs, breasts, lungs, kidneys, or other organs, or who have otherwise suffered enormously through cancer, decide none-the-less that they are blessed to have had their lives spared -- for however long they survive -- and they go on and become the most fulfilled, joyful people you can imagine. Then, in the very next room, is someone who has temporarily lost their hair, or had their vacation plans or their golf routine disrupted by cancer, and they are bitter, resentful, angry, and absolutely miserable. It is astonishing, and very sad to see. But it is more common than you could imagine. Seeing this has been an amazing teaching about life. It has shown me the incredible power of the human spirit. It has also shown me how important it is to watch where we put our focus, and to remember to focus on what is really most important in life. And it has shown me, over and over again, the limitations of the purely biomechanic view of medicine. Because -- and this also occurs more often than you would imagine -- individuals who are officially "cured" of their cancer may never be truly healed, because their heart has been broken from the experience and its impact on their life. Or they may live in fear that their cancer might come back. Or they may be filled with a residue of anger and outrage that they had to endure such an ordeal.
OneBody: It's wonderful that people who might not get to hear your message through other channels now have access to your book. How can patients work with their physicians to incorporate your principles into their own healing plan?
Dr. Geffen: One of the reasons I wrote the book was so people could have a practical guide, a reference, that is complete, and absolutely reliable. They can count on it to give them safe, meaningful, and reliable guidance about the entire journey through cancer. It was written by a board-certified, practicing oncologist who really knows what's involved in dealing with all aspects of cancer -- as opposed, for example, to someone trying to promote a particular diet, herbal compound, or intravenous vitamin program. You will notice there are no product endorsements in the book. Instead, what I'm saying is: Here is a model, a map that you can use to help yourself or your loved one navigate The Journey Through Cancer -- wherever you are right now, wherever you are starting from, and with whatever type of cancer you have. The book shows quite clearly how it is the basic, fundamental principals that ultimately matter the most -- not the specific details of one of particular chemotherapy regimen that you might receive, or what specific diet you might choose, or which specific herbs or supplements you could take, or which specific visualization technique to practice. When people understand the basic principles and ideas in the book they can then look around in their own community and find the specifics that really work for them -- the ones that speak to their own body, mind, heart, and spirit, and that fill in the gaps in a way that makes sense.
Working over the years as an oncologist, I recognized that there are seven distinct areas of inquiry and exploration that every single cancer patient will navigate through at some point or other during their illness -- especially if they want to heal at the deeper levels. Nobody gets through cancer without going through these seven levels at some point or another, and to some degree or another. T h e problem is that people are not aware of this. They don't understand what is really going on in their search for answers. I spent years listening carefully to people with cancer, at every step along their journey. Over time I began to realize that all the questions they were asking fell naturally into these seven distinct areas, or levels. I remember the moment when I saw the seven levels, when I saw what they actually were -- and also the pattern of how they all fit together. It all appeared spontaneously, like a flash of lightening, in a complete and entirely organic way. Recognizing the seven levels was an epiphany for me. I wrote the levels down, and started to share them with my patients. I was astonished at what happened, and how much it helped them. Showing them the seven levels was like giving them a key that unlocked and relieved the confusion of their own mind. It gave them a very elegant, ordered structure in which to put everything they were trying to deal with, including an overwhelming avalanche of questions about treatment options and every other aspect of their care.
For example, in a heartbeat, people understood, "Oh, okay, all of my questions about what diet I should eat, what vitamins, minerals, and herbs I should take, and whether or not I should take shark cartilage, or drink Essiac Tea -- all these are Level Three questions. They are simply part of 'The Body as Garden.'" When people realize this, they visibly relax, because up until that point they often felt that their very survival was dependent upon finding the precisely correct diet, or deciding whether they should take shark cartilage or not. As important as these issues are, they are all simply Level Three questions. However, people then also realize that there are six other levels involved in healing and transforming their illness, and those other levels have nothing to do with what they should or should not eat. So when people get this full perspective, they visibly relax, and everything begins to fall into place.
People anywhere in the country or the world can read the book and may realize, for example, "Okay, what my oncologist can really best offer me lies in the domain of Level One, 'Education and Information.' With my doctor's help I am going to get information about my cancer, the statistics, the percentages, and the conventional treatment options. But my oncologist may not provide that much input into Level Two, 'Psychosocial Support,' or Level Four, 'Emotional Healing,' or Level Six, 'Life Assessment,' so I've got to explore these on my own." Now, there is a extensive list of resources in the back of the book which provide a great deal of information about where to go to find help in these areas -- and every other area needed on the entire journey. Similarly, an individual may say, "My oncologist may not know that much about the very best diet or nutritional supplements that I should take during my treatment," but there are many specific, safe, reliable, and very practical suggestions in the book, along with hundreds of scientific references and dozens of books to which people can refer to get more information about these kinds of questions and concerns.
A very important distinction involved in Level Three, specifically, is that it provides a whole new context of how to begin thinking about one's body -- as a garden, rather than as a machine. Think of what would happen if just this one metaphor was adopted by our culture, as a whole. Imagine what would happen if tomorrow morning everyone in America woke up and said, "As of today, I am going to treat my body as a precious garden, and not as machine." Just think of the impact that would have -- on our lives, on healthcare, on how and what we ate, on how we cared for the environment, ourselves, and each other, and on how we approached our relationships. Just imagine how it would change things.
Therefore, this idea of "The Body as Garden" is an extremely powerful metaphor for people to understand. It opens so many possibilities, and allows us all to ask so many better questions than we usually ask. For example, "What can I do to cultivate the garden of my own being?" and "How can I truly love and nurture myself as a whole person" are much more inspiring and empowering questions than "How many milligrams of vitamin C should I take a day?" or "Should I eat a high carbohydrate versus a low carbohydrate versus a high protein versus a low protein diet?" Once again, make no mistake, things like diet and nutrition are very important to healing from any illness, and to living well in general. However, everyone is different, and no one diet will ever work best for everyone. Moreover, focusing so much time and energy on diet -- which many, many people in our culture do -- is, I think, fundamentally missing the point. Because, as important as diet is, who you are is not limited to your body. A n d your diet or exercise program is not going to make you live forever -- let alone bring you the genuine, lasting love, joy, and fulfillment that you seek. Nor will it solve the ultimate questions of life and death that, sooner or later, we will all confront. Diet, nutrition, exercise -- and, in fact, almost all of the complementary and alternative therapies out there right now -- are all Level Three questions. Yes, they are important, but they are not the whole picture. The human experience, and the journey of true healing, has seven levels.
OneBody: This message seems as important to family members and loved ones of people with cancer as it is to the patients themselves. I can only imagine how important a difference it would make to know that your loved one, if he or she does succumb to disease, leaves this life enlightened and in love rather than suffering and afraid.
Dr. Geffen: Yes, and that's my whole point. Eventually, we are all going to leave this earth. Thus, as radical as this sounds, I believe we would be well advised, and very wise, to consciously decide as a culture that what we want is for everyone to become as fully enlightened as possible, while they are alive, so that everyone can discover and experience the true love and joy and fulfillment that we are all seeking, within ourselves -- rather than through external circumstances, or through chasing material objects. While we are alive, and while we have the time, let us focus some of our attention inwardly -- to find the true source of all that we seek. This source lies within ourselves, not in the outer world of objects, events, and phenomena. This is what all of the great wisdom traditions of the world have been saying, for millennia.
If you are ill, or battling cancer or some other disease, these ideas become especially helpful and important because they can help you discover and abide in a state of love, joy, and peace within yourself, regardless of the circumstances. Then, the whole drama of illness becomes less severe, less intense. The major reason why people are so overwhelmingly distressed by illness and cancer in our country, and the main reason we spend so many billions of dollars on health care, is because as a culture we focus primarily on the physical and material dimensions of life. And since we've made the physical dimension of life most important, we believe we must save the body at all costs. I'm saying: Yes, let's do all we can to save the body, but let's also take some time while we are alive to appreciate the deeper meaning and purpose of our lives. And let's explore in a deeper way the mental, emotional, and above all the spiritual dimensions of life, and of ourselves. Let's work hard to live well, and lead healthy lives, but let us also teach people how to die with grace and dignity and harmony -- with the full knowledge that a very important aspect of themselves, their spiritual nature, is untouched by death. In this context, death becomes not such a big deal. It is not a catastrophe, or a failure. In my opinion, not living wisely is the catastrophe. And not loving is the greatest catastrophe. In our country, we do not focus on this. As an oncologist, I see people every day who have been diagnosed with cancer, and their life is completely flipped upside down. Everyone in their family is shaken to the core as well. Why? Because the illusion of immortality has been shattered forever. S u d d e n l y, they're shocked to realize that if who they've taken themselves to be all these years is really the truth -- namely, their physical body and their social identity -- then they may be in real trouble because it might come to an end sooner than they had planned. That is the source of so much pain and fear. Many people, however, get this "wake up call," and decide that it is time to find something deeper. That can be a glorious, wonderful thing -- a whole new beginning and adventure in their life.
OneBody: So some people come through their cancer happier and more fulfilled than they were before their disease? It seems almost like a gift.
Dr. Geffen: It certainly can be. It is truly one of the great potential gifts of cancer, or any challenge, for that matter. The real gift, whether you live or die, is to know who you really are, and to experience genuine love, joy, and peace in your life. This becomes possible, quite simply, when we take some time to sit still, and become quiet inside. It also becomes possible when we fully appreciate the transiency of life; it's exquisite, fleeting nature. To live every day and every moment with that awareness is one of the ultimate gifts a human being can receive. Fully recognizing how transient, and how precious, life really is puts everything into perspective, really fast. Suddenly, all the arguing and anguishing about which movie to go to, or what restaurant to choose, or what car to buy, becomes unimportant -- if not absurd. Instead, we can sink quietly into a deeper awareness of our true nature, and discover the love, joy, and fulfillment that we have always been seeking, deep within our own hearts -- instead of in external things, which, sooner or later, will fade and pass away. In doing so, we discover that the love, joy, and peace that we've been seeking all along is right there, in our own hearts, here and now. In fact, it has always been there, waiting silently for us -- because it is the truth of who we really are. This is the great blessing, the great realization, that is available to us all. Discovering it is the ultimate purpose of medicine, and I believe, of life itself.
For more information about Dr. Geffen and the Geffen Cancer and Research Institute, visit their web site at: www.geffencenter.com.
Copyright © 2000 Consensus Health Corporation.