the synergy of plants and modern medicine with Dr. Stephen Dahmer
a perspective on integrative medicine and mainstream healthcare
(sofi talk 02 transcription article)
Our goal with sofi talks is to examine the relationship between people and plants from all different perspectives. At sofi, we share the belief that by creating a discussion that revolves around a diverse array of perspectives, and by working out the differences between them, we just might uncover some new and impactful truths. As the second of our sofi talks, we are excited to feature the opinion of Dr. Stephan Dahmer, a member of the sofi scientific advisory board, and a board certified integrative family physician with experience in the development, research and clinical use of medicinal plants.
introduction
I want to start by saying that I won’t be sharing a magical cure for cancer, or a single plant that treats diabetes. I’m not here to reveal some traditional secret that no-one has heard about before.
What I can share with you, however, is some of the wisdom from the amazing experiences I’ve had — from working as a physician in the slums of Brazil, to Palau, and learning from the Maori in New Zealand, to the Navajo in the four corners of Arizona.
To each one of these amazing cultures, I brought my greatest gift as a physician, and repeatedly I found myself as a more of a student.
I had the opportunity to truly learn from traditional medicine and plant wisdom from each of these cultures to the extent that it quickly became imperative for me to incorporate this information into my career as a Western trained medical physician.
And throughout my travels, what I often saw never made sense to me: that is, that traditional medicine was so often seen as an enemy or challenge to modern medicine.
But I can already sum up my views on that notion, and I like to do so using a song I used to sing from childhood. You might know it; it goes, "you make new friends, but you keep the old, one is silver and the other is gold."
the lost synergy of plants and modern medicine: the value of integrative health
I’ll be the first to say I’ve been enamoured by the silver of modern medicine and I’m a huge fan of modern technology and pharmaceuticals but, in my experience and training, it’s to the detriment of tradition medicine and plant-healing that we often choose to view the two as mutually exclusive.
On the contrary, significant evidence points towards the benefit of combining the two, and allowing them to augment one another. And I truly believe we are at a precipice, and a point in time where we can actually accomplish this.
One of the first things that I witnessed in my travels is a deeper trust in plants as real medicine.
In every culture that I worked there was always a medicinal plant garden, and patients always had a garden in their backyard from which they would draw medicines to treat their ailments far before coming to the hospital or seeking attention from a doctor.
In Chile, I worked as a hospitalist and it served as a great example of this. We had the modern medicine afford to all of us, we had a four bed intensive care unit, and despite these modern advances, the majority of my patients would do everything to treat themselves on their own and not come to the hospital.
When they did come to the hospital, it was always made a point to visit the on-site medicine man; in fact, and often they would consult him before even coming to me.
And that trust was something (especially coming from outside) that I could never compete with. It was incredible not only to witness that trust but to also gain a sense of understanding the role of plant medicines within the community. The healing power of the relationships involved — from the plants in nature, to the shaman who would be providing the medicine — was just invaluable to experience.
Mostly importantly, again, it’s something that we don’t talk about in Western medicine.
In addition, medicines were never given just as a pill out of a bottle. They were prescribed in the context of a ritual. The mindfulness surrounding the preparation of that medicine, as well as the taking of that medicine, is something in Western culture that you only really see with things like taking our morning coffee or our morning tea. An action that we accredit with being just as much about the practice and the mindfulness of the routine as it is about the physical ingestion of the liquid.
But it’s something that should extend far beyond that in my opinion. In medicine, I think we really do a disservice to pop that pill and not embrace the ritual of everything that surrounds a medicine that’s trusted and revered.
Along those same lines, is the impact of research. In modern medicine, we typically conduct research comparing against a placebo response or sugar pill.
Throughout all my training in research, from medical school and beyond, placebo was always deemed something negative — a factor that we’re taught to study against, and not with.
In traditional cultures it’s quite the opposite.
This is one aspect that I think has inevitably got to be changed. Already, we’re beginning to see research studies that label placebo as something called a “meaning-response.” In other words the effects aren’t resulting from the placebo, they’re resulting from the attribution of meaning.
You think about this meaning-response in other cultures and you begin to understand the vast differences in how we view medicine.
Music, art, aromatherapy, even word incantation and chanting are all seen as perfectly effective meaning-response forms of healing; not only are they not compared against, but they’re actively embraced.
When I returned to the States between my second and third year of medical school, I did something very unorthodox.
I requested a year's leave of absence to work in the second largest slum in Brazil, and I wrote a story about one of my experiences in the healing centers there.
In it, I describe everything: from the beating of the drum, to the twirling and the dancing that occurred, to the scents, to specifically the use of plant-medicine in ceremonial practice. And what became obvious to me was how every single one of these factors played a contributing role in the community’s healthcare.
You see, it’s very rare in traditional societies that a substance or plant-based medication would be offered without guidelines that accompany that medicine, and that includes activities, nutritional regimens, refraining from alcohol, etc. Again, it’s recognizing that it’s not just a pill to be popped, but a journey of healing and mutual support to embark upon.
There is a tea they drink in Palau that’s studied by several of my friends and colleagues, called, “Delal a kar” — which translates to the phrase “mother of all medicines.” Not only does a name like that symbolize the strong reverence they have for this particular ingested remedy, but it also wonderfully highlights the difference between their cultural conceptualisation of medicine compared to ours.
We use prescription medicines from Omeprazole, to Zaponex, to Pravastatin. Names that don’t have much of a connection to healing.
You can imagine that if the medicine you were taking every day were called “the mother of all medicines,” that the physiological effects you experience from the active compounds within the plants would only be half of the benefit you’re getting; even just the contemplation of what you’re ingesting and the act of preparing your body for healing would have significant supplementary effects.
And I really see that we’re in the middle of a shift here, and it’s not just cannabis, and it’s not just psychedelics, but all plants.
restoring the synergy of plants and modern medicine
There are many things currently occurring in modern medicine that I think nicely set the stage for a wider embrace of plant-based medicine. First and foremost we’re seeing a market shift from acute care medicine, towards treatment for chronic and on-going disease.
Where acute care is analogous to an emergency model of medicine — it’s needing a very strong intervention to tackle a very strong infection, a broken bone, or a serious case of disease — chronic conditions often don’t require a huge forceful intervention.
In fact, the majority of what I see, and especially as a family physician, are things like anxiety, diabetes, obesity, and depression.
In integrative medicine we sometimes say,” when all you have is a hammer, suddenly everything begins to look like a nail.” And I discovered that in my work abroad that, really, although I was given a fantastic hammer — it made everything I was examining look like a nail.
Much of our healthcare right now is focused on these lower-grade, long-term conditions that in many cases are related to stress. Despite all our best efforts and pharmaceuticals, we don't really have a treatment for that stress. In fact, our treatments for acute issues don’t work so well at all for these chronic ailments, and when they do, they can cause us to chase our tails with a laundry list of side effects.
Studying plant-medicine enriched my ability to look at different pathways to health and healing.
As far as criticisms of plant-medicines, it’s long been held that plant molecules are very dirty. What people mean by that is that they’re inconsistent and there are too many variables.
Cannabis alone is referred to as the plant of 1001 molecules, which is why we have a tendency to only focus on CBD. Just imagine how hard it is to study just one compound in a well controlled lab-setting with appropriate parameters, and you can maybe gain a sense of how hard it would be to study 1001.
But despite the complexity you find with plants, I do predict that the opposite will soon be true. As our ability to collect data and create new ways to study plant-medicine evolves, that complexity that allows plants to interact with a multitude of receptor-systems and mechanisms within the body, will be our greatest asset.
Because plants have co-evolved with us over thousands of years, they offer a softer, gentler form of interaction with our human physiology — something within a medicinal setting that’s considered pure gold.
And there are so many examples within plant-medicine of where we can utilize those plant molecules, not just in treating a symptom, but as improving our entire approach to healthcare and problem-solving.
And I do believe we’re on this precipice where in the near future we’ll be able to harness this technology; where the same algorithms that can tell us what partner we’re most compatible with, or whether we’re more of a dog or cat person, can completely guide us to the right plant-medicine.
For all my credentials and all my background, everything I’ve done as a physician — from studying plant-medicine, to working in an ICU — comes down to treating that individual patient in front of me.
Plant-medicine allows that nuanced, N-of-1 treatment that really makes a difference.
The other thing that I’ve seen and witnessed in plant medicine, and which I think science is just beginning to understand better, is the difference between treating a symptom and really truly healing someone.
The vast majority of pharmaceuticals that I use on a daily basis (because, remember, in no way am I anti-pharmaceutical), are anti-hypertensive, anti-inflammatory, anti-acid, etc, always anti-this and that. In other words, they’re being used to treat a symptom of an underlying disease.
It’s pretty rare that we will actually use a medicine to go upstream and attempt to treat a root cause. One of the things we’re seeing about plants, and specifically a category of plant referred to as adaptogens, is that they have this ability to go upstream and help the body alleviate this stress and find homeostasis.
Not only does that fortify our health as human beings, but it may even aid modern pharmaceuticals in doing their job, too.
That’s where I see these two worlds starting to come together. It’s the idea that they can harmonize and fill in the gaps for one another in a really unique way.
We’re far from solving this quandary of true health in the modern world, but I have yet to come across a patient or even a friend who, if I asked, “would you like to feel better” would say no.
We are constantly looking for these new ways to improve our health, and I think that technology embracing traditional ways of healing, including plant-medicine, is going to offer this paradigm shift where we can have both new friends and the old — and where we’re effectively utilizing both the silver and the gold.
A huge thank you to Dr. Stephen Dahmer for his time and invaluable insight on integrative medicine. You can find the extended version of this conversation, among our other sofi talks, on the sofi website.
