The space between life and death is tenuous. No one knows, from one minute to the next, what might befall them.
I don’t remember exactly how I felt on the morning of September 17, 1986. I do know that it felt special because it was my fourteenth birthday. When my mother dropped me off at school, she asked me to be careful since she’d had a worrisome dream the night before. I promised I would.
After school, I remember walking towards the medical clinic where my mom worked. The afternoon temperature was over 100 degrees – not unusual for Tucson, and all I wanted was something cold to drink. I noticed a convenience store across the street, so I stopped at a crosswalk and waited for the light to change. After I began walking, everything went black: my only memories were the scream of sirens, muffled voices on a CB radio, and the feel of hot pavement under my skin.
I had been hit by an SUV speeding through a school zone at fifty miles per hour. The force of the impact shattered my spleen, split my left kidney into unsalvageable pieces, fractured my pelvis, skull, and ribs, and broke my femur in half.
I was rushed to the trauma unit at Tucson Medical Center, which had been established only a year before. As severe as these injuries were, it was the internal bleeding that troubled Dr. Richard Carmona, the surgeon on duty that day. With every beat of my heart, blood escaped from my aorta into my abdomen. Dr. Carmona warned my parents that I must be taken into surgery immediately. He said he would try and save my kidney, but my parents knew that what was really at stake was my life. My mother had studied medicine in Russia; she pressed Dr. Carmona with hard questions. He looked my parents in the eye, and assured them that he would care for me as if I were his own daughter.
Dr. Carmona operated on me tirelessly for six hours. After surgery, I was wheeled into the ICU in critical but stable condition. One month later, I arrived home in a wheelchair. Over the next three months, my femur was re-broken and re-set five times. Each of these attempts to straighten it failed, so I was placed in a full body cast for six months. One year after the accident, I walked again, although with a noticeable limp. Over the next decade, I endured multiple surgeries on my femur before it was finally straight. By this time, my body was functioning well, despite missing my spleen and left kidney.
I was incredibly lucky to survive. But it wasn’t until my discovery of Yoga that I felt like I truly began to heal my body and calm my frenetic mind. Yoga began as a workout, and soon became much more: a spiritual endeavor; an inner journey; a calling. Eventually I began to teach the practice to other yogis and expectant mothers, and to work as a birth doula.
As I continued on this path to recovery, something strange happened. I developed a nagging skepticism about Western medicine. Conventional doctors always seem to proffer their opinions in absolutes. They disdained many of the alternative treatments that worked for me, like homeopathy, chiropractic care, and acupuncture. When I became pregnant, my skepticism hardened into resentment. Western medicine became a labyrinth of insurance forms, fear, and restriction; our successful home birth felt safe, natural, and right. In Yoga, I’d found a path to wellness that I trusted, and I saw little place for Western medicine within it.
As my life moved on, I thought about my car accident almost daily, but I lost track of Dr. Carmona until a day in 2004 when my husband was watching the news. President Bush was announcing a new initiative to fight AIDS in Africa. I noticed the man standing next to the President at the podium, and stared at the television, to be sure.
“Oh my God,” I said. “I think that’s Dr. Carmona. The surgeon who saved my life.”
“If it is,” my husband replied, “He’s now the Surgeon General of the United States.”
The Surgeon General. The irony was profound. I owed my life, and the very possibility of discovering Yoga, to a man who was in many ways the figurehead of Western medicine in the developed world.
How had I grown so hostile to the health care system that had saved my life?
• • •
The cluster of low-lying adobe buildings making up the Canyon Ranch Institute appear to blend into the lush Sonoran Desert. When I arrived, a security guard checked my name and ID, and directed me to the appropriate office building. Once inside, I waited for a few minutes before being led into Dr. Carmona’s office.
It was a few weeks before my 39th birthday. I was nervous, and still felt a bit of disbelief that Dr. Carmona had agreed to an interview. He was more than a former Surgeon General: he was a Vietnam veteran, decorated with two Purple Hearts, and a distinguished professor at the University of Arizona. He had helped found the Trauma Center that made my operation possible. As if he that wasn’t enough, he’d served as a celebrated member of the Pima County Sheriff’s office and SWAT team.
After completing his tenure as Surgeon General, Dr. Carmona was inspired to join the team of the world-renowned Canyon Ranch Institute, a nonprofit that seeks to educate, inspire, and empower every person to prevent disease and choose a life of wellness.
In the twenty-five years since the traumatic day that our paths had crossed, Dr. Carmona had lived a life fit for the history books. I was a Yoga teacher, a doula, and a mom. A part of me didn’t feel worthy to sit face to face with him and question him about the direction of American medicine.
I took a breath. I reminded myself that my first mission was simply to convey my gratitude. More than anything, I’d come to thank Dr. Carmona for saving my life.
When he walked in the room, my concern melted away. Dr. Carmona could not have been more gracious, more humble, and more present. He greeted me warmly and with gratitude of his own. He showed me my hospital admission card: he’d retrieved it from his files.
“Not many people actually come back to say ‘Thank You’ ” he said.
And so our conversation began.
• • •
In many ways, ours was a curious reunion. It’s not often that we talk to our surgeons once our bodies have healed. It is even rarer to do so twenty-five years later. The idea that my doctor had gone on to become Surgeon General seemed like the kind of thing that only happens in movies. I filled in Dr. Carmona on the direction my life had taken: yogi, wife, and mother. A full life. An embarrassment of good fortune.
Still, I felt the need to express something more: this resistance to Western medicine that had manifested within me. Was it part of the pervading antagonism against the healthcare system, or something more? I wasn’t sure that Dr. Carmona and I could find common ground on the subject – and I was surprised by how quickly we did.
“I grew up in a poor Hispanic family,” Dr. Carmona said. “My grandmother used herbal medicine in non-allopathic, traditional ways to treat her family when they were ill.” Dr. Carmona mentioned that although he’d spent decades in the field of allopathic medicine, “I keep an open mind to my early experiences and to my observations traveling the world, where most people practice a very different health and medicine and it seems to work for them.”
I asked him if he thought the medical community at large was becoming more tolerant of alternate therapies.
“There’s certainly been a progressive change, and an inquisitiveness,” he replied. “The National Institutes of Health has a center for complementary and alternative medicine, and their goal is to look at these practices and try to define them. These days acupuncture is so widely used that it’s a part of treatment in the military and armed forces. It’s covered by many insurance companies. This is a measure of change.”
His answer surprised me, because outside of my homeopathic physician, I haven’t encountered much of that openness in my medical visits or doula work. Still, that didn’t mean it wasn’t happening. I asked if the medical school curricula were evolving to be more inclusive.
“There’s a defined sphere of practice within medical schools,” he said, “there’s still a certain cultural barrier there, and a belief that they have all the information they need about it. But I think it would be rather arrogant to dismiss, say acupuncture or herbal medicine, which have been around for thousands of years,” Dr. Carmona continued. “With functional MRIs, for instance, we’re starting to see how the brain changes when needles are put into the body. Something is changing,” he paused for a second, “We just don’t understand why.”
He proposed that in some cases, the benefits received from alternative treatments might be purely psychosomatic. “But if the placebo effect causes a third of the people to get better,” he said, “Why shouldn’t I be using it? Some people call that an enlightened view,” he said with a smile. “Some people say I’m not sticking to my allopathic principles.”
This refreshing openness was the first insight from my meeting with Dr. Carmona. Despite his many accolades, his confidence and authority was not tied to a need to find a single right answer. It was grounded in years of experience, on the battlefield, as a paramedic, and in the emergency room. His very demeanor conveyed that healing is not about an answer in a textbook, or a statistic in a medical journal: it’s about doing what works for one patient at a time.
“My personal approach has always been that I shouldn’t summarily reject what I don’t know, but seek more knowledge about it, and that’s what I’ve done,” said Dr. Carmona. “I always joke that my grandmother, who would have been 130 years old by now, would have laughed at the idea that herbal medicine was ‘alternative.’ This was mainstream to her. It’s practiced by billions of people all over the world. So it’s incumbent upon us to figure out how it fits in.”
• • •
I wanted to return Dr. Carmona’s spirit of openness. I wanted to learn more about the conventional physician’s side of the debate, so I asked him to explain some of the unique challenges that physicians are facing now that might be exacerbating the rift between Western and alternative philosophies.
“You know, part of the problem is that people go online and get a barrage of information,” he replied. “Just type in ‘high blood pressure’ in Google and you get three million hits.”
As a prospective patient and a parent, I’ve seen the expanse of online information as a positive development. I think that most of us feel more informed about our medical choices than we used to. From the point of view of the medical establishment, Dr. Carmona stressed that there is a fine line between educating the public and overloading them. “You want to go to websites that are vetted,” Dr. Carmona continued, “like Healthline or WebMD. They have doctors and nurses and professionals and look at all the information, so when you put in ‘high blood pressure,’ the information that you get is from health professionals, as opposed to just a general search online. Otherwise, you can get all kinds of charlatans selling things.”
Dr. Carmona also pointed to the shifting demographics in the United States, a quickly-changing landscape that is making physicians’ jobs even harder. “Under President Obama’s health care plan, there will be as many as 32 million people coming into the system that we have to be prepared to handle. And the truth is: there’s not enough primary care doctors out there, there’s not enough surgeons.” He stressed that each of our country’s many cultures bring different beliefs, traditions, and misconceptions about health care, and in some measure the medical establishment has struggled to synthesize and stay sensitive to those differences.
“Our population is becoming increasingly Hispanic,” he said, “and yet how many Hispanic deans do you have in schools of medicine and nursing? When it comes to health care, one size does not fit all. We are the most heterogeneous society in the history of the world. Our medical profession needs to reflect that, because culture plays a very strong role in understanding how we should exercise the privilege that we have to care for our fellow citizens.”
The next challenge we discussed was the elephant in the room: money. With rising healthcare costs, millions of people without insurance coverage, and a massive recession, the pressures on doctors and patients alike are stifling. In my own experience, when my daughter’s pediatrician has prescribed antibiotics and medications for her, they’ve been considered optional at best by my homeopathic doctor, and in practice, they’ve turned out to be not necessary at all. Have I just been lucky? Or is the current state of Western medicine less about what’s best for us, and more about what’s best for business?
“Political or economic considerations are not unique to Western allopathic medicine,” said Dr. Carmona. “People get skeptical of the marketing involved in medicine and begin to wonder, ‘Do I really need all these therapies? Do I need this operation? Do I need this drug?’” Dr. Carmona admitted that part of the public’s skepticism is healthy, but he resisted the idea that it’s an untenable problem. “It’s all the more reason that we have to do a better job about educating and being transparent.”
Finally, I ventured to ask Dr. Carmona about what might be the most controversial topic of all, the safety and efficacy of childhood vaccines. Although I had been vaccinated as a child, I had come to look at the current CDC schedule of vaccines as a bombardment on the body. As a parent, my husband and I had agreed to pursue a delayed and alternate vaccine schedule for our child. On that topic, the Dr. Carmona’s opinion was very firm.
“It’s time to get out from under that cloud of skepticism,” he said. “This is something I had to deal with as Surgeon General. People claimed that there was a government cover-up. I thought that was crazy. Why would the government cover up autism? That doesn’t make any sense. Why would I, as a father myself, deny that [the vaccines caused autism] if somebody gave me the evidence. I asked the question of the best minds in the world, at the NIH, the CDC, and the Universities. There was no evidence. That doesn’t mean that in five or ten years somebody won’t find a link, because science is ever-evolving, but at that time, we saw no evidence. I think we can’t lose sight of the fact that vaccines and vaccinology has been one of the greatest triumphs of medical science’s effort to protect the public. As Surgeon General, the best thing I could do is tell people that all my children are vaccinated with all the vaccines.”
Actually, Dr. Carmona even went a step further. He received a vaccination shot on national television, just to show how firmly he believed in its safety.
That act is emblematic of his character: his authority springs from his integrity. He takes full responsibility for the treatments he prescribes. I was reminded again of his promise to my parents, twenty-five years earlier: I will care for your daughter as if she were my own. Throughout all the challenges that the current healthcare system has – the costs, the information overload, and the cultural differences – this seems to be the core of the solution: the authentic trust between each doctor and patient. That’s what I have with Dr. Carmona, and that’s what we need to preserve and repair.
• • •
The cultivation of personal responsibility is the backbone of Dr. Carmona’s current work at the Canyon Ranch Institute. He calls it “the cultural transformation of a nation.”
“We need to change our culture,” he said. “As we raise our children, everything that we do should be about pursuing optimal health. How do we buy and cook food? How do we care for our environment so that we’re not polluting our genetic make-up by toxins that are around us? We all need to reject the bad behaviours and habits that are deleterious to our health.”
Dr. Carmona says that government and citizens have equal roles to play in this effort. “The government’s role is to make sure that every person has access to health care, that every person has access to good food. The rest is up to the individual.” He went on to say that America needs to reframe the way it calculates health care value. “The question is not how many sick people can we care for, but how many people can we keep healthy?”
Through their non-profit initiatives, Canyon Ranch takes this philosophy to underserved communities. They have partnerships in the South Bronx, rural Missouri and inner-city Cleveland. “We also just initiated our first international program in a rural area in Lima, Peru, where there’s high maternal child mortality,” Dr. Carmona added, with pride. “We’re looking for the toughest places because we want to be able to demonstrate that the model can work in the most difficult circumstances, in the most underserved populations.”
“People will still get sick,” he says. “There will still be disease, but we spend $2.5 trillion a year, 17% of our GDP, on what we call health care. It’s not health care. It’s sick care. Seventy five cents of every dollar that we spend on this so-called health care is spent on chronic disease, when most of those are preventable.”
Dr. Carmona added, “It is crucial for physicians to honor the lifestyle and cultural background of their patients, even if you don’t believe or understand how [non-allopathic medicine] works, because part of the healing process is that even if you don’t believe it, you have to understand that your patient believes it. To dismiss it could be offensive and a detriment to therapy and healing.”
It was getting late. We’d already talked well past our allotted time. Dr. Carmona stood up to show me some photos of him with notable dignitaries, as well as a tapestry given to him by the Dalai Lama. As I was about to leave, he reached into his pocket and pulled out a medal wrapped in paper and covered in plastic. He presented it to me in the palm of his hand: the Medal of the Surgeon General of the United States, inscribed with his name.
I was speechless. My hands clutched my heart. “Thank you,” I said. “What an honor.” He walked me out, and asked that I stay in touch. I got into my car and sat in awed silence. The medal lay on the seat next to me, glittering in the afternoon sun.
As I drove home, I thought about all the different courses of medical care I’ve experienced over the years. Today, I use a combination of many paths to create a greater sense of well-being. But the undeniable fact is, I have taken personal responsibility for my own health. That responsibility has spurred me to question and even challenge the doctors who endeavor to heal me. But it is also the greatest expression of my gratitude for their efforts.
Dr. Carmona saved my life. In doing so, he gave me the opportunity to re-discover health.
Aria Mayland is a doula and Yoga instructor. She lives in Venice Beach, CA with her husband and daughter. She is incredibly grateful to her husband, Jason Mayland, for all the help he gave her with this piece. www.ariamayland.com
Over the last thirty-two years, Canyon Ranch has become a recognized leader in health, wellness, and prevention. What started off as a small health resort in Tucson, AZ has grown to numerous Canyon Ranch locations all over the country, each dedicated to providing the best in mind, body, and spirit practices. “Here at Canyon Ranch,” says Dr. Richard Carmona, “we have everything from acupuncture to Zen. Most of the things we have here are scientifically based, but my colleagues here also work in some of what you might call ‘alternative therapies’.” Canyon Ranch promotes a holistic and integrative medicinal approach to health, a philosophy that has garnered them numerous accolades and awards for its innovative methods of promoting well-being. ??The first Canyon Ranch opened in 1979 by Mel and Enid Zuckerman. The two were so inspired by Zuckerman’s transformation from an overweight, stressed, and unhealthy man in his 50s, to an active, fit, and hardly recognizable version of his former self that they built a health resort dedicated to the transformative power of well-being. “Enid and Mel Zuckerman’s dream was to bring together all the elements of a healthy lifestyle to fortify mind, body, and spirit in a true resort environment, where guests could experience for themselves just how good healthy living could feel. The mission of Canyon Ranch reflects the Zuckerman’s fervent belief that all people have the power to live longer, healthier, more meaningful lives through healthy lifestyles.” ??In 1986, the Zuckermans were joined by partner Jerry Cohen and in 2006, Dr. Richard Carmona joined the team to become the CEO of Canyon Ranch’s Health division, where he oversees health strategy and policy for all of Canyon Ranch. Today, there are Canyon Ranch Resorts in Tucson, Arizona and Lennox, Massachusetts; Spas in Miami and Las Vegas, and SpaClubs aboard the Queen Mary 2, Oceana Cruises, and Regent Seven Seas Cruises.??www.canyonranch.com
Canyon Ranch Institute
The mission of Canyon Ranch Institute is to take the best practices that Canyon Ranch has developed over the last 25 years, package them in a culturally appropriate manner, and bring them to underserved populations in order to help inspire changes in behavior. Formed in 2002 by Canyon Ranch founders, Mel and Enid Zuckerman along with Jerry Cohen as a separate nonprofit 501(c)(3) dedicated to organizing their philanthropic efforts. In 2006, when Dr. Carmona left the Office of the Surgeon General, he was invited to join Canyon Ranch as the Vice Chairman and come on board as President of the Institute and CEO of Canyon Ranch’s Health Division.
?“We recognize that people from here are people of means, but the people who probably need what we have are the people who can’t afford to come here [to Canyon Ranch],” says Dr. Carmona. The outreach efforts of the Institute extend from Cleveland, Ohio to Lima, Peru. Dr. Carmona adds, “We’re looking for the toughest places because we want to be able to demonstrate that the model we’ve created actually works– in the some of the most difficult circumstances, in the most underserved populations.” The Canyon Ranch Institute aims to “accelerate cultural transformation” and “eliminate health disparities,” And “all of us here have a commitment to making sure we do all of this in a socially responsible way,” affirms Dr. Carmona.??www.canyonranchinstitute.org