Denise (00:07):
Myth, Magic, Mmedicine and everything in between two doctors talking…
Denise (00:15):
Hi, welcome to Myth, Magic, Medicine. Today's guest is Elizabeth Hughes, a Stanford trained physician, a dermatologist who was practicing for a couple of decades before she had a little bit of a change of direction. So I'm just gonna open it up to Elizabeth to tell you about herself a bit, and what led her to realize that the way we've been trained in Western medicine was not the answer to everything.
Elizabeth (00:43):
Yeah. Yeah. Well, thank you. Thank you. It's good to be here. Really. It's good to be here. Thanks. Um, okay. So, um, what happened for me was sort of this one patient that, that led to a series of other moments or epiphanies, but maybe, I don't know how many medical people are going to be watching this, but so this was, this patient who came to me. So I'm a dermatologist, and you know, bread and butter sort of dermatology is what I do. I do a fair bit of surgery and a woman came to me who was in her early eighties, but other than a leg ulcer, she was in perfect health. She had no underlying conditions that would give her a leg ulcer or make it so that the ulcer couldn't heal or anything like that. But what happened for her was after a small injury to her leg, which she took care of properly,, the sore didn't heal. She had, basically, she'd walked in, you know, the open dishwasher door, she'd walked right into that corner, you know, like right to that edge, you can just, you can just picture it.
Elizabeth (01:57):
She'd scratched her leg. She did all of the first aid things, you know, she washed and put a bandage on it. When it didn't heal a week later, she went to her doctor, the doctor said, well, maybe it's infected and took a culture and gave her antibiotics. And it got worse. Oh, well, maybe it's the wrong antibiotics, you know, et cetera, et cetera. So back and forth and back and forth, um, for months. And I don't mean like a few weeks, I mean, like six months, she had gone to all of her doctors and her doctors' partners. She had been going to wound care,, getting twice a week wrapped up in the latest bandages, that would, you know, the type of thing that you use for people with burns. She had seen a vascular surgeon, had ultrasound, really everything had been done.
Elizabeth (02:50):
And because she had been going to wound care twice a week for about three months, we had brilliant measurements that showed every week despite doing exactly what you were supposed to do. The wound was getting larger and not smaller, the opposite and I send people to wound care all the time for leg ulcers. And, you know, like I know what it's supposed to happen. The opposite was happening. So somewhere along the way, she had developed an allergy to one, some component of the bandaging that had been done on her leg because, you know, every few weeks when nothing was happening, they switched it up and they tried something else on the leg. And somewhere along the way, she developed an allergy. And so the question to me, as a dermatologist, what from a general surgeon who said, okay, we're gonna have to do a graft and I need to know what we can bandage her with later on. Right. That was, that was the question for me, the dermatologist, like, that was that,
Elizabeth (03:53)
Was that the first point you met her?
Elizabeth (03:55):
That was the first time I met her so that this leg ulcer that had been going on, everybody had given up on it healing naturally, she was destined for a skin graft. The patient herself told me that the surgeon said, "well, you've got a 50% shot for this to work". Like even the surgeon said, you know, I don't think this is, you know, this is not a hundred percent shot.
Denise (04:20):
It's still going to need to heal
Elizabeth (04:22):
It's still gonna need to heal. Exactly. And so, she unwrapped her leg and from knee to midfoot, you know, the whole area of the bandage, she had a raging contact dermatitis, red, scaly, blistery, weeping. And she had an ulcer that -we were looking at tendon! On the lateral side of her leg down, all from a little cut and all, because she had gotten absolutely appropriate medical care. She had not missed an appointment. She had taken every pill of antibiotics the whole way along, right? The whole way, done everything.
Denise (05:00):
Everything, the perfect patient,
Elizabeth (05:02):
Everything. And here's what happened. She said to me, you know, I you're talking medical things, but what she said to me was this, she said, "Everyone tells me I'm old and I'm just gonna have to get used to this." And, and something in me, like at that moment, I could just sort of, I don't normally, I don't normally sort of get forceful or strong or say no to patients, and I definitely,I don't think, I swear normally but I think what I said was "That's BS!" You know, like,that's BS and what happened. She's just like "Really, nobody has told me that this could ever heal " every single doctor, every single wound care nurse, every single everybody had told her.
Denise (05:58):
So from the very beginning, she'd been told it would be difficult, because it was a very minor injury.
Elizabeth (06:02):
It was a very minor injury, very minor injury. And nobody had told her along the way that it could heal. Okay. So back to the medical things, I don't make much of this moment. I just go on my merry doctor way. And as a dermatologist, the protocol for taking care of testing for allergies in a person who has an active dermatitis is you have to wait for the dermatitis to settle down. Like, I cannot do allergy testing on someone who's already reactive. it will just, it will just be worse. So I did what I would do for anyone else, Vaseline, a loose gauze, change it once a day, don't put anything else on it, come back and see me in three weeks. And then,in my mind I was like, okay, we're gonna start the testing, you know, the patch testing with the contact allergy.
She comes back in, three weeks later. And this time... Oh, I forgot to mention, that this leg, it was her right leg. So she could no longer drive. Prior to this she had been driving and playing golf twice a week
Denise (07:08):
It was really debilitating.
Elizabeth (07:09):
It was completely debilitating. So her daughter, who lived about 50 miles away, had been coming in to drive her to wound care twice a week and so it was totally messing up her daughter's life. So this time when she came back, when the patient came back to see me three weeks later, the second time, her daughter walked in with me instead of waiting in the waiting-room. And the patient said, "I don't know if I did this, right" I'm like, you can't mess this up let me look. So I removed the bandages, I cut the bandages off and -it's all healed.
Denise (07:42):
In three weeks.
Elizabeth (07:44):
In three weeks, the contact dermatitis is completely gone, which was like, pretty amazing, right? But the ulcer was gone - three weeks!
Denise (07:59):
Even if she hadn't had that long history, three weeks to cure such a deep wound is pretty...
Elizabeth (08:04):
It is completely impressive? Yeah. And it was, it was one of these moments that just stayed with me because I thought to myself, how many times have I sent a person to wound care for something that I didn't think would heal and reinforced that? Like, what are my biases that I may be passing on to patients? And what is the power that we're not harnessing in medicine? Yeah. Like what would've happened. And as we, as I have mentioned to you earlier, when we were talking, this sort of led me to a series of little, smaller, epiphanies that made me just realize that power of the subconscious, the power of the body to heal itself. And, how your subconscious assumptions, I don't even want to call them beliefs, like how your assumptions play into your healing.
Denise (09:05):
She wasn't necessarily thinking these things to herself anyway, although she had, by the time you saw her, she was already beaten down by it, because it had taken so
Elizabeth (09:15):
Long. Exactly, golf a couple times a week, I mean she was the 83 year old who took an aspirin a day. That was her medicine list. And she had zero problems like as a medical history she had none. And so she was the picture of health. And so clearly, she had probably an unexamined belief of her health, but the medical system is so biased toward thinking about illness, illness-focused, that it just sort of rubs off on people if you know what I mean? Like it just rubs off on people and you know, to talk about some other, you know, epiphanies that came along. So when I would have to go into the hospital to do consults, you know, I used to love to go into the hospital like, 'Oh, this is where people get well, like I'm gonna go in and make people well', and now I walked in, you know, I walked in and I said like, 'Oh my goodness, this is a temple to illness'. Yeah. we put illness on a pedestal and yes, not to say that there aren't good thing that happen. And not to say that you don't have to use medical treatments, but what if the underlying assumption was wellness and the power of the body to heal and use all the tools that we've got. How would that shift medicine and health in general? It's a fascinating question.
Denise (10:43):
Absolutely great. Well of course, you know, my own interest in hypnosis being used in the medical field, yeah. Entirely, subconscious beliefs, right? Drives so much. How has this experience changed your own practice?
Elizabeth (10:58):
Oh, dramatically.
Denise (11:00):
Okay. You like to explain?
Elizabeth (11:06):
So well, first off, I will say, that I spend a lot of time saying, oh, I'm gonna ignore that. I'm gonna ignore that. And then in the middle of the night, I would wake up and, have these little moments where it would, you know, I get the, you're doing medicine wrong. Like the, the voice of wisdom would come to me at three in the morning saying you're doing it wrong. And, and I was like, okay, I have to look into this. So it took me a long time to step into it, but I eventually got a health coaching certification. I do not do hypnosis, but another subconscious belief -changing technique. I was trained in, a technique called Psyche-K. And I did, I've got to say, a huge variety of other studies. I became a yoga instructor and my yoga training course was very, very heavily on Ayurveda which most yoga training courses don't have. Too II almost considered, getting a certification as an Ayurveda practitioner, which you can here in the Washington state area. There's a very good Naturopathic Medical College, very close to me. And they had an Ayurveda program, but it didn't work out for me to do that. But it was an option.
Denise (12:24):
Just tempting?
Elizabeth (12:26):
I studied with a shaman for a year or so, I just, it expanded my horizons. And I did this sort of in the background while I was still practicing medicine for a while. Like nobody would really know, like, you know, she's spending the day doing surgery and at night she's in a drum-circle, you know?
Denise (12:43):
Okay. So, were you intentionally hiding it or you just didn't see the opportunity to bring it up because most of us, worry about, I'll be that woo-woo doctor instead of the 'real' doctor. And, it's just that nobody, none of us, I think, and certainly nobody listening to this channel, please, believe that we should throw away Western medicine. That's got some value too, but there are so many other things that we ignore, that, because you can't put it in a box; it's harder to charge for; I mean, there is, there's certain mechanics of the business of medicine, right. A lot of it, I think is, just this fear that it's just woo-woo.
Elizabeth (13:22):
Right. Well, then I switched gears from a large multi-specialty sort of conventional medical group to joining a small group of doctors in a very small medical practice, who all had an interest in this, that I was able to find, and it was a combination. So it was an interesting combination because there were MDs,, there were also Naturopaths, there were...there was a chiropractor there, there was, one of the Naturopaths was also a chiropractor. There were massage therapists. There was, one of the naturopaths was also an Ayurveda practitioner. So we were in this sort of, like ,conglomeration where we were able to work together on that. And so I was, you know, a dermatologist some of the time while I was there, but I was also the coach, the, you know, deep, subconscious belief person, because they didn't have someone like that. And so while I was in that space, I had, you know, my dermatology office and then down the hall, I had my coaching stuff. Yeah. Yeah.
Denise (14:28):
Were you coaching physicians or were you coaching, whoever needed to be coached?
Elizabeth (14:34):
It was patients, but then I also had my own coaching practice. I was able to walk in two worlds for a while but what was really interesting was about 50% of people who were finding me were medical doctors, dentists, nurses. They were coming to me for, their own health concerns and recognized the limitations. And they weren't they weren't, you know, saying anything to anyone else, but yeah, I had all sorts of people and, by this time I had also opened up my practice to something that was online and working online as well. And so I was attracting people from all over the place, you know, people who were medical and I recognized within the, you know, the medical professionals that I was seeing, that there was such an enormous need in their own lives to bring this integration of, I hate to use the words body and mind because it sounds a little bit trite, but I mean that not just in this sort of mind, body medicine realm, I mean really, really, harnessing the power of what the body can do and how the unquestioned part of your mind drives that.
Elizabeth (16:05):
That's the part you don't think about, it's just there in the background doing its thing. Yeah. And eventually actually, uh, at the end of 2020, so it's been a little bit more than a year, at the end of 2020, I actually left the medical side of the practice entirely. This is because my own continued growth made it difficult for me to, what do I wanna say? To not open my mouth!
Elizabeth (16:43):
What I saw in a lot of, of the dermatology practices, you know, I'd see so many people, coming in for things like psoriasis, and just like, "Just give me the new drug, just gimme the drug that's on television. " I'm like, you know, yeah. I don't, I don't, that's not right for you. And guess what? There's some other things that you need to be doing first. And because, here's the thing, I had had a person, who had psoriasis, like this was another one of these little epiphanies you know, afterwards. A woman with psoriasis where, you know, again, this little, little belief sort of changed everything. And, you know, I know, we had a little conversation about her loving herself, the way she loved her children and doing for herself, what she would do, you know, for a child. And I didn't see her again, this is someone I had seen, you know, every three months for years, didn't see her again until she brought her daughter in for, like wart or something like that. How's your psoriasis? It's gone. Yeah. Like people don't even recognize, it's gone. It's gone. like, OK, there we go.
Denise (17:59):
Now, do you think there's hope to get this message to Western medicine? I mean, there are a few places where hypnosis is studied in, you know, Duke University has a section, in Stanford, your old haunting grounds, right? Those two, but, but it, in general, they aren't much, they don't much speak about it.
Elizabeth (18:18):
There's a great deal of interest. Absolutely. There is hope, the bigger question I think is, is what's it going to take for this to become part of the mainstream, part of, you know, your treatment plan,. You know, instead of, you know, like the treatment plan, first beta blockers and Ca channel blocker or whatever it is, where is it going to start? I
Elizabeth (18:41):
Yes, why don't we look at what you eat?
Elizabeth (18:45):
Right. So it's going to take quite a bit because medicine absolutely must have data. Like, we all want evidence-based medicine and we all want to have a protocol for this thing. Okay. So follow me here, but we got to follow the money. So that requires research and money. Now at the moment, people may not realize this, but something on the order of 80 to 85% of all research money is industry, pharmaceutical, companies. And that wasn't, even when I went to medical school, it was kind of 50-50 government and research, right? It's now overwhelmingly so, even places like Stanford, where I did my residency, gets money from industry. And of course, what does industry want? They want blockbuster drugs. Yeah. And so that's not going to make it into a journal, and then it's not going to make it into your standard of care guidelines.
Elizabeth (19:49):
And so it's not going to be paid for by insurance. So we've got this, and it doesn't matter what the, I mean, I often say that we could fill entire medical libraries with information about self-healing about, you know, the power of the subconscious, about what hypnosis or art therapy or whatever you want. You could fill a medical library with all the evidence, but it's not as much as we can fill, you know, a shopping mall with all the other stuff about how, you know, the, the pharmaceuticals, like, so there is evidence. It's not that there isn't but there's just this predominantly…
Elizabeth (20:37):
Much more.
Elizabeth (20:37):
…there's an avalanche of the stuff that's been paid for. Yeah. And that's where the problem comes. I, you know, I strongly believe that if, well, let me see how I can put this lightly.
Elizabeth (20:56):
It's okay. I can edit. Go ahead.
Elizabeth (20:58
No, I'm not going to... there is a real problem with the way, especially in the United States, that medical care is paid for that plays into it. Medical care is, you know, the insurance companies make a profit off your illness. And so, you know, your treatment needs to be as cheap as possible to get some sort of reasonable outcome. And I mean, I use that term, reasonable outcome, because it's not really good health. So if there's anything else additional,
Denise (21:33):
It's not going to be paid, no, they don't want to pay for
Elizabeth (21:34): ayurveda
No, they don’t want to pay for it, that's not going to be paid for. So I actually think part of getting it into Western medicine is for the general public to realize what a disservice their insurance is doing for them. And having them recognize that either these need to be coordinated into treatment or to just say, this is important enough, and I'm going to, you know, use these techniques, out of pocket because it's that important it's as important as, you know, whatever else.
Elizabeth (22:11):
Yeah.
Denise (22:13):
Thank you. That was great, so interesting. There are so many different ways to approach the subconscious you've, did you say you'd studied Reiki?
Elizabeth (22:32):
No, I haven't studied Reiki. Yeah, no, I haven't done Reiki, but absolutely all of these wonderful biofield therapies. And, and so, I mean, it's, it is amazing what is available and what's wonderful is the nursing tradition has that is sort of built, it may not be part of the main curriculum, but there is a tradition of healing-touch and that came from the nursing background that we doctors need to bring in, you know, we doctors, like I'm a doctor, I'm not a nurse. Well, I guess what we need, we need more of that patient level caring.
Denise (23:16):
Right. There was a big push when I was a resident, which is back in the eighties, I'm an old person. There was a big, "high-touch, high-tech”, sort of mantra, right? The nurses were massaging NICU babies, which is lovely. We suddenly started talking about skin-to-skin. No whisking babies away from their mothers and doing alll the tech stuff but none of the support stuff, but it's baby steps and we seem to realize these things and then pull back and it's probably finances that do it. You know, "You can't prove to me that doing that did anything, so we're gonna stop doing it."
Elizabeth (23:59):
Right, right, right, right, right. And it's, and of course, it's very hard…
Elizabeth (24:06):
to do placebo studies on these things, unfortunately, because the mere act of being in a study is a placebo effect. Right?. And there's, there's great, you know, in I think it's the Harvard School of Placebo Studies with Ted Kaptchuk who has done, has done these studies where people just, I can't remember what they did, but they took a handful of people with, you know, a medical condition or something like that, and just monitored their data. And somehow they got IRB approval for them, the people not to know that they were in a study. And then they had people who were in this study, but were told they were, you know, like we're just enrolling, so we're gonna wait and we're gonna see you when you're in your, you know, when we're all ready, we're gonna start the protocol.
Elizabeth (24:51):
And then they had people they actually put in the protocol and the people who were in the waiting room for the study did almost as well as the people, you know, it's almost the same level of improvement as the people who are in the actual protocol that they're in that like, that's just the feeling of hope, that feeling of hope is kind of missing from medicine when we're all trying to be realists. And we're all, as I will say again, we doctors we're afraid of being sued for not, you know, living up to our promises. So we
Denise (25:27):
Never promise anything.
Elizabeth (25:28):
Yeah. Never promise anything. So that woman with the leg, there was no human way, if a second person walked in I would never say, oh yeah, I can get that healed in three weeks. Yeah. Right. Just look at, I would never do that because, you know, yeah.
Denise (25:42):
It's always couched as "most people"
Elizabeth (25:46):
Right. Most people, most people. Yeah.
Denise (25:50):
Yeah. Well, thank you very much. And I hope you'll come back again and we can talk about some more stuff. That would be great. Thank you so much.
Elizabeth (25:58):
You're welcome. This has been a pleasure. Thank you.
Denise (26:01):
Thank you for joining us at Myth, Magic, Medicine. If you have found this episode useful, you can apply for free CME credit through the link provided below
If you're not a medical professional, please remember while we're physicians, we're not your physicians. So please consult with your own healthcare professional if you think something you have heard might apply to you or a loved one until next time.
Ayurveda
https://bastyr.catalog.instructure.com/browse/ccce-catalog/continuing-certificate-ed/courses/online-ayurvedic-health-advisor-certificate-program--fall-2022
Placebo Studies
https://www.health.harvard.edu/mental-health/the-power-of-the-placebo-effect
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MMM EH edited (Completed 06/15/22)
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