The secrets of good energy


splashToday was a good energy day. I went for a hike, spent time in my garden, and I just felt good. On the hike I met a friendly person who had nice energy, and while working in the garden I felt the peaceful, calm energy that nature imbues on a warm, sunny day.   And then later in the day, I was even able to muster enough energy to tackle a few household chores.

Energy. We often talk about our energy as if it is mystical force coursing through our bodies. We feel it, we know it when we have it, and of course we know how it feels to be low on energy. While having energy to live is truly an amazing gift, it is not altogether mysterious. We have our mitochondria to thank. Our body has 17 trillion cells, and inside each of those cells lie anywhere from hundreds to thousands of mitochondria, depending on the energy needs of the particular cell. Mitochondria take in the nutrients we eat in the form of carbohydrates, fats, and proteins, and to make a long story short, create “ATP,” the high energy molecule each cell uses to live.

If mitochondria create that “good energy” we experience, it is worth our while to consider how we treat our mitochondria. The understanding of how mitochondria influence human health is a rapidly growing area of scientific research; here are some practical tips from this research to help you support your mitochondria:

1.  Exercise. Yes, yet another benefit of moving one’s body. Regular exercise is associated with greater number and better functioning mitochondria. And, having more mitochondria is associated with longevity and less medical problems than those who have fewer mitochondria. In other words, exercise increases the number of mitochondria in your body, and more mitochondria increases the odds for a higher quality, longer life.

2.  Caloric deprivation. Maintaining a relatively lean body composition as one ages promotes “biogenesis,” or creation, of more mitochondria. This is supported by research: both in laboratory mice as well as in humans, having a lean body mass is associated with longevity. Does this mean we should be starving ourselves? I don’t think so; what it implies to me is that in order to age well, it behooves us to be mindful of our lifestyle such that we maintain a healthy body weight.

3.  Put good things in your body, and avoid toxins. As it turns out, mitochondria are delicate little structures that are easily damaged. The individual molecules that perform the biochemical reactions needed to create energy, as well as the DNA within mitochondria, are easily damaged by environmental toxins. While it seems obvious to suggest that one should avoid ingesting such toxins as heavy metals and pesticides, I suggest you also include on that list less obvious substances such as junk food, fast food, pop, and other highly processed foods. Diets rich in these types of food are associated with a wide variety of diseases, including diabetes, heart disease, and cancer. Not surprisingly, there is a growing body of research linking mitochondrial dysfunction with these very same diseases.

In the clinic, patients occasionally ask me what would help them have more energy. Now you know the secret: support your mitochondria!

Want to know more? Check out my podcast on Mitochondrial Medicine.

Doctor as patient – a cancer journey.


dr ms cancer hike2I was asked to speak at the 2016 kick-off meeting for Kittitas County’s Relay For Life. I was grateful for the opportunity, and this is what I said:

Thank you for inviting me to share a few words tonight, and thank you for caring about your family, friends and community members who experience cancer.

Relay for Life is important for our community, and I would like to express why. But first I would like to provide a little background about myself and my cancer experience.

As a family physician, I see cancer from different perspectives, and help patients in different ways. I diagnose cancer and have to share this news to patients and families.  I take care of people who are in the midst of their cancer treatments. I help patients who have had cancer, as many cancer survivors have special follow up needs, and many are left with chronic medical problems as a result of their cancer or cancer treatment.  I also celebrate with my patients when they are cured. And I care for people with cancer who are dying, where the focus is comfort.

I am also a person who has had cancer. I have received the diagnosis of having cancer, I have traveled the winding path that is the cancer journey. It is a path that travels through long dark tunnels; a path that can seem endless and grueling; and a path that rises to summits upon clear mountain tops where the air is clear, fresh and happy.

Having a cancer is a physical problem, but from my experience in treating cancer patients and in fighting cancer myself, I feel that some of the most powerful aspects of having cancer have to do with how it affects the soul.

The fear and sense of loss that is experienced by many– if not all of us– who receive the cancer diagnosis, is very difficult. It is not only the fear of death, but also a profound fear of loss and uncertainty. Thoughts spring up unbidden: What will this cancer do? Will it separate me from my family? Will I leave this Earth and the beauty that is life? What will the treatments do? Will the cancer leave me physically maimed and unable to live as I have known? Who will I be when it is over? My life may change and never be the same.

All of a sudden life becomes potentially so short. Probably my greatest fear was that I might become pulled away from those I love. Fear and loss. It feels as though the foundations of one’s life shakes and may be swept away. The fear that cancer provokes is formidable.

Another powerful and very difficult feeling many people with cancer struggle against is that of isolation. When I was told I had cancer, I was quickly swept up into the medical process of diagnostic tests, then treatments, and then follow up appointments. It was almost as if I had entered a time-warp, a different dimension of life than what everyone else was experiencing. The routines of work, errands, socializing– activities I took for granted– suddenly stopped or changed significantly. A person with cancer steps out of his or her prior life and into a different one, a new life that is not wanted. I remember writing in my Caring Bridge journal, crying as I did so, that “I want my previous life back!” It is this different, separate life, that promotes a feeling of loneliness and isolation. I was fortunate and extremely thankful that I had strong and wonderful support from my family, friends, and larger community. I remember, on multiple occasions, asking Anne, my wife, how did a person who was alone, without others to support them, manage this journey on their own? The thought of negotiating cancer on my own was inconceivable.

Cancer, though, is transformative. One enters the fire and is transformed, emerging a stronger soul. I don’t think this transformation is a voluntary choice, but it seems inherent in the cancer journey. And if a cure is not possible and one is ultimately consumed by the fire that is cancer, it is not without intense personal growth.

In my own personal journey, I experienced profound fear, worry, and a sense of loss. Fortunately though, I experienced the power of hope and felt my inner strength. My fear became replaced by hope. And throughout my cancer journey I felt tremendous support and love, which melted away feelings of isolation. The opposite of fear is hope. The opposite of isolation is support and love. I wish that no person had to experience cancer. But if cancer occurs, my wish for others is that fear is replaced by hope, and that isolation is replaced by feelings of connection and support.

Experiencing hope and loving support helped me muster the courage to make the cancer journey, and fortunately, I have survived. I celebrate every day: I am cured. Is it because of the type of cancer I had, my health, my attitude, the support I had, the medical treatment, or just plain luck? I really don’t know. Maybe a little of everything. Maybe mostly luck. I just know I am extremely thankful.

So what does this have to do with Relay For Life? It has everything to do with Relay. Relay is an important fundraising event for the American Cancer Society, but to me the much more important aspect of Relay, and the reason I want to see Relay flourish in our community, is the symbolism it offers.

Relay embodies hope. Relay is a positive event, it is about believing in a cure, and it is a celebration. Participating in Relay For Life strengthens the belief in the power of the human spirit to overcome cancer and prevail.   Meanwhile, walking through the darkness of night and experiencing the beautiful dawn is an affirmation of the strength and endurance of the human spirit.

Relay is also about love and support. It is about people from our community gathering to support each other– to support those who have cancer, families that are affected by cancer, and those that have lost loved ones to cancer. The physical presence of people coming together during Relay is a powerful antidote to the isolation so many people affected by cancer feel. I am filled with gratitude and a feeling of interconnectedness when I think of Relay.

This event is about people coming together to support each other, to feel the power of hope and the human spirit, to console each other, and to celebrate together.  This is why Relay for Life and other cancer walks are so important. They symbolize the forces in the cancer journey that conquer fear and isolation:  that hope is stronger than fear, that we are not alone, and that love is more powerful than cancer.

It’s time to give Measles the boot.

Football-player on the  football ground

It can be gone. It’s up to us. Let’s finally give it the boot.

Measles hovers at the threshold of our home; let’s join together and give it a collective shove.

While much less common than in the past, the Measles virus still pops up here and there in our country, causing disease that puts about 25% of those who get infected into the hospital. It can cause a devastating brain infection for one in a thousand, but the primary way it inflicts its damage is by actively suppressing our immune system. The virus stuns, or inactivates, our white blood cells such that they become unable to protect the body. As a result, one becomes vulnerable to a variety of bacterial infections.

The most common cause of death from Measles is bacterial pneumonia. Meanwhile, it is one of the most transmissible viruses known. In other words, it is extremely, extremely contagious– possibly the most contagious germ there is.

Worldwide, Measles is a big problem. Did you know that as recently as 2000, Measles was the number one cause of vaccine preventable deaths, and the fifth leading cause of deaths overall, in children less than five years old? That makes me pause. That’s a lot of children who die.

And the thing is, no one needs to die from Measles. No one. The Measles vaccine is arguably the most effective vaccine modern medicine has to offer, and what’s more, it confers lifelong immunity. In other words, the vaccine protects you, completely and forever.

When I think about Measles, I hope for the day when it is just a memory, a disease that once was and is no longer. This vision is not far-fetched or out of reach.  In fact, The World Health Organization believes the Measles virus can be eradicated from the Earth. The virus has no animal reservoirs, which means that if it is not in humans causing disease, it has no place to hide. If humans are vaccinated, it has nowhere to go.

It can be gone, it is up to us. Vaccinate yourself, vaccinate your kids; let’s take that next step and be free of this disease. Let’s finally give Measles the boot.

Gratitude and the Yin of Medicine



What does gratitude and a poke in the arm have in common? A lot.

Gratitude. What a beautiful word; to be grateful is to be thankful for today, to appreciate the people in your life and what you have, in the here and now. It is the awareness that what we have today is a very precious gift. Gratitude is in the behavioral science news a lot these days. Research has shown that being grateful improves ones health in diverse ways. Appreciating and giving thanks regularly has been shown to help one feel more satisfied with life, be happier, boost the immune system and even to reduce the chance of having a heart attack. In other words, giving thanks for what you have today strengthens your health in the present while also promoting a healthier future.

So how does this relate to getting a shot? Vaccination, in my opinion, is the “gratitude” of modern medicine. Receiving a vaccine preserves life as it is, while at the same time quietly setting the stage for a healthy future. Vaccinations have saved more lives than any other development in modern medicine, easily surpassing lives saved from antibiotics, cancer treatments, and even sanitation. Vaccination is the “yin” of medicine, quietly preserving a healthy state of being, rather than fighting disease when one is on the brink of death.

Having a grateful heart means making an effort to notice that “normal” is a gift, and is not to be taken for granted. It is not a fancy party or a vacation to the tropics; rather, it is getting out of bed in the morning, a cup of coffee, and your family. Gratitude is not glamorous.

Likewise, getting vaccinated does not grab headlines, and is not the flashy part of medicine. Sorry, no laser surgery or MRI guided stereotactic gamma knife operation at the Mayo Clinic. Nope, getting a shot is bread and butter prevention of a disease so you can live your life another day. Vaccines are truly the unsung hero of medicine, quietly doing the daily work of maintaining the status quo, of appreciating human health untouched by disease.

Next time you get that shot, maybe pause and reflect upon what that vaccine is quietly doing for you, now and in the future. A disease has not happened, and you have the opportunity to experience life to its fullest, now.