Tiearona Low Dog Elevates the Meaning of "Integrative Medicine"

I recently had the honor of interviewing Tiearona Low Dog, MD, a thought leader in health care, whose credentials include Director of the Fellowship at the Arizona Center for Integrative Medicine, at the University of Arizona; member of the White House Commission of Complementary and Alternative Medicine; member of the Advisory Council for the National Institutes of Health National Center for Complementary and Alternative Medicine; and most recently, Fellowship Director at the Academy of Integrative Health and Medicine. Following are excerpts from our conversation.

Michael Finkelstein, MD: How do you define "medicine"?

Tiearona Low Dog, MD: My definition of medicine was formed at a young age. I was coming back with my grandmother, from Medicine Lodge, Kansas, where we had attended a pow-wow. She was driving the pickup truck, and at one point she looked over to me and said, "You know baby, you have to remember that when you were born, you were set on a road, and that road is your medicine road. Everything you do in your life -- everything -- is medicine, good or bad: the way you think, the way you move in the world, the way you treat other people, the thoughts you think, the food you eat. All of it is your medicine, so think carefully about the way you live your life."

When I was older, I began to understand what she meant -- that it is life itself that determines our wellbeing. It doesn't mean that you don't get sick and bad things don't befall you. Certainly, all those things do. But it's a matter of viewing your life in a different way. It's not separate or apart from everything else that's going on in your life around you. You are intimately and intricately interwoven with it.

So when integrative-holistic medicine came about, I'd already been practicing as an herbalist and had studied as a midwife and had been doing martial arts for many years and had gone to massage school. So for me, integrative-holistic medicine just made sense. It didn't seem foreign to me; it seemed like that was a natural concept.

I also loved going through medical school. I learned another way of diagnosing disease and understanding pathology and using stronger forms of medicine -- surgery, prescriptions, etc., when the body really needed it. It felt like a very natural extension of what I already believed and was practicing. I was really, really grateful for that knowledge.

Unfortunately, we often get wrapped up in the things that are most heroic and mistake things that are gentle as lacking strength. I believe that many, many medicines and many things that we can do in our lives that act as medicine for us, that help restore our health, or promote our wellbeing, are gentle. We should never mistake them as not being strong or powerful.

MF: How can we help the public look at medicine this way?

TLD: It's somewhat difficult when the political structure of a nation basically only recognizes, endorses, and pays for one form of medicine. It shouldn't be a surprise, then, that people assume that's the medicine that people should use, because it's endorsed, sanctioned, regulated, and sometimes reimbursed. So part of the change will involve a new way of thinking.

It's going to take all of us recognizing that there are diverse ways to heal, and that everyone has a healer within themselves and within their homes. Healing should begin and end at home, whether that home is a physical home you live in, or one that embodies you in your soul. Helping people reestablish that connection and reassert the fact that they know more than they think; they understand more than they probably realize; and the decisions they're making are not only going to greatly influence their own wellbeing, but also the wellbeing of others around them.

MF: Tell me about your fellowship.

TLD: I was happily retired from the University of Arizona, for four or five months, before I was invited to lead another fellowship. They wanted it to be for doctors and nurse practitioners, sort of like what we did at U of A, which was my heart and soul for many years. I said I believe we have medicine but we have no integrated care. We've done such good work helping doctors learn more and think more broadly about health and medicine and wellness, but that is never going to change the trajectory of what's happening in this nation, let alone globally.

When they said, "Well, what would you envision?" I said it would be a fellowship that was inclusive of the many, many practitioners who are all working towards the same goal, which is promoting health, restoring health, and easing suffering. That is a very different mission than training physicians and nurse practitioners how to incorporate more of these into their practice. We need to begin to incorporate and bring together practitioners who work together, collaborate together, and who work with patients on many different levels. For me, it's like, we'll figure out as we go. We just have to know: Is the cause right? And it is.

MF: What are some first steps?

TLD: You start by providing an educational platform for people to learn and train together. Everybody has to have a common language, because if we're speaking Russian, Chinese, French, English, German, and Thai, nobody's going to be able to -- it's kind of like the proverbial Tower of Babel. We can't cross-communicate if we can't speak the same language, so everybody is going to have to become multilingual, and going to have to be at least bilingual so we all share one common core of language.

This is what we have to think about when we talk about an integrative assessment: I'm a family doctor, you're an acupuncturist, someone is a chiropractor. We have to learn to work together, to collaborate with patients and refer to one another and work together in teams. The education has to start. You have to create an educational platform for anything to begin.

We need to constantly keep our hearts very open, keep our feet very close to the ground, recognize that medicine in its fullness includes the clergies, pharmacists, dentists, massage therapists, nurses, shamans, and mothers. In the fullness of its true meaning, "integrative medicine" is so broad, there is room for everybody.