Reflections From Our Founder

September 8, 2020

Fair Winds and Following Seas

anastasiia-chepinska-OBmBHmrc3pw-unsplash.jpgCalifornia is ablaze. It was 130 degrees in the Mojave Desert two weeks ago. The Democratic and Republicans National Conventions have ended. The November election is coming toward us like a freight train. COVID-19 is flaring, subsiding, flaring again - and this is our new reality. Lives have been put on hold. Mortgages cannot be paid. American Airlines is laying off 19,000 employees. Concert halls are silent. Indeed, all of the work for the Institute is being done with Zoom calls, on-line classes, and by email.

Some people are talking about re-imagining healthcare. Some are talking about the obvious need for single-payer. Others are focusing on the way that the virus has been shining a bright light on the gross inequities in our country and the fact that America has failed to provide equal access to medicine. We know that a vaccine will not be the end of this.

I don’t think that re-imagining is enough. I don’t even think that healthcare is the subject. And I don’t think that the conversation starts with trying to answer the question, “How do we fix a broken system?” It is time for a paradigm shift. For radical change.

We need to be talking about biology, biography, and civic responsibility - and it is this conversation that will lead us to creating a world in which wellness and health are sustainable and valued.

The pandemic has clearly shown us that where you live, how you live, and the circumstances of your life will determine your disease risk and your outcome, but this is not news to us. Dr. Sandro Galea’s address at our 2019 symposium clearly outlines key factors such as connectedness, food, housing and jobs that are rarely considered when talking about healthcare reform. Institute Scholar Dr. Steven Woolf’s article about The Power of Prevention and What It Requires details the real cost of ignoring preventative medicine in favor of the healthcare system as we know it.

I have spent this summer in conversations with thought-leaders and practitioners from around the globe. We are looking for answers, but first, we are defining the questions.

Where do we go?  What do we do? How do we start? Is it possible to create a tectonic shift in the conversation which will lead to real and lasting change?

This summer, three generations of our family spent a week sailing on the Chesapeake Bay - and there is nothing like life with an infant and toddler on a boat to focus the mind. Some days were stifling, some evenings were breathtaking, once or twice the dawn brought rain. Our lives were defined by the forces of nature: the sun, the wind, and shining stars on a moonless night.

There was time to think. Time to see a young family coming up in a world that is fraught - and we are not done. Our work is not done. We need to be expansive in our thinking and our commitment to change. We need to listen to the voices of people from all walks of life, be they doctors, community organizers, economists, scientists, anthropologists, or historian - to everyone interested in making a difference. We must find a new way forward.

We must look everywhere. We must turn our expectations upside down. We must continue to ask questions and accept that sometimes the answers will sound crazy - and sometimes that is where the wisdom lies. And in the midst of the chaos that is our world today, I must remember those nights on the boat, when the welcome breeze whispered a message of hope for the new day. Fair winds and following seas.

We can do this.


 

June 17, 2020

Where the River Meets the Sky

Elsworth_Chester_River_MD2.jpgSome days I sit, staring out at the Chester River which flows to the Chesapeake Bay, which empties into the Atlantic. It’s beautiful here. There is room to think, room to dream, room to reflect. It is not Baltimore. It is not Hong Kong.

The Institute for Integrative Health is on Fleet Street in Baltimore, Maryland and, in many ways, this is our town. But our work has taken us around the world, with many stops including Hong Kong, visiting and collaborating with our colleagues at the Chinese University of Hong Kong.

There’s a headline in last week’s Washington Post which reads, “We don’t get justice” and the story comes from Baltimore. It details the death of the youngest victim of COVID-19 in the region – a 15-year-old, whose race and place on the economic ladder left her particularly vulnerable. She lived and died in southeast Baltimore, her home, less than four miles from our office on Fleet Street.

I would like to be in a world where George Floyd was not murdered by a policeman. Or Freddie Gray. I would like to be in a world where Dar’Yana Dyson didn’t have to die from a virus she made every effort to avoid. I would like to live in a world where the voices of freedom in Hong Kong are not silenced, and my friends do not have to live in fear.

But this is our world.

A poem I read recently by Lynn Ungar says, “The fact that you are swept along by the river is no excuse. Watch where you are going. Lean in toward what you love. When in doubt, tell the truth.”

I wake up in the morning with options – and I know I have to lean in. We have spent decades striving to broaden the view of medical care through an integrative approach. We have cross-pollinated - connecting the dots between science and sociology, nutrition and wellness, clean air and healthy communities. We have helped disseminate information, funded projects, and supported the work of brilliant thinkers who are seeking to change the status quo. But it is not enough.

The incredible inequities in America which have been laid bare by COVID-19 and by the unwarranted death of black men have been brought to us by a broken system that is upside down. Simply put, racism and social injustice is a public health crisis that puts the entire community's health at risk, not just those of color. This must change.

We cannot sit idly by as communities that have been historically under-served in every way, suffer at a disproportionate rate. We cannot pretend that this problem will go away. And we must address the bigger issues.

Healing is not about writing prescriptions. Healing is about listening. Wellness is a daily practice – it’s food, and sleep. It’s clean air and water, it’s hope and dreams. It’s freedom.

Around the world, people are marching for justice. In the poorest neighborhoods, people are fighting for their lives. The courageous voices of teenagers are ringing out to remind us that the earth is struggling. There are throngs of people protesting in the streets of Hong Kong, London, New York and Washington, DC.

There is an urgency, an opportunity for change, and this change is not incremental. We cannot go back to normal, now is time to bounce forward to a new normal.

At the Institute for Integrative Health, we have always been dedicated to envisioning a world that values wellness, that treats people with dignity and listens, that recognizes healthcare is not just about medicine, but also the interconnected web of everything in our lives, our communities, our planet. The work of our Scholars, Fellows and programs is raising awareness about inequities - the challenges being faced by primary care providers during this time of COVID-19, the undue impact of COVID-19 on communities of color - and is helping people and communities to heal from trauma and thrive - through art, time in nature, healthy eating. Now, at this moment where evolution meets revolution, our work is adjusting and growing. . . we choose to lean in.

 

May 20, 2020Brian_Berman.jpg

Dear Friends of the Institute, 

I am deeply grateful. Around the world, first responders, doctors, nurses, and family members are putting their lives on the line every day. Researchers are working around the clock to find new ways to treat the sick and find a vaccine. For many, life has been put on hold. Paychecks have stopped arriving, and in these hard times neighbors are reaching out to help neighbors, businesses are bringing food to emergency rooms, and hotels are opening their doors to exhausted doctors and nurses, who are afraid of bringing the virus home.

In the face of a global pandemic, my work continues. Our work continues.  

I have spent my life seeking to transform medicine. It has led me to examine our healthcare system’s overriding focus on treating disease rather than promoting wellness. We started the Institute for Integrative Health in Baltimore searching for people who were prepared to ask questions that would challenge conventional thinking about healing and society – looking for science-based answers that would shift the global conversation from the status quo and all that encompasses, to creating and maintaining health. These are revolutionary ideas. 

While seeking to create an epidemic of health we have been answering some of the questions that are now finally at the forefront of international conversations centering around the pandemic. Who is most at risk and why? How can we change that? How can we build more resilience? How do we move forward? When western medicine doesn’t have all of the answers, what does integrative medicine have to offer?

Mission Thrive Summer Video

Our Scholars, Fellows, Visiting Visionaries and forums are shining a light on how primary care is crucial and yet undervalued in this country, how the arts can support well-being and resilience, and the critical importance of seeing the whole person and understanding the context of their lives when envisioning a world where health is for everyone, not just those who can afford it. We are partnering with members of our community, evaluating the impact of urban gardens and “wild” nature in hospital settingsteaching kids about nutrition who live in food deserts, and we are working with medical school students, giving them the essential tools of how to cook, what to cook, and how food fuels the body, so that they can go on to lead patients toward healthier nutritional choices. 

It sounds so easy, and so normal when you think about it. If kids understand how to turn raw food grown in their garden into delicious meals, they will have a better life outcome. If medical students understand that it’s possible to easily cook nutritious food that is also delicious, they can better inform their patients, and everyone will be healthier. If people understand the value of nature in supporting resilience and wellness, humans and the planet will thrive. These are just some of the ways our thinkers are changing the world. There is more, so much more.

At the Institute, ours is not the work of finding a vaccine. Every day, we are working with our partners around the globe to catalyze a new paradigm, actively bringing substantial and lasting change to the way that wellness is valued and supported in all our communities. 

At this moment in time, the world is facing tectonic shifts. It is a moment that allows for the possibility of real transformation, a moment that asks for the best from all of us. We must be nimble, dedicated to change, and ready with new ideas. Here at the Institute, we are.

Wishing you and your loved ones health and wellness,
 
Brian M. Berman, MD 
President
The Institute for Integrative Health 
Professor Emeritus Family and Community Medicine
University of Maryland School of Medicine