I'm sharing an operating room in Manhattan's prestigious Columbia University Medical Center with two other invited interlopers, Jeffrey Zimmerman, a doctor of Oriental medicine specializing in Qigong energy work, and Rochelle Aruti, a massage therapist with self-described intuitive gifts. We each have our reasons for being here.
Zimmerman wants to show that a Qigong master such as himself can unblock and harmonize the energetic life force that runs through us -- what the Chinese call chi -- to speed healing in an unwell patient. "We need to demonstrate that the effect of Qigong can be measured, that it can influence actual biological processes," he says. "Otherwise it all sounds like hocus-pocus."
Aruti is taking the empathic abilities she's honed as a massage therapist and offering them up to patients undergoing surgery. "I can support them through the surgery even if they're under anesthesia," she says. Once, Aruti says, she watched her own four-year-old son being operated on "and saw him peering down from the ceiling -- and knew he was okay."
As for me, I'm a journalist interested in the collusion of (and occasional collision between) high-tech surgery and alternative medicine, including what most people would regard as its outer reaches, the "energy medicine" world of Zimmerman and Aruti. In other words, we're all waiting for Oz.
That would not be the wonderful, if ultimately hapless, Wizard from the movie (though, God knows, talking to Zimmerman and Aruti, I know I'm not in Kansas anymore), but Mehmet Oz, 43, a nationally prominent cardiac surgeon at Columbia University Medical Center. In the realm of mainstream high-tech medicine, Oz is an indefatigable superstar, "healing with steel," as the surgeons like to say, on the order of 400 surgeries a year, mostly coronary bypasses and valve repairs and replacements. For the past decade, he's been the driving force behind Columbia's influential mechanical heart program, refining and implanting the Ventricular Assist Devices (VADs) that piggyback onto patients' own hearts, buying them time until a donor organ becomes available.
But Oz's boldest career move has been to leverage his considerable mainstream reputation in the service of alternative medicine. As he explains in his book Healing from the Heart, he got the idea for another program at Columbia -- the Integrative Medicine Program -- ten years ago after he witnessed the rejuvenating effects of a massage that Aruti gave his wife just after childbirth. Today, the program oversees therapeutic massages for some 90 percent of the hospital's cardiac surgery patients and conducts research on a wider and more exotic range of complementary medical therapies. That would include a study just getting under way starring Jeffrey Zimmerman, who will be moving his trained hands over the bodies of volunteer cardiac patients to see if he can lower their levels of BNP, a hormone produced by the heart and brain, high levels of which are associated with poor cardiac health. The idea is that by pushing the edge of alternative medicine, Oz might someday be able to offer his patients better recoveries from surgery, and better overall prognoses.
On this early morning in November, as the gray uptown Manhattan streets begin to lighten outside, Zimmerman, Aruti, and I are more than ready to greet the bridge-building surgeon. And whether he knows it or not, so is the unconscious patient, a 78-year-old retired PR man by the name of Bob Goldwater, who at this moment looks like a piece of ravaged Halloween candy.
Goldwater's torso is wrapped up in what looks like orange cellophane, his chest is sawed open and retracted to expose his troubled beating heart, and a vein from his leg and a mammary artery from his chest have been harvested to replace his God-given coronary arteries, all of which are 80 percent blocked with cholesterol-laden plaque. As Oz delicately stitches the replacement vessels onto the heart (they look like strands of spaghetti), Zimmerman and Aruti make their own less tangible contributions. "I can feel some stagnation in Bob's energy, so I'm working to support the kidneys," Zimmerman says, weakness in the kidney's energy, or chi, being central to the traditional Chinese conception of heart disease. Aruti is simply concentrating on being a friend to this man she's never met to help him better weather the operation.
Goldwater has also been outfitted with a set of headphones and a guided imagery cassette tape that Oz believes can help patients withstand the stresses of surgery. (Oz recently coauthored a study demonstrating that patients have some subliminal awareness of their surroundings even under heavy anesthesia.) Still, we all hold our breath when Goldwater comes off the heart-lung machine that's pumping blood through his body. His own heart just sits there in the chest cavity, beating irregularly, until Oz touches it with the defibrillator paddles and it lurches back to life. "It's like a wild python beating in there," Oz says with satisfaction. From his machine-gun conversational style to his habit of powering down the hospital halls at an Olympic race-walker's pace, Mehmet Oz is a can-do surgeon down to his toes. "Heart surgery was created for me," he crows. "It's immediate gratification, high pressure, high risk but high reward." How he of all people should have found his way into the often intuitive, ambiguous world of alternative therapies is a matter of genealogy and serendipity.
His father, a Turkish immigrant turned Delaware surgeon, made sure that Mehmet spent every summer of his childhood in the old country. In his book, Oz recalls how shocked he was to discover that his relatives in the Turkish countryside didn't have toilet paper, so they used the time-honored left-hand-then-wash technique. After a debate about proper hygiene, young Oz had to concede that his family, living in an area that lacked modern sewage facilities, had a point.
From such homely lessons came an education in cultural relativism that would later leave him impatient with the orthodoxies on both sides of the medical divide: the hippieish conception of high-tech medicine as toxic overkill, and the lofty scientific dismissal of Eastern therapies like yoga and acupuncture as a refuge for wishful thinkers. "If I had to pick one thing," Oz says, "I hope I'm remembered for being a translator between those two worlds."
To that end, he sees his role not as that of a cheerleader -- the alternative field has plenty of those, he says -- but as a quality control expert, someone with the analytical rigor to "cull the wheat from the chaff," and the professional clout to push for promising therapies, like massage and yoga, in the face of an indifferent or even hostile medical establishment.
"Heart surgery has this macho quality, and alternative medicine has a touchy-feely reputation," says cardiologist Dean Ornish, an Oz admirer and alternative medicine guru in his own right. "Mehmet shows that it doesn't have to be one way or the other."
Unlike the cardiologists who spend most of their time trying to prevent cardiac disasters, Oz enters the picture primarily after the horse is out of the barn. His natural laboratory for measuring the efficacy of various alternative therapies is his operating room. "If it works for a heart patient looking at the abyss," he says, "then that wisdom can be shared with others."
The largest study under way at Oz's Integrative Medicine Program takes as its starting point the fact that as a group, women tend to have poorer recoveries after heart surgery than men, perhaps because they have more frequent and more severe postoperative depression. Oz seems to take the problem personally, not only as a heart specialist but as an ex-college jock (Harvard varsity football and water polo) who can't abide losing.
"We know from the data that one-fifth of heart surgery patients have depression, which increases their chances of dying," he explains. "I don't want to give up that kind of advantage to the opposition. So I'm going to do everything I can to make sure that doesn't happen to my patient, and that includes guided imagery, massage, yoga, and meditation."
While no one has done rigorous studies showing that yoga and massage can reduce the incidence of heart disease (or depression), there's a mountain of epidemiological data linking stress and negative emotions to an increased risk of heart attack. So over the course of the next year, 150 women recovering from heart surgery will receive various tools designed to help them reduce the stressors that can hinder recovery: yoga videos and mats, alternative-health booklets, guided imagery tapes, and every noncoercive blandishment the staff can think of to induce them to give these therapies a try. The women will then be monitored and compared with a control group receiving standard medical care minus the alternative medicine.
The whole project also gets the doctor's MBA juices flowing. (Oz earned his business degree along with his M.D.) "This program is cheap, and we can mass-produce it and give it to other hospitals," he says.
As Oz enthusiastically sketches out his vision of the future, the neat little boxes that are habitually drawn around high-tech and alternative medicine disappear. In ten years, he says, shopping malls will have kiosks where you'll pop in for a coronary readout. "The machinery inside will check C-reactive protein, homocysteine, and cholesterol, as well as test for disease markers we don't even know about yet," he says. "You'll walk out of there with a precise calculation of your risk of having a heart attack, and you'll also be given a list of mind-body therapies that are of particular value to people like you: yoga, meditation, biofeedback. We'll catch the people who are walking time bombs before they go off."
All well and good. But Oz also has a vision of the future of surgery, one I got a glimpse of during the operation I witnessed on Goldwater. It's much less concrete than one-stop shopping-mall diagnostics, but it's Oz's nature to go out on a limb. In fact, that's probably why he was attracted to energy medicine in the first place: It's about as far out there as you can get.
Traditional Eastern medical and spiritual systems assume the human body is animated by an energetic life force, be it the chi that masters of Chinese Qigong like Jeffrey Zimmerman believe they are tapping into, or the prana that collects in seven chakras running up and down the body that healers in the Indian yogic traditions say they can manipulate.
Western science isn't oblivious to this notion of a human energy field. Our hearts pump in a rhythmic pattern of electrochemical impulses, for example, and even heart disease has an electrical component, Oz says: "As plaque becomes unstable, it grows more charged, attracting other particles. That increases the likelihood that it will break off and cause a clot to form, which triggers the heart attack. It's like magnets interacting."
Still, the idea that a healer could somehow direct his or her own energy field to interact with another person's seems, to the Western mind-set, like fantasy. But if the idea pans out, Oz thinks energy healers could have a significant effect on heart patients or, for that matter, on people undergoing any type of surgery.
"Patients often retain fluid after surgery," he says. "But I've had people tell me that after an energy treatment, they were peeing all night long." Theoretically, a therapy with that kind of power could affect other metabolic processes as well: It might reduce the amount of anesthesia a patient would need, for example, and perhaps even lower levels of stress hormones and create more relaxed respiration -- all of which could possibly help people recover more quickly and easily.
Despite raised eyebrows from some of his colleagues ("I like Mehmet, but sometimes his enthusiasm outpaces the data," says Richard Sloan, the head of behavioral medicine at Columbia University Medical Center), Oz presses on. To date, his studies of energy healers working over petri dishes of bacteria and cancer cells have gotten what might be described as provocatively ambiguous results. (In the cancer cell study, one of his five practitioners scored as well as a standard dose of chemotherapy in thwarting cell mutations; the others, however, had no such effect.)
But the winner in the bunch is a study he coauthored in the Journal of Alternative and Complementary Medicine two years ago, in which he demonstrated that four out of five energy healers could alter the shape and color of an energy "corona" captured by placing a fingertip on photosensitive paper, a process known as Kirlian photography. The control subjects, on the other hand, couldn't affect the image produced by their fingertips at all.
History will judge whether Oz has come up with a photographic novelty act or the beginnings of a theoretical explanation for energy healing that makes sense to Western science. I confess I'm rooting for the latter.
I recall my morning in surgery with Bob Goldwater. After Oz had done the bypass and the surgical resident was stitching up, Zimmerman, Aruti, and I traipsed after Oz into the adjoining OR. One of his protégés was performing a transplant, removing the patient's old heart and sewing in the donated new one. Oz had us don surgical gloves so we could feel the original heart, an organ that is, as he says in his book, "the closest physical thing to the ethereal soul." But even he looked surprised when the disconnected heart began to warm and twitch in Zimmerman's cupped hands. "It's the Qigong!" Zimmerman exclaimed.
"It's not supposed to do that," Oz said calmly. But he was, he later admitted, "intrigued." Another piece of the energetic mystery to chip away.
Staying Out of the Operating Room
Most of Oz's work is with people whose hearts have already landed them in the hospital. But to keep them from coming back, and for anyone looking to avoid heart disease, he recommends this basic prevention program.
Eat Right
Oz's prescription for a healthy heart and long life relies heavily on diet. For his patients, he recommends Dean Ornish's rigorous low-fat, high-carb diet, the only diet, he says, that has been demonstrated to halt or even reverse heart disease. But for himself and his family, and anyone not suffering from heart disease, the doctor advocates the so-called Mediterranean diet with its emphasis on fish, healthy monounsaturated fats like olive oil, and fresh fruits and vegetables. These foods contain heart-protecting phytochemicals and antioxidants, and most important, he says, "they're not fried or processed with trans fat."
Take a Few Pills
As for supplements, Oz says he always asks his patients how many pills they're willing to take, then customizes his recommendations accordingly. But everyone gets the advice to take a multivitamin with vitamin B complex. The Bs -- notably B-6, B-12, and folic acid -- offer valuable heart protection because of their role in controlling the production of homocysteine, a substance that corrodes arteries.
He also advises most people to take omega-3 fatty acids. They reduce inflammation and significantly reduce the incidence of fatal arrhythmia after the onset of a heart attack. Oz recommends 2 grams a day, either from oily fish like salmon or from flaxseed oil, or in supplements.
"There's a justifiable concern about mercury in fish," Oz says, "but salmon are young fish and therefore less likely to have high levels." And for men over 40 and women over 45, he suggests a baby aspirin a day. It reduces inflammation and serves as valuable anti-clot insurance.
Get Moving
Oz rides his bike vigorously 20 to 40 miles on weekends because he enjoys the physical release and the feeling of being aerobically fit. But you don't need to work that hard: Thirty minutes a day of brisk walking has been shown to reduce heart disease risk.
Oz is particularly keen on the stress-reducing benefits of yoga. "Even if my patients don't want to do the physical poses," he says, "I'm pretty firm about them learning to do yoga breathing: relaxing the stomach so the diaphragm drops down." And if it's affordable, the doctor suggests a weekly hour-long massage. "Most people enjoy it, and there's evidence that it improves lymphatic drainage," he says.
Cultivate Your Spirit
Recently, Oz served as an investigator on the well-publicized Duke University Mantra trials that found that cardiac patients who received music, guided imagery, and touch therapies, and were prayed for by a variety of believing strangers, suffered 30 percent fewer complications over a six-month period.
"I don't know if we'll ever know exactly what these studies are measuring," says Traci Stein, director of Columbia's Integrative Medicine Program. Still, Oz has seen enough in the cardiac trenches to believe the human spirit plays a key role in preventing and recovering from illness. "Maybe it's because you deal better with anxiety and loneliness when you have some kind of spiritual outlook," he says. "It's hard to define, but I do know that you need to give your heart a reason to keep beating."
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