While I Appreciate All the Systems Out There, Ayurveda Is the Most Complete For Me: Dr Sheila Patel, Chief Medical Officer, Chopra Global

One of the core teachings in Ayurveda, says Dr Sheila Patel, M.D., Chief Medical Officer for Chopra Global, is that one’s personal body is “inextricably connected to the environment around you. The environment can also be thought of as your extended body. So, whatever is happening outside in nature is expressing itself through you as well.” This makes Ayurveda not just a vehicle for how we heal ourselves, but also how we heal the environment our actions are interwoven with.

Dr Patel will be speaking at the inaugural session of Namaste 2021 on August 13th on Ayurveda and Yoga and how through them the world engages with India. Here, she speaks on bringing Ayurveda to a western audience and the powerful perspective and impact that this ancient science has on health.

What was the impetus for you to shift from your wholly modern medicine training to integrative medicine? Was it a personal choice, your own experience with modern health systems or was it a curiosity to know more about Ayurveda and Yoga?

I would say, honestly, it was more because I was seeing the limitations in Western medicine practice. In my practice, for almost fifteen years, I worked in very small towns. I really got to know my patients because I'm in primary care as a family medicine physician.

People would come to see me, but I would also have the opportunity to see them if they came into the emergency room or were admitted to the hospital. In those fifteen years I learnt that we have great tools in modern medicine. We had better tools for when people were really sick to be able to help them, but then they would come back to the office and ask what they should do so that it didn't happen again.

And we really didn't have any answers to that. Our system doesn't teach us that and I found that very unsatisfying. So, of course I knew about Ayurveda and I had practiced yoga, but I was not educated on how you can use them as a healing system.  Apart from using Yoga for physical issues and being introduced to Ayurveda at home as food and using food for different issues. It is obviously so much more than that, but I didn't realize that at the time.

Some of my patients started coming to me and saying they had read this book or article about magnets or whatever fad was going around at the time. I knew enough that Ayurveda and Yoga are healing systems that use many, many different types of tools of which I didn’t really completely understand but which could be used for healing along with modern medicine. It was really mostly because my patients were not getting better from these chronic diseases and because I found my toolbox was very small, that I started exploring different ways of healing and that of course took me back to Ayurveda’s whole healing system.

I pulled out all my old books that I had bought over the years, but since I never really understood how to apply it, they just sat on the back shelves. When I started reading them I thought to myself, this explains all of our life experiences and it opens us up to using all these different tools that apply to the mind, body, spirit, all these different layers. We are taught in the yoga tradition that the body and mind are really one system, and all of these concepts made so much sense to me when I started thinking about what I had seen in my medical practice and how really, we need to activate our own healing ability for anything to work. 

While I appreciate all the different modalities and systems out there, to me, Ayurveda was the most complete. It's this consciousness based approach to healing which really encompasses everything about life. The tools it offers are so broad, you can use sound, colours, mantras, exercise, you can still use modern medicine, because that’s just another tool you just have. You just use it with more awareness. All of these basic principles made so much sense to me looking for the root cause, prevention and creating health. For instance, if you're doing a treatment you take care you don't get something else out of balance, and all of these concepts that I wasn't taught in western medicine. That was the start.

Was it easy for you to openly explain this to your patients in your practice in the United States?  One psychiatrist mentioned in an interview that she would use the tools of Vedanta during her counselling but not mention it to her clients, who perhaps would not understand the context.

There are some issues that keep people from embracing part of what's taught in Ayurveda. When I started reading a lot of books were very traditionally written, which of course was amazing, but they were described in a very particular context, they were written for the Indian context. Even for me--because I was raised in the West--while I appreciated it, it was hard to  translate that to myself and to my patients living here in the West.

I was living in Wisconsin and practicing in a very small town and nobody there really knew anything about Ayurveda. When I moved to California and started coming to the Chopra Center  and learning about Ayurveda and immersing myself in it, I actually got involved in some of the programs on meditation and yoga. The lectures I heard there explained all of this deep Ayurvedic and Vedic philosophy, in a way that we could understand it.  You can definitely explain all of these concepts, without even having to use any kind of language that people find might be a barrier. That's what I do now and we try to teach things that are very accessible for people. 

I usually do like to at least mention that a lot of these principles come from our ancient tradition called Ayurveda. I tell people we can apply these in the here and now, anywhere on the planet, because I like to honor the fact that that this does come from a very deep tradition, but you don't have to bog people down initially with a lot of Sanskrit terminology and they can still understand it and apply it.

Do you think that the current health care systems understand the complex interplay of biology, behavior, culture and environment while dealing with health? Do we even have a universal understanding of health? 

Definitely, in the allopathic or the Western medical system that I trained in there's no good foundation that puts all of these concepts together. I went to medical residency 25 years ago,  and we had to have a several weeks course on the biopsychosocial model. So even at that time, people were appreciating that people's environments (but that meant family, the environment, community that those things) could have an effect on their health. It was kind of the first initiation of how stress can affect your health but not to the extent that Ayurveda would have it--as the entire foundation of health. The environment, meaning the earth and the planet, is also part of our body. That is a concept that we don't hear about except in very small circles of people that are doing environmental medicine and things like that. The typical Western doctor is still  just at the beginning of understanding that even the mind and body affect each other, I think, even though we would think that it's a given. They still don't understand how important those connections are. 

Does Western medicine actually even connect parts within the body itself, let alone the mind and body? Has super specialisation fragmentized the body?

Western medicine is a very reductionist model,  so you just look at one thing. We do have a very highly specialized system, where the specialist says this is happening in the heart, but no, it doesn't have anything to do with your thyroid or your gastrointestinal system. Now things are starting to change as we're learning about the microbiome. People and even doctors are starting to understand,  things are connected in the body; but they're still not using that as a foundation for treatment plans. It's still very, very narrow. In primary care, and I am a primary care physician, I think because you're taking that holistic approach, there's a little bit more appreciation of how everything is connected. 

So, when one of my patients comes back and somebody has put them on a medicine, it's my job to think about how it might be affecting everything else. But I would say, the vast majority of physicians are not thinking that way, because the foundation isn't built on the idea of connection, it's built very much on the idea of separate systems. And then you narrow things down and you look at a very narrow window of physiology, and you treat that and lose sight of the big picture.

They've also made it very easy to find medication for things which reflect that we are not in tune with our body like taking medicines for sleep, and other very basic things which you mention in an article in your blog (Can’t Sleep? How to Treat Sleep Issues Without Medication - Deepak Chopra™️). How do we break these lifelong habits with Ayurveda, which calls for a  lot of investment in your own health and a lot of discipline?

 I really feel  a lot of it is just educating people for which we need time with our patients, and that's something that's been challenging. We're not really focused on preventing disease here, we are dealing with people who are already sick. So there's not enough time, but I think number one is educating people, and you have to have  conversations with people. We could try medicines, but that's a last resort. We have to tell people let's try these things first, because this has no side effects, and I think most people don't want to have the side effects. But I think a lot of doctors just immediately go to medications and they don't even know what to recommend before that.

So I educate people and it doesn't have to take that long, it might be just five minutes. I explain  to them that there are plants that have molecules that can help us induce our natural sleep. It can give us natural calm, and help us heal from the inside. They have less side effects and are not addictive, so why don't we try these things first especially with sleep medication? I don't prescribe strong sleep medications because they have a lot of side effects, and there are lots of things that we can try first that will help in the long run. 

You're right that people need to be engaged in their health and that I think is the biggest challenge. I've even heard doctors say that, “just take this pill and don't worry about it” or “it's fine, you can take this forever.” That may be the case for some people, for some it can cause severe issues. Firstly, I think doctors have to take their time and secondly,  patients have to want to be engaged in their own health. That is a big challenge but more and more people are realizing that they don't want to just get better, they want to be healthy 10 years from now. So I tell them, let's find a way so that you can still be healthy 10 years from now.

Since the time you joined the Chopra Center, what has been the trajectory of the Center? It's gone from strength to strength and plays a very important role in American society and is probably reflective of how perceptions have changed. Could you describe this journey? As an organization what were the steps that you took in educating people?

I think Deepak (Chopra) was really one of the first people who talked about Ayurveda in a language that's understandable to people and in a way that doesn't necessarily have to be in a very traditional sort of way that someone might practice it in India, because the foods that people eat are different, the lifestyle here is a little bit different. It's still using the foundational principles of Ayurveda and so that's actually when for the first time I really understood the benefits of Ayurveda. I've been with the organization for 11 years, but the Chopra Center  was started over 25 years ago with just  a little Center here in Southern California by Deepak along with another physician named Dr David Simon. 

They realised they have to educate people and Deepak has written over 90 books reminding people about their health. Ayurveda is intuitive and so it's just reminding people we do have the ability to heal ourselves. We have to give our body what it needs to do that and we have to take out the things that are interfering with that. Initially, it was a center where people who were looking for holistic and natural ways to heal or weren't being served in the western medical environment could come to. 

Many years ago, we started teacher certifications so people could come and learn to teach meditation and go through a certification process to learn and teach Ayurvedic lifestyle. We now have over 400 teachers around the world and not all of them are actively teaching, but they are touching all of their communities and spreading the word. Over the years now, as there are other organizations  training in Ayurveda,  it's becoming more and more, I don't know if I'd say mainstream yet, but definitely more recognized than it used to be. So that's exciting and the future for us is really how to reach the most people. We are trying to create partnerships. In 2019, the Chopra Center in California was a physical space, but now we take our teachings and the programs that we were running to other places around the country and eventually around the globe. 

Given the role of government and the pharma industry in healthcare, what is the role of private partners in creating awareness and are there counter pressures against Ayurveda? A recent media report said that prescription will now be mandatory for herbal medicine. Is that a good thing or a bad thing? Will it actually make it more difficult for practitioners?

Yes and yes. I do think these sorts of quality measures are necessary. We have the National Ayurveda Medical Association (NAMA) that certifies training programs, so people know if they're going through a program that has met some sort of standards.

Also herbal treatments have to be tested, because they can be contaminated. Some people are very nervous about taking herbs and so if there's testing done and there are quality measures, you can feel comfortable recommending them. I recommend a lot of herbs but I'll give people certain brands or make sure that they're tested. Otherwise you can lose credibility and the Western system, for whatever reason, is a little bit skeptical sometimes of new paradigms, new or different ways of treating things so they will look for anything to criticize Ayurveda, or using herbs, whether it's Chinese medicine or whatever. It gets a lot of attention and even basic practices like Neti cleansing or Oil pulling or other different things--they'll talk about the few cases where somebody could have felt some side effect and it blows up. Whereas millions of people are doing it without any problems. So I think whenever you're doing something outside of the medical system, you just always have  to be a little cautious. It's unfortunate.

But I think in the long run, it will help maintain credibility. I don't think that it would be a good idea to hold these herbs to the same standards as Western medications and things, because then the accessibility starts to go down. If you make things too challenging people will be deterred and then even being a practitioner becomes very expensive and Ayurveda is  meant to be for everyone. I think finding that fine balance between maintaining good quality and accessibility, whether it's the products or the practitioners, is very important. 

What about the products that you prescribe? Is it something that is made by your organization or do you source and recommend products made by other organizations?

I do both. For many years, we had our own signature products. We had some herbs, teas and spice blends. We are in the process of reformulating all of our products and it's going to be coming back in 2022. But for many years, most of the time I was at the Chopra Center, we had herbs that we recommended to people which were triple tested and of good quality. So if there is something that we manufacture or produce ourselves, we recommend that. But there are many different herbs and we certainly didn't produce all of the different ones that are out there, so there we've looked at some companies that we feel comfortable with.

What about research? The Ayush Ministry has now started trials with 2000 patients across different cities in the UK to check on the effects of Ashwagandha on Covid recovery. (India, U.K. to conduct clinical trials of ‘Ashwagandha’ for promoting recovery from COVID-19 - The Hindu). In India we accept what the vaidya says as it is an ancient science. What is the direction that Ayurveda research should take - should it be to convince the Western scientific community or to find how Ayurveda can be integrated with Western medicine?

That's a great question because, to some degree, we have to have validation for using herbs. Practitioners here have to be very careful as there's a lot of medical, legal issues around anything we recommend. So, to have some studies and science to back what you're recommending is necessary here. You are absolutely right, though - the way science and even  research was created here is very reductionist. It's like you're looking at one thing. You pretend you're controlling everything and you introduce Ashwagandha to one group and one group doesn't take it and then look for statistical differences. Then you say, “look what Aswagantha  did”, but the problem with that is that in Ayurveda you're not just using it in isolation. 

You're looking at the whole system and making multiple recommendations to somebody. In the western paradigm of research and science, people will always ask “What did it, what was the one thing that created this effect?” So there's this  contradiction between how science is done and how whole systems of medicine like Ayurveda and Chinese medicine work.

It was important in this last decade to have science that showed how a spice can really have some epigenetic effects and how herbs have very potent anti-inflammatory effects. So now there’s an explanation for how therapeutic these herbs and spices can be. But moving forward, we cannot sustain this level of research for every single herb and spice. So we work with researchers who are also trying to shift the research paradigm and are looking at whole systems research. 

We also need to look at how we can integrate these thousands of years of knowledge of Ayurveda with the modern scientific model. We have to find a way to merge the two and we don't have a solution for doing so yet. The other thing is, Ayurveda is very personalized whereas modern sciences study populations. Modern science studies if the majority of people get better or not. The truth is that even if the majority didn't get better, there might have been four or five people that got better but we just ignore that. We have to find ways to study the efficacy of ayurvedic medicine, without using our modern paradigm. It's really hard to study  individualized practice treatment. But they are starting to create these studies, where you just look at one person, you make an intervention and then you apply it to other cases. You look at the effects on that person over time. I think modern science is always going to be there, but we can't wait for that to validate everything in Ayurveda, although at some point we may have to.

How do you work with yoga in your practice and is it something you recommend as part of Ayurveda? Do you use yoga for therapy?   

Yes, absolutely. We teach yoga, the restorative or hatha yoga style with the Pranayam because as we know first of all yoga is a spiritual practice, but short of that it's really balancing the entire nervous system and creating that self regulation. Mindful Movement is one of our pillars of well being. We call it stress management, and it's about meditation and healthy eating. We incorporate yoga into daily routines and it helps in getting normal restorative sleep, healthy emotions, mindful movement and that's aligned with the circadian rhythms. Those are all of the different pillars that we talk about, and so, mindful movement is where we incorporate yoga because Ayurveda says movement is life. We try to teach how to balance  different forms of exercise. We do need some aerobic exercise, weight bearing exercise, but we also need the flexibility type of exercise that yoga can give us. 

Sometimes they come to us talking about the body and then we introduce  them to all of these benefits to the mind, benefits to the nervous system, benefits to our genes to reduce inflammation and all of these things now that are starting to be shown that yoga does. Then we talk about yoga for all of these different areas. For example, for sleep, we might teach a little restorative yoga that someone can do in the evening.  

People are speaking a lot about Yoga now and getting some structure around these things. There are Certification programs for people to become a certified yoga therapist. Not only can you teach a yoga class for the general public  but you can also use it therapeutically.

How can we take this knowledge for individual growth and wellbeing and apply it to other issues in our communities, neighborhoods, with countries at the global level?

Our mission at Chopra Global is to empower personal transformation. So we talk about personal transformation for social transformation  and for global well being because we know everything's connected right. When people are working on elevation of their own consciousness, naturally,  that elevates the consciousness of everything around them on the planet.

There are some very core principles in Ayurveda which when you start to learn Ayurveda,  naturally makes you more socially conscious. You think of the environment as your body, so why would you trash the environment if that's going to turn into your body, eventually? I found myself, even though I considered myself a pretty responsible person,  thinking about the soil actually becoming my body and that the air is my air. When we start to awaken that consciousness within ourselves, we realize we're connected to everything and so why wouldn't I want to take care of everyone around me? I love teaching and telling people  we don't have to force things when we do the right things together. It's actually a very gentle process,  and it's really just removing the things that are interfering with our natural healing. We've modified things in the West here, relative to the traditional practice but it's the same idea - eliminate all things that are interfering with that natural healing ability and bring in the nourishment that the mind and body need to heal itself and that's all you need to do.

(Sheila Patel, M.D. is a board-certified family physician who is passionate about bringing holistic healing practices into the Western medical system. She earned her M.D. at the University of Wisconsin Medical School and completed her residency in family medicine at the Ventura County Medical Center in Southern California. For more than a decade, she practiced full-spectrum family medicine, from prenatal care and deliveries to ER coverage and primary care for all ages.)