Interview with Dr. Len Saputo : Integral Health Medicine
by Richard Whittaker & Rue Harrison, May 4, 2014
Len Saputo’s book A Return to Healing is a clear and rather grim assessment of the state of health care and the negative aspects of big pharma in the U.S. It’s a disturbing read, and a compelling one. It ended up in my hands somehow to add its voice to other pleas for addressing endemic problems in health care we face today. Let’s not even mention how the industrial food complex is contributing to increasingly disastrous public health issues like obesity and diabetes.
These problems are so big it’s hard to imagine how one might make a difference in helping us move toward a more compassionate and less bottom-line way of caring for people. And yet, against all odds, there are people dedicated to making a difference such as Dr. Len Saputo. After reading his book, I asked him for an interview. We spoke one evening at my home in Oakland. My wife, Rue Harrison, a Marriage and Family Therapist, joined us.
Richard Whittaker: I was curious about what you wrote about being in medical school, that it was kind of a military culture and that students go for long periods without sleep.
Len Saputo: Throughout our whole training it’s like that.
RW: So the point is, and I think you make this point very clearly in the book, there is a natural diminishment of a person’s capacity, because they are tired. So what’s the logic behind that?
LS: I’d like to know that myself. I don’t see that that’s a wise thing to do. The people who engage in that kind of behavior are authoritative people who want to control things. A lot of what we do is not based on good medicine. It’s based on the way medicine is practiced. A lot of that is run by the people who pay for the education, which is the pharmaceutical industry to a large extent. They fund a lot of things, like research grants. NIH spends $32 billion a year in research; the pharmaceutical industry spends $92 billion a year. So there’s a lot of control that comes from that. And there’s this thing called “publish or perish.” You’ve heard that one?
LS: If you don’t publish and you don’t bring money in, then you’re not really going to last in that setting very long. You’ve got to bring money into the university by getting grants. Like I’m involved in a grant now with UCSF from the National Institute of Health for $7 million dollars. We’re doing work on infrared light therapy. And a lot of that is about my own work. About half of that money, I’m going to guess, will go straight to the university. The rest will go to the study. It’s almost tragic that that much money is spent on a study that’s not going to decide that much. The fact is I already know what the outcome of the study should be, because I’ve been doing this work for 15 years. And I know it works. But we still have to prove that it’s right.
LS: So that kind of control is huge in keeping the facility running. If they gave the grants away, it wouldn’t work financially.
RW: I remember in your book you described idly looking at an ad about a device using light to help people with pain. Is that what you’re referring to?
RW: It sounded like one of those moments where, even though your mainstream training might lead you to assume this was quackery, something in you was curious and decided just to take a look at it.
LS: I’ve always kind of been that way. When I first went into medicine, I was really disappointed in how it was practiced, because of the detached role that we took. The approach was “give me a prescription pad and a pen.” I’d write a prescription for everybody who came in, sometimes two or three—or more. And quite frankly I played tennis more than I practiced medicine. I’ve played the senior circuit. And it wasn’t until the late 80s that I began to see another way that medicine could be practiced that I could buy into.
RW: So this part where you’re writing a prescriptions for every patient was just what you’d been trained to do.
LS: Yes. You can play this game where you have this symptom or that disease, and then it’s which drugs do you use? That’s the mentality. It’s not like, gee, I wonder why that person has this problem? I wonder what really caused it?
That’s why I said, I do ear-work, because it’s what I believe in.
RW: You do what kind of work?
Rue Harrison: Listening to people.
LS: Yes. It’s like psychotherapy, because that’s the basis for almost all illness. It depends on your faith. I have a lot of faith that the universe is very organized, and in a way that’s to our advantage—many times for reasons that we can’t understand; but there are always lessons there. If we listen to those lessons, we’ll learn something. What you think becomes such a powerful manifestation of your health; headaches, hypertension, diabetes, cancer—anything that you can think of that’s a disorder. It always has spiritual roots to it, and emotional, psycho-spiritual roots. I mean, in training we were told about stuff like that, but we never really practiced that way. We were still in the “prescription technology” mentality. I’m not saying there’s not a place for it, nor that there aren’t wonderful things in medicine. I would be the first to tell you that we’re really hot when it comes to doing things. But it’s not just about doing to, it’s about being with.
RW: We can "do to," really well. That’s what you’re saying?
LS: Yes. But we don’t be with very well, and that’s a huge part of what healing requires as opposed to fixing symptoms.
Rue: Just a couple of generations ago there was the ideal of the family doctor, who was like what you’re talking about.
LS: Dr. Welby. Yes.
Rue: But that went away.
LS: Well, yes, it did. As medicine became a business rather than a service, we saw that transition take place at the speed of light. Now what we have is a business where we spend $2.8 trillion dollars a year on healthcare. It’s twice as much as any other country in the world, yet we’re ranked by the World Health Organization as Number 37.
RW: What you just said—that medicine used to be a service, and then it became a business—is such a major point.
LS: And here we are. Well, it’s not just medicine that’s business. It’s law. It’s medicine. It’s science. It’s religion. It’s sports.
RW: And it’s education, too.
LS: It’s the culture. The culture is a business-oriented, materialistic-oriented community.
LS: As long as we’re that way, what difference does it make how you go about what you do? You’re going to be there to make money. Now fortunately for me, I don’t have to work. So I see my new patients for an hour-and-a-half. But I get paid for about half that, because most of my patients are Medicare patients. So I don’t make any money. I practice and I haven’t taken home a check in years.
RW: You’re practicing as a service, then.
LS: It is what I try to do. That’s why we invented some of the things we did, like the Health Medicine Forum, which was such a key way for me to express my thoughts and feelings about how medicine is practiced, and what it could evolve into if we just cared.
RW: How long ago did you embark on this path and begin searching for some alternative?
LS: I probably always had a lot of that in me. Somebody would come to me and they couldn’t pay for it, I wasn’t going to withhold service, and I still don’t. I work on a sliding scale. If somebody comes in with a diabetic neuropathy, a painful horrible condition, and I can fix it in 10 minutes, am I going to say come back when you have the money and then I’ll treat you? There’s something awfully wrong with that.
LS: At the same time you have to live. I really believe I’m being taken care of, and that’s why I don’t have to work, because I never made much money in medicine. I never did. I could have. There are a lot of people making half a million or a million dollars a year, because their goal is to generate income. But for me, the practice of medicine is for making other people happy, for making them feel good. When someone comes to see me, that’s the objective.
And that’s what love is all about. It’s not about what we think it is. When we’re young and have hormones raging, we find somebody that’s attractive. That’s about you. But love is really about the other person. I think that’s how community is built and, until we operate that way, we’re not going to see that shift. It’s about caring. You have to be lucky to care.
RW: Would you say more about that a little bit?
LS: Well, I’m greedy, basically. I want the best thing for me. And what I find is the more I give, the more I get back. [laughs] So why not be greedy? Give as much as you can! Because you’re only here for a couple of nanoseconds out of 13 billion years, anyway.
RW: There’s a saying in a group I’m part of that’s attributed to Gandhi: be selfish, be generous.
LS: Yes. It’s the same thing. He’s right!
RW: You said you don’t have to work. So does that mean that you’re independently wealthy?
LS: My dad was a barber. My parents worked hard to buy real estate. And some of the real estate they bought turned out to be good real estate. That’s why.
RW: And you speak of faith, so tell me a little bit about this.
LS: It’s my spiritual life that runs me.
RW: Can you say more about that?
LS: It’s not religious; it’s spiritual. It’s a deep conviction that things work out for the best even though a lot of the time that’s not understandable. Somebody gets cancer. Is that a good thing? You have to be a moron to think that that’s a wonderful thing to get. But most people that you counsel who have cancer have had tremendous opportunities.
Rue: They grow.
LS: They grow. They do grow, and at a very high price. But they grow. Would they have grown otherwise? A lot of the time I don’t think so. So I have great faith that I’m being taken care of. I just have to continue giving. If I do, it all comes back.
RW: Would you speculate about where that faith comes from?
LS: The experience. My life has been very, very difficult—particularly when I was younger. It was very difficult for me to work through the first 40-45 years. It wasn’t until I was close to my 50s that I began to appreciate the things in life that really matter, and to see the intricate organization and perfection of how things unfold. It’s mind boggling.
There’s a lot of suffering. The Buddha was right. It is about suffering, and we suffer every day. But then we have moments like this, because it’s wonderful to be able to communicate with people who understand this.
RW: Years ago when I first came up to San Francisco, I had a little job painting for a man named Dr. Spotswood. He was a psychiatrist. I asked him, “Dr. Spotswood, you’re a psychiatrist. What’s the world that you see? What have you learned as a psychiatrist?” He said, “What I’ve learned is that it’s a veil of tears out there.”
LS: Well, psychiatry has gone down the tubes. They should be embarrassed. It’s become psycho-pharmacology. Is it really the neurotransmitters that are the problem? Or is it life itself, and the suffering in how it unfolds—and the PTSD that people have? I mean it’s pretty obvious that it’s the struggling through life that causes the problems. If you can adapt to it, no sweat; but if you can’t, your health gets bad, because of the mind-body inseparability. But psychiatrists have lost it. I mean you do the work. You’re the new psychiatrists. It’s the MFTs who are doing it all today.
Rue: Right. I hear the stories. I have one person who says when I try to tell my psychiatrist my story—and this is at a public clinic where she’s getting her pills—he says, “Take that to your therapist.” It’s because he doesn’t have the time.
LS: I know, I know. But what do you mean he doesn’t have the time? There’s something else he is missing, not time.
RW: Oh, you know, I wish Peter Newsom was sitting here. He’s a friend of ours who is a psychiatrist. He would love you.
LS: He would agree, probably.
RW: He would. Peter told me that medical school almost killed him.
LS: Do you know what the suicide rate is? [no] And suicidal ideation? I think 11% of medical students consider suicide.
RW: He told me medical school was just absolutely dreadful.
LS: It’s the most unloving, autocratic system. It’s about following their rules. A lot of it is by proclamation. When you take issue with that, you get into trouble.
Rue: Is it based on weeding out the herd, or something like that?
LS: No. I think it’s just about imposing their belief system, and it’s full of flaws. It’s not so much about how do you feel about what’s happening? Or do you think there is another way to do this? It’s like, this is it—you don’t answer the question right, you don’t pass your boards.
I don’t think there’s anybody qualified to test me for my ability to be a doctor now. I would take strong exception to answering most of the questions that are there, because they’re all geared to what drug are you going to use? It’s all about thinking about what disease is. They have no concept of the fact that there’s only one thing that goes wrong when people get sick.
RW: What’s that?
LS: That your cells don’t work perfectly. It’s cellular malfunction that causes every disease, at some level. Of course it’s all psycho-spiritual. But then if your cells are all healthy, how are you going to be sick? The thought should appear, well, how did cells get unhealthy? There are only four ways: your genes, but that’s 95 percent epigenetics— meaning it’s the environment that triggers your genes to be on or off.
So genetics would be one. Another one is your psycho-spiritual essence, because what you think, and what your belief system is, has a big effect on your biochemistry and your physiology. Candice Pert started this stuff, I don’t know how many years ago, and I see it every day in my practice. So those are two things.
The third thing is if you think of a cell as a microscopic industrial plant, it’s got to have raw materials or you can’t make the products it needs. So if you don’t take it in, it’s not there. So is nutrition important? Well, we weren’t taught that—although I did have one hour of nutrition in medical school, and they still do.
RW: One hour?
LS: Yes. So that’s why the cancer doctors say eat what you want; it doesn’t matter. It’s like, really? Then the last thing that can make a cell not work is when something is put in there that doesn’t belong there, or when there is some kind of physical trauma to it. Those are the four mechanisms that cause 100% of the diseases we see. Now why wasn’t I taught that? I had to figure that out. Isn’t that something?
RW: It’s good hear this.
LS: You know, I lectured to medical students at Stanford six months ago. And I said things like this all the way through. I could just imagine what was going to happen when it was over, because I saw the old professor there looking around. But at the end he stood up and said, “Saputo, we should clone you.” That blew me away.
RW: That’s hopeful.
LS: He was in his 80s, a professor emeritus. But he had something to do with the wellness side of what they teach the Stanford medical students. And the students loved it. Their question was, where are we going to learn this?
I said, “I’m sorry, but you went to a place where they don’t teach this. And I don’t know of another place that does. So you’ll just have to get through your training, and if you still have anything left in you when you’re done, then maybe you can shift the way you think and the way you practice. But for now, you better just answer the questions the way they want you to or you won’t even get the opportunity.”
RW: Now you’ve been trying to create a clinic for practicing this more sane, approach to medical practice.
LS: I t’s the old medicine of the shamans. It’s been around forever. All we need to do is study it a little. Is there something to it? Does it work? I think it does. So why not? And placebos are the most powerful medicine. There’s nothing close.
Rue: So does that mean that when people want medicine, you would prescribe a placebo?
LS: No. But you could. I’ll tell you about a study that was done on people with irritable bowel syndrome. One group got a pill and another group didn’t. The pill had written on it, “placebo.” And the doctor said, “Oh, look. It’s a placebo. Take one twice a day and come back in six weeks. There’s nothing in it but a little sugar. Take them anyway.” They did. They came back. They got better, statistically better, than the group that got nothing.
RW: So the question is, why?
LS: Again, it’s the belief system; it’s the unconscious mind. The conscious mind says this is stupid. There’s nothing in it. How’s it going to help me? But the unconscious mind is programmed: pills make you better. That’s ingrained in us in such a deep way.
That’s why 30% of what we see with most pills is placebo effect. But if we see a 32% or a 33% benefit, the big pharma says, “See, the pill works.” And that two or three percent comes at a very expensive price, usually. Medicines are extremely dangerous. For example, there’s a pill that was for hypertension. Do you know what it’s used for now? To grow hair on your head. Now is that a little frightening that we didn’t know that?
RW: There’s so much that’s scary, terrifying. But unfortunately, we’re just a big science experiment—and not just with medicines, but with pesticides, and everything.
LS: GMO foods. So that tells you about placebo. See how powerful that is? We’re really not very independent creatures. Our unconscious thoughts and feelings regulate our bodies. It’s very hard to be authentic.
RW: What do you mean by that word, authentic?
LS: Honesty is one thing.
RW: Do you mean as a doctor?
LS: No. As a human being. We all try to tell the truth the best that we can. That’s good. But that’s not being authentic. Authentic is laying out there how you feel about stuff without any fear that you’re going to be judged, or it’s going to be wrong or whatever.
You can be authentic and say, well, what you see is what you get. If you don’t like it, it’s none of my business. That’s your problem. If you don’t like me, I guess you’re not going to spend any time with me. Cool. Then I go on being who I am, clearly.
So I don’t have to hide things or lie or present myself in a way that I’m not in order to look good to get your vote, or whatever it is. That’s what authentic means to me. Is that what it means to you?
Rue: That sounds good. I like it. But sometimes it’s hard to know what you feel. And it’s often hard to be able to say it.
LS: Yes. Well, with the way we’re trained and because of our fear of being judged. I learned that what someone else thinks of me is not my business. It’s their business.
RW: That’s a very big one to learn.
LS: Yes. Not many people do a thorough job of that. It’s one of the things that comes with age.
RW: Right. It’s a slow journey. The fear of what others think is a great tyranny that may be almost universal.
LS: Yes. We all have it in some form.
RW: Would you give a little history of your efforts to bring together like-minded, but differently-trained practitioners.
LS: I started the Health Medicine Forum, a non-profit educational foundation, twenty years ago. Our goal evolved into learning how to practice integrative, holistic, person-centered preventive care. There are four pillars to it. Our first efforts were to “show and tell.” We had an orthogonal chiropractor say, “This is what I do.” We had a person who did neurofeedback, a homeopathist, and so on. We had a couple of weekend events at Mt. Diablo Hospital—Friday, Saturday and Sunday—that were like magic. Two hundred people would come. They’d all be talking about what they do.
RW: And this would be all practitioners?
LS: At that time it was only for practitioners, yes. Did you know Richard Miles? [no] You missed something. Richard was one of my mentors. He is now gone. He was always talking about the role of spirit in healing and about treating people with a “bag of tools” instead of being with them and supporting them.
In one event in 1997 or ’98 we had 50 or 60 people presenting. We would get into the role of spirit and healing. We had a skit. We had people chanting. We were singing. We were talking about all this stuff. The atlas orthogonal chiropractor was talking to the person who was doing Chinese medicine. We got to appreciate what’s out there.
I mean, doesn’t it seem logical that it could be of some value to know what these other people are doing who studied for years? There’s an arrogance or a defensiveness, a weakness in saying, well, it’s really Chinese medicine, you know? Or no, no. It’s Ayurveda. No, it’s Western medicine and our drugs. No, it’s chiropractic. No, you’ve got to be able to do hypnotherapy.
There’s a place to go beyond where your training stops and to be open to the principles of other disciplines, even when contrary to your own, in order to learn about what’s involved. We haven’t solved this epidemic of diseases that affects more than half of us. Do we need some help? You think maybe there is some value to all of these people that are spending all of this time learning about acupuncture or herbs or whatever it is they’re learning? There could be some value there. So let’s listen to them. What a concept!
RW: What an idea. Now you said that Miles talked about treating people with tools. But what you’re saying is…
LS: He basically was making a joke of it. You don’t treat a set of symptoms just with a bag of tools. It’s also about being with, not just doing to. That’s what I learned from Richard Miles.
RW: Okay. So is the Health Medicine Forum still going?
LS: I t is. But it’s done nothing in terms of public interaction for almost four years. That’s when I stepped back as the founder and director and brought another person in and said, “Take over. I’ll be on the board of directors. We’ll talk and have meetings.” And we’ve been talking and having meetings. Our last event was “The Biology of Belief” around the book by Bruce Lipton. He was a speaker. 500 people attended at the Lesher Theater. That was the last thing we did. We decided to stop, because I think we finished our work.
LS: Our work was to learn about integrative medicine and to be holistic—meaning to look at the inseparable nature of body/mind/emotion/spirit. It’s all one thing. There is no such thing as just a body or just a mind or just an emotion or just a spirit. You can’t dissect it. It’s one whole thing. And the prevention part of that is trying to treat people as people rather than doing things to them; we learned that.
Then we took it to another level. After we defined it, we had to find out how do you use it? So I got this idea of well, let’s get six or eight of us together. At one of the big meetings, there were 150 people. Six or eight practitioners up front, and a patient.
I’ve moderated probably 350 events since that time, and I remember walking up to the podium for the first Healing Circle thinking what the hell am I going to do? I had no idea what these people did. I wanted to learn about it, but how was I going to moderate that? It finally occurred to me, just shut up and listen. Let them handle it.
RW: Is this at the beginning of this process?
LS: After about a year. We were in a place where we had found out what other people do. We knew how to work together. We knew we wanted to treat the whole person, all that stuff. So that’s what unfolded. I didn’t say much of anything. It was just, what do you think? And to my shock, we all came to the same conclusion; we just took different paths. It didn’t matter if it was the Chinese medicine doctor or the psychiatrist or the internist or the person that did Native American medicine. It didn’t make any difference. It’s was all coming from different perspectives, which is comforting.
RW: It's very comforting.
LS: Because it tells you that it does all fit together. The magic of the universe is still working. These people aren’t stupid just because they don’t know what I know. Maybe they’re stupid if they only do one thing.
So that led to the concept of a healing circle where we get six or eight or ten people together and one person will be the patient. How that unfolded was much deeper than anybody thought, because you have to talk about yourself in an uninhibited, authentic way. It’s not so easy, because I’m not going to let you find out this about me. Right?
LS: So we practiced this for about a year. Then we took it out into clinical practice for free.
We probably did 100-150 of these. They take two hours. First, the person writes an autobiography about their physical health from birth to now, their emotional health from birth to now and their spiritual health from birth to now. Then I would pass that around to each of the practitioners for each of the healing circles.
At one point we were doing four healing circles a week. I would go to all of them. Nobody else did. I did, because I thought it was really important. We learned how to listen to each other. We learned how to listen to the patient, and to care. That is a recipe for healing.
Rue: In those later ones, the patients were not practitioners, right?
LS: Right. When we were learning about it, all we had were practitioners, and that was really good because we all got a taste of that. It’s not an easy thing to go through that. So in that process we learned that there are a lot of ways to connect with people and to help them to see what they were doing with their life. They paint a picture for you with the autobiographies. Then you listen and ask a few questions, always being respectful of who they are and not being overly invasive. People start to see things, because you’ve got a group of practitioners there who are not getting paid, who are there only because they want to help.
RW: That part about not getting paid is an important piece of something.
LS: It becomes giving rather than bartering. I care about you. I will listen. It’s a gift. There are no strings. I expect nothing back from you.
That’s like people go berserk. I’m important? You care about me? You’re really listening to me?
Yes, because you matter. And when they get better, I feel good. I actually learn things I could never have learned about life. The experience of each practitioner is a private thing, because you’re experiencing what this poor person is suffering from. You’re almost walking in their shoes, and if you walk in their shoes, you’ve got a shot at doing a few things. But you want to try not to judge and just support. So it’s back to being with rather than doing to. If the patient can get a little insight, maybe they’ll make a little left turn in how they’re behaving; they do all the work, and we can do this so much faster, because of that deep sacred space that’s created.
Rue: That’s beautiful.
LS: It really is. So that’s what the healing circle does. We started the Health Medicine Institute in Lafayette. I found an investor and we had a five thousand square foot building that had about 15 practitioners, including a Native American Indian chief. He did some great work.
RW: I don’t doubt it.
LS: We had people who did everything. We had Rosen work there and the somatic experiencing of Peter Levine, which I think is unbelievably powerful medicine. It’s probably what I lean on more than anything else in my practice.
Rue: Oh, really?
LS: My right arm is my somatic psychotherapist. Why? Well, a lot of people, as you know, get stuck in their head. They “know” everything about themselves. Oh yeah, this happened and that happened. But the somatic psychotherapist realizes that the muscles of the body are part of the whole person. They don’t care about what you think. They just vomit up information when you release those muscle tension patterns. When it releases that information, it comes into conscious awareness.
So this stuff comes up and a person will feel terrible. Then you ask the question. “Are you okay?”
“Well this isn’t much fun. No, I’m not okay.”
“Do you think maybe you could stand that feeling and try to disassociate the connection made when you were a young kid when all these things happened, but you didn’t have the tools to deal with it? And today you do. Do you think that might be worth it?”
“Well, okay. I’ll give it a try, but it sure doesn’t feel good.”
That takes time, three months to a year. These people are suddenly working with their MFTs and with the somato-psychotherapist. And it’s not a 10 or 20 year process with a therapist just rehashing the old stuff again. So for me, that was a huge insight. Do you know Peter Levine and his work?
Rue: Yes, and I took a workshop on somatic experiencing.
LS: Wouldn’t that be neat if you could actually touch your patient legally? You probably do anyway, because you know it’s important.
Rue: Sometimes, but not often. I must admit I tend to be somewhat rule-bound.
LS: I mean, what would happen to you if they found out you hugged a patient? They would probably take your license away.
Rue: I don’t think it’s that bad, but you’re trained so stringently—at least I was—never to do that.
LS: I talked to somatic psychic therapists, and they say, “Well I would never give psychotherapy, because it’s against the law.” I’m thinking what the hell is the matter with you people? Who makes these laws? Well, it’s about business turf wars.
Rue: It is a lot about turf wars, yes.
RW: We were just watching this wonderful film about Milton Erickson last night. You know about his work?
LS: I’ve heard of his work, but I’m not an expert in it.
RW: It’s right up your alley, let me tell you. I don’t know if he would use the same language you’re using, but he was one of the most incredible healers around, and he was a medical doctor. He didn’t just take things said on authority. He wanted to learn directly.
LS: He thought for himself.
RW: Very much so. And consequently, he came up with stuff that was real and worked. He healed many people no one else could deal with.
LS: Well, you’ve heard the statement, the universe is reflexive?
RW: I’ve heard that, but what does it mean?
LS: What it means to me is that you can find truth in just about everything. You can build a case for something and then when you’re done, someone else can build a case that’s just the opposite. And that’s right, too, from that perspective.
If you’re going to understand it in its totality, you’ve got a lot of work to do. There are a lot of perspectives. So reflexive universe means there’s a truth in everything. Our job is to be patient with it before we throw it out.
RW: There’s a group of people that I’m involved with called ServiceSpace, a good group. A principle I’ve heard said there is “assume value in everything.”
LS: Oh, yes. That’s what it’s saying, because there is. Even the psychotic person has gotten value from some of the things they do even though it may not be the smartest thing to do.
RW: So if you assume value, in theory, you may actually come to understand something that you wouldn’t have understood otherwise.
LS: Sure. That’s what the healing circle teaches us, because it’s a mutual healing. It’s not just the patient that heals. Everyone heals.
RW: That’s really something. Everyone heals.
LS: Everyone there who is giving and listening and caring, is healing.
RW: That’s beautiful. So the Forum hasn’t given a public event in four years? And you’re saying its work is done?
LS: Well, it comes in cycles. There’s show and tell; this is what the different practitioners do. You learn to respect that other disciplines do things that might be useful. You learn how to work together in different ways, and you teach what you can about how that system works.
That’s a story. It’s got a beginning, a middle and an end. The question is where does the Forum go from here? My answer is, let’s do it again. Because there are at least two or three people in the world who haven’t been exposed to that yet!
We can do it in other ways. We can take it to the hospital, for example. I’m working now to try and get the ear of some CEOs at hospitals, to provide them with a portal on their website where I can teach lifestyle medicine and health medicine.
I think there’s a great possibility that could happen, not because hospitals care about that at all. What they care about is filling beds. They want sick people, because that’s how they survive. But public awareness is starting to move into the arena of the importance of wellness and prevention and nutrition and natural therapies and getting away from the staggering number of deaths each year from drugs. I don’t mean street drugs; I mean pharmaceutical drugs taken as directed.
RW: It’s incredible, isn’t it?
LS: We lost eight thousand people in Iraq, and that was over ten years. Well, what do you think of the pharmaceutical industry? We lose many more than that each year from the use of pharmaceutical drugs, just in the U.S. Many of those are the expected side effects. “Well, that’s the way it is. We did our best.”
RW: Why don’t people…?
LS: Watch a direct-to-consumer ad on TV that talks about Advil. That group of drugs, the non-steroid, anti-inflammatory drugs, kill a huge number of people each year and puts even more people in the hospital. And that’s only from that one class of drugs. I mean, hello. Then you have to look at the karma of big pharma, which is unbelievable. It is truly a business, but they will tell you “We’re here to help you.” They lie. Do you remember the Vioxx story?
Rue: Only that a lot of people died from that.
LS: I’ll tell you the story. In 1995 Merck knew that it caused heart attacks and strokes. In 1999, when Vioxx came out, they withheld that information. We know that, because under The Freedom of Information Act we got those records. In 2004 it was taken off the market, because too many people were dying; about 50,000 people died from heart attacks and strokes, and they eventually took it off the market. Now let me ask you a question? Is that murder?
RW: That’s a good question.
LS: To me it’s just straightforward. It’s legalized murder; I mean, they knew it. It was premeditated. They made money. They knew they could get away scot-free, because that’s what happens.
RW: Is Tylenol part of that body of drugs?
LS: No, it’s not, but it has its problems, too.
RW: I heard a program on This American Life about Tylenol. That’s another scary story.
LS: Tylenol - acetaminophen - can cause lots of problems, like liver transplants. If you want to OD on something, don’t do Tylenol. You probably heard of Darvon years ago. It’s a pain medicine. It was taken off the market two years ago after 50 years. Why? It was causing fatal cardiac rhythm disturbances. Do you think they really didn’t know about that?
Rue: Those things are terrible.
LS: It’s all about money. Keeping in mind it takes about five hundred million dollars to bring a drug to market now. So they deserve something, but it shouldn’t be just a business. Our government could assume that responsibility, but it doesn’t because the ties between the pharmaceutical industry and Congress. They donate a lot of money. There are about six representatives for every Congressman that have to do with the business of drugs.
RW: There is also the health management organizations that are part of this whole thing. Right?
LS: That’s all about profit. I could never work for an HMO, and they wouldn’t want me. They would kick me out in five minutes.
RW: So medicine has moved from being a service to being a for-profit phenomenon. And the corporations all have this beautiful little mantra: our first obligation is to our shareholders.
LS: Well, they’re in business to make money. They’re not in business to provide you with help with pain in your joints or whatever.
RW: These are very distressing things to look at.
LS: When you’re looking at the influence of the insurance industry and the pharmaceutical industry on Congress, the Congress people should be ashamed of themselves. This Obamacare thing, they knew what they were doing from the start. Universal healthcare, yes, it’s great. Let’s do that!
It’s better than what we’ve got, but it’s not a good healthcare system, because it isn’t a healthcare system at all. It’s a disease care system. Right? They depend on you being sick— and you expect to get sick, because you learned that. Then you expect to be helped.
What actually happened with Obamacare? A couple little things here and there, and it was a good thing. But who benefitted? A few people who were really poor got Medicaid or MediCal, the same thing, because they extended the amount of money you could make and still get the insurance. Then you had disease care insurance that’s not convenient and not very good, for the most part. I trained at Highland Hospital. I know what that’s like. It wasn’t good care. End of story. It wasn’t.
Rue: The place was just overwhelmed? The doctors were overwhelmed, right?
LS: And they don’t know that much. They’re students who are running the place, to a large extent.
Then there’s another group of people who don’t qualify for MediCal or Medicaid, but they can’t buy insurance. That’s where the government subsidies are coming in. That money is on a sliding scale meaning the less you make, the more the government will pay or the more you make, the less they will put in.
That money all goes where? Direct to the insurance company. It doesn’t go to the person’s hands. It goes directly from the U.S. Treasury to the insurance company. So now the insurance company is getting money it never would have gotten before, because these people couldn’t afford insurance. They can’t afford to use it, because the co-pays and deductibles are too high.
So what was achieved? Oh, I got insurance. I have to pay for that? I can’t afford that. There is a ceiling on it. I think you can’t spend more than $12,000 in a year on your healthcare. After that they pay for it. That’s a good thing, but $12,000 is a lot of money. Imagine what that means to somebody who is making almost no money.
Rue: It’s just for catastrophes, that’s all they get?
LS: Well it didn’t even help them there, because they weren’t going to pay for that anyway. They just go to the emergency room and be taken care of. So what was accomplished? The insurance company gets a check now from the government every month. Right? And the people who couldn’t afford to pay for care before can’t afford to pay for it still. They are squeezing the poor people once again.
I’ve studied Obamacare. I gave a talk on it. What we have is a conflict of interest between the pharmaceutical industry and the insurance industry with Congress. In 2009 when the election was about to happen and they were talking about universal healthcare, they basically were trying to tell us that we should all be entitled to health insurance. I don’t think they really were serious about it. What happened is Bachus in his committee of Democrats and Republicans wrote a 2,600 page bill that, of course, you can’t understand, because it was designed to be that way. In all of the double talk there, it means money is going from the Treasury to the insurance industry, and big pharma is going to profit from that as well. So that’s what that was about.
And who wrote it? It’s that one committee that wrote it. But who wrote it there? The insurance industry wrote it. We’re pretty far gone as a country. So when we single out medicine as the problem, we’re mistaken. Medicine is just another part of the culture that has become a business.
We don’t have a community where we care about other people in a way that’s helpful. I mean we don’t even know our neighbors, a lot of us. We don’t know our patients. We don’t know our clients. We’ve become independent and adversarial and competitive, which is the opposite of what I think we were put here for. We were put here to join together to develop community, to help one another, to look at our weakest link as the part that we need to invest the most in. “It takes a village” is right. It absolutely takes a village to make a community.
So the question I would ask is where do we go from here? Where does the buck stop? How do we live up to doing our part? It’s basically about setting the example and not having huge expectations that you’re going to make huge dents in cultural evolution, because that’s what we need. The culture must evolve from its narcissistic, self-centered, adversarial, defensive place to one that’s built on giving, sharing, loving and working together because we care. Until we evolve from here to there, all we can do is our little part. Maybe it will inspire somebody. Maybe just one person. That’s better than no persons.
RW: I think it’s a Gandhi quote that’s something like this: whatever you can do may not seem like much, but it’s very important that you do it.
LS: Just one thing.
RW: One of the ServiceSpace community’s principles is to serve with what you have. And that you never know what the effect of a small act done with real generosity will be.
LS: Change occurs from a single thought. It’s painfully slow. In my opinion, we’re probably not going to change a whole lot in my lifetime. But if we do, I will embrace it. If we don’t, I will continue to hope to inspire people to want to change rather than legislate change. You can’t legislate change, really. That’s a misconception.
Put everybody in jail, that’s what we’ve done. How do we create these people who are in jail? I’ve taught tennis at San Quentin, a great experience. I couldn’t tell those people from my friends. And you go really? I wouldn’t turn my back on some of them, because I know why they’re there. But if I was raised in the Iron Triangle of Richmond I think I would reside in San Quentin, probably.
How do you get out of that mess? Somebody has to want to care. Why do we have homeless people? I tried to do something in San Francisco a couple of years ago. I worked with Angela Alioto and the city council there. I wanted to provide services for them and give them some things. I had a partner I was working with. They didn’t give a stuff about it, really. I finally gave a scathing talk to the Board and they just laughed at me.
If there is an afterlife, what are you going to say? I made a lot of money and I put a lot of people into harm’s way, but my family did good?
LS: [to Rue] That’s why you have patients. Me, too. That’s why you’re writing.
RW: I relate to what you said about it taking a long time to work through some stuff. I was listening to Salvador Minuchin once on the radio. He’s been an influential thinker in family therapy. He was on Fresh Air. Terry Gross said something like, “It seems like so many families are dysfunctional. Are all families dysfunctional?” I was surprised by what Minuchin said. He said, “Well, families are what they are. There’s no family where there aren’t problems. So there’s no point in calling them dysfunctional.” But this is touching on such big problems and big issues.
LS: When you use the word ‘big’ like that, it conveys a feeling of hopelessness.
RW: That’s true.
LS: I don’t have that feeling.
RW: That’s wonderful to hear.
LS: Because I’m inspired to do my part. And I am in other ways, too. I have a website. In my opinion, it’s the best medical website on the net. I’ve made 2,500 audios and videos myself with my wife. They’re organized into health assessments. It cost me money to keep the site open. I don’t make any money from the site, but it’s putting out a message. And I’m getting questions from people from all over the world—from Germany, England, Portugal, Sicily—saying, “What do I do? I read this article, but how do I apply it?”
I spend time everyday answering each one of those emails and I try to counsel people and offer them a Skype consultation. If they can’t afford it, I’ll do it for free.
RW: That sounds pretty satisfying.
LS: Well, it’s greedy.
RW: Yes, the way Gandhi was greedy.
Rue: What is your website?
LS: It’s doctorsaputo.com. Join it. It doesn’t cost anything. Take one of the assessments. There are 33 health assessments, all different kinds of health issues; cholesterol, diabetes, back pain, whatever you can imagine. It takes three minutes or four minutes to fill it out. It’s yes, no or multiple choice. And what instantly comes back are audios or videos that I think would apply to the way you answered your questions.
LS: So you may get 25 audios and videos, or more in some cases, that are short and right to the point. They will educate you about what you need to know to be able to treat that condition in the best way—at least the way I think is the best way.
Rue: That’s terrific.
LS: Yeah, it’s all free.
RW: Well “free” in the sense that you’re not charging, but not free in the sense that you took time and energy. You spent energy and time.
LS: And money, a lot of money.
RW: So are they free?
LS: I t’s not free to me, but it won’t cost you anything.
RW: It won’t cost me anything, but you paid for it. You’re giving it as a gift.
LS: It’s a gift. That’s right. That’s why I wrote the book. The book sold 4,000 copies.
RW: Not bad, compared to the average.
LS: It’s terrible. But everybody should read my book, because it’s an eye-opener.
RW: I agree. Everyone should read your book. It is an eye-opener.
LS: That’s why, when I went to Stanford, I took 100 copies and said, “Here. You can each have one.”