Patients Can Have Power

Patients Can Have PowerAn Interview with Bonita K. Vestal, M.D.

Anne Hendren Coulter, Ph.D.

EDITOR'S NOTE: Our managingeditor, Anne Hendren Coulter,Ph.D., recently interviewed Bonita

K. Vestal, M.D., a pédiatrie oncologist whohas left active oncology practice to counselpatients with major medical problems onways to manage their illnesses and lives inmeaningful ways. She works in the Integra-tive Health Building in Boise, Idaho.

Anne Hendren Coulter: Why did youleave oncology?Bonita K. Vestal: I never intended to

leave oncology, but I knew that I wasdone with physical medicine. I had donesome 20 years of solo oncology practicehere in Idaho, because there was no otherpédiatrie oncologist in the state. That wasa pretty huge undertaking and it wasexactly what I needed to do. I lovedoncology in my pédiatrie training; it wasa perfect fit for me and my interactivestyle with patients. It was a simplething—serving people where they live—and I had a great network of professionalcolleagues to assist me by telephone.I left medicine because I knew I was

done with that. There was more to do. Ihad done pédiatrie oncology, taken goodcare of people, and enjoyed my work, andreally, really poured my life into it, to thepoint that I was a bit weary of the physi-cal exertion. And what's worse, thepatients and their families were still goingaway hungry. Because, remember that inmy 20-year career, technology ruled: Iwould spend my whole 15-minuteappointment [with each patient], some-times, involved in calculations. You haveto get the height, the weight, the body392

surface area. You have to go to the laband get the white count, and the neu-trophil count, and calculate the absoluteneutrophil count, and then go to the pro-tocol and see what dose [of medicine] togive the patient, if the absolute neutrophilcount is at a particular point on day 14. Ifit's a go, you have to go back to the chartsand calculate the fluids, the antinauseameds and the actual chemotherapy dose,and then there's the patient [who needsattention too].You're sitting there doing all these

numbers with your little calculator, andthe patient's mother asks you somethingabout "what are we going to do about herphysical education or her absences—hermissing her history examination?" Andmy first impulse is to say: "Please don'tinterrupt me while I'm calculating; I don'twant to make an error," because peoplehave died of miscalculated chemotherapyerrors.

Something in me was saying: "Wait aminute. These people are asking a ques-tion about how to live their lives well.And you're doing numbers." It becameclear to me that my role in patient carefrom that point on was to work in a lessphysical realm—to work with the mind,the emotions, and the spirit of the person.I'm doing nothing different than I didbefore. It's just that now I have time forthe part that seems to really matter for thepatients.AHC: And do they now have an oncol-

ogist to do the calculations?BKV: Absolutely. They have an oncolo-

gist and several other subspecialists ontheir team. Rather than not knowing whatdrugs they're getting, or not knowing ifthey're going to get sick or lose their hair,they all know that they're strong peoplewith inquisitive minds. They know that

they can always participate in whateverhappens to their bodies. For the nextappointment, the doctor has a new drug,and [a patient is] going to say: "Wait aminute. I want to know more about this.Where does it come from? And why is itbeing used in my case? And how is itgoing to work in my body? And what amI going to feel?" So they're controllingtheir own fear by asking good questions.AHC: Have you become part of a

team?BKV: I hope so.

AHC: Does the oncologist call you inand ask: "Will you take care of thisbecause I can't do it?"BKV: I would like to think it's coming

to that. One thing I want to make clear,however, is that probably fewer than 5percent of all patients are ready to do thiskind of work. I'm quoting that figurefrom Rachel Remen [M.D., University ofCalifornia Medical School, San Francisco].I went to Commonweal [Bolinas, Califor-nia] and asked her what she thought ofthis. I knew that I had to leave physicalmedicine and try doing this, and I didn'tknow of anyone else who had actuallydone this kind of a practice.So I asked her: "How do you call peo-

ple to this work? How do you make itavailable for them if they want it?" Shereminded me that it is personal transfor-mational work. It's work for those whoare awake and want their lives toimprove. The way I look at it is that theillness is an initiation. It's like an initiato-ry gate and, after passing through it, theperson is never the same again. [Suchpeople] are marked in a way that thewhole tribe can identify them. They'rewiser, they're richer, they know more,they're grounded, they're peaceful, theyknow what their lives are worth. You

ALTERNATIVE & COMPLEMENTARY THERAPIES—DECEMBER 1998 393

"I love hanging around people with cancer,because they clear up their priority lists so fast."

asked me: "Why did you leave oncolo-gy?" I didn't. I didn't ever want to leaveoncology. I love hanging around peoplewith cancer, because they clear up theirpriority lists so fast.AHC: Are they part of a select group,

then?BKV: Yes. I think that cancer patients

are [part of] a select group of people andthat those who choose to explore themeaning of the cancer in their lives, thoseare the ones who are really exciting to bearound. Because they're fearless in look-ing at the obstacles, the wrinkled places,or why their relationships don't work, orwhy they haven't spoken to their daugh-ters in 7 years.AHC: So, do people with cancer treat

fear differently?BKV: I think they are just like every-

body else. The thing is that [one is]much more likely to wake up and say:"Gosh, there are some things about mylife which I know I must finish." Or:"There are some things about my lifewhich I would love to change." I seepeople regularly who come and tell methat they're exhausted in their lives andnow they have cancer. And I'll say:"Well, what have you been doing inyour life?" I can think right now of ateacher, who has been a teacher for, Ithink, 27 years. She's close to 50, but shelooks 37 and she's undergoing treat-ment for breast cancer. She's worriedabout when she's going to go back towork. So I asked her: "Do you love yourwork?" She said: "I love teaching and Ihate my job." She said: "Last year wasthe worst year I've ever had. I don'tknow how I'm going to face returningto the classroom." The cancer is neverthe most important problem. It's just acatalyst.

AHC: If these people can face cancer,are they lucky?BKV: Yes, I think so. And they've

taught me and others to look at our lives.One patient was afraid of her therapy:Her mother had died of breast cancer. Itold her stories about the children I havetreated with chemotherapy, who—andthis is true—are now sending me wed-ding announcements and pictures of theirbabies, and it's chemotherapy that we cancredit that they're here today. They didn'tlike it, but they were children; theyweren't afraid of it. It was just a wrinkle;they had to get through that.AHC: Do you still recommend

chemotherapy even as a so-called holis-tic physician?BKV: Definitely. It's harsh; it's toxic.

And I believe it's best to take excellentcare of the body when one is givenchemotherapy. Chemotherapy is one ofthe few tools we have to rid the body ofcancer. So you bet, I have high respect forchemotherapy. I think it is easier on thebody if one also looks at one's life, doessome work. Acupuncture is extremelyhelpful for controlling nausea and exer-cise is extremely helpful for overcomingthe malaise and fatigue.AHC: What do you get your children

to do? I mean, do you recommendacupuncture to the children?BKV: No. And, as a matter of fact, what

I'm saying now is about adults. Because,first off, now, I see mostly adults. Aboutonce a week, I'll see somebody between12 and 20, usually at the request of anoncologist or another physician in town.AHC: Don't you miss seeing the chil-

dren?BKV: It's really hard for parents, prob-

ably way harder than for the child, whenthere's cancer in the child. And so, they

Bonita K. Vestal, M.D., Integrative HealthBuilding.

want to know that they're doing the verybest for their child, and this might be anIdaho thing, but very few parents areopen to anything, even deep relaxation orhypnotherapy to help with nausea. Theythink of that as some kind of meddlingwith the mind, that is, not safe. Parentsdon't routinely want their children toexperience alternative therapy unless thesituation is such that traditional interven-tions are failing.But, I found that when the chemothera-

py was no longer working, people wouldfind their own way to Essiac tea (Ottawa,Ontario, Canada). What I saw in childrenwhose therapy was failing is that theyremained radiant and reasonably com-fortable. It really helped those children.They were comfortable, and their

394 ALTERNATIVE & COMPLEMENTARY THERAPIES—DECEMBER 1998

"Breast cancer studies have shown us that womenwho stay active and do exercise have far less nausea."

Medicine wheel made out of willow.

metabolism worked better. I've neverseen Essiac cure cancer, but I've seen ithelp people feel better, and look better,and function better.AHC: Did you get permission from

the parents to let the children do this?BKV: They did it without even asking

me. This is people finding their ownpower. I never recommend something toothers. I say: "There are things out therethat you might be offered, you mightfind, and you might think you want totry. If that happens, please come talk tome and I'll help you with it." But, the lastthing people need sometimes is one morething to do, or more information.Some people just need to take their

child home and have the pastor comeover and have people join in prayer and Iwould always say: "If you feel like youwant to invite me, I would love to partici-pate in the prayer." So, when childrenwere dying, I would take my nurse andwe would do home visits.

AHC: How you recommend alterna-tives?BKV: When I get a clear sense of what's

going on in the person, then I ask the per-son: "Are you feeling this right now?"The person almost always says "yes."Then I'll say: "What do you think that'sabout?" Almost always, the personknows exactly what it is and then I'll say:"Well, you know, a lot of people who suf-fer with this find a lot of relief when theystart doing some bodywork, or yoga, orfollow a particular dietary plan, like elim-inating dairy. People who have a lot ofnausea [from chemotherapy] shouldprobably eliminate animal foods beforethey're treated." I just mention this topeople, and then they go read, and thenthey try it, and sometimes they say:"Wow, this is really helpful!"AHC: Basically, you offer the alterna-

tives but make no suggestions?BKV: That's right. They come and give

me feedback, and we begin to fine-tunethe experience. They'll say: "I tried this,and I had a nausea-free day." For exam-ple, one high school girl, who was a

patient of mine, was in the early phase ofchemotherapy. This was in the early1980s. She had a chance for a cure and wewanted to use the drugs aggressively,which we did, and we told her that shewould want to take it easy. She wouldcome in the first thing on Wednesdaymornings and then go home and rest allday. But she was an outstanding studentand an artist. One time there was an essaydue to be read aloud in her pre-lunchtimeperiod, 11:00 class. She went fromchemotherapy to that essay class and readthis awesome paper. It was very wellreceived and she stayed at school the restof the day. She came running to the officethe next morning and said, you know:

"Going to school cured me! I don't haveto stay home anymore." Now those breastcancer studies have shown us thatwomen who stay active and do exercisehave far less nausea.AHC: Do you still see the children?BKV: Actually, I got a call this morning

from my primary nurse to tell me that oneof the children I took care of in highschool, now 23, is doing poorly in thehospital. He had already called me lastweek and said he was beginning to failand he wanted me to be standing by. If heweren't able to come to me, he asked if Iwould come to him. So, I've left the phys-ical medicine behind, but I'm still avail-able to the people who want to work thisway, whether they're grown up or not.AHC: What will you do with this

young man?BKV: He likes to draw. We'll talk about

what he has been drawing, and how hisinteractions with others are going, andwhere he has emotional pain still. Andyou know, quite honestly, the cancer hasnever been something we've talkedabout. I mean we talk about it when heasks: "What does it mean when they wantto do monoclonal antibody therapy?" Buthis real issue is that his mother aban-doned him when he was 2. So he's had awonderful stepmother. His biologicmother has been trying—as any momwould, I guess—to get back in his lifebefore he dies. He has a lot of reconcilia-tion work to do.AHC: How did you begin to develop a

style for counseling after all the years asa clinical oncologist?BKV: What I did was what I advised

my clients to do: Turn to what interestsyou, what lights your fire, to what warmsyour heart. I have always enjoyed people.In fact, I was a psychology major under-


"Whatever the familybrings with complete belief helps."

graduate. I noticed that I kept reading inthat area [psychology], as opposed toreading medical journals avidly. Being inIdaho and having to find my own way, Ihad to learn how to deal with dying chil-dren and dying adults, because that wasnot part of my training. In order to learnhow to do that, I had to leave this culture,because this medical culture saves people.Its intention—explicit intention—is tostamp out disease and overcome death. Ifound myself studying cross-cultural soci-ology and anthropology, and I began totravel, and share what I learned.AHC: What do you mean by cross-cul-

tural learning? What cultures did youstudy?BKV: One time, I spent a couple of

weeks in east-central Africa in a nurseryfor newborns, which was really just a rowof boxes that looked like orange crates.They didn't have IVs. They didn't evenhave bottles or nipples. They had a groupof moms come in out of the village, bare-chested, who ran their breasts underwater (no soap), to visit these babies. Thebabies could suckle from the breasts; ifthey couldn't do that, we had trainingcups, the kind of cups that small childrenhave. You learn what these peoplebelieve. They believed that, if the babywas meant to live, it would live. In thatculture, if you have a preemie, you eitherknow it's going to live or you know itwon't live. The baby is treated accordingto that belief. I learned what a huge rolebeliefs have in healing and how much ithelps when people help themselves.When the family turns towards the ill oneand brings in whatever it has, whether it'sthe patient's favorite food or a lovingtouch or a song or a new name, whateverthe family brings with complete beliefhelps. Then I looked at this culture and I

saw how frightened people are, howpowerless they look, and how over-whelmed [they are], not only by the ill-ness but by the treatment, because it'scancer and the treatment's just awful.AHC: Where did that lead you?BKV: I began to wonder: "Where is the

power in this culture?" The people arewithout power, and they're the ones whoneed to heal. And I see in Africa, and inother so-called "primitive cultures,"places where there's no technology,where people know they have to rely ontheir own selves. The first thing theyknow is that they have to live wellbecause they might die at any momentand that they can't die in peace if theyhaven't lived well.We have children in school and they're

learning arithmetic, reading, spelling, andall of that. And children in land-basedcultures are learning that they have to beaccountable for everything they do. Theyhave to help with the work, and theyhave to play fairly, and they have to tellthe truth or else somebody will get hurt.They learn respect for the naturalrhythms—the seasons, the daylighthours—and our children don't learn thosethings—at least not overtly. There is a

greater respect for all of creation whenyou don't have technology, and that helpspeople live well.Bringing that back home, I tried to help

my cancer patients. I can't think of adirect example right now, but I see peoplein this culture living fast-paced, multi-tasking lives, accomplishing all kinds ofthings. And I'm thinking it would be so

simple to develop an attachment to cre-ation...just to sit down. My first teacher,for example, had me sit on the earth daily,every morning, and give thanks for mylife and my connection to all of life. With

Integrative Health Building, Boise, Idaho.

the winters in Idaho this meant I had a

tarp and a down comforter. I did thatevery day for a year. Then I began to readabout the use of herbs, and I began tolearn about the energy centers in thebody.AHC: So did you begin to integrate

these ideas into your practice?BKV: Absolutely, [by first], just

reminding people of the small goodthings. I worked with a 14-15-year old, asophomore in high school. [She had a]surprise diagnosis of leukemia and shewas a beautiful girl, a cheerleader, andvery prominent socially. She was intelli-gent, so she was terrified. She came froma good family. [The family members]were all gathered around the bedside,and they were listening to what I was say-ing. So I asked them if they would bewilling to contribute something rightnow, in this moment of the telling of thediagnosis? I said: "Let's all sit quiet forone minute and come up with one wordor one short phrase that we know about


"I'm interested thatthe outcome is peaceful."

Four Questions forCancer Patients

Dr. Vestal has four questions that shehas synthesized from works of others. Thefollowing questions make use most notablyofWayne Muller's How Then Shall We Live3-and Angeles Arrien's The Fourfold Way)3 Dr.Vestal superimposes these four questionson the four directions in Native Americancosmology to help people recognize andreclaim their power:1. What are the three most commonwords or phrases you use when describ-ing yourself?

2. What do you love?3. What is one thing you know now thatyou must do in your lifetime?

4. What is one thing that everyone whoknows me knows about me?These questions seem to capture

everyone's interest quickly and, even in a

large group, the members have the senseof having learned useful things aboutthemselves.

aMuller, W. How Then Shall We Uve: Four SimpleQuestions That Reveal the Beauty and Meaning ofOurLives. New York: Bantam Books, 1997.; bArnen, A. TheFourfold Way: Walking the Paths of the Warrior, Teacher,Healer, and Visionary. HarperSanFrancisco, 1993.

Amy, that will remind her who she reallyis." I had known this girl for only a cou-

ple of hours by that time, and I alreadyknew that she was strong, and so myword was "strength." Her mom probablysaid "radiant," and her father said "pre-cious," and different people said differentwords for her. What it did was bring usall around her in a healing communityand remind her who she was, so that, yes,she was terrified of the illness and proba-bly more scared of the treatment, but shewas forced to remember, forced to at least

look at and acknowledge that peoplecould see her for who she really was. Wejust kept that going gently during hertreatment, you know, so here was Amywith her strength to receive herchemotherapy. We described thechemotherapy as something that wouldhelp her and work with her strength. Insubtle and very small ways, I would justhelp people remember the good things.AHC: Was her process of healing

greatly improved by the methods youwere using?BKV: You know what? I can't tell you

that I know that. But I can tell you sheknew herself better. Here's one thingabout cancer that drew me to that field.We in medicine, and people who have thedisease, have no control over it. The out-come is always an unknown. All you getis the chance to walk with somebody andhelp that person right now. When I treat aperson with cancer, I go in there with allof my training and all of my education,and I do my utmost best with the tools Ihave. I do it to help this person feel betterand do her life better. If she comes into itscared and shut down and diminishedand self-pitying, she's not likely to do herlife better.AHC: How does all this affect out-

come?BKV: I'm not even interested in out-

come. I'm interested in living well. I don'tmean to sound harsh with that, but basi-cally, I'm interested that the outcome ispeaceful. What I really mean is that I'minterested that people know themselvesas having lived well. Then the outcomedoesn't matter. The outcome, of course,matters to them, especially to children, ifthey have to give their lives over. Theyusually have only sorrow because theydon't want to leave, but they don't have

fear and resistance. Children don't,because they know it's done.AHC: Are your patients still basically

cancer patients?BKV: No. That was my original inten-

tion. Here's what happened. M. camewhen she was diagnosed with breast can-cer. I had, whileJ was an oncologist,worked with her mom, L., who died frombreast cancer. I had just worked with herin a way of talking and comforting her,because she was a friend of a friend. Andso, L. had died. M., her daughter, got can-cer, and came to talk to me, and found herown power very quickly. We had, maybe,two sessions. And she just galloped for-ward. She's a very healthy, well-integrat-ed young woman. And so, she's doingfine.And then her brother called me, and

asked: "Could I get an appointment?" Isaid, "Well, D., do you have a medicaldiagnosis?" And he said: "No, I have a

relationship problem." So I said: "Well,I'm not trained as a relationship coun-selor. Perhaps you want to see a marriageand family counselor. Shall I give yousome names?" But he said: "No. Thework you did with M. was so powerfuland helpful in her life that I know I wantto work with you." And so I said: "Well,knowing that I'm not a traditional coun-selor, and I don't do psychotherapy, I'lllet you have one session, and we'll evalu-ate together if it's even appropriate." Wetalked about D. and the relationship, andhis life pattern. And then he went andworked on the relationship, and he andhis fiancée went to a relationship coun-selor.Then he told his friend: "You know, if

you want to get started on something,you can call her and get an appointment."So, about half of my roster of patients will


"The south on the medicinewheel is the healer archetype."

call up and say: "I'm really stuck. And Iwant to work on my life." I'll remindthem that I don't do addictions counsel-ing, I don't do eating disorders, I don't dorelationship counseling: This isn't psy-chotherapy. If they can see in the first 30minutes this isn't what they want, we'llpart company, no charge, and they can gotry somebody else.AHC: What happens in a typical ses-

sion?BKV: Someone may come to me say-

ing, "I'm newly diagnosed with breastcancer, and I have some important deci-sions to make." She'll come and tell meshe has a 2 V2 cm lump and the plan is a

needle biopsy, and then a lumpectomy,and then radiation, then chemotherapy.And she's terrified of all of the abovebecause she doesn't know what itinvolves. So we talk about the immediateproblem, the lump in the left breast. I tellher what I know and how muchchemotherapy has helped the children,and all the things people can do to makechemotherapy tolerable, and how easyradiation of breasts is, and, by the way,[I'll ask] what's happening in her relation-ships at work and in the rest of her life.And oftentimes, during those questions,tears begin. We'll then make anotherappointment and I'll ask her to tell her lifestory.In the life story, we're going to find out

what happened to her that shaped herresponses in the present problem, andwhere her strengths are, and who validat-ed those strengths. If a person has obvi-ous virtues that no one has validated,then that person has no idea she haspower. Here I am a stranger and a coun-

selor and I say: "Oh, I see, you're alwaysthe one in the family who cares whenthere's a broken relationship. You always

want to help the two parties get backtogether." Or: "You're always the onewho knew she had something more to dothan just make the family run well."I have a lady right now who has been

mothering since she was in the seventhgrade, and she's always wanted to writepoetry. Now when she writes poetry, shewrites these just outrageous, truthful linesabout being used, and being held back.And her husband says: "That's terriblestuff; don't let anybody ever read that."And it just happens to be her emotionaltruth. So, what I work with, in a quickanswer, is the immediate problem in thelife story. For people who are intochemotherapy and are ready to go onProzac [fluoxetine hydrochloride, Eli Lilly& Co., Indianapolis, Indiana], usually Iask for their life stories first. And then Iask: "How did the problem come in? Whois there for you?" I also have a bunch oftools that I use.AHC: What are the tools?BKV: Again, these are teachings from

indigenous cultures. I use the under-standing of the quality of the four direc-tions. If people are going down inself-pity, if they are totally sorry for them-selves and unable to take steps on theirown behalf, I can identify them as beingin the shadow side of the south positionon the medicine wheel. And what I knowabout them is they have very, very stronghealing energy. Most people that I seewho are scared fall in this category. Thesouth on the medicine wheel is the healerarchetype. The shadow side of that is self-pity and fear about dying and sickness,and once I know that, we're there. Thatgives me something to tell them: "Well,you have this strong quality of healer inyou." Keep in mind that most of the peo-ple I see are breast cancer patients, most

A Creative, AdventurousPath for Cancer SurvivorsDr. Vestal is part of a larger team that ¡s

taking cancer survivors out onto the landto remember their connections to all ofcreation. The pilot prpject, "Coming Hometo Yourself: An Outdoor Odyssey," tookplace in the Flathead Valley in westernMontana, September 23-27. The projectwas organized by Living Art, in Missoula,Montana, and funded, in part, by a grantfrom the Jerry Metcalf Foundation, Helena,Montana. The 5-day retreat was designedto let nature provide challenges forbuilding, safety for reflection, andinspiration for growth, while participantsenjoyed scenic beauty, fresh wholesomefood, and the companionship of otherswho were seeking meaning and purpose inthe journey with cancer.

By using outdoor adventure, such as

river rafting and hiking, combined withcrafting with natural elements, singing,dancing, writing, and drawing, participantscan rediscover their own initiative andcreativity, recover a sense of perspective,and renew their commitments to the workof healing.For more information on the project,

contact Pamela Kierulff, marketingconsultant for Living Art, 5950 WildcatRoad, Missoula, MT 59802, (406) 549-5329.

of them are women, most of them are

mothers. You know, a mother is a primalhealer.I'll teach the person that the person in

the south needs to work with the energyof the north, which is the warrior. Youhave to carry some warrior medicine inyour bundle. You have to apply it rightnow. The warrior is simply somebodywho stands prepared. There is no need togo conquer anything. People have a very


"Knowing that you lived well isthe very best preparation for death."

hard time with the battle metaphors, so Ihave this little medicine wheel made outof willow. I tell the person to hold it, and Italk to the person about warrior medicineand how it has nothing to do with con-

quering. It lets people be authentic andtrue to themselves. There's a lot of vulner-ability in being true to yourself. So, I usethat tool.From other teachers, I have learned

important life questions (see box entitledBonnie's Four Questions for CancerPatients), and it's interesting to me thatthose can be superimposed on themedicine wheel. At least in my head,there is a natural superimposition. WhenI go out and teach, I show how thatworks. I point to other aspects of the fourdirections that people already havegoing in their lives. They might havestrength or leadership, and that's a northvirtue. Or one might be a visionary, apoet, and that's an east virtue. And so, Igo for what they already have, andremind them that that's already in place.I listen to people's life stories and whatthey've always done and where they'vebeen hurt, and lost their own power. Ifthey can see that, they begin to grieve forthemselves, and I think that's healthygrief. "Oh, oh, I've never stood on myown feet." Or, "I've always assumed thatI needed a guy to take care of me." Youknow? People start waking up to theirown weaknesses and they might be 53years old.AHC: What do you teach the older

patients?BKV: First, we kind of celebrate:

"Well, hey, you're still alive. We canstill work with this. You can knowyourself as whole in this lifetime; whata relief." And you know, after all thoseyears of working in hospice, I noticedthat the fear of death for most olderfolks is that they don't know them-selves, they know they haven't done a

lot of important work, nobody taught

them how, nobody offered them a

chance. They still have much to do; theyknow it, and they can't. It's too late.Knowing that you lived well is the very

best preparation for a good death. So, youmight die of pancreatic cancer, but if youknew what you needed to do and, hard as

it was, you did it—you went and forgavethat person or you stopped being a chiefexecutive officer and learned how to playthe violin—if you specifically knew whatyou needed to do, then you have peaceand you have this huge sense of: "Ah, lifeis rich. I learned so much while I've beenhere that I am nothing but thankful."That's the thrust of the support groupthat I run. I don't even know if I shouldcall it a support group, but people comefrom the hospital support groups. We sitand talk about how to live well and whatis still going on in our lives in this season.AHC: What's the difference between

your counseling and so-called "talk ther-apy," psychotherapy?BKV: I honestly don't know the

answer to that question. It may not bevery different. That's why I said what Idid about feeling most comfortable inthe medical realm. One thing I experi-enced when I was an oncologist was notbeing able to find a counselor whounderstood cancer, or chemotherapy, orradiation therapy, well enough to putthose in perspective. And so the patients'behavior was guided by their fears andtheir understanding or their misunder-standing of what was going on in theirlives. So, I am most comfortable whenpeople have medical illness. Somebodyhas hypothyroidism, and that person'slife's been out of whack for a year. Andthe person can't get anything done. As a

medical practitioner, I know what that'slike. And, yes, it takes that long. It maytake that long to get well again. So astandard psychotherapist might thinkthat their clients are stuck, or unwilling,and what I'm thinking is that they need

some tender support while their physicalvehicles get better. I can think of sometools they can use. They can do somebodywork, they can start walking an

hour a day.My intention is to offer the highest spir-

itual principles I know, to help peoplelive well. And so, whether one has cancer,or depression, or a runaway child, one iswelcome to come and face one's own life.And I'll encourage them, and point thedirection towards-what work they mightwant to consider. But I don't do therapyon them. And, they don't have to havemedical diagnoses even though all mytraining, all of my experience, is in illnessand healing.

Exercise, Good Food, andReflection Help All Patients

AHC: Do you recommend exercise forhealing?BKV: I think everybody needs some

movement. Physical movement, everyday. A person who's really depleted frommajor surgery can't go out and walk anhour a day, so you might suggest some-thing different for that person. You mightsuggest that the person walk outdoorsand get the mail every day or sit in thebackyard for 30 minutes a day. I just wantsick people to be connected with nature.So that they know their places in creation.Having an hour outdoors every day,choosing foods that are suitable, that onehonestly knows will help rebuild thebody, that will contribute to one'sstrength.AHC: Do you have some nutritional

guidelines for clients?BKV: I say: "Choose your foods with

your highest consciousness....Pick thingsthat you know will help build your body,that will keep your body clean." And ifyou're taking chemotherapy, then youwant pure, clean foods, you don't want toadd to the burden of toxins in your body.


"Your body holds informationthat isn't available through the mind."

If a person's having trouble with nausea, Iwill suggest that one may want to reducethe intake of fat and protein in the 24hours before one receives chemotherapy.Make it easy on your digestive system.Don't add to the burden on your diges-tive system, when it's already being chal-lenged by nausea. It's my belief thatpeople have their own ideas of what'sgood for them, and I highly respect eachindividual's ability to know that, andchoose well.One thing that most people—a lot of

times women, overweight women—willconfess to is indulging themselves whenthey feel sad, or scared, or alone. They'llindulge, usually with sugar, often withchocolate. That indicates to me thatthey're not nurturing themselves in a

healthy way on a regular basis. They areso starved for attention, affection, andnurturing that they'll binge on choco-late. For that kind of a person, I'll ask,you know: "Would you like to try a

daily nurturing practice? How about afragrant nighttime bath with an aromat-ic candle? How about doing that everyday for a hundred days? It's givingthanks for your day, letting go of whatyou don't need, letting that go down thedrain, and just enjoying the fragranceand the sensory experience for your-self." Once you get people nurturingthemselves on a constant daily pro-gram, they begin to enjoy, even honor,who they are, and they don't want tobinge anymore, there's no need for it.To me, that's a spiritual rectification.You no longer need to misuse yourbody. People sit in bathtubs and theystart imagining and remembering.Think of how little time in our culturewe have to reflect.[One may be] reflecting in the bathtub,

and thinking: "Oh, oh, I would never saythat again to her." Or, "I hope, I hope Inever do that—think of what my mothersaid to me, I would never want to do that

to my children." The wisdom that yougather from remembering and sorting atthe end of your day is important. Most ofus don't take time to do that. [Instead onetakes a] fast shower in the morning [and]falls into bed at night. I ask people to doconstant nurturing for themselves, so thatit will bring their souls to greater wake-fulness, make them more accountable forhow they have been, [and] how they wanttobe.AHC: What other alternative therapies

do you recommend for cancer patients?BKV: Well, for chemotherapy patients,

acupuncture may help with nausea, itmay help to keep the immune system inbalance, but my most typical use ofacupuncture is for chronic misery—tohelp keep the balance, because we haveto know where our life's energy is. Thatold vital force, or chi, has to flowthrough our bodies harmoniously onceevery 24 hours. Most of us don't takecare of our chi. We just go, drop some offat the grocery store, then some at thegym. I sense that, for my own self,acupuncture helps me pull my energytogether, and then, if my body has a

healing need, my body takes care of it,because I've taken care of where myenergy is and how it's running.AHC: Do you have other therapies

that you suggest to clients?BKV: I just have to read the individu-

al. I have to sit with the person for awhile. And then I can ask: "Hey, youknow, have you ever thought aboutfocused, conscious bodywork, holistictouch therapy, [in which] somebodyruns the meridian and notices the ten-der points, and then starts reading yourbody map? Would you be interested inthat?" That's something that helps me,as a fairly cerebral person. For Western-ers, working with the body, or usingnonordinary states of consciousness,such as guided imagery, breath work, oreven yoga therapy, may seem strange.

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Yet, if it is harmless, and apparentlyeffective, patients find it encouraging.This boosts their energy and raisesinterest in doing inner personal work.Your body holds information that isn't

available through the mind. My colleague,Suzanne Lewis, B.S., is a holistic touchtherapist. And we sometimes do team ses-

sions [in which] she will touch until shefinds the tender points. If, for example,there is pain on the left thigh, it's the innerfemale responding to the outer male. Inthis case there may be a place in thepatient's life [in which] she's not feelingunderstood, not able to stand up and feelthat she can stand on her own in the faceof some masculine influence on her. Peo-ple are just astounded that their bodieshave given them this much information.We don't ask them to answer us. We sim-ply point out what we're reading. Andthen they may begin to cry, and we mayjust, you know, touch that point and com-fort them, and say: "That's right. Do yourwork. You're doing well."AHC: If you were to summarize how

your work has changed since you werepracticing as a pédiatrie oncologist, whatwould you say?BKV: I'm doing nothing different than

I did before. It's just that now I have timefor the part that seems to really matter forthe patients. D

To order reprints of this article, write to or call:Karen Ballen, ALTERNATIVE & COMPLE-MENTARY THERAPIES, Mary Ann Liebert,Inc., 2 Madison Avenue, Larchmont, NY 10538-1962, (914) 834-3100.

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