Settling in

I made it! I’ve been settling in, grocery shopping, exploring Boulder, hanging out with my roommate (who flew in from Croatia!)...  and tomorrow we start!

I’m usually a goal-oriented person but I’m trying not to set too many goals or expectations for the month. I really just want to be completely present and soak it all in.

Besides yoga, it looks like I’ll also be learning quite a bit about rolfing and cooking while I’m here. Two of my roommates are rolfers and the woman who owns the house is a caterer (she’s been making me the most incredible raw kale salads…. YUM).

This is what is on the agenda for tonight:

Lots of reading to do... 

Live the questions

Tomorrow I head to Boulder for the month for yoga teacher training!

The past few days have been a mix of everything… mainly excitement, nervous anticipation, and sadness to be leaving my life here. 

More to come from Boulder, but first one of my favorites quotes that I've been thinking about lately...

Live Everything

I want to beg you, as much as I can,

to be patient toward all that is unresolved

in your heart and to try to love the questions

themselves like locked rooms and like books

that are written in a very foreign tongue.

Do not seek the answers, which cannot

be given you because you would not be able

to live them.

And the point is to live everything.

Live the questions now.

Perhaps you will then gradually,

without noticing it, live along

some distant day into the answer. 

~ Rainer Maria Rilke

A little exercise: Good for your telomeres

We know that stress shortens telomeres. This new study indicates that this may happen only in inactive people.

The study at UCSF looked at 62 postmenopausal women suffering long-term stress (caregivers of chronically ill loved ones). They divided the group into inactive and active people (active = at least 75 minutes of weekly physical activity). It turned out that only the inactive group had shortened telomeres.

Wow! Another reason to make time for exercise… especially if we lead stressful lives. Seems that even just a little physical activity can protect these important pieces of our chromosome.

One of the lead telomere researchers, Elissa Epel, said:

"Telomere length is increasingly considered a biological marker of the accumulated wear and tear of living, integrating genetic influences, lifestyle behaviors, and stress… Even a moderate amount of vigorous exercise appears to provide a critical amount of protection for the telomeres."

To me, one of the most exciting things in the article was the last paragraph about how they are now telling people the length of their telomeres to see if this impacts people’s lifestyle choices (to reduce stress, eat less meat, exercise, drink less alcohol, etc) in order to keep their telomeres long and healthy. Can’t wait to hear results of that study...

Urban farming

“The problems that exist in the world today cannot be solved by the level of thinking that created them” 

~Albert Einstein

One reason I am falling in love with Philadelphia: the new way people are thinking about food here.

In the latest issue of Philly's Grid Magazine, they had this great article (page 11) about urban farming and the success of Will Allen in Milwaukee. This is what Allen had to say about it:

“We can create thousands of jobs with this new kind of farming, with urban agriculture. Just think of all the categories of jobs: you’ve got installers, carpenters, plumbers, truck drivers, accountants, electricians, aquaculturists, planners, architects. In a rural area, you don’t need these jobs. Industrial agriculture gets rid of jobs; the machines do everything. This is hand work, it’s communal work, which is important and fun for all of us, all the generations, from little kids to school-age kids to teenagers to college kids. Everybody is involved.”

Jobs, healthy locally grown foods, community-building.... how can we not do this?

(For more, check out this great NY times article about Will Allen)

Talking about food

Loved reading this article about a physician, Dr. Michele Couri, who talks about vegan/vegetarian diets with her patients including a macrobiotic diet for cancer patients.

Couri says health care “is inescapably bound to the poor American diet with too much meat, dairy and processed foods and not enough vegetables, fruits and whole grains.... Our country is subsidizing the wrong things. We subsidize corn and high fructose corn syrup, but not organic fruits and vegetables.” 

As has been mentioned, medical school does not provided much teaching in this area. Most of what we do learn is disease-specific: low salt for high blood pressure, low saturated fat for high cholesterol, low carbohydrate for diabetes… but there is so much more!

Yoga in school

A few weeks ago, Caitlin and I started teaching Ashtanga twice a week at a local high school (thanks to Ty!). The students seem to like it and we've been brainstorming about how to bring more yoga into the school system. Part of gym class? Instead of detention? Early morning before school starts? During lunch? After-school program?

Here are some reasons why yoga, and Ashtanga in particular, seems to work well for high school kids (I'm sure there are many more so please add to this):

• Builds physical strength.
• Skill-building: Students learn and memorize the poses (and thus become potential future yoga teachers).
• Development of a self-practice: Students can practice at home on their own time (and teach their families/friends).
• Improves focus and concentration (as this school showed with their morning exercise program).
• Consistent: Students practice the same poses each class and know what to expect.
• Reproducible: Since all Ashtanga teachers teach the same practice, schools and students will not be dependent on one particular teacher.
• Cheap: No equipment or gym membership needed.
• Community-building: New people meet each other and practice next to one another, sharing vulnerability.
• Increases awareness of food and the body (brings more mindful eating)
• Pushes students to their edges: Helps overcome fear and mental limits. Love this quote: 

“It is a tremendous thing for a person to get, to realize, that the things that we set as extreme limits for ourselves are just in our mind, and we have to be careful of the limits that we impose on ourselves. As human beings it’s amazing how prevalent this is in our society."

~Chuck Miller

What is health?

What is health? We have asked many doctors for a definition. The usual reply is “normal, balanced function” or “freedom from disease.” When we asked what disease was, the answer came: “absence of health.” So we were back where we started. The frankest answer we ever had came from an American doctor who had practiced medicine for sixty years. To our question “Do you know what health is?” he answered without hesitation “Of course not.” We believe we are correct in stating that no medical school in the United States offers a course on health.

~Living the Good Life by Scott and Helen Nearing

The Nearings wrote this in 1954 and it is still so true! While medical school has been absolutely excellent in teaching me about disease, it has taught me little about health. The Nearings are right, we should be asking what is health? 

One reason I am so drawn to yoga is because it helps answer this question. At its core, yoga is the study and practice of the essential components of health: strength, flexibility, balance, concentration, discipline, energy, vitality, community, and more.

Yoga for sleep

“Health is the first muse, and sleep is the condition to produce it.” 

~ Ralph Waldo Emerson

Not being able to sleep is one of the most frustrating things for me and it’s been happening a lot lately. Maybe it’s because I sense things changing. I leave for Boulder in a week and many things will be different when I return (friends moving away or busy in residency, the start of my residency application process, etc).

All I can say is thank goodness for yoga. My sleeping troubles almost always have something to do with underlying stress or anxiety or sadness, and I really think yoga helps me process those feelings while also energizing me mentally for the day ahead, quieting my mind from unsettling thoughts, and exhausting my body for sleep at night (except maybe when I overdo backbends).

Which is why I was happy to wake up this morning to results from this study of 410 cancer survivors finding that yoga can help improve sleep at night and decrease fatigue during the day. They looked at gentle Hatha/ restorative yoga twice a week for four weeks. I can’t help but wonder what they might have found with a more physically intense and daily Ashtanga yoga practice over the course of years rather than weeks. 

As Dr. Kathryn Schmitz from Penn commented, most physicians tell cancer patients to "take it easy," but that "What we conclude based on a really thorough review of [yoga programs] is that it is absolutely safe for cancer survivors during and post treatment to be physically active, and indeed there are tremendous benefits to doing so."

What makes us happy?

Check out this article Josh found on what makes people truly happy. It’s about a study that followed 268 men who entered college in the 1930’s… following them through war, careers, success, failure, love, relationships, marriage, divorce, parenthood, retirement, death.

For me, I don’t think any kind of research study could get it more right than Allan Chalmers when he says a person needs just three things to be truly happy:

Someone to love. Something to do. Something to hope for.

Rekindling

This is what actually gets me up every morning for mysore practice...

“In everyone’s life, at some time, our inner fire goes out. It is then burst into flame by an encounter with another human being. We should all be thankful for those people who rekindle the inner spirit.”  ~Albert Schweitzer 

Rekindling. Yes that's what it is. 

Yogi movie night

If you're standing in a field in Iowa, there's an immense amount of food being grown, none of it edible. The commodity corn... nobody can eat it. It must be processed before we can eat it. It's a raw material, it's a feed-stock for all these other processes. And the irony is that an Iowa farmer can no longer feed himself.  ~Michael Pollan

Yogi movie night tonight! We'll be watching King Corn.

If you're in Philadelphia and interested, you should come! Email for details...

The yoga home

There’s a lot of talk among doctors and policy-makers about creating the “medical home” – where each person would have a primary care doctor to provide comprehensive medical care.

This has got me thinking about the idea of the “yoga home” – where each individual would have access to a yoga teacher and a community for health and wellness.

One way of working towards this is by offering yoga in schools. It seems that teachers/schools can be more effective than doctors/health clinics at making lifestyle change and preventing illness. A few reasons why: 

• Kids go to school every day, for most of the day. 
• Kids eat a lot of food and snacks at school. 
• Schools are places of learning (both in and out of the classroom). 
• Childhood/adolescence is when we develop many of our life habits and goals.
• Teachers know their students: they know what drives them, what bores them, what they think about, who they spend their time with, and what they go home to.

This "yoga home" wouldn't have to be limited to students in the schools, but would be for anyone and everyone in the community: teachers, administrators, parents, community members, etc. 

Vulnerability in practice

I spent a good chunk of the weekend reading Rachel Naomi Remen’s book Kitchen Table Wisdom, and this was one of my favorite parts:

"At the heart of any real intimacy is a certain vulnerability. It is hard to trust someone with your vulnerability unless you can see in them a matching vulnerability and know that you will not be judged. In some basic way it is our imperfections and even our pain that draws others close to us."

I think this is one reason why yoga is such a powerful way to build community. The old practice next to the young, the experienced next to the new, men next to women, teachers next to students. Everyone is vulnerable, everyone is exposed, there is no judgement.

An inclusion diet

The New York Times had a great article yesterday about Scott Jurek – a vegan ultramarathoner. If you haven’t seen it yet, it’s worth the read. 

Photo credit here  

I love seeing articles like this in the New York Times (thank you to the author, Mark Bittman!), because being vegan does not mean you have to be weak and wimpy… Jurek’s easy days are 40-mile runs! 

He says, “When you’re a vegan, to increase your calories as you increase training you need more food. This isn’t an elimination diet but an inclusion diet.”

An inclusion diet, I love that.

Jurek also says: “None of this is weird. If you go back 300 or 400 years, meat was reserved for special occasions, and those people were working hard. Remember, almost every long-distance runner turns into a vegan while they’re racing, anyway — you can’t digest fat or protein very well.”

Many people who get into yoga move in the vegetarian/vegan direction, but it's great to hear about other athletes doing this as well. 

I wonder if there have been any studies looking at how the switch to a vegan diet impacts people's athletic performance?

Moon day

In the Ashtanga yoga tradition, the only days off from practice are Saturdays, ladies holiday (for women), and days of the new and full moon. Today is a new moon and I am loving the time for sleep, coffee, and reading.

I never used to think about the moon. When working in consulting (9-6 office job), the majority of my days were spent under a roof except for the 15 seconds walking to and from my car. Because of Ashtanga, I now keep track of what the moon is up to (just put moon calendar up on blog on the right).

Two questions I’ve been wondering about:

1. What is the reason for resting on moon days? I’ve never been able to find a good answer.
2. Traditionally, are we supposed to fast on moon days? I’ve heard this but am not sure if anyone actually does it.

Yoga: a minimalist's path

I love the simplicity and minimalism of the Ashtanga yoga practice and just wrote about it in this guest post for my friend Ben’s blog, Minimalist Muscle.

I discuss the 7 reasons why Ashtanga yoga is a minimalist's gym (I’m sure I left some things out so please add to this list if you think of anything!):

1. Yoga minimizes equipment: The only equipment you really need is your body. No shoes and no socks. A mat is nice but not even necessary. No need for weight machines – your body provides all the weight and resistance you need.
2. Yoga simplifies food consumption: The practice of yoga brings greater awareness to the food you put into your body. People become drawn towards simple, healthy, whole, vegetarian foods that nourish the body.
3. Yoga minimizes lost time and money: While I may not always have the hours to devote to the physical practice, the practice of yoga helps simplify life habits (minimizing loss of precious time and money), including: 
• What I eat
• The time I go to bed
• The relationships I nurture
• The way I socialize
• The things I buy
• The projects I invest time and energy in
• My professional interests and direction
4. Yoga turns you into your own teacher/trainer/coach: In the Ashtanga yoga style, everybody learns the postures and the correct order in which to do them. This means you can practice anytime and anywhere (i.e. hotel room floor when traveling). 
5. Yoga develops functional muscle: The Ashtanga yoga practice will help you build muscle while also increasing flexibility... the ideal combination for a healthy, lithe, functional body.
6. Yoga de-clutters unproductive thoughts: The physical intensity of the yoga practice makes your mind focused (it’s hard to think about anything besides breathing when your muscles are shaking, sweat is dripping, and you’re trying to hold a certain position). Thoughts, worries, anxieties, stresses that usually clutter your mind are minimized and silenced.
7. Yoga is a traveling gym: The Ashtanga yoga community is a global, growing community of people with shared interests, purpose, and goals. In many cities all of the world, you will find an Ashtanga teacher that offers the same practice…. it’s a traveling gym that meets you wherever you are.

Anger

I’ve been feeling angry with my body lately. Terrible allergies, restless unfulfilling sleep, and now my wrist hurts during practice. The wrist is so essential to yoga and I automatically think of the worst possible scenarios. Ugh!

“Holding on to anger is like grasping a hot coal with the intent of throwing it at someone else; you are the one who gets burned.” 

~Buddha

(And the burn is even worse if the person you are angry at is yourself!)

In theory, letting go of anger is the thing to do…but it is HARD in practice!

Questions, visions, missions

Let the first act of every morning be to make the following resolve for the day:

• I shall not fear anyone on Earth.
• I shall fear only God.
• I shall not bear ill will toward anyone.
• I shall not submit to injustice from anyone.
• I shall conquer untruth by truth.
• And in resisting untruth, I shall put up with all suffering.
• ~Mahatma Gandhi's mission

Last night during dinner on the balcony with good friends, some ever-present questions surfaced: where we are going with our lives, who do we want to be in 20 years, are we on the right path?

The idea of creating a personal mission statement came up … we googled it and found this: Stephen Covey's mission statement builder.

We went through the 10-steps of questions and it churned out our own personal mission statements (totally nerdy but we loved it).

Anyway, I couldn’t help thinking that this is something primary care doctors should be doing with their patients. How great would it be to have this in the front of medical charts and be able to check back on it each time a patient comes in for a visit. 

Books and ideas

Food and medicine are not two different things: they are the front and back of one body. Chemically grown vegetables may be eaten for food, but they cannot be used as medicine.” ~Masanobu Fukuoka

I spent a lovely chunk of the day in the windy park with fun, thoughtful yogis talking about this amazing little book:

The One Straw Revolution, by Masanobu Fukuoka.

Some passages to remember... 

“Do nothing” stance to farming 

He talks about a “do nothing” stance to farming, teaching that the best methods for food cultivation are those aligned with nature -- minimal soil disruption (no tilling or weeding) and no application of chemicals (be they fertilizers or pesticides).

(This really resonates with me for thinking about medicine… what are we farming in our bodies? What are the best methods for health cultivation? Seems to be those that are aligned with our natural bodies - minimal disruption of bodily processes and no application of chemicals.)

Pursuing a subject in its wholeness

He condemned the “piecemealing” of knowledge by specialization; he believed that a subject should be pursued in its wholeness.

“An object seen in isolation from the whole is not the real thing. Specialists in various fields gather together and observe a stalk of rice. The insect disease specialist sees only insect damage, the specialist in plant nutrition considers only the plant’s vigor. This is unavoidable as things are now.”

(This is why I like Family Medicine -- a pursuit of medicine in its wholeness) 

Seeking the essential nature of man

“Various religious groups have come to take up natural farming. In seeking the essential nature of man, no matter how you go about it, you must begin with the consideration of health. The path which leads to right awareness involves living each day straightforwardly and growing and eating wholesome, natural food. It follows that natural farming has been for many people the best place to begin.”

(Yes! Just like how the practice of yoga leads people towards these ideas of eating whole, local, natural foods) 

Human tampering

“Human beings with their tampering do something wrong, leave the damage unrepaired, and when the adverse results accumulate, work with all their might to correct them. When the corrective actions appear to be successful, they come to view these measures as splendid accomplishments. People do this over and over again. It is as if a fool were to stomp on and break the tiles of his roof. Then when it starts to rain and the ceiling begins to rot away, he hastily climbs up to mend the damage, rejoicing in the end that he has accomplished a miraculous solution.

It is the same with the scientist. He pores over books night and day, straining his eyes and becoming nearsighted, and if you wonder what on earth he has been working on all that time – it is to become the inventor of eyeglasses to correct nearsightedness.”

(Sounds similar to the huge cost of medicating people for problems we create through our poor lifestyle choices -- including the food we eat and the way we treat our bodies)

The four principles of natural farming 

1. No cultivation: no plowing or turning of the soil... the earth cultivates itself naturally by penetrating plant roots, microorganism activity, animals, etc.
2. No chemical fertilizer or prepared compost: this interference drains soil of nutrients… if left to itself the soil maintains its fertility naturally.
3. No weeding by tillage or herbicides: weeds are important in building soil fertility.
4. No dependence on chemicals: weak plants, disease, and insect imbalance develop as a result of unnatural processes. 

(I think these principles could similarly be applied to medicine and health of the human body) 

Naturally grown fruits and vegetables
“No matter how hard people try, they cannot improve upon naturally grown fruits and vegetables. Produce grown in an unnatural way satisfies people’s fleeting desires but weakens the human body and alters the body chemistry so that it is dependent upon such foods. When this happens, vitamin supplements and medicines become necessary. This situation only creates hardships for the farmer and suffering for the consumer.”

The Western Diet

“One might suppose that Western dietetics, with its elaborate theories and calculations, could leave no doubts about proper diet. The fact is, it creates far more problems than it resolves. One problem is that in Western nutritional science there is no effort to adjust the diet to the natural cycle. The diet that results serves to isolate human beings from nature. A fear of nature and a general sense of insecurity are often the unfortunate results.” 

(So true... we may talk about eating nutritiously but we rarely talk about eating with the natural cycle... this is one reason I am so drawn to the idea of eating locally)

Sickness

“Sickness comes when people draw apart from nature. The severity of the disease is directly proportional to the degree of separation. If a sick person returns to a healthy environment often the disease will disappear. When alienation from nature becomes extreme, the number of sick people increases. Then the desire to return to nature becomes stronger. But in seeking to return to nature, there is no clear understanding of what nature is, and so the attempt proves futile.”

“Doctors take care of sick people; healthy people are cared for by nature. Instead of getting sick and then becoming absorbed in a natural diet to get well, one should live in a natural environment so that sickness does not appear.”

Death
“When rice is planted in the spring, the seed sends out living shoots, and now, as we are reaping, it appears to die. The fact that this ritual is repeated year after year means that life continues in this field and the yearly death is itself yearly birth. You could say that the rice we are cutting now lives continuously…

The same thing that happens to rice and barley goes on continuously within the human body. Day by day hair and nails grow, tens of thousands of cells die, tens of thousands more are born; the blood in the body a month ago is not the same blood today. When you think that your own characteristics will be propagated in the bodies of your children and grandchildren, you could say that you are dying and being reborn each day, and yet will live on for many generations after death.”

Practice as a duty

One reason to get up to practice before a full day of work, school, projects, etc:

"To keep the body in good health is a duty…

otherwise we shall not be able to keep our mind strong and clear.” 

~ Buddha

Rachel and Camille doing an early morning practice in their bedroom before heading to the hospital!

Ben Franklin, a yogi?

At the age of 20 (in 1726), Ben Franklin developed these thirteen virtues. He wanted to cultivate his character, and he practiced these for the rest of his life:

1. Temperance. Eat not to dullness; drink not to elevation.
2. Silence. Speak not but what may benefit others or yourself; avoid trifling conversation.
3. Order. Let all your things have their places; let each part of your business have its time.
4. Resolution. Resolve to perform what you ought; perform without fail what you resolve.
5. Frugality. Make no expense but to do good to others or yourself; i.e., waste nothing.
6. Industry. Lose no time; be always employed in something useful; cut off all unnecessary actions.
7. Sincerity. Use no hurtful deceit; think innocently and justly, and, if you speak, speak accordingly.
8. Justice. Wrong none by doing injuries, or omitting the benefits that are your duty.
9. Moderation. Avoid extremes; forbear resenting injuries so much as you think they deserve.
10. Cleanliness. Tolerate no uncleanliness in body, clothes, or habitation.
11. Tranquility. Be not disturbed at trifles, or at accidents common or unavoidable.
12. Chastity. Rarely use venery but for health or offspring, never to dullness, weakness, or the injury of your own or another's peace or reputation.
13. Humility. Imitate Jesus and Socrates.

He sounds like a yogi! I think Ben would have loved our little mysore community here in Philadelphia.

Loving the heat

The warm weather brings a hot and sweaty practice… I’ve missed it!

As I mentioned in this post a few months back, I found my body temperature rises about 2 degrees during my practice (this was not the most accurate measurement and I think it's probably higher than that).

But my question is: what is the effect of generating this daily fever as a result of practice (or any other sweat-inducing exercise for that matter)?

Treatment for certain tumors includes the use of regional hyperthermia (temperatures up to 104-109 degrees Fahrenheit). The high temperature sensitizes the tumor to radiation and/or chemotherapy. Exercise can’t raise our body temperatures that high, but what might be the effect of the more mild increases in body temperature that exercise creates?

I couldn’t find an answer to this specific question, but I did find this paper, which discusses how “mild hyperthermia” enhances immune system functioning and may provide long-term protection from tumor growth. They write:

“There has long been appreciation in this field of the potential similarity between exogenously induced hyperthermia used in the clinic and natural hyperthermic states which occur during fever. Because of the close association between fever, inflammation and immune cell activation during infection, several investigators have speculated that there could be significant effects of elevated (fever-range) temperatures on enhanced anti-tumor immunity.”

I wonder how high we can get our body temperatures during practice... (trying to think of a good way to measure this?)

Might yogis (and other athletes) who create and sustain and daily “fever” have stronger immune function as a result? And might this help fight infections and cancers over a lifetime? 

Countdown to yoga teacher training!

Less than one month away until I head to Boulder for Richard Freeman’s 200 hour month-long yoga teacher training! I could not be more excited for this month of protected time and space for yoga... and it could not be happening at a better time. 

I really like the way Richard talks about the asana practice here (Thanks Laruga for sharing this!): 

“One meditative yoga posture flows through endless forms, just as one being manifests an infinity of forms. Currents of energy rise and spread, pulling the body through a whole spectrum of attitudes and viewpoints, postures strung like flowers on the thread of the breath. This movement produces spontaneous meditation by awakening the core energy of the nervous system, connecting it from its root to the crown of the head.” 

I'm looking forward to thinking more about how to bring yoga into the medical world, including 1) mysore-style medicine and 2) making yoga more accessible to people. 

I'll repost this great video of Richard Freeman talking about how physicians should give patients a self-knowledge, and thus help turn them into their own doctor.

Perspective

I’ve been buried in research... recruitment, enrollment, and running to and from the lab. Today was a much-needed day off to regain some perspective.

Looking at this picture helps too (that little white dot is our earth!):

Photo credit here 

“There are two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.” 

~Albert Einstein