Health Longevity Secrets

On Healing with Dr Amitha Kalaichandran

• Robert Lufkin MD • Episode 201

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What if healing isn't the same as curing? Dr. Amita Kalaichandran draws from her unique background in conventional medicine, public health, integrative approaches, and journalism to reshape our understanding of true wellness in ways that might surprise you.

At the heart of this conversation lies a powerful distinction: while Western medicine excels at curing (removing disease), healing represents something far more profound—a return to wholeness that integrates illness and challenges into our lives. Amitha thoughtfully explains why even those facing terminal conditions can find healing, creating meaning and wholeness right through the end of life. This perspective challenges our cultural tendency to view death as simply "losing the battle" with disease.

The discussion moves into fascinating territory exploring psychological safety in healthcare settings. Drawing from Amy Edmondson's groundbreaking research, we discover how the ability to speak up without fear creates not just better patient outcomes, but also nurtures innovation and prevents provider burnout. This concept extends beyond hospitals into every workplace, where a sense of belonging and voice directly impacts both individual health and organizational success.

Perhaps most intriguing is Amitha's nuanced take on psychedelics as healing tools. She explains how substances like psilocybin and MDMA might work on the brain's default mode network to "untangle the knots" of fossilized thought patterns where traditional therapies sometimes fail. The conversation acknowledges both the promising research and necessary cautions while suggesting that these compounds might offer flexibility in thinking that many of us lose as we age.

Don't miss this rich exploration of healing that weaves together cutting-edge science, ancient wisdom, and practical insights for anyone seeking a more integrated approach to wellness. Subscribe now and join us in reimagining what healing truly means for body, mind, and spirit.

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Speaker 1:

Dr Amita Kalai Chandran received her medical degree from the University of Toronto and completed a fellowship in integrative medicine through the University of Arizona. She also completed psychotherapy training through the Medical Psychotherapy Association of Canada and a journalism fellowship at the University of Toronto. Hey Amita, welcome to the program.

Speaker 2:

Welcome. Thank you so much for having me.

Speaker 1:

I'm so excited to talk about your amazing book On Healing that just came out. You've got to read it. It's fascinating. But before we get into that, let's tell the audience a little bit about your background, because you come from both conventional sort of traditional allopathic Western medicine but also some alternative training as well. Can you tell a little bit about your path, how you got here and became interested in this space?

Speaker 2:

Sure. So my path is probably pretty unique in terms of just conventional medical training. So I actually started off training in public health and global public health and epidemiology at Johns Hopkins. So that's what I did right after college and that was originally my first passion. It's still definitely an interest of mine research and public health and there I really focused on preventative health, preventative medicine on a global community scale. So all kinds of different interventions, the research behind it, the epidemiology behind it, and I realized that in order to make the impact that I wanted, I wanted to have that patient care experience, not just at the public health level. So that took me to the University of Toronto I'm Canadian. That's where I did my undergrad degree, I did my medical training there and then I went on to residency in primary care, specifically pediatrics, outside of Toronto in a smaller town, and that's when I really realized that there was a lot of what I was learning which I know you can relate to that wasn't necessarily applicable to the day to day aspects of well-being and health, and I was experiencing that myself through burnout.

Speaker 2:

That led me through to doing a fellowship in integrative medicine at the University of Arizona, and I usually define integrative medicine as the evidence-based approaches that are involved in you know, eastern medicine, alternative medicine, but really where there's a science-backed approach, so it's effectively a form of lifestyle medicine. I also did a fellowship in journalism and that led me to understanding the importance of information, scientific literacy and communicating that information effectively to the public. So that led to articles in places like the New York Times, wired, and in between, I founded a small tech startup. It was a kids' health app in 2015. That was a really interesting experience. It was before AI was mainstream, so it was a bit of a struggle trying to get that, you know, to be successful, but it was such an amazing experience and that led me to consulting for places like Twitter and a number of other companies that focus on health and wellness and longevity, which is what I do at this time.

Speaker 1:

Yeah, I love your diverse background and that you bring expertise from so many different areas and in particular in the book on healing. I particularly love the sort of psychological overlay that you bring to the book and talk about that. And just talking about healing, who's this book for? In other words, can everybody heal? I mean, let's say I've got stage four metastatic cancer. Am I a candidate for healing?

Speaker 2:

I love that question because it really allows us to talk about what it means to heal and how healing is different than curing. And I think the biomedical model typically focuses on this idea of curing, ie removing disease, getting rid of disease, getting rid of illness. But healing is much bigger than that. Yes, it can include curing, but more broadly, it's about this return to wholeness, which is really this idea that Wendell Berry, the American poet, described. So returning to wholeness really means integrating that illness, that disease, that hardship, that challenge to become a more resilient version of yourself.

Speaker 2:

So if you do have, if it is someone that has stage four cancer or terminal illness, they can indeed be healed. Cancer or a terminal illness, they can indeed be healed. There is a way to return to wholeness, even if you know it is through the end of life, and you know there's stories in the book. There's a story in the book that, where I talk about someone who was facing that terminal illness and they did find healing People can be healed during the death process, during the dying process. I think we're more aware of that now as we talk, as we have more frank conversations of end of life. So I definitely think you can be healed. Healing is for everyone.

Speaker 1:

Yeah, it's such a great message. I mean in in, in Western medicine I you know, I remember sort of a culture or an attitude I still exist that you know when patients get better it's a win, and when the patient doesn't get better, it's a loss. And it is a loss certainly. And when they die of cancer, they lose to cancer and it's a negative thing which it is. It's a negative thing which it is, but on the other hand, there are possibilities for healing, even in a situation like you said, like that, that we can all become better people and move to a better space in our journey which is ultimately through death for all of us. But by healing we can elevate our experience above whatever the physical constraints of our, of our world are. And that's that's what I really really enjoyed, that part of your book, and you take this, this really like holistic approach to healing. So can you talk a little bit about about the, the advantages you think to to integrating the physical, emotional, social aspects? What advantages does this give us compared to more traditional approaches?

Speaker 2:

There are a lot of advantages, I think, and, just to be clear, and I think you would agree, that the conventional approach is not necessarily negative or bad.

Speaker 2:

It's just not the whole story and the magic really happens when we combine the best that we have of, you know, rigorous research, trials, science with everything that we know about other elements that keep us well, like social connection, like our physical environment, the design of our workplaces, the culture of our workplaces.

Speaker 2:

You know the importance of things like understanding your own history and your story, and you know traumas and triggers. All of those things are like little puzzle pieces that keep us well but also contribute to illness or a lack of wellness. And a really good example of this is if, for example, someone is like what happened to me, having symptoms that are related to your environment, like your work environment or your home environment. That's not necessarily pathological, right. If someone is feeling chronic stress because their home environment is highly stressful, or their work environment is highly stressful, or they don't feel like they belong, or they feel like it's not a place they can thrive, feeling anxious or depressed or not, or having issues sleeping, is probably your body and your mind telling you that this is an unsafe situation and to make those make those changes. So it's really about taking that more whole person approach that looks at the environment, that looks at the mental health, that looks at the emotions and then sees how it all links together with physical health as well and then, ultimately, longevity.

Speaker 1:

Yeah, I mean I was struck in your book how the concept of psychological safety is really pivotal in the narrative. So how does fostering an environment impact both on individual healing but also maybe organizational well-being in health care settings?

Speaker 2:

So the pioneer there and I'm so grateful she blurred my book as well is Amy Edmondson. So she wrote some really great books on psychological safety and did some of the first studies that looked at specifically hospital environments and hospital teams and how a lack of psychological safety impacts patient outcomes, medical error rates, that sort of thing. And by psychological safety she effectively means the ability to speak up without repercussions if something is incorrect or wrong or troubling. So that could be anything from you know a nurse wanting to speak up because they see that the doctor is writing the wrong dosage of the medication, right? So if she's able to speak up, the patient is likely to get the right dose of medication. If she feels that if she was to speak up she or he was to speak up that they would be reprimanded, they're less likely to speak up and that could have a poor patient outcome. So that's the difference between sort of, or that's effectively the meaning of what we mean when we say psychological safety.

Speaker 2:

Now, if we think about just in a workplace culture situation, that has a ripple effect on the psyche of healthcare providers too, because if you can imagine if you're going into work every day knowing that you can only really focus on specific tasks and that if you notice that something is off, that you just don't have the ability to speak up, you will be in a state of fear and anxiety because you can't speak up. But then you know something is not quite right and that actually does have an impact on one's health. It links also to this idea of moral distress, so that sense of feeling completely helpless, even though you're one is faced with something that's immoral or unjust. So it all kind of links together and it ultimately does impact workplace culture, which impacts the health of individuals but also the outcomes and the performance of the organization.

Speaker 1:

Yeah, this whole area has become a political minefield with today's culture. You know, at the time of this recording your alma mater, johns Hopkins, has had hundreds of millions of dollars withheld from their public health programs, largely through the. You know, withheld from their public health programs, largely through the effect of dismantling USAID, but not on the political side. But just how do you think? Have you talked to your colleagues at all about those repercussions or ramifications of that?

Speaker 2:

Yeah, I think that's a really important question. You know, there's been a lot of dismantling, whether it's a very longstanding research studies like the DPP, which is the big diabetes study. There's a lot of NIH funding that's being cut. So we live in a time where there are a lot of cuts to rigorous science programs, rigorous research programs. You know it's just happening now, so I've had a few conversations with colleagues. There's definitely a lot of concern, a lot of fear, and so I don't know what the answer is.

Speaker 2:

My hope is that these are, these could be reversed. I don't know if that's the optimist in me, because I can see why. I can see why, why one would suggest cuts in different areas right. So in general, looking at organization, in general, cuts are made for the purposes of saving money and efficiency. Sometimes that can end up going too far, where the cuts are made in the wrong places, and so that's why I'm hopeful that we'll hear that potentially, some of these things will be reversed, but I don't know if I have a clear answer on that. I definitely would say that we have to stay informed and advocate as much as we can for good research, for efficient research as well, and effective research.

Speaker 1:

Yeah, it's certainly such a challenging time we're in. I guess, looking at your experiences with workplace challenges like in the medical field, if you could wave a magic wand, what reforms do you think would be valuable to promote a healthier environment for healthcare professionals?

Speaker 2:

So I think the first thing that I would recommend is that anyone that is in a leadership or management position be empowered with the skills and the resources and the time to do some very serious self-reflection and integration work on their own traumas and triggers and things like that. Because when you think about the average healthcare leader, especially if they're a physician, most of them haven't really had a break since they were an undergrad right. Most of them do research in the summertime and it's just a ladder that you keep climbing. Then you know if you get into an academic hospital, then there's additional pressure. So again, the ladder just never. It just continues to elongate. So you can imagine, if we take our compassionate approach you know a compassionate lens that most individuals in these positions are not exactly the most integrated, the most calm, the most grounded, the most centered, because they're trying to manage all of the different expectations of themselves and try to find some way to lead and manage effectively. That's why so many struggle. So I would say, you know, to start off is to be able to give these leaders and managers the opportunity to you know whether it's some type of a course, some type of time off to really sit with that really reflect and think about what their vision is in terms of being a leader and being a manager. And I would start there.

Speaker 2:

I think the second thing is about how do you create a culture from the ground up that is conducive to thriving so not just performance or patient outcomes or value-based care metrics, but to thriving Because all those things go together. When you have a healthcare system, when you have every person on the team rowing in the right direction, feeling like they belong, feeling like they can speak up. With this good psychological safety, you will get high performance, you will get great patient outcomes. That's what Edmondson's research found. So it's about how do you create that in a way that's not just you know several things that are sort of listed in policy documents but actually enforced. How do you build accountability?

Speaker 2:

And I think the third thing is to create a culture that is conducive to innovation. And that's where the psychological that's the other side of the coin with psychological safety is. When people speak up, it's not just that they want to speak up because they see something that's wrong. They want to also speak up because they see something that can be done better. And I think the best innovators you know and we're probably seeing some of an like, a bit of an exodus in the conventional healthcare system into tech. For this reason, because so many see the inefficiencies, see the opportunity for innovation, and if institutions and workplaces in healthcare are more conducive to those ideas, I think you know again, that's where I think the magic can happen.

Speaker 1:

What do you think people or institutions where I'm from like conventional allopathic medical schools, this sort of thing and the kind of the mainstream Western medicine. What do we get wrong about healing? In other words, what are some things that we could change that would have a huge impact?

Speaker 2:

So I would start with what we all get right right. Well, western medicine gets right and Western medicine gets a lot of things right, especially when it comes to acute care and procedural interventions, where things go a bit sideways. I'm a bit cautious to say it's like it's the fault of the system. It's more that the incentives are set up in a way that kind of make those outcomes inevitable, and what I mean by that is what we get wrong, or what the conventional system gets wrong, is waste. So lack of efficiency, a lot of spending, excessive spending and poor patient outcomes. So we haven't really reduced the burden of a number of different chronic diseases, even though the cost of the system increases every single year. Right, so there's clearly a disconnect there and it's likely, at least in part, due to the incentives being more aligned with, you know, more interventions, more costly care. If we're able to shift the incentives so that we have more of an upstream approach that prioritizes lifestyle interventions, that prioritizes things like diet, exercise, movement, I think that we're, we create a different system and I think that's what value-based care is trying to do, with limited effectiveness of course, but at least it's an attempt.

Speaker 2:

And I think this is where lifestyle and integrated medicine plays a role is if we're able to teach healthcare providers even just like giving them a toolbox that they can share with their patients of some, you know, some very basic information on nutrition, sleep, exercise, movement, then we can help set them up for success with their patients.

Speaker 2:

At the same time, we also have to respect that these physicians often don't have very much time with each patient, so if they're meant to do X, y and Z plus counsel their patient, we're just potentially adding more to their plate. So I think're meant to do X, y and Z plus counsel their patient, we're just potentially adding more to their plate. So I think that's really where the innovation side comes in, like, how can we get this done in a better way? And that's potentially where the role of tech and startups come in, where we can actually help provide this care or this management or this information to patients before they even get to the hospital and actually prevent them from needing to go to the hospital in many cases as well. And I think that's where we're headed.

Speaker 1:

Yeah, it's such a great point you make about how Western medicine, conventional medicine, is so effective with acute diseases. The pills, the surgeries, you know they work. You know, in a lot of situations and for chronic diseases that we're facing now they really don't work as much and, as evidenced by the epidemic, biblical numbers of these, you know, chronic diseases we're facing now in the 21st century, is that a fundamental problem of the way the Western medicine is set up or will it be able to somehow pivot and do what it does with chronic disease with its pills and surgery and tools that it's so effective with acute disease?

Speaker 2:

Mm-hmm. Yeah, yeah, I think what we're starting to see, and why I'm pretty hopeful, is that we're starting to see this very slow shift and I think it will hopefully accelerate where hospitals will become more focused. Acute care should be in a hospital setting. Anything that requires you know, medication management, counseling on diet, exercise, nutrition all of those elements can be done virtually, can be done through various tech ecosystem platforms, ideally when they're all integrated with medical records and prescriptions and all that kind of stuff. So I do think that we're seeing that shift. It's just a question about how fast we'll get there, because I definitely, I definitely can see that it's that it's happening.

Speaker 1:

Yeah Well, we keep our fingers crossed, changing gears here a little bit. Your book. You talk about psychedelics and and healing and psychedelics have. We're having a renaissance and in the psychedelic field, after being, you know, illegal in most cases for decades. Um, what is it about psychedelics that heal?

Speaker 2:

So in chapter 10, so this is the chapter that I added right at the end of the book. It's chapter 10. And I was trying to figure out if I was going to add a chapter on psychedelics. Psychedelics you know, there were a couple of big studies that were just published in JAMA, new England Journal of Medicine, that was looking at specifically psilocybin, and I thought, you know, is this something I should be talking about? Is this something people are going to be talking about in a couple years when this book comes out? And the way that I squared it was, I think it could be interesting or I saw that it could be interesting if we, if I, was able to contrast psychedelics with opioids and just call the chapter plant medicine, because all of us know the dangers of opioid addiction.

Speaker 2:

Now, I think that's you know. We're all up to date on on the devastating impact of opioid addiction. We also know that opioids are very effective for pain, right? So there's always nuance. I think I always joke that if there's one keyword for this book, it's like understand that there's nuance.

Speaker 2:

Nothing is ever black and white. Psychedelics are similar, so it's not a black and white thing where there's a lot of hype about it. There's a lot of excitement about it. I think that excitement and hype is valid. Or, you know, or treatment for, or new treatment for, refractory depression, ptsd, anxiety for decades, right, it's all pretty much been in the same class of medications, so having something new is exciting. I think the initial trials have been really interesting, especially with psilocybin for trauma and depression and MDMA for trauma. I think those two specifically are really interesting.

Speaker 2:

But we have to be cautious, right? I think there is some barriers to, you know, sort of widespread use. Obviously, there were some regulatory hurdles a couple of years ago that I think were important to look into, because anytime you bring something into the mainstream, all of the studies have to be done in terms of efficacy and safety, and so we're still in that period. That said, the goal of the chapter was to present the evidence that we have right now, with some of the drawbacks, and I talk about, for example, the recreation, a case of like this.

Speaker 2:

You know this very famous case in Canada where this young man took a recreational dose of psilocybin mushrooms like a high dose and had a very negative reaction that had a lot of consequences. And so, again, it it's the nuance, it's that, yes, there's immense potential, but it involves understanding the set, the setting, the dosage, the intention, making sure that it's a supervised experience, making sure that the safety and benefit ratio is there. So I know I sort of digressed a little bit, but, all that to say, I think there's immense potential, but we, I think we just have to stay tuned.

Speaker 1:

Yeah, it's such a fascinating area. I mean, what is it about those, those drugs? If you take recreational drugs, let's say, let's say you take opioids and, like you say, they'll make the pain go away. But I won't have any insights into life. You know, I snort a couple lines of cocaine. I'll have some interesting conversations with friends, but I'm not going to rethink the worldview or necessarily have any deep healing. But what is it about psychedelics that? Where do they take us or what is it about them that allows them to have these effects that we don't see with other drugs of abuse or other recreational drugs necessarily?

Speaker 2:

Yeah, I think that pharmacology is very fascinating and I know Michael Pollan has written a lot about this as well. It's interesting because most scientists will point to an area of the brain that they call the default mode network or the DMN, and the theory is that psilocybin, mdma and other psychedelics effectively act on that network and almost reset things. So if someone, for example and using Michael Pollan as an example, because he talks about this well in the book where, if you're feeling this sense of stuckness, right, if you have early childhood trauma or a series of difficult events that almost cause a fossilization of a sense of self or a sense of moving around in the world or responding to situations that is maladaptive, all the therapy in the world and all the SSRIs potentially in the world could not necessarily undo that fossilization. But what some of these psychedelics reportedly are able to do is that they almost kind of untangle that you know, those knots so that things just are smoother so we can have more insights and more flexibility. I think the flexibility is a big part of it is flexibility of thinking, understanding a situation in a different way, integrating it in a different way, and self compassion as well. I think that's part of it.

Speaker 2:

I think there's also been experiences in some of these research trials to have this entheogenic effect. So this especially with MDMA, but to a degree with psilocybin too. So this linkage to the spiritual world ayahuasca is also one that's known for that, even though it hasn't really been researched in the same way. And so even just that sense of something bigger, that sense of awe, that sense of okay, I understand my place in the universe, I think that sense of the sublime can also have an impact. But the actual nitty gritty in terms of how is this biologically plausible, what is the actual mechanism? I think even the best researchers in the world are trying to piece that together.

Speaker 1:

Yeah, yeah, the stuckness you mentioned. It's almost. I've heard it described too as what people go to as they get older. You know they're stuck in their ways, they're old, they're inflexible, whereas a child has many options, it's creative, the world is super, but it's almost too many options and then, as you get older, expertise is narrowing down the choices, so you don't even consider different things, you go right to the what is the right solution. So it's almost like there's a place for even all of us, as we get older, to to, um, get out of the groove of the record per se and turn, you know, get out the default mode network, get out of that and open the possibilities that psychedelics could, it could do. Do you think there's a place for? Well, I guess it begs the question. I guess we can all heal and that we've all had childhood trauma. Nobody gets, nobody has a good childhood. You know, and I mean in all ways, we're all gently traumatized and some severely traumatized. But do you think there's a place then for psychedelic healing for everyone?

Speaker 2:

Potentially, you know and I think back to your point just around sort of the stuckness like there's also, there's also in it. So there's a maladaptive side of it, right, and then there's adaptive or positive side to that. So when we build these pathways or these ways of thinking, it's in order to navigate and survive and, ideally, thrive in the world, right, there's a reason most of us might take the same pathway to work, or, you know, it's just easier, there's less cognitive load, you know. But where we get into trouble is when, when it leads us to making assumptions or in maladaptive thought patterns that ultimately actually don't help us thrive, don't help us, are not conducive to well-being.

Speaker 2:

So that's the stuff that you know is rooted in the early childhood trauma. And, to your point, it doesn't necessarily have to be big T trauma. It can be, you know what, what a friend of mine calls benign neglect. Right, it can be. It's how we sort of like, how all of us, you know, our, our childhoods, really, you know they imprint on us and they basically are the mold by which we navigate all of our relationships in life, you know. And so how do we now create that flexibility? So to your point, I think psychedelics potentially have a role there, so does so do other? You know modalities, therapy, even conversations that we're having now. You know, I think, pop culture. I was watching a really interesting episode of White Lotus. I don't know if you watched that show yesterday. You know there's a really wild scene in yesterday's episode.

Speaker 1:

No spoilers please. I haven't watched the last episode yet. No spoilers.

Speaker 2:

But we're seeing in pop culture, just even the power. I'll tell you, it involves a powerful conversation between two people, but the ability to be vulnerable and to be open and to lean into that curiosity and wonder and dare to see something differently. It doesn't mean that you have to see something differently, right, but it's about stepping back a little bit from you know, those ingrained, the stubbornness, the survival mechanism, and just step back just a little Like what if? What if I did it this way? What if I saw the situation this way? Can I have a little bit more compassion for this individual? Can I have a bit more compassion for myself? And that opens, opens a whole new pathway. And I think it can be facilitated again with, with psychedelics. But there's so many other tools, there's so many other doors into the same room, so to speak.

Speaker 1:

Yeah, it's. It's fascinating and how things like meditation, even, you know, turning down the default mode network and other types of introspective practices can all get us the same way. It's almost like how a metabolically healthy lifestyle is gets us, you know, improves our obesity, our diabetes, our cancer, our heart disease, our Alzheimer's disease and even our mental health. It's funny how so many of these root, foundational elements affect so many diseases and so many things in our life. Well, I want to be respectful of your time. And what else? What else? Is there anything we haven't touched on that you'd like to, you'd like to mention or discuss now?

Speaker 2:

Yeah, I mean, I just think we're at a really interesting time. I think both of us, you know, have worked in the area of with all of these other tools, whether it's just better information online, better quality information, better quality information with AI modalities, now the option of various different platforms to take ownership of their health, to see their own data platforms, to take ownership of their health, to see their own data. So we're at a really interesting turning point and I'm just really excited to see what's next.

Speaker 1:

Yeah, definitely. Well, the book is On Healing Amita. This has been wonderful. Get the book to dive deeper into the things we've talked about today. But, thank you so much. Maybe tell, tell our audience how they can uh, how they can reach you at your website and social media.

Speaker 2:

Sure, definitely so. Uh, so the website for the book is on healing bookcom, so you can read more about the book there. Um, I did a limited series podcast there as well. Um, and then my general website is drmethacom, so you can read a little bit more about me there as well.

Speaker 1:

Great, Well, thanks again, amitha. This has been a wonderful conversation, and thanks for your great book. I really enjoyed reading it.

Speaker 2:

Amazing Thanks. Thanks, Dr Lufkin.

Speaker 1:

Call me Rob.

Speaker 2:

Rob.

Speaker 1:

All right, thanks, bye-bye.