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| Hpathy Ezine - August, 2008 | |||||
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Amy RothenbergInterviewed by Alan Schmukler |
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| AS: When and how did you first experience the magic of homeopathy? AR: I don’t much like the question. After more than 22 years of practising homeopathy continues to be part of the deeply satisfying work I have in helping patients and in training students. It requires ongoing study and attention to, for me to keep improving my skill. There are elements that have become easier and there are the delightful fast and powerful responses to remedies, but mostly, working as a physician, I am taking care of my patients over time, over years, over the birth of children, over times of education, through the loss of loved ones or dreams. The daily interactions, the drawing out of compassion and the faith my patients have in me is where I find the magic. In my relationships with patients who have trusted me enough to come in and share their stories or students who have believed in my and Paul’s work enough to come learn with us, this is where magic happens, but not without a lot of dedication and a lot of work. Is there magic in homeopathy? I don’t know. I think there is clarity and good prescribing, there are strong vital forces that can take the stimulation of a remedy and really run with it and then there are the many more patients that take time and care and ongoing effort.
AS: Through NESH, you and Paul have sent thousands of people into the world as homeopaths. Do you ever get feedback years later? What kind of responses have you had? AR: I suppose I could write a book of love letters I receive from students. Here is a small sampling: (Yes! I do save them, for those days when I need a ‘pick me up’!)
Back to me writing: I had the occasion to give the commencement speech at the National College of Naturopathic Medicine in Portland, Oregon, my alma mater. After the ceremony an older woman came up to me. She grabbed my arm and said to me that she had heard me give a lecture on homeopathy on the radio some 15 years before. At that very moment she knew she wanted to do what I was doing. After having raised a family, she began her undergraduate studies, got all her prerequisites and finally was accepted at NCNM. That day she herself had finally graduated! She came up to thank me for inspiring her so many years before. Now that was an interesting story! I often get emails and postcards from people thanking me for some insight or a particular lecture and sometimes from many years ago. Helping students to understand what they don’t understand and to be quietly supportive and encouraging and to know them as individuals is part of my work that I adore. Watching understanding come across a person’s face is one of the greatest delights a teacher can have; hearing back from someone who feels that their work with me has helped them with their work with a patient makes my day every time. I also try to help students figure out what it is that they can best bring to their practice in terms of skills like case-taking, listening, being caring. I encourage them to embrace those things they already do well and build upon them. I have a stack of holiday cards from students that say things like- Thank you for believing in me when I did not believe in myself; thank you for all the time you spent with me when I was struggling with xyz; thank you for not being in a rush with me during our clinical work; thank you for guiding me to streamline my casetaking; thank you for modelling balance in your own life, etc. Last month I received a beautiful card from a man I taught in the 1990s. It said simply: “Your work continues to inspire me. My patients have you to thank.” AS: Such profound gratitude says it all. Having a homeopathic practice with one’s soulmate is a fantasy many have had, but you and Paul have manifested that dream. Can you shed some light on that experience? How do your styles differ? Do you often consult each other on cases? AR: Paul and I are very blessed to have each other in life and in this work. We have very different strengths. If you met us you would also know we have nearly divergent personalities and unique temperaments. I am a people person, I am a morning person, I have very healthy habits of living. Paul is a serious and original thinker, a devout student of this art and a disciplined writer. He is encyclopedic in his interests and knowledge of many subject areas and sees connections among and between many of them. I am a book artist and a cantor, I am committed to daily exercise and getting lots of sleep. Beyond a sweet love that we share for each other, we adore our children and pour ourselves into creating a loving and warm home and family life; we do well with long stretches of time together in quiet or chatting or just working side by side. We have also found ways to be alone and apart especially when work has us on the road. We are both good communicators, remember to do small kindnesses to and for each other and we have fun with each other and among family & friends. We have been blessed with a marriage we treasure for its sweetness, for all the things we have accomplished together and for the dreams will continue to nurture. Our youngest child is 16 now ( with a 17 & 19 year old as well) and though we will miss the hub-bub of a busy family life, we are also looking forward to what the next phase has in store! In terms of our patients, we love practicing with one another. When we are stumped with a patient we will see the patient together. If it’s my patient, Paul takes the case and if it’s his patient, I take the case. This is one of the small gifts we give each other. It is remarkable how a different person asking the same question often gets a totally different response. We can help each other see things more clearly. I have strengths in understanding people and Paul has strengths in understanding remedies though, obviously we are both good at each side of that equation. We love to be at the office together which we do one day a week, we meet in the lunch area for a chat or take a short break together. Paul often sends me his patients that he thinks I will connect with better; I will sometimes send him a patient I think he will be more in synch with. We have terrific support from our front office, Linda & Kim who understand our work and handle nearly all the administrative duties, freeing us to focus our attention and thoughts on our patients. AS: That’s a wonderful love story. Speaking of stories, people come to homeopaths with complex histories, with symptoms due to traumas, multiple miasms, toxic chemicals. In presenting a case, they forget things, remember them wrong or just lie. In light of that, can we still expect consistent and favorable results? Does the Cycles and Segments perspective lend some order to this? AR: Accurate and effective casetaking helps us sidestep mistakes that can be made by incomplete stories, patients who are not good reporters or those who may be less than forthcoming. Cycles and Segments does an elegant job of allowing us to see the patterns and underlying tendencies which is the most paramount thing. The smaller details are less important . It is the themes and the generalities upon which we should prescribe. C&S liberates us from the struggle with minutiae that can bog down many a homeopath’s case. For more information on Cycles and Segments please see www.nesh.com AS: Most homeopaths never stray beyond prescribing homeopathic remedies. As a Naturopath, do you think that’s always sufficient? Should schooling in homeopathy include other complementary modes? AR: As a trained and licensed naturopathic physician I do use a wide range of natural medicines with my patients. I spend a lot of time helping patients figure out how to be less stressed out. I work with diet and exercise; I use botanical medicines and some supplements. I often refer patients to a yoga class or personal trainer. I know my homeopathy is going to go a lot further with a patient if they are also doing these other things. I am clear with my prescribing in terms of what I expect the remedies to do and not do. All that said, it is difficult to be good at everything. My training was unique as a physician level practitioner of natural medicine. Within homeopathy training, perhaps it makes most sense to stick with the homeopathy and master that. If one is able to expand to some of these other areas, wonderful; if not, hopefully there are others nearby you can send your patients to for such support and recommendations. AS: How do you handle the question of vaccination in your practice? Do you see homeoprophylaxis as an alternative? AR: I do not use homeoprophylaxis in my work. I have not seen any good research to show it to be effective in terms of antibody titers. I see vaccination as another kind of stress to the system. In some patients it will not be particularly impactful. For others, those who are susceptible, it can cause issues. I support informed consent for all patients. Many come to us fully vaccinated and we are fine to treat them regardless. AS: Let me go back to cycles and segments for a moment. It was hoped that this would create more predictability in prescribing. Has that been borne out? Are different homeopaths more likely to come up with the same remedy, using this method? What effect will this have on the practice of homeopathy? AR: Wonderful question, and YES! That was the entire goal of describing this way of seeing things. We are currently teaching a clinical course for those who have completed our full training. We are amazed over an over again how most everyone in the group of 50 will come up with the same 3-4 remedies. When you know what you are looking for in terms of what is most limiting to the patient, i.e. what needs to be cured, then you will more likely be on the same page in terms of remedies that come through the analysis and ensuing repertorization. Predictability and reproducibility are both very important elements to bring to homeopathic prescribing. I know when I am teaching in more traditionally medical settings such standardizations of care, even though they are by definition of homeopathy, individualized, help many practitioners feel more comfortable embracing the practice of homeopathy. AS: In England, there is a concerted effort to close the homeopathic hospitals. What is the best strategy to deal with critics? What do homeopaths need to do to move us closer to being mainstream medicine? AR: We must conduct research that proves the efficacy and cost effectiveness of this medicine. The research design must be such that the outcomes will reflect the efficacy. We must be asking the correct questions and have competent practitioners do the prescribing. We are involved with one such study at the moment on the treatment of flu. Our pilot study this year was most positive and so we expect our larger study for next flu season also reflect efficacy. On another note, I think presenting a unified and professional front is essential. Squabbling amongst ourselves will never advance the cause. I also believe that the practice of homeopathy in the context of broader complementary and alternative medicine (CAM) is the most effective approach. In this way we can use whichever natural medicine approach is most indicated for patients at hand with their particular pathology. It also allows the homeopath to be more flexible in terms of prescribing say for an acute illness during constitutional care and allows the homeopath to not over-prescribe remedies when they are not needed. AS: For practical and legal reasons, homeopaths in the U.S. don’t get much opportunity to practice emergency medicine. Have you and Paul had occasion to treat such cases now and then? AR: Yes we have, both in the hospital and en route. Many of our patients will call us at such times and we prescribe for them as we are able. We also know that there is a time and place for all sorts of medicine and that if there is a true emergency often the very best place to be is in the Emergency room. We are always happy to help pick up the pieces afterward as needed! AS: There’s a big difference between book learning and working a live case. What kind of practicum do your students get? AR: After the first few sessions of our class, we begin to see live patients during school hours. We train our students in all aspects of casetaking and let them practice those skills. We work quite a bit with video taped patients as well and help students see the different elements of casetaking as we go. We do have some time devoted to paper cases so students can begin to see patterns, to find the Segments and put them into Cycles, to start to find appropriate rubrics to put in the Segments etc. Over time skills grow so they can then be applied to live patients the students see on their own. AS: Are you and Paul working on another children’s book now? Can you tell us what it will be about and when it might be available? AR: Paul and I are working on many things at the moment! Busy people! The next peds book should be out in 2009. It will be similar to the first one, practice based and detailed materia medica on how the patients appears in the office and how they behave at home, in social settings etc. We have taken up the study of all the wild remedies, so the book will be somewhat intense! Hyos, Verat alb, Tarent, etc. It’s the kind of book where you need to tell readers, “Put on your seatbelt,” before reading! We continue to write and publish the Herscu Letter, which comes out twice a month, and is subscription based, ( see www.nesh.com for info on that.) I am also putting the finishing touches on a book: A Case in Point: Stories from Naturopathic Medicine, which I hope will be out in 2010. The cases and stories in this book aim to present a wide breadth of patient experiences. A strong and underlying philosophy that informs my work comes through the narratives. You will start to see what kinds of things are important to my prescribing and hopefully start to understand the sorts of results, in term of symptoms, in terms of lab work, in terms pace that are part of this kind of medicine. I hope what emerges is a greater understanding of how one doctor practices as well as an appreciation of the gentle effectiveness and power of naturopathic medicine and homeopathy. At this time many patients are looking to CAM approaches for both prevention and treatment of all manner of illness. There are many answers and many paths we take to healing. This path is the one that I offer and in it have found meaningful, challenging and inspiring work. I am rarely bored and never complacent. There is always more to learn, more people and families to try to help. So in this book there is also the story of my own evolution as a doctor and hopefully some will find that compelling. AS: I look forward to the next pediatric book, since the first one was the gold standard. I’m sure A Case in Point: Stories from Naturopathic Medicine will also be a treat. Since you handle a wide range of problems, could you tell us which cases are the most challenging for you? AR: The most challenging cases are those where there are very few physical symptoms, unclear or weak physical generals and no strong mental or emotional symptoms. Sometimes a patient presents like this because of medications which have blunted them. Some present like this because they are quite healthy but have an illness which is incurable. I also find challenging those cases where there are strong maintaining causes, either environmental or related to relationships or family dynamics. I can give a very good remedy but the person’s whole life situation does not support the patient moving in a direction toward health. AS: The price of homeopathic treatment in the U.S. is commensurate with the years of study required and the time involved in working a case. However, it reduces accessibility for many people. Do you see any way to get the insurance industry to open its doors to homeopathy? AR: The insurance industry is increasingly looking for cost effective ways to prevent and treat illness. Having regulated and licensed providers is a prerequisite for insurance companies to begin to look at a particular approach. Those licensed under other medical degrees ( MD, ND, DO etc.) often can have their services covered. That all said, I would hope that as a country the USA would begin to move toward a more equitable way of providing medical care, including complementary and alternative approaches like homeopathy. Patients are certainly clamoring for it and we do know that for many common acute and chronic ailments, natural medicine approaches are not only effective but also cost effective. AS: There has been a tendency in provings to look for connections to the source. A prover of Eagle blood may have dreams of soaring. By speculating beyond the proving and being “animal-pomorphic”, is there a danger of becoming too poetic? Or does all this just raise us to new levels of understanding? AR: I am a poet at heart so do not prefer to bring poetry into this discussion with a negative connotation. I do not believe the Doctrine of Signatures has any place in botanical or homeopathic medicine. Provings are best conducted when double blinded and neither the “practitioner” or the “patient” should know what substance is being proven. The lead investigator of course needs to know, but the blinding aspect is an important part of any pharmaceutical experiement. Paul Herscu, my husband and partner extraordinaire has written a very thoughtful and comprehensive two volume set of books on Provings. We have, at our school conducted numerous provings. Paul lays out in the first volume the rules of the game and exactly how to conduct a proving. We also model the work with a proving of the remedy Alcoholus. In the second volume Paul offers a complete and annotated review of many of the major articles and pieces written about provings since the beginning of this profession. Anyone seriously interested in understanding provings, but more importantly understanding how integrally connected to patient care provings are, should read the book. If you do not know what symptoms to take from provers, you will likewise not understand which symptoms to pay attention to in your patient. Deeply understanding the philosophy and execution of provings by definition should help your practice. Leave off the doctrine of signatures and you raise the conduction of provings to science. AS: Where would you like homeopathy to be in ten years? How do you see it evolving? AR: I just returned from time on the Navajo reservation in Arizona where I was helping administrators think of how to integrate traditional Navajo healing alongside complementary and alternative medicine within the allopathic out patient/in patient state-of-the-art hospital. The work was very gratifying and there is much potential there. In my dreams, that is where we are headed, truly integrated into the medical world. The best doctors of the future will know which patients need what, when. The best homeopaths likewise will be able to take advantage of all that allopathic medicine has to offer both diagnostically and treatment-wise and will be able to effectively guide patients though the (often time) confusing world of allopathic medicine. I have always believed there are enough sick people to go around. I often pray that I receive the right patient at the right time and that I know what will be best for the patient overall. Most of the time that includes prescribing homeopathically, but not always. There are many routes to healing and part of my job is directing my patients to appropriate routes. I would also like to see the more scientific, predictable and repeatable approaches to homeopathy underscored. Part of what I love about our approach, Cycles and Segments, is that in a large group of homeopaths working on paper, video or live patient cases, we often come down to 3-4 remedies that everyone can live with. This approximates a science, instead of 20-30 remedies, everyone fighting from their own disparate perspectives. So it is my dream that homeopaths ground themselves in approaches to case-taking, case analysis and repertory work and long term case management that can be passed from one generation of homeopaths to the next, that can bring the practitioner to a small handful of remedies that are likely to be effective and that ultimately, enable homeopaths to follow their patients over years over the course of the patient’s lives. I am now at the point in my own practice, 23 years in, where I am seeing the children of children I once saw. This is gratifying indeed, for a number of reasons. First of all, the quality of the relationships, the depth of trust and familiarity is a comfort to all. Secondly, I can see the pathology of families unwinding and can take a small bit of satisfaction from this. I would also like to see a continuation of well conceived and well executed in vivo studies on homeopathic treatment. This is essential and informs much of the rest of what we will be able to accomplish. In summary, well trained homeopaths taking their rightful place in the world of medical care, that is where I see homeopathy headed in the next decade. AS: Thank you for sharing with us today. I hope everyone will be inspired to explore Cycles and Segments and we look forward to your next book. ---------------------------------------- Amy Rothenberg is a licensed naturopathic physician with more than two decades working in the clinical field of complementary & alternative medicine. In addition to seeing patients, she authored the chapter on homeopathy in the Humana Press 'Complementary and Alternative Cardiovascular Medicine' and writes a monthly column for the National Center of Homeopathy’s monthly magazine, Homeopathy Today. Dr. Rothenberg served on the Board of Health in Amherst Massachusetts for six years; she is active in the legislative arena helping to support efforts to license naturopathic physicians in all fifty states. Dr. Rothenberg was the editor of the New England Journal of Homeopathy for ten years until 2002. She is a sought after speaker by both lay and physician audiences and is often interviewed by members of the press on topics related to CAM medicine. She has guest lectured at medical schools, colleges, for industry as well as to insurance companies helping her audiences to understand the essential philosophical and practical approaches used in CAM medicine and helping to open communication among and between practitioners with widely disparate backgrounds. She teaches a course at Hampshire College entitled: Complementary and Alternative Medicine: Understanding the Modalities, Assessing the Efficacy. She is currently writing a book about her experience as a naturopathic physician, told through patient stories and experiences. # # # |
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