Meta–Physician….Another Name For Integrative Practitioner

I have been working on my presentation for JFK Hospital's Symposium on INTEGRATIVE MEDICINE.  My topic is IRRITABLE BOWEL SYNDROME.  It is an ideal topic for me because it allows me to explore the metaphysical basis for healing as well as expressing the basic approach that I take in my practice of gastroenterology.

I believe that any physician who has been in a successful practice for many years is already a meta-physician without necessarily realizing it.  By definition, such a practitioner understands that in order to treat a patient, the whole person must be considered.  This is the real meaning of holisitc, the recognition that the patient is far more than a physical being. When someone arrives for an office visit with a physical complaint, emotional, psychological, sociological and spiritual elements are often at play.

The use of the term Integrative Practitioner is the latest effort to describe someone who incorporates scientifically derived Evidence Based Medicine with the pragmatic concerns of a multi-dimensional being whose problems often transcend such an approach.  The world of alternative therapy, mind-body therapy, herbal therapy must be considered as well.

The meta-physician appreciates the complexity of the multidimensional patient as well as their personal choices as to what type of therapy seems to resonate with them.  The meta-physician understands the power of the mind to heal and therefore makes use of the placebo effect. [Rather than demean it].  The meta-physician understands that he or she possess shamanic power as regards the healing interaction.

 Rather than instill fear, the meta-physician understands the power of compassion and the alleviation of fear.  Therapies are much more potent when delivered with such an awareness.  Studies have clearly demonstrated that an open and warm interaction between patient and doctor leads to much improved clinical outcomes.

The meta-physician understands that despite the value of scientifically derived Evidence Based Medicine, science remains in imperfect source of knowledge.  Science is malleable, capable of self-correction over time.  But the patient who confronts the meta-physician must be addressed in the present moment.  Science is often inadequate as the only source of wisdom, particularly when it contradicts the clinical experience of the meta-physician.

The meta-physician / integrative practitioner must weigh the risks and benefits of any therapy that is initiated.  Each patient is unique.  They respond uniquely as well.  Practice requires the appreciation that what is required is the patience and intuition of an artist.  Trial and observation. Feedback and re-evaluation are necessary tactics.

My wish is that the meta-physician/integrative practioner will become the paradigm for the 21st century medical caregiver.


 A recent article by Steve Salerno in the Wall Street Journal [May 1, 2009] recalls the failure of 'The Secret' to explain the economic downturn which has affected so many Americans.  How come visualizing all those expensive cars and McMansions didn't keep the repo man and foreclosure courts away?

Perhaps by borrowing a page from Kabbalistic metaphysics we can see just why.
Kabbalah envision four worlds of which the one we inhabit is ASSIYAH the world of action.
Above this world, dominated by human beings, is YETZIRAH, the world of formation.  BERIYAH, the world of creation exists at an even higher spiritual plane.  The pinnacle of all the worlds is ATZILUT, the world of emanation.

Whether or not there is evidence for such worlds, it is an interesting exercise in thought to visualize that they do, in fact, exist.  It may be perfectly reasonable to 'visualize' what you want in life.  A detailed description of a variety of objects, states of mind and goals realized are fine.  Consider that the act of creating them in thought actually does cause them to manifest.  The problem is that they manifest in the higher worlds of YETZIRAH or even BERIYAH.

Unfortunately  we actually inhabit ASSIYAH–the world of action.  We still need to manifest our deepest wishes and dreams in this physical plane.  In effect, we need to make them happen in this existence.  They will not automatically 'drop down' into this world of action by themselves. 

We are the actors, the creators in this world.  There will never be a substitute for hard work, drive, determination and persistence.  These may even trump pure talent and genius.

So for those of you who were 'taken in' by The Secret, you have my sympathy's.  You were not wrong to do all that visualization, you just were creating them in different worlds.  No wonder they never happened here!


Is beauty a quality of the world or merely our perception of it? In the eyes  of the beholder alone or reflecting some universal truth?

How well we know the power of  cultural trends and media to dictate what is considered beautiful.  Historically any art lover recognizes that the rounded, full-fleshed beauties of Dutch painter Peter Paul Reubens would hardly be acknowledged as such today. Likewise anthropologists can point to numerous examples of cultures with elongated necks from ring insertions, tatoos and piercings are regarded as erotic adornments.

But human beings may inherently respond to certain facial proportions.  This seems to have been demonstrated in newborns from a variety of races and cultures.

When it comes to our fellow creatures, we clearly have a bias towards certain 'cute' animals such as baby pups. kittens, bears, tigers and lions.  While octopi, squid, spiders, snakes, jelly fish and others make us squirm.  Yet clearly to a member of the same species–they would have no other mate!

Yet to human beings, beauty has a meaning which transcends mere physical form.  Our language displays this deeper metaphysical understanding.  Compassion,faith, peace-seeking, courage, self-sacrifice, kindness, charity and cooperation are universally regarded as acts of beauty. 

So while we may be victims of certain cultural biases–we know what true beauty is–when we experience it.  Rather than state beauty is in the  eyes of the beholder, we might consider it to be in the heart of all who choose to be awake. 


Over the years many will describe a physician as having a 'good' or perhaps 'bad' bedside manner.
Presumably what they mean is the doctor's personality: how friendly, kind, perhaps compassionate they appear to the patient.

Occasionally one will hear that the doctor had a 'terrible' bedside manner, but "he was a great doctor,  anyway so I continued to go to him."

Ladies and gentlemen–as a physician in private practice for over thirty years now–I would like to express an opinion.  There is no such thing as a 'great' doctor with a 'bad' bedside manner.
Of course, one can speak of a surgeon who is know for his or her technical expertise.  Perhaps they even have a history of good outcomes.

But I truly believe that a physician's bedside manner is  inextricably linked to his or her ability to 'heal' their patients. 

Patients appear in my office with a variety of symptoms and complaints.  What they ALL have in common is….fear.  One of my most important tasks in establishing a healing relationship with them, is to reduce their fear and win their confidence in my approach to their problems. We all understand the power of the mind to aid in the healing process.  A patient who feels that their physician deeply cares about their health will most likely activate their body's healing properties.

Now, physicians will occasionally look askance at other physicians who, they claim, have built a large practice based on their personality and bedside manner at the expense of their medical expertise.  Of course that can be the case.  But for the most part I still contend that how I treat my patients:  the concern, focus, kindness and interest in them as individuals will result in a better outcome.

One obvious aspect of such a relationship is that the patient will be more willing to share their complaints with the doctor.  Some patients may actually be intimidated by an overbearing or unfriendly physician.  This will undoubtedly lead to a breakdown in communication and probably reduce the chance for true healing to occur.

A physician who exhibits a poor bedside manner may have a higher percentage of patients who do not follow their specific recommendations which clearly impairs the healing process.

So always seek out a physician who is not only medically competent but who truly cares about their patient's well-being and is able to communicate it clearly and directly.  It will hasten the healing process to be sure.

IBS– An Integrative Approach — I

I am beginning to prepare a lecture on Irritable Bowel Syndrome to be presented at JFK Medical Cener in Edison NJ in June.  I will be discussing various aspects of this extremely common 'condition'.  In a series of upcoming blogs I will hope to share some of my thoughts with you regarding IBS.

Although this is clearly the most common condition that I treat in my practice of Gastroenterology, my training in dealing with IBS was sorely inadequate.  I assume that the professor types at Mount Sinai did not deem it 'ineresting' or 'fascinating' enough to assign too much time and effort in discussing it.

However, once in clinical private practice, its ubiquity became clear.

IBS is the quintessential 'mind/body' condition.  It affects at least 20% of the population according to statistics.  I believe the true numbers affected are much greater.  It is all a matter of degree, after all.  Those who seek medical attention for 'nervous diarrhea' or 'abdominal cramps' during times of stress vary according to the personallity of the individual patient.

The term "integrative" has only been in usse for a few years.  It reflects the attempt to incorporate standard 'scientifically tested' treatments, including pharmaceutical drugs, with the more 'alternative', 'holistic' approaches. 

The 'integrative'' approach, in my estimation, is compatible with a "metaphysical" approach–one that incorporates a variety of modalities {pharma drugs, herbs, supplements, energy healing, meditation, yoga etc} with an underlying philosphy which recognizes the patient as a 'holisitic' being, having physical, emotional and spiritual components.

In response to a criticism that metaphysics is too esoteric or irrelevant to daily living, I would insist just the opposite.  Understanding the  nature  of reality allows one to approach the world and its challenges with the correct perspective.   A pragmatic attitude incorporates all types of healing modalities with an emphasis of continually evaluating what works for that unique patient.

At this time, medical science by itself is inadequate to heal the individual patient.  IBS requires an integrative approach to healing.

The meta-physician seeks to understand their patients by understanding the nature of reality.  Once a deeper understanding is achieved, the " integrative"  approach is a natural outcome.


I have touched upon this dichotomy in earlier blogs.  What is the great distinction between these two concepts?  To speak of natural  we imply that whatever occurs is discernable based upon either logic or scientific principles.  What confounds many scientists today is the myterious nature of such principles. 

Science was supposed to clarify the nature of reality.  It actually did so beginning in the sixteenth century and leading up to and including the dawning of the 20th century.  The clockwork universe as discribed by Isaac Newton and Galileo seemed destined to completely obliterate the mysterious unknown.  Only religion dared claim mystery as their realm.  Both scientists and philosophers began to see science as revealing a natural  explanation for everything.

The realm of the supernatural was deemed either ignorance of the power of unrealized scientific truth, or the irrational rants of religious fanatics. 

In the 19th century Napolean was rather taken aback when his chief scientist the Marquis de la Place failed to mention God in his description of the origins of the universe.  A true scientist, la Place famously responded, "Sire, I have no need of that hypothesis". 

By the beginning of the 20th century all mystery formerly the realm of God and  religion, was to be banished by the clear light of science.

Unfortunately for those fans of logical metaphysics, it didn't work that way.  Both quantum and relativity theory have provided physicists and philosophers with suprisingly bizarre and even 'counter-intuitive' metaphysical views on reality.

I invite the reader to explore these fascinating, mind-bending concepts on their own. 

But it would not be a stretch for some to question the difference between natural and supernatural.  Perhaps they are two different concepts for the same reality–a reality which is not neatly comprehended by our present thought processes.

The dichotomy between these two concepts may very well reflect the duality of body and mind first articulated by French philosopher Rene Descartes.

What we perceive as two distinct forms of reality may very well be linked by understanding the concept of energy.  If energy exists as a spectrum, it is very possible that the distinction between mind and body, between physical and spiritual, may very well reflect a difference in vibrational energy.

What appears at first glance to be totally and completely different modes of being may actually be different forms of the same substance.  At first glance it is difficult to assume that water, ice and clouds are merely different forms of the same H2O.

The presently recognized electromagnetic specturm of which visible light resides in the center, may reflect one of an infinie number of yet unexploared spectrums.

Natural?  Supernatural?  Let's keep the dialogue open.


Suicide–even the word can evoke pain and even revulsion in many of us.  Traditionally, religions have vehemently proclaimed how 'evil' the action truly is.  Hell and damnation are the rewards of a suicide.  Often suicides are not even buried with others.

The causes and suffering that leads an individual to take their own life has challenged the most astute students of the human mind and personality.  Some look to biologic, even genetic factors.  Some believe that suicides are mentally deranged at the time that they perform their act.

This blog posting follows the last because I would like to relate a story I heard from a talented but amateur psychic/medium.  I will paraphrase–

A close friend of my Mom's lost her son to suicide.  His name was Joe and I believe he was in his early twenties.  I didn't know him well but felt the intense pain of his mother.  I tried to contact him mentally–and did.  He communicated to me that he believed he was in hell.  He had been a Roman Catholic and knew the consequences of committing suicide–hell.  He said he was in a very dark place, very frightening.  He was alone.  He understood the pain his Mother was going through and was so sorry that he killed himself.  He realized that it was a stupid act, that he didn't escape anything and that he only caused those he loved to be in more pain.  A week or so later I tried to contact him again–nothing.  I felt terrible for  his family and for him. Where was his soul I wondered?  About a month later I tried again.  This time he came through and was totally different.  He let me know that he was at peace, was in a place of warmth, light and love.  We believed that he was now in heaven.  When I asked what happened he replied– "I forgave myself".

I thought that this was an amazing encounter.  Some readers will obviously question the entire experience.  Could she have fabricated the entire story, or even fantasized that it happened?

There is no 'proof' that this occurred.  However, I do find it credible.  I know the woman.  I know that she told few others about this experience.  There was nothing to be gained by her creating any of it.  And furthermore, there is a ring of truth to it. 

If we do survive physical death, if there is a soul consciousness which persists, then it makes sense that a suicide would experience all of it.  Even the 'life review' which has been described during the NDE [near-death experiences] replays all the actions of our lives including the feelings of everyone we interacted with.  If this is true, the suicide will experience hell–one of their own creation.

When they come to accept their own mistakes, realizing that their karmic journey was interrupted and may need to be redone, forgiveness is possible.  This is not an excuse, nor does it undo the damage to those left behind.  But the soul understands that it must do so in order to move on, to learn, to grow and evolve.

Forgiveness of self and others is a necessary step towards healing–in death as in life.


The biggest threat to our own happiness is often–ourselves.
We can be our own greatest critics.  We can exhaust ourselves with self-recrimination.
We can fail to forgive our own shortcomings and errors in judgments.

In case you haven't noticed–we are imperfect beings.
In the bigger metaphysical picture–we are "here" to learn and therefore have much
work to do.

We will all be guilty of making mistakes–some minor, some huge.  Some we can escape
punishment or retribution, some not.

We all know what they are.  We cannot pretend that we don't.

But the path towards healing requires, even demands that we acknowledge our mistakes, make amends when possible, learn from them, pledge to not repeat them–and move on.

Only by forgiving ourselves can we do so.

The difficulty in dealing with this problem is that it may be acting on a subconscious level.  We may or may not acknowledge the source of our actions.  We may consciously believe that we're 'OK' with what we've done and that we are moving on.  But it may not be the case.
We may need to invoke some techniques from cognitive therapy.  We may need to give ourselves affirmations of forgiveness. 

We need to put the whips away. Self-flagellation hurts.  We need to stop sabotaging ourselves because we feel guilt over what we have done.

We need to believe that we deserve to find peace and happiness–to become what we desire.  But it will never happen as long as we continue to believe that we 'deserve' to be punished, to be sad, unfulfilled.

So let's face our demons, acknowledge our pain and the pain of others, learn our lessons and move on.  The metaphysical journey is ours to create.

Don't waste your incarnation!–forgive yourself!



Most of us find ourselves caught in patterns of behavior which can lead to unhappiness, frustration and feeling trapped.   Because these patterns have become habits, we fail to recognize them.  We fail to realize that without an awareness of this trap, we can never hope to break out of these patterns and heal.

We all have unique ways of dealing with  frustration and suffering.  Some of us react by becoming aggressive, compulsive, frenetic.  This may serve to temporarily relieve the tension our suffering engenders.  It may help to some degree because individuals who react this way are often deemed 'successful' in life.  They are the great 'multitaskers' who continuously push for what they want.  They often 'succeed' in satisfying material desires–money, homes, economic security.

They clearly need to explore the silent underbelly of their suffering in order to find happiness and contentment–but at least financial insecurity is not their problem.

There are others who react to sadness and frustration by the opposite response–they withdraw, become even more passive and less 'productive'.  Their vicious cycle is reinforced even further since financial/economic  insecurity is usually magnified.  This only contributes to their sadness and suffering.

For such individuals there may be an approach that offers at least some relief of their suffering.  They need to explore the following equation and reverse it.

 Whereas their suffering leads to passivity and more suffering—they need to address the effect, the inactivity first.  By addressing the passivity first, they can actually reverse the equation.  Their suffering will diminish when they observe their own activity, their ability to 'accomplish' something.  They will be able to alter their own self-image which has contributed to their suffering.

A simple but effective analogy involves the feeling of sadness and the act of smiling.  Under ordinary circumstances we smile only when we feel good.  It seems bogus to try to smile when we don't feel like it.  Yet science has demonstrated quite easily that the act of smiling, however forced it may be, actually leads to an emotional transformation–we start to feel happy.

Is this merely a bandage for our inner suffering?–Perhaps.  Yet it is surprisingly effective, at least in the short term.  It can reveal to ourselves an ability to pro-actively alter our state of mind and reduce the suffering which contributes to our passivity. 

Reversing the equation can reverse our suffering by revealing our ability to empower ourselves–truly a healing experience.