Portraits by Caitlin Abrams
Main image by Paul Nelson; Styling by Stacy Forti
Integrative medicine is hard to define, but just as American English is distinct from British English, integrative medicine is different from medicine a generation ago. The federally funded National Center for Complementary and Integrative Health defines it as “bringing conventional and complementary approaches together in a coordinated way.”
“The old [medical] model was ‘find it and fix it,’” explains Dr. Scott Schwantes, associate medical director at Gillette Children’s Specialty Healthcare and head of the hospital’s neuropalliative and integrative care unit. “The new model is ‘mind and body.’”
Peek into Minnesota’s leading hospitals, health care systems, doctor’s offices, and psychiatry practices today and you’ll see hundreds of examples of integrative medicine. At the Mayo Clinic Healthy Living Program, throat cancer survivors learn new cooking methods and cardiac patients fill yoga classes led by yogis specializing in Reiki, an energy-based healing therapy. At PrairieCare Hospital and Clinics, the fastest-growing acute mental health care chain in the state, suicidal teens have access to a mental health coordinator who focuses on spiritual growth and exploration. At the three Twin Cities Mother Baby Centers, state-of-the-art Neonatal Intensive Care Units, lactation consultants, aromatherapy consultants, and groovy low-light spa-like rooms coexist so that new moms can sleep and heal before and after childbirth. At The Waters, a senior care center that now has six Twin Cities locations, residents participate in spiritual, emotional, and physical programs in collaboration with the University of Minnesota’s nationally leading integrative think tank, the Center for Spirituality & Healing.
How did a state best known for icy winters and politely wary emotional engagement become the leader in something so darn soft? The reasons are varied. “Minneapolis is a green, outdoorsy, progressive community. No one here seems to be held down by traditions, and they aren’t afraid to try something new,” says Dr. Stefan J. Friedrichsdorf, medical director of the Department of Pain Medicine, Palliative Care, and Integrative Medicine at Children’s Hospitals and Clinics of Minnesota. “It is just something that seems to be in the DNA of the city. What takes the rest of the world 17 years to adapt to comes here very fast.” Friedrichsdorf should know. He was born in Germany, where he was a pediatric resident before moving to Sydney, Australia, for his fellowship at a children’s hospital. He was then recruited to Minneapolis, and today he runs North America’s largest pain and palliative care training seminars for health professionals—so that Minnesota’s integrative care advances can be used in the wider world. “There are some people for whom [integrative medicine] intuitively makes sense,” Friedrichsdorf says. “That Western medicine is good, it’s great, but it’s not the end. If people combine the best of Western medicine with the best evidence-based results from other traditions, the results will be better.”
Friedrichsdorf makes a convincing case for integrative medicine in the various studies he’s led and published in journals such as the Journal of Palliative Medicine (palliative medicine being a specialized care approach for people with serious illnesses). One study showed that children with fatal cancer who received palliative care, such as massage and whole-family counseling, lived with a better quality of life, had more meaningful happy experiences, and suffered less fatigue, diarrhea, seizures, and pain—and saved their insurers an average of $275,000 for home-based palliative care. That insurance savings—and the fact that insurers are now covering more complementary medical therapies—is certainly another reason integrative care is on the rise in Minnesota and around the country (according to a federal survey released in 2015, close to a third of U.S. health care consumers used complementary therapies with traditional medicine between 2002 and 2012).
“A thing they call ‘the triple aim’ is the holy grail of health care these days,” explains Penny George, the visionary philanthropist who funded a good part of the local integrative movement (read her story on page 29). George describes the triple aim as improving patient satisfaction, clinical outcomes, and cost savings, and she says integrative health medicine delivers on all three. Imagine, George continues, 100 elderly people in a hospital, and none of them can sleep. If 100 get a sleeping pill, some will have drugs in their systems that could cause them to fall in the bathroom and hit their heads, costing the hospital tens—if not hundreds—of thousands of dollars. But what if instead those people are lulled to sleep in a quiet room with acupressure, the smell of lavender, and a nurse using “narrative therapy”—talking to them and understanding their wants and needs and calming their minds? Everyone’s happier.
Dr. Deborah Rhodes, an internist at the Mayo Clinic, emphasizes that wellness goes beyond soothing white robes and pretty smells. “If you want to optimize cancer outcomes based on true data, we don’t see anywhere to go but with integrative medicine,” she says. “Weight, inactivity, stress, poor diet—that’s what brings on so much disease and so much recurrence. Learning to relax and eat well is the embodiment of all our best advice accrued from giving medical care. But every doctor knows telling someone to make exercise a priority and actually getting them to change are different things. . . . The missing piece is turning our best advice into action that patients want to take.” That’s why there are now life coaches, nutrition coaches, masseuses, acupuncturists, and yogis on staff at Mayo Clinic.
Integrative medicine may be hard to define at first, but, like a new language, you begin to recognize it when it’s pervasive. Listen for words like resilience, mindfulness, sleep, listening, purpose, community, and wellness. And don’t be surprised that people from Europe and the Middle East are jetting to Minnesota to learn mindfulness and how to eat well. “There’s just been a belief in Minnesota that we can always do things better,” says Dr. Henry Emmons, a psychiatrist known for his work in resilience.
The following stories are those people in Minnesota’s integrative medicine community who illustrate Emmons’s theory. By bringing unconventional remedies into the mainstream, they’re helping to revolutionize health care in our state. It turns out the path to better medicine is a little softer than anyone anticipated.
Dr. Gregory Plotnikoff’s medical detective work looks at the whole patient.
Dr. Gregory Plotnikoff
In the erstwhile TV series House, Dr. Gregory House treated patients who are medical mysteries. The dramatic show typically kicked off with a series of acerbic and combative interviews, then whipped in some illegal breaking and entering of patient homes, and wrapped up with an elaborate connect-the-dots ending, during which we learn that the supermodel was bleeding from her eyes because the next-door neighbor was too often spraying poison on the roses, which somehow engorged a parasite she had picked up while modeling furs in an abandoned Siberian zoo. Well, in Minnesota, we have a real-life solver of medical mysteries, and his name is Gregory, too—but that’s where the similarities end.
Dr. Gregory Plotnikoff has the calm, patient, open demeanor of the more social sort of Buddhist monk. Patients come to him as a sort of last resort after visits to doctors, subspecialists, and hospitals have left them without answers. Plotnikoff—an internal medicine and pediatrics specialist who left Abbott Northwestern and will open his own clinic this spring—then starts his journey with the patient. He conducts lengthy in-person interviews with patients and reviews their thick stack of files, sometimes doing genetic workups or running new tests and spending hours in a medical library getting to the bottom of his hunches. If Gregory House’s medical process was a series of short, sharp shocks, Gregory Plotnikoff’s is a chain of slow interactions. But his results are just as remarkable.
There was the woman who had become so immobilized by muscle weakness with no identifiable cause that she’d run up tens of thousands of dollars in medical bills and had her children taken by state authorities because she could no longer care for them. Plotnikoff talked to her at length and developed a hunch that basic malnutrition might be at play. He discovered she lacked detectable vitamin D levels in her body. “So many doctors hate testing for vitamin D. Don’t ask me why,” he shrugs. “They think it’s for hippies, or they’ll say there are no double-blind studies. Who would fund a double-blind study? We already know vitamin D deficiency is a disease and that vitamin D is not patentable and practically free.” Five dollars worth of vitamins later, the woman eventually recovered and her family was reunited.
He introduced a child with a mystery illness in a pediatric intensive care unit to Thai singing bowls to promote healing. That interaction led to a discussion of the child’s strengths and his desire to ring the bowl to celebrate other successes. Over time, the child revealed he had been repeatedly sexually assaulted, which he had never felt comfortable revealing to a doctor before. His history of assault was the missing key to the correct diagnosis. “People are unique. Their stories are unique. And sometimes their illness or suffering comes from that uniqueness,” says Plotnikoff. “Most medicine is for the middle of the bell curve, and insurance isn’t designed to give anyone in the system time to understand what’s unique about a patient.”
Plotnikoff cites another patient who was repeatedly hospitalized for acute pancreatitis. Plotnikoff found through bloodwork that she had sky-high levels of a unique acid in her system. This led to an analysis of the microbiota in her gut, which had been taken over by nasty bacteria that was then killed with an antibiotic. “I thought, ‘If the best gastroenterologist couldn’t solve this looking at structure and anatomy, if CAT scans and ultrasound MRIs didn’t find it, maybe it’s gut ecology,’ ” Plotnikoff says. “That’s a good example of alternative medicine—it’s not an ‘alternative,’ it’s ‘and’ and ‘plus.’ ”
“Patients with severe illness and no diagnosis, those are my specialty,” Plotnikoff says. It turns out there are a lot of those patients, and sometimes the wait to see Plotnikoff can take a year.
To remedy this, he’s opening the aforementioned Minnesota Personalized Medicine near Loring Park. He’ll have staff and colleagues, including nutritionists and another internist to help him get to the bottom of medical mysteries, most of which he now feels certain can be unraveled through various methods of considering the patient on a personal level. How personal? One avenue of inquiry will be called the “personal narrative,” which builds trust and finds the details other doctors may have glossed over or were never told. Another way will be personal genomics—analyzing a patient’s DNA for clues about possible disease. Plotnikoff will also test individual biochemical functioning to identify, say, the idiosyncratic ways some patients process vitamins, minerals, or hormones. Finally, he’ll use personal microbiomics, an analysis of the trillions of cells that make up one person’s intestinal bacteria.
What can this hyper-personalized approach do that the best conventional tests can’t? Plenty, Plotnikoff says. In hospitals today, he explains, you’ll find people who have been admitted for pain, because they were suffering, and teams of professionals around them looking for a mechanical cause of the pain. When the pain has no mechanical explanation, says Plotnikoff, look for a psychological root. “You’ll see someone who has $90,000 worth of tests and is no closer to healing. What would $90,000 of massage, acupuncture, and resilience training have done for that person? When I studied palliative care, it changed my life. I thought: ‘These patients receiving palliative care are receiving the best care in the world. But why does someone have to be dying to get good care?’ Medicine is not just pharmaceuticals; it’s also nutrition. But only the smallest percentage of medical schools meet the bare minimum of nutrition classes.” The Journal of Biomedical Education reported in June 2015 that only 16 percent of American medical students amass 30 hours of nutrition training. “How many people are sick because [the medical students] don’t have the fundamentals?” continues Plotnikoff. After meeting many years’ worth of patients with life-wrecking and unhealable gut issues, Plotnikoff noticed that certain fundamentals such as diet, exercise, and mindfulness practices could heal the majority of those patients. That’s when he co-wrote what is considered the gold standard book in integrative medicine with Dr. Mark Weisberg, about digestive problems. Called Trust Your Gut, it focuses on less-than-dramatic medical answers than you might find on House, but there’s more actionable advice, like how to sleep better when you are in a panic about stomach distress.
“I’m kind of tired of the self-sufficient virtuoso model of healing,” Plotnikoff says with a sigh. “There’s nothing proprietary about what I do.” More than genomics, metabolomics, and microbiomics, he says, his new practice will focus on talking, listening, and thinking. It may not make for good television, but it makes for very good medicine.
Patient-centered medicine is a core tenet of all integrative medicine. Briefly, it’s the belief that a person’s medical issues—heart trouble, knee trouble, depression, etc.—are not the same mechanistic problem as a car’s carburetor trouble. People are different, both genetically and in their lived life. Thus, medical issues are seen as a part of the whole person: how they eat, how they live, what their genes are, and more. In other words, you can’t understand a disease without understanding the person.
MN Personalized Medicine
Opening in April, Dr. Gregory Plotnikoff’s personalized medicine practice will seek out the answers to medical mysteries for people with complex, chronic illnesses. 1409 Willow St., Mpls., mnpersonalizedmedicine.com
Mayo Clinic Center For Individualized Medicine
Genome sequencing and pharmacogenetics are just the beginning of understanding highly personal diseases at Mayo. 200 SW 1st St., Rochester, 507-266-2633, mayoresearch.mayo.edu/center-for-individualized-medicine
Women’s Center at Park Nicollet
Here, every patient is assigned a navigator to answer questions and help find the right clinicians. 6500 Excelsior Blvd., St. Louis Park, 952-993-3282, parknicollet.com/womenscenter
On Pins & Needles
Acupuncture takes center stage at Abbott Northwestern’s Penny George Institute for Health and Healing.
Cynthia Miller, Bob Decker, and Jennifer Blair, part of the acupuncture team at Abbott Northwestern
Bodies still conceal medical secrets, and one of them is why acupuncture is so effective at easing fibromyalgia symptoms. A 2006 Mayo Clinic study proved that was the case, and now acupuncture is standard treatment for pain and nausea from a variety of causes. The “why?” may remain a mystery for a while, but the “where” of acupuncture these days is found inside most major medical systems in Minnesota.
Acupuncture is the practice of using fine needles to manage the flow of qi, or energy, through the body. The acupuncture team at Abbott Northwestern, based at the Penny George Institute for Health and Healing, is unusual because it can be requested by physicians or patients inside the hospital for any reason, not just for more common cases such as nausea from chemotherapy. On any given day, a bedridden mom in the Mother Baby Center might be receiving acupuncture. Same goes for a man recovering from open-heart surgery in the cardiac unit. The most striking use to someone unfamiliar with the practice is in the hospital’s Joint Replacement Center, where post-surgery patients do physical therapy together in portable reclining chairs. Once the physical therapy is over, the lights are turned low and the acupuncture team goes to work.
“When we started, the doctors would basically say, ‘I don’t know what you guys do, but it’s working, so keep coming,’ ” says integrative provider Jennifer Blair, who has been with Penny George’s acupuncture team since its inception in 2005. Historically, Blair says, doctors have used traditional Chinese medicine to treat specific conditions—say, for shoulder pain. “What we’re really doing is creating access to a complete medical system, access to a tradition that has never separated body, mind, and spirit,” she says.
Cynthia Miller, another member of the Penny George acupuncture team, started her medical career as a nurse before being drawn to traditional Chinese medicine and how it might help people more than she was able to with the traditional methods. Her team also offers patients aromatherapy, energy work, music therapy, reflexology, acupressure, massage therapy, and mind-body and relaxation techniques. “A lot of people don’t appreciate that what we do is often to allow people to participate in their own health,” says Miller. “When you see mind, body, and spirit as connected, you’re not powerless waiting for something to happen. You can do things with self-care that make you feel better.” Miller gives patients acupressure cards that help relieve their nausea by pressing on acupressure points with their fingers. “I find that really empowering and encouraging for the patients,” she says.
Bob Decker, another founder of the acupuncture team, began his career as a pharmacist. “Even when I started in pharmacy, you could see there were a lot of side effects of meds. In a nursing home you’ll find people on 11 meds per person and [there are] so many side effects. I started thinking, ‘Gee, aren’t there other options we can explore?’ Today I worked with a couple of cancer patients who had their own side effects they were dealing with—a couple of knee-joint issues and somebody with anxiety and depression. Pain, anxiety, depression, nausea, and digestive issues, these are things acupuncture is very good at dealing with.” The outcomes the acupuncture team has brought to Abbott Northwestern and other Allina locations have convinced the hospital to offer the services in its standard care. Acupuncture might remain a mystery, but the reason health systems pay for it is crystal clear.
Healthy Living as Medicine
Everyone knows that food, exercise, stress, and health are intimately interconnected, but it’s never been more vivid than when 70 percent of adult Americans are obese or overweight, 29 million have diabetes, and the leading causes of heart disease and cancer are lifestyle related. If your best intentions don’t get you to eat right, exercise, and manage your stress, can cutting-edge medicine? These doctors are going to try.
Mayo Clinic Healthy Living Program
Offering customized weight-loss plans, athletic optimization consults, deep tissue massage—and pedicures. 565 SW 1st St., Rochester, 507-293-2933, healthyliving.mayoclinic.org
Carolyn Denton, MA, LN
A Functional Nutrition teacher at the U of M, Denton helps people figure out their food if they have conditions ranging from an autoimmune disease to insomnia. Partners in Resilience, 1409 Willow St., Mpls., 612-874-8608, partnersinresilience.com
Como Clinic Breastfeeding Center
Linked to reductions in obesity, asthma, infections, and even cancer in kids, breastfeeding is the earliest intervention for good eating. New moms and babies get the help they need at the Como Clinic. 2500 Como Ave., St. Paul, 952-967-7955, healthpartners.com
The Taj Mahal of Wellness
A tour of Mayo Clinic’s new 106,000-square-foot wellness center, replete with hot tubs and a cooking school.
The Mayo Clinic's Dan Abraham Healthy Living Center: a living wall.
Is there such a thing as the Taj Mahal of wellness? There is in Rochester—Mayo Clinic completed it in 2014. These 106,000 square feet of gleaming surfaces and next-level medicine is called the Dan Abraham Healthy Living Center, and it soars from the heart of Rochester toward the giant prairie skies. The facility showcases Caribbean-colored glass and interlocking open staircases and promotes “non-exercise activity thermogenesis”—a fancy way of saying you should take the stairs. In addition to staircases, this temple of wellness holds yoga studios fragrant with sandalwood and big enough for tennis matches. There are hot tubs made of white marble and trembling with sea-colored water. The center boasts a gleaming participatory kitchen with yard after yard of granite countertop. A professional chef shows how to make a barley risotto with fresh thyme and squash. Dieticians, exercise specialists, and physical therapists with terrific posture and exquisite teeth are ready to meet with you about goal setting, whether that’s bike riding on weekends or making dinner twice a week. To help you meet your goals, these health care professionals make regular coaching phone calls for added encouragement. Look carefully into all the corners of the Healthy Living Program and you’ll also find more traditional medical tools, like those tricked-out treadmills designed for cardiac stress tests. Patients, especially weight-loss patients, fly in from places like Saudi Arabia and Mexico to book themselves into various two-or-more-day “experiences” (starting at $1,900), where they do everything from strength tests to general exercise recommendations to learning to cook to getting full physical assessments. They can also get massages, take Pilates classes, and even get mani-pedis.
How did the Mayo Clinic, a place best known for high-wire treatments for complex heart and cancer cases, get into the mani-pedi business? Dr. Donald Hensrud, medical director of the Healthy Living Program, says he and his colleagues have known for decades that the majority of cardiac and cancer cases come from poor lifestyle choices. We’ve heard it before: Americans eat too much of the wrong things and don’t move enough. “But saying people should eat better and be more active—try to manage their weight—and getting it done are different things,” says Hensrud. “People are great at short-term changes. After the holidays, people try to change things suddenly and in a big way with their New Year’s resolutions, but after a few weeks they can’t do it anymore. We wanted to take a crack at changing that nut of long-term behavior.”
We’re all familiar with the story of the gang member who gets shot and carted into the emergency room to be put back together again, only to hit the streets and take another bullet. But there’s analogous behavior happening in less dramatic ways in every doctor’s office, says Hensrud: folks with new heart valves who won’t exercise and manage high blood pressure; women in recovery from breast cancer treatment who increase their risk of recurrence through excess weight; obese patients who undergo bariatric surgery, lose weight, and then gain it all back again.
“I’ve been interested my whole career in preventive medicine,” Hensrud says. “But somehow people don’t really appreciate how powerful preventative medicine really can be.” Hensrud cited a study that found if women maintained five simple behaviors—not smoking, a normal BMI, a good diet, not drinking too much, and staying physically active—they could prevent 83 percent of cardiovascular disease. The study then asked how many women followed those behaviors. The answer? Three percent.
The Mayo’s Healthy Living Program is the big intervention meant to move healthy living from something doctors talk about to something patients do—forever. “A real key here is individualization,” says Hensrud. “We ask people, ‘What are your goals, what is your life like, where is there space for change?’ They’re going to do what they want to do anyway—all people do. So what we do is try to come up with practical and enjoyable ideas. If it’s enjoyable, then it’s hopefully sustainable. Making health behavior changes is associated with a lot of negative emotions. I hear, ‘Oh no, groan, moan, I have to go on a diet.’ It’s negative, it’s restrictive, it’s unpleasant. But eating healthy and eating well are not mutually exclusive terms.”
To that end, the Mayo’s enormous and dazzling participation kitchen shows people how to cook—and cook healthy. The executive wellness chef and dieticians focus on practical strategies like parboiling barley one day to use in three meals during the week, while emphasizing the need for small, sustainable shifts in eating habits—cooking one night a week before trying to cook two nights a week. Elsewhere in the center, yoga and massage are offered for stress management because, according to the American Heart Association, stress doesn’t just make you snap at your sweetheart, it also causes high blood pressure, irregular heart rhythms, and arterial damage.
To understand why the Mayo is going so big in healthy living, says Hensrud, think about how life has flip-flopped in the past 100 years. Americans weren’t always this obese. Death used to be something surprising and sudden. “The medical system evolved in a disease treatment model. Mayo evolved as a tertiary care center, where people came if they have complicated needs or conditions.” But today, Hensrud says that with a large percentage of obese adults, many conditions aren’t that medically complicated—they’re emotionally complicated.
Would a heart rate–lowering massage and a good soak in a hot tub help you start taking care of yourself? The Mayo is betting a good chunk of its treasure and future that it would.
The University of Minnesota’s Center for Spirituality & Healing is a hotbed for teaching integrative medicine.
Mary Jo Kreitzer, founder of the University of Minnesota’s Center for Spirituality & Healing
A little girl at the Masonic Children’s Hospital in Minneapolis wakes up from a bone marrow transplant in severe pain. Standing with her parents, a masseuse eases her into sleep using Japanese Reiki massage. In Edina, at The Waters senior living center, residents meet in the afternoon to discuss their life’s legacy. At Salo, a financial staffing agency with offices in Chicago and Minneapolis, the top brass blog about eating healthy and living in the moment (Salo was the first “Blue Zones Certified Workplace” dedicated to helping employees make wellness changes at work and at home). What do these moments of wellness have in common? The University of Minnesota’s Center for Spirituality & Healing and its founder and director, Mary Jo Kreitzer.
It’s hard to express the many tendrils that spread out from the Center for Spirituality & Healing. It’s an academic research institution and a training center for people working in every facet of medicine, from doctors, nurses, and administrators to hospital architects. The center also acts as a consultant, working with Fortune 500 companies and community centers that want to transform cultures. The academic arm has about 80 faculty members, with some 1,000 students enrolled each semester, and it offers 45 courses each term. Though it has a soft-sounding name, it’s in hot demand in the marketplace, receiving a sliver of its funding from the U of M and generating the rest itself, mainly through grants and consulting fees.
The center got its start with Kreitzer, a nurse who likes systems and likes to listen. The daughter of a nurse, Kreitzer graduated from nursing school not aware of the broad range of alternative therapies. It wasn't until she became a pediatric nurse practitioner that she started learning about various complementary therapies from what other universities were doing. “It was very humbling, finding out there was a whole world of healing I had never heard anything about in my training,” she recalls. “Patients would talk about their values of health care and healing, diet, food, lifestyle changes. The more I listened, the more I discovered that there was a whole lot more out there.” When she later became director of the U of M’s nursing practice and research team, she set a goal for all nurses: Start listening to patients. She wrote down what she heard and took it to Dr. Frank Cerra, an executive in charge of the college’s health sciences school at the time, who had a mind for teaching academic courses on the added benefits of healing. “He said, ‘This is much bigger than a couple of courses. This is going to be transforming health care,’ ” says Kreitzer. The pair commissioned a task force for the Center for Spirituality & Healing. “I guess I’m just a different breed,” Kreitzer laughs. “I’m also a big-system thinker and have always been interested in health care policy in general. The trajectory of my thought process was: ‘My gosh, people are wanting this and needing this, there’s evidence it works, how do we build it into systems?’ I just have a passion for creating system change and organizational change.”
From the beginning, she knew she would need to provide evidence-based research and results, so she became a principal investigator on dozens of trials and studies on the impact of integrative therapies, looking into everything from the effects of meditation on organ-transplant patients to the impact of health coaching on anorexia sufferers. Published results in hand, Kreitzer started meeting with anyone who would ask—physicians looking to decrease their patients’ suffering, hospital administrators wanting to reduce staff burnout, heads of nursing wanting new ideas for previously intractable patient health problems. Kreitzer became known as the person who had what everyone wanted: answers and a way to implement them.
“Seventy or 80 percent of how healthy people are has nothing to do with doctors and medicines,” she says. The little girl in pain from a bone marrow transfer is in better shape after massage than she would be with only pharmacological pain relief; seniors are happier and live longer when they contemplate the positive legacy they’ve created; and financial accountants are more productive when they have support from the top to make time for the gym. Even with these strides, Kreitzer says her work is far from done. The next big tasks involve helping health care providers suffering from burnout, depression, anxiety, and stress. Suicide among doctors needs real attention, she says. Annually, 400 doctors kill themselves, and female doctors are three times more likely to attempt suicide than their male colleagues. “Once suicide and burnout are addressed, we must move the model from [baseline] wellness to flourishing,” Kreitzer says. Sounds like a lot of meetings, but Kreitzer is ready for them.
Hippocrates, the ancient Greek father of medicine, knew and recommended massage. Today, we know touch makes our muscles feel better and measurably decreases stress hormones in the blood, including cortisol. It also boosts our immune system, including the production of white blood cells. In the past 20 years there have been thousands of medical studies showing that massage definitively reduces back pain in cardiac patients and the pain of fibromyalgia and osteoarthritis. It even helps premature babies gain weight. Would Hippocrates be surprised at how many state-of-the-art medical facilities are offering massage these days? Actually, in a world of MRIs and fetal surgery, he’d probably find massage the most understandable thing modern doctors advise.
Penny George Institute for Health and Healing
The largest health system–based integrative care practice in the country, Penny George provides services at six Allina hospitals. The staff includes massage therapists, acupuncturists, acupressure providers, Korean hand therapy practitioners, and more. 2833 Chicago Ave. S., Mpls., 612-863-3333, allinahealth.org
Pillsbury House Integrated Health Clinic
In the Powderhorn neighborhood of Minneapolis, patients receive free acupuncture, chiropracty, and massage from students at Northwestern Health Sciences University. 3501 Chicago Ave. S., 3rd Fl., Mpls., 612-787-3636, nwhealth.edu/pillsbury-house
Integrative Health Clinic, Hennepin County Medical Center
The Holistic Physical Therapy unit at HCMC’s Integrative Health Clinic offers hands-on healing for various injuries. 730 S. 8th St., Mpls., 612-873-4377, hcmc.org
Looking to bounce back after a health scare or other life tragedy? Dr. Henry Emmons is here to help.
Minneapolis psychiatrist Henry Emmons, author of two bestselling books about resilience
It's not every Iowa med school student who heads out on weekends to be with Trappist monks. “Do you know the Parker Palmer idea of ‘you wear other people’s faces when you don’t know your own’? That was me at the time,” recalls Dr. Henry Emmons, today a Minneapolis psychiatrist who has developed a program to teach resilience to groups through health care systems. “The way I dealt with [being lost in the world] was to go on retreats. I was not Catholic, but I was attracted to it. It was extremely nourishing as a lost young man. If I had a week off, I would go to a monastery and enter into the silence. It was really, really helpful.”
Emmons was unhappy at med school, and in addition to visiting the monastery, he read philosophers such as Thomas Merton. Later, he trained with Jon Kabat-Zinn, the medical school professor and creator of “Mindfulness-based stress reduction,” a program of mindfulness training used nationwide in hospitals to help very sick patients. Still, even with his spiritual leaning and training with Kabat-Zinn, Emmons says he saw himself as nothing more adventurous or pioneering than a working doctor, so he returned to Minneapolis to practice. It was here, working with his local clients, that Emmons developed the three pillars of resilience captured in his bestselling books The Chemistry of Joy and The Chemistry of Calm. “I found that my typical patient had tried all different sorts of things already, drugs mainly, and for a good number of people the problem was really how they were responding to their own thoughts and emotional reactivity,” Emmons says. What was worse was what they did with that emotional reactivity—like spend all night not sleeping while eating pizza and drinking. Teaching his clients how to quiet their minds and giving them insight into what foods and movements would make them feel better led them to be able to sleep, which made them less reactive. Word spread in health care circles that Emmons had achieved what therapy often hadn’t. For one thing, resilience training wasn’t open-ended, but rather a course of limited duration teaching specific skills. For another, it didn’t require that therapy-averse patients say anything at all about their inner landscape or why they wanted to be resilient. Even though resilience training happens in a group, Emmons insists that it isn’t group therapy. “Group therapy is more a processing of things, and it’s ongoing. We are not focused on getting to your story. We are interested in learning skills that can help you deal with any number of events in your life.” These life events can range from house fires to cancer diagnosis. And unlike many psychiatric medicines, resilience training doesn’t produce side effects such as suicidal thoughts. Today, Emmons’s psychiatric practice, near Loring Park, is called Partners in Resilience, and it’s where both health professionals and laypeople take his 10-week course to teach resilience. The health system Allina offers an eight-week resilience program based on Emmons’s work, and resilience training programs are popping up all over the country, taught by people who have taken Emmons’s class and who use The Chemistry of Joy workbook as course material. Resilience training is poised to be the part of the integrative health movement most likely to leave the medical universe entirely and live as something you’re likely to find in a high school curriculum alongside classes in financial literacy, home economics, and driver’s ed. It only makes sense: Bad things happen to good people—and they even happen to kids who head off to med school and find it wasn’t what they imagined at all.
Wellness, Well-being, and Resilience
Well-being and wellness are what happen when different areas of your life are in balance—your health, your relationships, and your purpose all humming along and feeding each other in a nice way that makes you feel balanced. Resilience is returning to well-being when bad things happen. If you don’t have wellness or resilience you’re more likely to get sick. A key to integrative health is the idea that well-being and resilience can be taught—and they’re being taught right here.
Partners in Resilience
Dr. Henry Emmons’s psychiatric center for resilience training. 1409 Willow St., Ste. 400, Mpls., 612-874-8608, partnersinresilience.com
Pathways Health Crisis Resource Center
Founded in 1988 and devoted to providing resources to people in the throes of life-threatening or chronic illness, Pathways offers free treatment to some 8,000 people a year. 3115 Hennepin Ave., Mpls., 612-822-9061, pathwaysminneapolis.org
Comprehensive integrative offerings are found at fast-growing local chain PrairieCare, which has an in-patient hospital and six clinics in and around the Twin Cities. 763-383-5800, prairie-care.com
No Needless Pain
Dr. Stefan Friedrichsdorf is on a mission to improve pain management for kids.
Dr. Stefan Friedrichsdorf, medical director of the Department of Pain Medicine, Palliative Care, and Integrative Medicine at Children’s Hospitals
In the 1980s, they used to do open-heart surgery on infants without anesthesia,” explains Dr. Stefan Friedrichsdorf, with the rapid and unhappy air of someone who has repeated something horrible a number of times and still finds it appalling. Friedrichsdorf is the medical director of the Department of Pain Medicine, Palliative Care, and Integrative Medicine at Children’s Hospitals in Minneapolis—one of North America’s largest such centers. “They would do a little something to paralyze the muscles, then strap them down and start cutting. There was a crazy belief that babies did not feel pain. I can tell you that cancer pain is the same for a 3-year-old as it is for a 30-year-old.” Friedrichsdorf has devoted his life to moving the needle—quite literally—on children’s pain. He decided to become a doctor after he saw a child die alone in a cancer ward in his native Germany. He went on to discover a variety of techniques to help children cope with their pain. One such method has pediatric patients blowing bubbles, which calms their breathing and distracts them from pain when, say, a needle stick is coming. Friedrichsdorf says we take common needle pokes of childhood far too lightly. He says the proper procedure for all shots and blood draws should be to apply Lidocaine or something to numb the skin, then engage the child in an age-appropriate distraction technique (blowing a pinwheel or, for babies, a dose of sugar water). Allow the child to have some control, he adds. “Do you want to sit in mommy’s lap or do you want to sit alone?” explains Friedrichsdorf, who has worked with thousands of children throughout his career and has three of his own, ages 7, 8, and 10. “One out of four Americans is needle-phobic,” he adds. “Seven percent of Americans don’t vaccinate because they don’t want to deal with their child’s pain. I’ve seen five children die of measles. Will that make us take pain seriously?” In the next few years we will see changes to Minnesota’s needle-stick protocols based on Friedrichsdorf's methods. He predicts the changes will spread to the rest of the country. “There should be no needless pain, no unaddressed pain. This isn’t voodoo,” he adds. “If there is less pain from vaccination, there will be less dying from measles.” Although pain from a needle prick might not seem comparable to an infant not getting anesthesia for surgery, the philosophy is the same: Kids’ pain, no matter the source, is serious and should be treated as such.
Stress and Pain Management
Stress isn’t just a fleeting annoyance—it’s why people get metabolic diseases of the heart, then can’t sleep after heart surgery. Pain isn’t an uninteresting byproduct of the true medical condition—it creates its own metabolic cascade of effects that make people sick. Integrative health puts a premium on managing both issues.
Pain Program, Children’s Hospital
One of the leading pediatric pain programs in North America. 2525 Chicago Ave. S., Mpls., 612-813-6000, childrensmn.org/services/pain-program
Neuropalliative Care, Gillette Children’s Specialty Healthcare
Part of the focus at Gillette Children’s is on massage and healing touch, which can help kids with complex lifelong medical issues improve their day-to-day lives. 200 University Ave. E., St. Paul, 651-291-2848, gillettechildrens.org