An Interview with Dr. Bernie Siegel

by Veronica M. Hay


 


For many of you, Bernie Siegel needs no introduction. He's the man who, more than 15 years ago, began talking about patient empowerment and the choice to live fully and die in peace. As a physician who has cared for and counseled thousands with life-threatening illnesses, Dr. Siegel, who prefers to be called Bernie, embraces a philosophy of living - and dying - that stands at the forefront of the medical ethics issues our society grapples with today. Just as his two previous bestsellers, Love, Medicine & Miracles and Peace, Love & Healing, broke new ground in the art of healing, the third of Bernie's ever-popular inspiration books, How to Live Between Office Visits: A Guide To Life, Love and Health addresses the key roles that self-knowledge, love and acceptance play in both living life fully and preparing to die naturally.

THE INTERVIEW

Veronica: The medical profession has been slow to accept the belief that our mind influences our bodies. In your travels and various talks and workshops, would you say that a greater number of health care professionals are beginning to accept this idea and use it with their patients?

Bernie: Yes, I see it in a mechanical way, that lets me know this is happening - meaning who invites you to speak. Years ago, if you got invited to, lets say a major hospital, by the social worker, a lot of the doctors would say, "Why are you inviting him here? He is a trouble maker." Now the doctors are the ones inviting me and listening as well as the medical students. So, I see that kind of shift. I see that I am not so controversial in the sense that you don't get invited to a program and at the same time have people invited to fight with you and argue with you over whether it is scientific or not, or you're making patients feel guilty if you say that they can accomplish something.

Now, I am more often invited for information and to give people that information, rather than people arguing. I'm not saying that occasionally, like the other day, somebody doesn't still call up and argue with you, sighting statistics to fight with you but avoiding all the statistics that would support you. And some of it is how we are trained, that we are very diseased oriented and truly in a sense medicine is a very mechanistic, depersonalizing training in many institutions still. A lot are changing, and that is really one of my goals - to change the medical education so that when physicians come out they are open to all of these things and are not afraid of new information and looking at new things.

But right now, I'd say most physicians see new information as criticizing them, as saying, look what you don't know, look what you are not doing right, rather than saying, thank you for the new information. It's your telling me that I don't know something, or that I am doing it wrong. Doctors, since they themselves (again this is a generalization) have a great deal of difficulty with feelings and emotions because we are not trained in how to deal with them and all that we are going to see and run into in our practices, including the death and the disability, and so we bury our feelings and really try to get our patients to do the same thing, so we don't have to deal with the emotions of the patient.

Veronica: Do you think more and more doctors are actually asking the patients what is going on in their life?

Bernie: I think more are, not as many yet, as I would like, and that's why one of my goals is to humanize medical education so that we will have doctors who understand that we are taking care of people, not just diseases. I do think more and more are and part of that is because patients are now getting empowered and are willing to speak up and say, "I don't want to be treated like a room number or a disease, I want to be treated like a person."

Veronica: You also say in your book How to Live Between Office Visits, that most physicians would not be physicians nor want their children to become physicians and others are becoming so specialized that medical care will be affected adversely. Could you explain that?

Bernie: If you just interview doctors, and ask them if they would do it again, become a doctor again, the majority, in many studies, would say no, they would not, and they would not tell their children to do it either. Some of it is political and economic, in the sense of how difficult it is getting to practice and enjoy practicing, but you see my point again is, if you don't get any joy out of people, then there really is very little reward in medicine.

The money doesn't make up for the time and the pain and the difficulties that you encounter. You could do something else that is far less traumatic and a nice living and so if the physician looses that sense, which I think many physicians have, that I am here to care for people and let the people restore me and let me restore them, and there will be a reward here. Then, I think you would tell your children, this is wonderful, a wonderful thing to do, go be a doctor, because you will love it.

But since we are not feeling that, we say don't, because what we are feeling is, the forms you have to fill out, being on call, at other peoples demands, the emotions that come up when you can't cure somebody, you feel like a failure and not knowing how to deal with all of that. It is a lot easier to say, I would never do this again, or let my children do this. And again, what it gets back to is, that somewhere in the process, we have to say these things are going to happen. How will you deal with them? Let's talk about it, lets talk about your feelings, let's share them, not hide them, not cry in stairways or empty conference rooms, but let's talk to each other and to the people we are caring for!

Veronica: What are some of the ways in which the medical system of education and practice could become more humanized?

Bernie: Well, on a practical basis, number one, we want medical students to meet patients when they first get to medical school, not spend a couple of years reading books and forgetting the books are about people, so that when they meet a person, they don't just see the disease, they see the person. I think if we told these students in the first week or so of medical school, you will meet people, you will interview patients, or you will have some 90 year olds or people with chronic illness come and lecture to the class about their lives and about what they want from the medical profession.

I've always said I would have doctors and nurses who have been sick talk to the students about what it was like to be the patient. I would make sure the students spent a week or so in bed in the hospital and again share that experience or make them walk with a walker or blindfold them or plug up their ears so they couldn't hear, you know, so they understood what it was like to have these various disabilities. And in some sense, to be what one woman said, to become natives, to have some sense of experience of illness so that we are not just tourists in this process.

Veronica: Like in that movie, The Doctor?

Bernie: Yes, I think that movie took a lot of the things I wrote about, but didn't give me credit, because it wasn't in the book, The Doctor. There, a doctor got sick, and then they made the movie much more elaborate, but it is exactly that kind of thing, using some of those techniques and allowing them to become part of the doctor's teaching and then as I say having sessions where you sit down and say: a five year old dies of Aids, a five year old is hit by a car, a forty-five year old is dying of cancer or some other disease. You can't cure them. How are you going to feel? What are you going to do when the child dies? Are you going to help the family? Are you going to run away from them because you can't deal with the loss? What are you going to do? Those are things I would sit down and talk about as well as why you became a doctor. Because, if you became a doctor for healthy reasons, that's wonderful, that you like and want to help people, but if you became a doctor for what you might say, psychologically unhealthy reasons, then we need to look at those now, so that you don't destroy the patient with your attitude and words.

You see, if you go in to be a psychotherapist, you'll spend time learning about yourself. If you go in to be an oncologist, or a surgeon, or an internist, we don't concentrate on what you will say to people, we concentrate on teaching you how to operate and write prescriptions and make a diagnosis, but your words are even more powerful in some instances, than the medicines and the operations. We can kill or cure people with our words too and those are things that doctors need to be trained to understand, how to communicate. We need a course in communication. How do you tell somebody something so that you don't kill them with words and statistics and to realize people are not statistics and you don't know the future for individuals. So, we'd better learn how to communicate, how to give news and how to help people to live with what they are learning from us.

Veronica: Would you recommend a person diagnosed with a serious illness try an alternative method of treatment, such as consulting a Reiki practitioner, or someone like that, in addition to seeing their physician?

Bernie: Well, I would recommend that they do everything they wanted to do, because part of it is responsibility. When you say to me, would I recommend, my answer is, I don't prescribe for people, because I don't want them to do what I'm telling them and then to have more side effects, so I call life a labor pain. What I am saying is that I don't want you to have pains that I impose upon you, I want you to have your labor pain and give birth to yourself. So, if you said, I want to travel to Germany to get a treatment, or I'm going to Mexico, or I'm going into Reiki, or I'm going to eat vegetables, or I'm going to have chemotherapy radiation, that is fine, that is your choice. I will help you by laying out all the things that I think are good for you and then let you say this is what I choose to do. That is where I would like to empower patients, I don't think it is proper for me to say, you must do this, here is your prescription, now go and do it, because what I know is, if you don't want to do it, you will have lots of trouble with whatever treatment it is, and then I'll say, all right, I guess you 'll have to stop that.

So, I like to lay things out in front of people and say, all right now, let's talk about what you would like to do, what you want to do. What are your choices? What are your feelings? And we will go at it. I also work with drawings a good deal, so that I know the inner feelings of the person, meaning that if you said: like for Reiki, draw yourself having Reiki therapy, draw yourself having chemotherapy and then let's look at the picture. So, if the picture looks wonderful, terrific! If the picture looks horrible, we'll talk about where that is coming from and if your are going to get it, then maybe you will have to change your feelings and beliefs about it, before you go and receive it.

Veronica: Would you do that for each alternative that is available?

Bernie: If someone's having conflict over a choice, I would say, draw the choices and lets see. If you said, I don't know who to marry, I'd say well, if you have several people in mind, draw yourself with them, and lets look at each picture. So, it's the same kind of thing. Understand this, it may sound nice to say I'd rather eat vegetables than have chemotherapy, but I've seen the drawing of the kitchen looking worse than the drawing of getting chemotherapy. Because the man hates vegetables, so for him, that's a worse treatment than chemotherapy. He said, I prefer chemotherapy, because I would like to eat all these other things, and you and I might laugh at that saying, I wouldn't have said that, but that is his statement, so that is why it is not fair for me to impose vegetables on him, when he prefers chemotherapy.

Veronica: But, if he drew a beautiful picture of a Reiki session or some other form of treatment and it looked really peaceful, then that would be a good indication that this kind of treatment might be right for him?

Bernie: Yes, then I could say to him, "Look at how beautiful this drawing is, there is an intuitive part of you that knows this is good for you - go!" And it often takes away people's fear of a new treatment, because they know they did the drawing and they say: "Yes, it looks beautiful!" I'd say yes, that's right, and it is coming from you, so don't be afraid, don't let your intellect get in the way, don't think about it so much, go with your feelings.

Veronica: Why is there so often a remission of cancer and then a recurrence?

Bernie: Because, cancer is a tough disease to cure and it often exists in many parts of the body, so that you can remove or treat it, and it may come back later. Now, that has a lot to do with physical reasons, as well as psychological reasons. This is where I often talk to people about the role in their lives and a simple example may be 'a man is his job'. If you said who are you, he tells you he is a lawyer. When he quits being a lawyer, his cancer comes back. You see, he retires. A woman is a mother, and she says I'm a mother of nine so I can't die. Well, when her ninth kid marries and leaves home, her Cancer comes back. Now, I don't think that is an accident either because it is like these people suddenly have no meaning to their lives and there is a certain amount of depression and despair that comes with that, which also can lead to the disease reappearing, because the immune system is no longer fighting it or suppressing it. And there are also people who live fully in love and die also when the disease comes back, but they are still helping themselves live a longer, healthier life. And that is something we have to remember. We are all going to die, so dying isn't a failure, it doesn't mean you did something wrong. We are fighting certain diseases and changes in the body. What I always say is that if you show me a lover versus someone who isn't, the lover, if they both had the same disease at the same time, the lover is going to live a longer, healthier life. Matter of fact, one study just showed that if you take an optimist and a pessimist who have the same Cancers, the optimist lives longer than the pessimist. So, helping people in group therapy and stress sessions and training and teaching helps them resist Cancer literally and live longer. But, what you have to remember is that it is not a failure, if the disease comes back. That's why a lot of people are afraid to participate in any of this because they have grown up feeling like failures, so they don't want to draw pictures, join groups, fight a disease, because if it doesn't go away, it means they did it wrong and they are so afraid of being graded.

Veronica: Do you ascribe to the theory of disease, that it is just that, a dis-ease in the body and each type or area is related to a specific problem?

Bernie: I think that is getting a little bit extreme, in the sense of, if you have a tooth ache, it means this - I have to say this though, if you read these lists at times, when you have problems, it is amazing how accurate they often are, but I think it can get too extreme, to lock into that kind of what I call, cook book response. What I find easier to do, is when somebody has a toothache, or backache, or Cancer, I'd say, what are you experiencing, tell me the words that will let me know what you are going through and in the metaphors that they use and the words that they use, we usually find the answer to the pain and what needs to happen in their life. Meaning, that if you just took a simple example, people could all have a backache but one has pressure, one has a knife, one has somebody squeezing them, and on and on. And so, if you looked at why the word squeezing, why the knife, why the pressure, how do those fit your life, then people say ohh, I know what's causing the pressure. I know who is sticking a knife in my back, and then they begin to work on their life.

Veronica: What is the key to living between office visits?

Bernie: If I had to simplify it, it is learning who you are in the sense of your true value and worth. The kind of feeling people have when they look at a new born baby. You know, you go - "Ahhh, it's perfect!" Well, why don't we feel that way when we grow up? So, its understanding your worth and value and beauty and then saying, "What am I here for?" And I think that what we are here for is to contribute love to the world in our own unique way and that means if you want to be a plumber, fine, if you want to be a housewife, terrific. Just find your way of contributing to the world and then go and do it. And I know that life is difficult. Life is not unfair, it is difficult. Everybody is subjected to troubles, that's life, but that doesn't mean it isn't fair. We are all having our troubles, but we have to learn to deal with the difficulties and use them and go on and keep contributing.

 

Veronica: How does one deal with the sadness of seeing someone you love in pain?

Bernie: Oh, you die first, so you don't watch any! That's a good solution isn't it? How do you deal with it? You use the pain, that's my only answer.

Veronica: You mean just let yourself feel the pain?

Bernie: You feel it, you grieve. You see, my little story in one of my books is that this man couldn't function because his daughter died and one night he had a dream that he was in heaven and all the children were marching by with beautiful bright candles except this one child, who turns out to be his daughter, and he says, "Dear, your candle is out. I will light it for you." And she says, "Dad, they do light it here, but your tears just keep putting it out."

So we're here to participate joyfully in the sorrows of the world. That's a quote from Joseph Campbell. The world is filled with sorrow, we're not going to change that. You feel the pain and you use it.

Veronica: How do you use it?

Bernie: You use it constructively. If you don't like what you see - if the headlines show pictures of children in Rawanda dying, you have a choice, get off your butt and go to Rawanda, and bring them home or feed them or donate some money, but do something! Or, say I can't let this happen again, I don't want another war, I'll get involved in politics - do something! And the same is true if your loved one dies - what have you learned from it, what have you experienced by it, you're going to die too, so did they leave any unfinished business, did they share love, learn and use it, don't just keep walking around complaining and blaming everybody.

Veronica: Can you talk about the role laughter and joy play in healing and staying healthy?

Bernie: I think that laughter, joy and play, as well as love, are the most physiologic states we can be in, and the way I like to think about it is, anything that makes you lose track of time may in a sense make you ageless. If you think two hours is five minutes, sometimes when you are having fun, then what is your body doing, does it get two hours older or five minutes older? My sense is that it probably only gets five minutes older, because of the hormones and the changes that are going on in your body, that you are not aging. And so, I think you can help avoid aging by living a life full of love and joy. Again, that doesn't mean you don't have trouble, but you are making a choice about what you experience and feel, and the kind of change that that creates in your body is what helps you resist illness and just stay healthier and younger.

Veronica: So, do you mean completely involving yourself in a project that you love, so that time seems to stand still?

Bernie: Yes, that's why my definition of play is something that makes you loose track of time. So, whether you are working in the garden or in a convalescent home as a volunteer, if you are participating and enjoying so that when two hours are up, you thought five minutes or ten minutes went by. I experience this when I paint because I loose myself totally in the painting. The other day I worked for two hours and somebody called on the phone and I criticized them for calling me back right away when I told them not to call for an hour. And the man said, "It's been two hours!" I couldn't believe that two hours had gone by. And that's the kind of thing I mean. Get yourself into that kind of state and it is incredibly healthy for you.

Veronica: So, that would be one of your happiness habits, to do things that you love?

Bernie: Well, there are so many things that we can build in that different people do, but I think it's things that would interrupt your day. Like every morning, I will meditate and pray, it's my way of refocusing. I also say I talk to God during those times. It's times when I just go inside myself for my thoughts, for my prayers and to really work with myself. I like the idea of having bells go off during the day and I love it when you have clocks or chimes and this came from a buddhist monk, Tick Na Han, who said when you have temple bells, you stop and you breathe peace. But, he said you don't hear them in western countries, so if you put a clock in with a nice chime, every time it goes off, stop and take a breath and breathe some peace. Or, if you don't know how to do that, then let the telephone become a bell of mindfullness, so if the phone goes off, you don't grab it, you breathe peace for three rings, then you pick it up and you can hear the difference in yourself and in your voice. Try it, and see what this does to you. In the next three days, every time you hear your phone ring, do not pick it up until the third ring, and each ring just say, I am breathing peace for myself and the person who is calling. Then pick it up after the third ring, and you will feel a difference in your voice and the way you say hello to that person. So, its those kinds of things that you build in.

It could be a stop sign, it could be any symbol, but each time you see it during the day you say, "Ok, stop, focus, breathe peace." It could be a red light, you know the things that usually agitate people, turn them around into bells of mindfullness, and to happiness.

Veronica: To bring us back into the moment?

Bernie: Yes, and there are other ways, even carrying certain notes in your pocket or things that you pull out and read or look at. I also carry a book with me, a blank paper is all you need so that if something happens, touches you, makes sense to you, write it down and then put it in your little book later that night so that you collect all these little things, that help you and teach you and you have your own little collection. I call it your own little bible and it works wonderfully to look through it to have these little sayings and events that re-remind you about life and how to get through and how to live.

Veronica: Do you believe in miracles?

Bernie: Yes, I believe in miracles. I don't like the word, because I think it confuses a lot of people. To me, a miracle is something unexplainable. It's like our universe is a miracle. We will never get around to explaining it. But when something happens that I see or experience, I would rather call it a mystery. I believe very much in the mystery of life and hope someday there will be a lot of things that we will understand and explain so they won't be mysteries any more, because it is exciting to learn about these mysteries, about the Universe, about creation, about all kinds of things. I am always astonished by nature. I think nature is a miracle. When I think of how much knowledge is in a seed, I'm in awe. And how a seed knows how to grow up and be what it becomes, how an egg turns into a human being or a frog, whatever, it's just awesome. So I think life is a miracle.

Veronica: What are you doing these days? I know you retied from surgery in 1989.

Bernie: I am busier now than I ever was. I retired from surgery because it was impossible to do, it was like doing three different things. I was a surgeon, I was counselling people, I was answering phone calls and letters. I was going day and night. I stopped the surgery because that was the most mechanical thing I was doing and I don't need to keep doing that. I'd been the doctor, I saw what all this could accomplish in patients and I felt that if I could change how doctors were created, I'd help a lot more patients than by being the doctor. So, I am not retired. I need to retire, believe me. I am teaching, writing, speaking, travelling to pass that word.

Veronica: Thank you Bernie. To our readers: I highly recommend Bernie's book, How To Live Between Office Visits. It is a compellingly moving book, full of as much courage and love as the man who wrote it and the people it was written about.


 

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