Background Image


Yesterday, while catching up on medical concerns with a patient before we started her Osteopathic session, I said “oh, yes, I tried that too” to convey understanding about what she was telling me regarding her experience with ADHD. She had been wondering whether to try a new treatment, and she stopped short. She was so surprised, and asked me, “Wait, you have this?” And I said, well, not the hyperactivity symptoms, but yes, I’ve been dealing with it since I was a teenager. It seemed to help her trust what I had to say about effective treatments and medication options, so I thought maybe it would be helpful to write about too.

Typical of many girls with mild attention-deficit symptoms, my main issues growing up were becoming bored and fidgety or even combative after only a few minutes of something I wasn’t extremely interested in, forgetting to do things like homework while doing adequately in school (so as to not raise any red flags learning-wise), getting in trouble over and over in class for falling out of my chair or daydreaming or talking, having major depressive symptoms with serious irritability and quickly becoming frustrated, and being able to ‘hyper-focus’ for hours on end on something I was truly interested in (in my case it was usually books or video games).

It wasn’t until around age 12 that I realized one day playing my game-boy, that my body was hurting all over laying cramped on the couch playing, and I didn’t want to eat dinner because I’d just ‘won’ and the game had automatically started over at a harder level… I was willing to be in pain and not sleep or eat in order to keep playing. I felt so angry about everything (mostly at my mother insisting that I pause the game- which turned off automatically after 10 minutes on pause so I rushed through eating), especially at any attempt to get my attention- I was so intent that didn’t hear anyone unless they were touching my shoulder at which point I would jump and yell at them- that a lightbulb went off: I didn’t like myself like that. I decided to put the games above my tallest bookshelf and not play them again.

Somehow I got through college (with an unimpressive GPA from taking so many classes and not being able to complete the entire curriculum for any one of them), but afterwards I was lost. I didn’t know how to do anything but be in school, even at the sliding-through level I generally took, and I was dealing with emotional trauma I hadn’t had help processing yet, so my mother paid for me to go to therapy while I looked into going to grad school. I took Effexor (venlafaxine), which is a combination SNRI (serotonin and norepinephrine) receptor blocker. In those three months, my mother and I didn’t fight once. (A miracle, honestly, given our violent and frightening history.) I studied for the MCAT, albeit cursorily, by skimming the entire Kaplan book in 3 days, seated at my desk, without music or food as with my previous study habits. And then, at the end of the summer, the relationship I was in went through a rough patch, and I stopped my medication cold turkey. (NEVER do that, by the way. Withdrawals are absolutely horrific.) Fighting with my mother commenced shortly afterwards, and I was told to either pay rent or leave, so I left the next morning, and decided that I’d try to find ways to deal with my sensitivities and attention issues without medication if I could.

The next chapter of my life really began after a year of working in a restaurant, using alcohol to calm myself down in order to be social, and playing video games until 3am most nights, when I somehow was accepted into medical school. I went through two video games there, one each year I lived in Kansas City, until realizing after one 8 hour bout wherein I ate an entire box of Better Cheddar crackers and drank only 20oz of Mountain Dew that day, that again, this was not the way I wished to live. My ban on video games resumed. I finally learned to study, even though it was with enormous amounts of caffeine, and also tried a few other anti-depressants and stimulant medications, but every one either gave me untenable gastrointestinal side effects or caused such nausea and anorexia that I would stop after 2-3 days. Personally, with no medical evidence for this, I blame the withdrawal-induced traumatic brain pathway I gave myself, and assume my gut-brain connection just decided it had had enough of me messing with it.

Now, I never had the major issues or severe symptoms that some of my patients have experienced, but it was enough of a problem that when I was semi-officially diagnosed (I didn’t want it on my medical record, so my psychiatrist at the time just spoke with me about it at length), it was actually a relief to know I wasn’t simply ‘lazy’ or ‘lacking motivation’ as I’d been told when I was younger. As for the sometimes frightening hypersensitivity to sound and busy environments I had experienced since I was about 6 years old, my psychiatrist attributed those issues to the same group of symptoms, and gave me a ‘good’ reason to leave environments that were difficult for me to handle and to take time to myself when I was overwhelmed.

Fast forward through residency, where the stress of losing my mother, 100-hour work weeks, and the fear of causing harm to patients seemed stimulating enough to force me to learn what I needed to become a good physician… then to today, and my current way of living. I’ll share the things I’ve learned, many of them in the last 5 years, that help me accomplish necessary tasks, and allow me to be creative and passionate without letting me forget about responsibilities I’ve taken on. I don’t do every one of these perfectly, but these are definitely the most helpful non-medical ADHD symptom modifiers I’ve found.

* I meditate every day. As my ‘Insight Timer’ on my phone records, I’ve missed 3 days in the last 400. And I felt it when I did! Nothing has given me more insight or helped me more in my own life, and nothing has allowed more healing. I recommend developing a personal regular practice of some kind very highly, no matter what your experience level or belief system.
* I take on only as much as I truly can handle- Some days that isn’t much, and as an introvert, I need a lot of time to recharge between activities. If I don’t take the time I need, or if I stack my schedule too high, I get sick, depressed, frustrated, and am ineffective at work.
* I haven’t had a TV since I was 19, and only watch with my housemates when I truly have no responsibilities and can waste a few hours, and really enjoy what is available. Otherwise I keep a Netflix queue and only watch when I can truly take time off.
* I am not allowed to play video games, and if I try one that makes me think about it after I put it down, or if it causes me to miss something someone around me said, it’s over.
* I go to bed at 10pm and get up as early as I can- my favorite time is 5:55am. I need a lot of sleep to recharge, to allow my overstimulated brain to ‘file’ important things and get rid of things I don’t need, and to make sure I am well-rested and alert so when I need to focus during the day I am able to without medications or caffeine.
*  As much as possible, I eat whole foods without chemical additives and avoid refined sugars (including agave, hfcs, brown rice syrup, coconut sugar, and crystalline fructose… there are probably more…). Some people may benefit from avoiding flour also, and some may benefit from avoiding dairy. Personally I love home made sourdough bread and grass-fed whole milk for the omega 3s, but that’s my personal preference.
* I don’t try to multi-task anymore. It’s not possible anyway, and it’s not worth the frustration and disappointment when I fail.
* I write everything down in pen, keep an online office schedule also so I have to cross-reference and don’t forget something, and I make lots of hand-written lists, but re-write them when many things are crossed off or too many new things have been messily added. I do not use my phone calendar or reminders (I am on the internet too much anyway, and writing with my hand allows me to remember photographically much better than typing), and when I leave myself a voice note or need to write a note in my phone, I transfer it to a word document as soon as I can or put it in my written paper calendar, or I act on it right away.
* Most of all, I am as understanding and realistic as I can be about myself. I keep what matters to me in the forefront of my mind, and stop to reevaluate as needed. I am comfortable being wrong, and work daily on being flexible while sticking to what is important to me.

I hope that was a little helpful, and if nothing else, sometimes it helps to know that doctors are regular humans too. The people I look up to most are those that have had to work with something that was not easy and found ways on their journey to be even more bright, loving, and compassionate. In my case, I hope to use my experiences to help others if possible, and at the very least, to learn to be more peaceful and kind to myself.

6 Healthy Breathing Practices

Sustainable Health Nutshell: The breath is the simplest tool you have to increase your physical, mental, energetic, and emotional health. Try some of these exercises to learn more about your own body, breath, and energy.

Why is breathing so important? In yoga practices, the breath is an observable aspect of Prana, or energy, but prana is more thoroughly defined as the ‘breath of life’ or ‘energy of life.’ It includes all flows, seen and unseen, such as blood circulation, digestion, and nervous system flow as well as flow of creative thought, emotion, and energy through acupuncture meridians. Even things that don’t ‘breathe’ have prana- rocks, water, and the air itself, and all prana affects all other prana. The best example of this is that a huge amount of herbal medicine deals with the ‘life energy’ of plants and how to change human energy that is diseased by using healthy plant energy. Improving your breathing and learning about it can do wonders for many aspects of your health- let me know what you think of these exercises. (They are marked with *** to make sure you find all 6 to try!)

Physical Health:

Breathing deeply and slowly moves the large diaphragm as well as the lower pelvic diaphragm, and improves lymph flow and digestion, which together improve total health remarkably. Try breathing consciously throughout your day to improve oxygenation, and use the two following practices for a few weeks and see how your fitness improves.
*** 1) While sitting to work or relax, try getting up every 15 minutes or so to walk and stretch, and when you think of it, take a deep slow breath, with even counts of several seconds in and out, filling up your abdomen first and your upper chest last.
*** 2) While walking, hiking, or running (other rhythmic exercise may work as well, but these are the easiest to start with), try inhaling through your nose for 4 steps and exhaling through your nose for 4 steps. If this is easy at your current pace, increase to 8 steps in and out. Go up to 20 if you can. Breathe in deeply, all the way into your abdomen, and fill up your upper chest last, keeping your neck and shoulders relaxed. See how your breathing speed needs to change with increases in pace or hill grade, and how you can extend your breaths by slowing down. First, slow your usual workout pace to work on increasing your breathing depth and slowness, then increase your pace while keeping your breathing slow and deep. You’ll find you are less fatigued after a workout, more energized, and after a while able you may be able to work out longer and with less injury.

Mental Health:

Several meditation traditions use the breath as a focus or point of concentration to help settle the mind. The Anapana portion of Vipassana training is a good example of this. *** Try the following for 7 days and see how you feel. Before breakfast and dinner, spend 5 minutes calming the body with Nadi Shodhana or Nadisuddhi (= alternate nostril breathing) (my simple video is here) followed by 5 minutes of breath observation in this manner: Sit comfortably, close your eyes, and intend to simply observe. Watch the air go in and out, feel the temperature of the air in and out, notice the moisture, or whether one nostril is more open than the other, feel the breath on your upper lip, in your sinuses, and down your throat. Notice if the breath is fast or slow, and if it changes when thoughts or emotions arise. With each thought, emotion, or sensation, observe how your mind automatically judges each thing as ‘good’ or ‘bad.’ When you realize you are no longer sensing your breathing, return to observation. This is the most basic form of meditation, which uses concentration on a physical sensation to calm the mind and learn non-judgement. This is not the easiest form! But it is safe and something anyone can try. Twice a day, 5 minutes at a time is a nice beginning practice. Let me know your results and what issues and resistances arise for you, for they can be very helpful in learning compassion for yourself. How you respond to this type of meditation can lead you in a direction of learning other forms as well, so please ask questions if you like.

Emotional Health:

Next time you’re feeling a powerful emotion, notice your posture and breathing. Our response to emotion is physical as well as energetic and emotional, so many types of emotional reactions can be understood and helped to shift by gently changing our posture and breathing. Over time, the body can store stress unconsciously, which can contribute to blocked energy flows and ill health. To help with this on an emotional level, try the following two simple exercises.
*** 1) When anxiety arises, notice your breathing and see if you can slow it down (even a tiny bit!) and deepen your breaths into your abdomen instead of your upper chest. Count seconds and see if you can make your exhalations longer than your inhalations. Straighten your posture and close your eyes to focus on your breathing. Sit or stand with your back against something sturdy like a wall or tree trunk, and press your shoulderblades into the wall as you breathe slowly and relax your neck and head back towards the wall.
*** 2) When anger arises, first remove yourself from the object of your anger to give yourself time. Notice your breathing and see if you can create slower even breaths, the same number of seconds in and out. Place your right hand on your heart and your left hand on your belly. Let the anger shift and subside as you continue to breathe. As it subsides, clearer thought will return regarding the situation you just put on pause, and an ability to intend non-violent resolution may become easier over time.

Energetic Health:

Learning about your own subtle energy is fun and can also give great insight into any health issues, especially recurrent or persistent ones. Western medicine uses things like biofeedback to teach how breathing affects and is affected by relaxation, blood pressure, and heart rate as well as mental and emotional stability. In many different branches of eastern medicine, breathing practices are used as a tool for healing, and some are very powerful (a teacher is always recommended since these practices have physical side effects- especially if you have health problems, so please be gentle and mindful and consult your physician). Pranayama (‘extension’ or ‘drawing out’ of the life energy) is a group of practices that help you understand your breath (and energy) flows, and how controlling the breath and observing changes in your own energy can teach you about your own system. Qi Gong is one of the most structured and gentle practices, and finding a teacher is definitely recommended.
*** I teach something called the Healing Breath (a shortened version is in video format here), which can be used to relax the body, but also can be used to clear out negative energy. Once sufficiently clear and able to feel a sensation of heat in the lower abdomen (the location of the lower dan tien in Chinese medicine or the 2nd chakra in Ayurveda), healing energy can be sent to different parts of the body, or even to the hands to encourage healing in others. To use this breathing activity in that way, take a slow breath into the abdomen for 7 seconds, hold for 3 seconds, and breathe out slowly for 12 seconds- keep this rhythm going for 5 minutes. On the in breath, picture clear positive energy flowing into your energy system, and on the out breath, picture any negative or unhealthy energy swirling in your lower abdomen then returning to the earth. Once you feel more clarity and joy present, and possibly heat in the lower abdomen, intend for the clear healing energy now swirling around to be moved on your out breath to your hands. Allow the sensation to grow. After practicing this for a good while, see if you can send the healing energy to other parts of your own body. Expecting results creates resistance, so just practice and see how you feel, have fun with it, and above all be gentle and don’t practice for too long at a time. Enjoy!

stop and smell the roses :)

Daily Routine

5/12/13 edited! see below for minor additions :)

Sustainable Health Nutshell: Keep a schedule and routine to allow your body to trust you, so it will not have to compensate for stressful circumstances (that over time leads to ill health). Starting every morning off with a gentle cleansing routine sets a stress-free tone for the day and prepares you to calmly meet whatever demands life has in store.

A fellow meditation teacher recently led me to a site that included Dr Vasant Lad’s daily routine suggestions. I was initially entertained by the sheer number of things one is “supposed to do every morning” (19!), but as I thought more about it, I decided rather than writing them off, I would try the suggestions in order and see if I noticed any changes. After two days, my system has had a major overhaul. So I figured I should tell ya’ll about it so you can too!

Now, in Ayurvedic school we learned a loose bunch of suggestions for mornings that seemed nearly impossible, and until I was in my own practice and doing the suggestions myself, I had no idea if any of them actually worked, so I think my recent (in the past year more or less) obsession with routine is because of direct experience more than any teaching I’ve received.

The following is a modification of Dr Vasant Lad’s daily routine prescription. I have combined a few steps so it seems less overwhelming, and changed the order of a few d/t my own experience, as well as added my own suggestions. Please let me know if any of you try all these steps and how you feel! I used to meditate immediately on awakening, check my email on my phone directly after, do the other steps whenever I felt like it, sometimes in the afternoon, and sometimes picked up a Backyard Bowl hot quinoa bowl on my way to work late in the morning. Since spending last week with my grandfather, I decided to get on a schedule while there to make caring for him easier, and it seems to have stuck, so upon returning I started this daily routine and am not going back- I have more energy and feel much less pressed for time during the day, which helps me get even more accomplished while feeling super relaxed. Enjoy!

1. Go to bed early! Before 10pm.  Wake between 5 and 6am (at first you may need more sleep to catch up, that’s ok). Look at your hands, move them over your face and down to your waist to clear your aura. Move to get out of bed, touch both hands to the ground, then to your forehead, then fold at your heart. Give thanks to the earth and the divine for the opportunity to practice your true purpose today: to be a light of love, joy, peace, and compassion.

2. Wash your face (try just a splash of rosewater), rinse your mouth and eyes (pure additive-free eye drops work well).

3. Drink a cup of warm or room temp water. Sit in a squat pose and do 5 min of alternate nostril breathing pranayama [if your nose is clogged in the morning, do the nose oil first :) ). Then evacuate the bowels and bladder. Cleanse yourself with a bit of rosewater followed by a few drops of sesame oil on your paper.

4. Gently sniff 1 drop of plain or herbalized sesame oil into each nostril (Nasya), place 1-2 drops of sesame oil into each ear (Karana Purana).

5. Scrape your tongue, brush teeth, and use a ‘gum annoyer’ if you have one. Hold and swish 1 Tbsp of sesame oil in your mouth (Gandusha or Oil Pulling) until out of the shower, then spit into toilet (in order to not clog sink or shower).

6. Do your daily warm oil massage (Abhyanga) with the oil prescribed for you- if you don’t know, try sesame or sunflower, then take a warm shower.

7. After the shower, use simple gentle scents without chemicals, and dress in clothes that lift your spirit and feel comforting.

8. Exercise gently- yoga, a 15-30 minute walk, or stretching exercises- this warms the body and starts the metabolism.

9. Meditate. If you are new to this, start with 5 minutes of the Healing Breath pranayama I may have given you already at your appointment. If you’ve been taught to meditate, aim for 20 minutes, but start with 10 if that seems too much. Remember, you can likely sit easily for 2 hours watching a movie, so sitting lovingly with your highest self for 20 isn’t nearly as hard as it sounds!  :)

10. Eat a nourishing breakfast, seated, near a window, without computer or phone. Breathe in the scent of spices, chew well and enjoy helping your body digest, enjoy with gratitude.

Still a lot of steps, but getting up early, giving yourself this time to care for and show utmost respect for your body is a game-changer. See what appeals to you, try a few steps, or commit and jump into the whole routine- let me know how it goes!

And for fun, here’s another picture of my fantastic grandfather- please wish him a happy 91st!


Links day!

Just a quick post to say hello to some friend’s sites I’ve been overdue to link to:

1. Didi Pershouse has a Center for Sustainable Medicine too! How great is that! She came up with the name back in 2006, and I came up with mine in a brainstorm sesh a few years later- love it how great ideas are birthed simultaneously by many of us!! She’s on the other coast up in Vermont, so we’re doing a little back-and-forth on how to collaborate and get our extremely-similar messages out! Check out her site linked up there, and by all means if you’re on the East Coast, go see her!  :)

2. My friends at Rebelle Society have published two little bits of my writing, see what you think, and leave comments please!

a. My poem Guru            b. my modified meditation manifesto (not the same as the one here… I might just keep writing them :)

3. A great talk by Choyam Trungpa on how to talk to kids about meditation

4. My friend Dawn from MedMob who lives in Canterbury England and has a business called “Fresh Connective Coaching” linked to ME and said such sweet things!!!! so here’s her blog (with her post about me first, but please check out her other fabulous articles too!)

5. My friend Robert who is a great supporter of MedMob and is a fabulous artist and yoga teacher as well as a physicist (! right?), has a line of t-shirts he’s working on called Rocket Buddha. Please take his survey and let him know which ones you’d like best!

6. Then there’s this guy, Ben Riggs, whose articles keep popping up and are a really good perspective (and less wordy than mine!) on meditation and evolution… Reading other people’s ideas is a great way to open up your mind and learn new things about your own… Enjoy his posts!

That’s probably good for now… In other news, the new office is picking up speed which is great, MedMob Santa Barbara has returned to Thursday nights in Alice Keck park, I’m offering free Biodynamic CranioSacral treatments to friends/family while I’m refining what I learned at my conference in Oregon last month, and in April I’ll be in SF for the weekend of the 13th and in STL from the 27th-May 6 for my Grandfather’s birthday and my cousin Danny’s pharmacy school graduation. Busy fun times. Hope everyone is well- please drop me a line and tell me how you’re doing!

Much love,



Sustainable Health Nutshell: (I tell all my patients the following- thought it was a good time to reiterate!)
My job as a doctor is to help you contact the part of yourself that knows what is best for you and will allow you to most efficiently bring yourself back to balance and truly heal. I cannot fix anything and could never (and would never) do your work for you. If it were even possible, that would be cheating, and disrespectful to your own process. I can, however, help you contact that part of you that naturally pulls you towards health, I can educate about physical, mental, and energetic things that may help you become more aware of how your body works, I can translate your body’s messages, and I can encourage tissues to live in a place of more ease and efficiency with OMT… and I can hold space and encourage you to do the right things for yourself. But only you can truly heal yourself, or rather, remember that you are whole and allow parts of you that have forgotten that fact to reintegrate.

This may be a bit esoteric, but after spending 4 days immersed in what I can only describe as ‘medical meditation,’ I thought it was a good idea to put it out there since the concepts are central to what I’ve been doing all along anyway. (yay, synchronicity! love when that happens) The class I took was phase 2 of Osteopathic Biodynamics. The system teaches how to contact and engage the patient’s indwelling therapeutic force and promote healing. After learning and using Osteopathic manipulative skills for years, it’s fascinating that I’ve seen more healing happen with this version of A.T. Still‘s teachings than the standard methods developed and taught since his passing.

When I teach meditation (see my little manifesto here), I teach a technique to help students connect more easily to the part of themselves that is peaceful- really, that is pure consciousness, or love, or their soul that is a part of God, or whatever you like to think of it as (semantics and religion don’t really matter- the technique works whether or not you believe in anything or even the technique!). The funny thing is, what I learned this week was how to apply that exact principle to treating patients. The same core part of each of us that is peaceful, calm, and full of love, that is unfettered by the messiness we call ‘daily life,’ is what my teacher, Dr Jim Jealous, calls “the Health.” And the same thing I’ve been calling the ‘unified field’ or ‘pure consciousness’ is what he terms “the Tide.” Now, if I hadn’t been meditating and teaching it and attempting to get my patients to do the same, this whole class might have sounded not a little insane to me. But as it stands, I’m definitely interested in learning more, and can’t wait to use the skills I’m learning to help my patients and improve my Osteopathic technique.

So, it seems there is a practical medical application for meditation, and I am so glad I was led to it. Learning how to contact that indwelling therapeutic healing force that we all have to bring all the layers of ourselves back into the wholeness that we’ve forgotten we are. Who wants a treatment? :)


Ashland, Oregon