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Full Transcript:

Note: This is an original transcript–edited for sense, length, and clarity.  If you have any questions or concerns, please email our host, Doria Lavagnino, at doria@sheventurespodcast.com.

Intro:

Doria Lavagnino: If you’re anything like today’s guest, you might believe that conventional Western medicine and more of the Eastern modalities — such as breathwork, meditation, spirituality, essential oils, and acupuncture — are key as an integrative approach to the health of our bodies and minds. Today’s guest is an infectious disease and integrative medicine physician who has been in academic medicine practice for more than 30 years. She’s also a sprint triathlete — very impressed by that — wife, mother, and has developed an expansive toolkit because of unforeseen transformative events in her own life — one being the loss of her son at 18 due to suicide and [another being] her cancer diagnosis. She is co-author of the book Breath for the Soul, a roadmap to integrative wellness. Dr. Jan Patterson, welcome to SheVentures! 

Dr. Jan Patterson: Thank you, Doria. It’s great to be here!

Doria: Your life is an incredible story. I want to start with, when did you know that you wanted to become a doctor?

Becoming a Doctor 

Jan: I think it was in high school. Before that, I had always thought about being a teacher because I loved school. Then, I got into high school and loved biology and wanted to work with people. I ended up in academic medicine [and] got to be a doctor and a teacher, so I got to do both things! It was in high school that I first decided that it was something I was interested in. 

Doria: In infectious disease, specifically, what interested you? You studied that at Yale, I believe. What interested you?

Jan: Yes, I did my infectious disease fellowship at Yale. My infectious disease [interest] started in medical school at UT Houston. We had a very dynamic infectious disease group. 

During my fourth year of medical school, I did a rotation in India. I saw a lot of infectious diseases there. I always found infectious diseases fascinating. It seemed, to me, to be the most interesting part of medicine because there was such a spectrum of diseases. A lot of times you could see it through the microscope and cure it with medicine, unlike many chronic diseases. I think it was very interesting. 

Doria: That would be fascinating. You remind me of my life partner who was born in the U.K., but he’s of Indian descent. When he was 8 or 9 years old, his parents decided to move back to India. As a result, because his immune system wasn’t accustomed to many of the viruses, he ended up getting meningitis and malaria. There is so much work probably still to be done. I would imagine it’s getting better, I hope. 

Jan: It’s getting better. In low- and middle-income countries, especially, there is still a lot of work to do because of the environmental and socioeconomic conditions and access to medicines and healthcare. Yes, there is still a lot of work to do. In the U.S. of course even, we have a lot of health disparities. We certainly saw that with COVID-19. We have a lot of work to do. 

Doria: You are a woman in medicine. Now I suppose that’s not as novel but at the time that you were, how was that experience for you?

Jan: It was eye-opening. I had grown up in a religious Christian home and was kind of sheltered. I was in public schools and everything, but [had] kind of a close circle of friends. When I got to medical school, I remember walking in, actually on the first day of medical school interviews saying, “Wow, I’m in the minority here.” I had not thought about that so much because I was raised to believe I could do anything I wanted to do; if I work hard and be persistent, that all [would] pay off. My class was about 25 percent women. Now, classes are 50 percent or more women. [It’s] great because people like women doctors; they think we’re very empathetic. At the time, yes, I was a minority. 

I have to say, I grew up in Texas but then did my training at other places — internal medicine at Vanderbilt in Tennessee and infectious disease training at Yale in Connecticut. [In] Texas, especially at the time [of] the early 80s [and] late 70s, there was not a lot of enlightenment about how to treat women. I had to look past all that; keep focused on what I wanted to do and ignore the nonsense.

Doria: Yeah, I understand that. It’s hard to explain to my Gen Z children. They are very woke. I understand and applaud it. But 35 or 40 years ago, it would have been impossible to become a doctor if every time you experienced a microaggression you stopped, you know what I mean?

Jan: I know exactly what you mean because I remember looking past all those things. Now, even 40 years later, I’ve looked back and I’m starting to heal from [them]. I didn’t realize it at the time, but there was some injury there. I was determined to move ahead and do what I needed to do; I forged ahead and ignored it. Looking back, I can forgive others, which is healing. 

Doria: Yes, I’m on my own journey [and] have realized that when I harbor anger toward others, the only person that gets hurt is me. It’s a journey but I’m grateful. I understand what you’re saying in that when you get to that place in life where you can forgive, it’s not that you’re saying it’s okay you’re just saying —

Jan: “Let it go.”

Doria: Yeah, let it go!

Conventional Medicine and Holistic Therapies

Doria: You started as a medical doctor, in the traditional Western sense. You believe that conventional medicine is effective, but you also believe that other modalities can enhance efficacy. Where do you believe traditional medicine falls short and when did you start to identify that?

Jan: Well, I’ve always been interested in herbs and natural products. I think, even though I grew up in [a] city, my parents had come from a rural background. My dad always had a big garden. We had goats. I learned to milk goats and all those things. I always had kind of an interest in natural things — herbs and essential oils.

After the loss of my son, I discovered how to use essential oils. I found that they were helpful to me in my grief, as well as with a lot of other physical complaints — seasonal allergies and things like that. I began to think, “Well, if these things are helpful, there must be other holistic therapies that are helpful.” 

That’s what led me, eventually, to do a fellowship in integrative medicine at the Andrew Weil Center at the University of Arizona. That’s where I learned about simple yet effective things like breathwork, movement, nutrition — nutrition is so important and we ignore it — and spirituality. The thing about Western medicine — I owe being free of cancer to conventional medicines, so I’m all for [it] — but, I think, that many times it lacks a component of spirituality. 

That’s what integrative medicine does. We approach the whole person: body, mind, and spirit. I think [that] unless we address the mind and spirit, a person cannot be fully healed. I think that conventional medicine addresses the physical body, but many times, not the mind and spirit. That’s where I saw the shortcomings, and I certainly felt [them] after the loss of my son. I needed something more than conventional medicine. These other things helped me and that’s what took me on my journey to integrative medicine for others. 

Losing a Child 

Doria: I want to go back to integrative medicine, but I do want to speak about the loss of your son. I, as a mother, can’t imagine what that must have been like to lose a child. Are there any tips? I don’t want it to sound that way. Teenagers — I’ll use my 15 and 18-year-olds — are all over the place, just by nature. They do experience depression. How can listeners know when it’s something that should be taken seriously versus a phase?

Jan: Well, I think we don’t always know. At the time, I looked around at some of Will’s friends and they were going through some of the things he did and we didn’t lose them to suicide. Will had a mental illness and, I think, it wasn’t addressed well by conventional medicine. I feel some guilt about that because I probably should have shopped around for other doctors. At the time, I felt like things were being addressed as best they could so I did what I could. I think the important thing is to keep the lines of communication open. Ask them how they’re feeling. Is there anything bothering them today? [Then,] just listen — be there and listen. I think those are very important things in keeping the lines of communication open. 

Doria: I love that answer. I realized that my instinct is to fix things and give advice and that is not, usually, what my daughters want from me. They, actually, want me to listen. When they want advice, they will ask for it. I think what you’re saying is so profound about really listening. 

Jan: Yes, I found that to be true in my grief journey. After the loss of my son, I got a lot of inane platitudes. Those were not helpful; people think they’re being helpful by saying those things. The thing that was most helpful to me were those few people who would just listen to what I was going through [and] what I was feeling. They would sometimes share their memories of my son, which was nice for me and still is. It’s the listening [that] meant so much more to me than trying to give advice. As you said at the beginning, you can’t imagine what it’s like to lose a child until it happens to you. People who haven’t lost a child really can’t advise about that. The best thing to do is to listen, and that was so meaningful to me. I think for anybody in crisis, listen first. If they ask for advice, then that’s the time to give advice. The most important thing, I think, is to listen.

Doria: Then, of course, if something more serious like actually saying, “I’m going to kill myself,” are things that one should do more than listen to. 

Jan: Yes, I think in any circumstance if you see a lot of behavior changes — change in appetite [or] activities, loss of interest in activities or others — those are times to seek medical help. Make sure that, first of all, everything physically is okay. Then, [involve] somebody who is a mental health professional to address mental health issues. 

Doria: When you talk about your grief, what helped you — other than people listening — holistically to go through? I’m sure it’s an ongoing process, even today.

Jan: Yes, I’ve learned that grief is a journey. My faith helped me. I’m a Christian, and so I believe that I will see my son in some form, eventually. That gives me a lot of hope, and that’s encouraging to me. It actually helped me a lot to have meaningful work. I kind of took my work for granted before that. I felt at some level that I was doing something meaningful. After my son died, meaningful work gave me a reason to get out of bed in the morning [and] feel like I was doing something to help others. That was a real blessing to me. Those things were key in my recovery — my continuing recovery, I would say.

Doria: Yes, continuing recovery. Did integrative medicine play a role in your recovery?

Jan: Yes, so as I mentioned, I discovered essential oils. I found that there have been some essential oils that have been studied in depression. There were some that, actually, I realized helped me with my grief. When I used them daily, I just felt better. That was kind of a revelation to me. As I did the fellowship, things like meditation, breathwork, exercise helped me tremendously. Movement, whether it’s vigorous exercise like running or moderate like walking or gardening, those things are helpful to our mental health. There’s more and more evidence that movement is helpful to us. Those things, in particular, and my spirituality were helpful to me. 

Integrative Medicine

Doria: I was raised in Portland [Oregon] in the 80s. There was some knowledge of integrative medicine, even at that time. I think what was lacking was evidence that it actually did what people were saying that it does. Do you feel that over the last 30 years that has changed? Is there more evidence that shows that these modalities — when used either in combination with some Western therapies or not — are effective?

Jan: Yes, there is quite a bit of evidence. A lot of the fellowship training was looking at evidence-based integrative therapies. There is a great deal of evidence [that] all those things that I talked about — breathwork, mindfulness, meditation, spirituality, nutrition, and movement — are helpful. The problem is that those things don’t get marketed. There’s no money behind those things, so they don’t get marketed. They’re not a routine part of our medical training, [which] is to give a pill or procedure; do something [or] prescribe something. A lot of it is self-care. 

That’s what [the] book is about. Breath for the Soul: Self-Care Steps to Wellness [is about] using things like breathwork, movement, nutrition, and spirituality for things like stress, anxiety, depression, and grief. In that, I talk about the evidence for all these things. My co-author, Phyllis Clark-Nichols, is an inspirational author. She writes a spiritual guide to go along with [it]. There is some “science meets spirituality” in this book. You get both. 

Doria: I noticed there [are] places where people can use it as an actual workbook. 

Jan: Yes, we did some templates. That’s thanks to Phyllis, really. She made some templates where you can make your own self-care plan and say, “What aspects of these things am I gonna use for myself?” You can actually take some action.

Surviving Cancer

Doria: You also are a cancer survivor. I don’t really have a sense of chronology in terms of when you experience these different events.

Jan: It was a few weeks after I lost my son that I was diagnosed with uterine cancer. I was already in a lot of grief, of course, [and] having that diagnosis was a double whammy. There’s a silver lining that came from that. When I got that diagnosis, I realized I wanted to live. After the loss of my son, I was not suicidal but it was difficult to get up and go every day. With the diagnosis, I realized I have a lot to do. I [have] my husband, living son and daughter-in-law, my other family and friends. I have meaningful work that I want to do. In that sense, it was helpful. 

I had to have the surgery, and it was an early stage. There were a few cells in the abdominal fluid, which people don’t really know exactly what that means. My doctor was concerned, so I took two years of hormone therapy after the surgery. I’m cancer-free now. It’ll be 11 years this month. I’m very grateful to be cancer-free. 

Doria: I am so happy. I can’t imagine. I want to express my sorrow that you experienced those two things simultaneously. At the same time, being a person of faith myself, I wonder if there’s a reason behind why things happen the way that they do. What are your thoughts on that?

Jan: There are some things in life that are certainly divinely inspired: people come into our lives, decisions that we make — certainly the ones that we think about a lot, pray over, and seek guidance for. I think that some things in life are random. They’re just random bad luck. I do believe that whatever happens to you, you can use it for benefit. You can learn lessons from them. I certainly [did]. The cancer diagnosis actually made me think differently and realize that I did want to live. I had a lot to live for. That was a good thing that came out of that. 

Unexpected Journeys

Jan: I had some other events in the next couple of years; my dad had dementia and my mother died six months before my son. My dad couldn’t live by himself, [so] we had to bring him here to live in the same town as us so we could help take care of him. That dementia journey was very difficult over the next few years. Then, I had a brother who was developmentally disabled from birth [and] I became [his] guardian. He was chronically ill. It was very difficult to deal with all these things. My faith was helpful to me. I grew in my faith during that time. I learned a lot of lessons. There was some good that could come from all of that stress and difficult times. 

Doria: For someone who is dealing with either a cancer diagnosis or something that is unexpected, can you maybe speak to some of the tools in your book that might be able to help them in some way?

Jan: Yeah, I think part of spirituality is a connection with others. During those times, it’s very important to connect with others, whether it’s your friends or family. Honestly, sometimes family in those times can be difficult. It may be helpful to connect with friends or a spiritual advisor from whatever faith you know. A connection with [and] talking to others can be very helpful. 

I found movement to be very helpful. Exercise was something that got my mind off the most horrible things I had been thinking about and ruminating on. [It] made me think more positively. 

Doria: I love that.

Jan: The standard American diet has a lot of inflammatory foods. It doesn’t help our body or mind to eat a lot of processed food and fast food. When we eat more anti-inflammatory foods like fruits and vegetables, nuts, and plant-based foods, [they] are helpful to our mind and our mental health, as well as our physical health. There’s evidence about that now, too. I think eating well is helpful. In times that are difficult, you may have to get help from friends or [find] a meal service if you don’t feel like cooking for yourself, which is certainly imaginable. 

Breathwork on a day-to-day, moment-by-moment basis is something that can help us with stress and anxiety. In my grief recovery, grief can come in these overwhelming waves. [It can] hit us without you even knowing it’s coming. One thing that was helpful to me is taking some deep breaths. I had some essential oil blends that I went to that were my go-tos for times like that. I would take some deep breaths and inhale these essential oils. These aromas go directly to the limbic system in our brain, which is the part of the brain that controls our emotions. It can actually be very helpful, calming, and relieving some of the things that we’re going through. I think all of those things are helpful if you’re having difficulty sleeping. 

There are a lot of hints out there for what you can do for what’s called sleep hygiene. Now, there are self-care things that you can do, but if you continue to have problems you [should] talk to your doctor. Grief can become depression. [It] can be prolonged and become depression. Talk to your doctor [and] your healthcare provider if you’re not able to get on with your usual activities after six months or so. 

Doria: That’s very helpful. I wish I had spoken to you in 2013 when I lost my father. What I felt as a woman, and I had two young children, is that I really identified when you said that you felt some guilt. Trying to be all things to all people is incredibly stressful. What I found is that I did the best I could, but obviously, I couldn’t be in control and be everywhere at once. That’s very helpful, this idea. Interestingly, I’m not particularly athletic, but I did run the New York City Marathon once. 

Jan: Good for you!

Doria: That was the year after my father died. It really can make a big difference in also distracting, not in a way that you don’t want to think about it, but just kind of harnessing your energy in a different way.

Jan: Right, so if you’re out trying to run miles and miles, you can’t really ruminate on the negative. You’re having to move, breathe, and keep going and so you’re thinking about those things rather than ruminating. I found that’s what helped me.

Doria: It’s true.

Jan: To your point, we can only do what we know to do at the time. We can only help as much as we know to help at the time. I believe that that’s what we were meant to contribute, and that’s what we could do. We need to feel good about doing the best that we can at the time.

Doria: Yes, and for me also it’s been about forgiving myself — even if I’m too hard on myself — for not being able to do the job that I thought I should.

Jan: One of the things that we talk about with this [is]: Self-care is not selfish. Self-care is something that we need to do to be able to take optimal care of others. As women, as you point out, we are caregivers, naturally. It’s often much easier for us to have compassion for others than to have self-compassion. We need to remember that self-compassion is very important. Part of self-compassion is self-care and taking the time and effort to take care of ourselves. That’s really not selfish. It’s the principle about “you’ve got to put your oxygen mask on before you help the person next to you.” It’s that way in regular life too; We have to take care of ourselves so we can take optimal care of others.

Biggest Wins

Doria: You’re incredibly accomplished and modest. I want to ask you professionally or personally, what do you consider to be your biggest wins?

Jan: I feel like my greatest accomplishments, personally, are my two remarkable sons. Though one son has passed away, I am very proud of the men that they were — the man that he was, the man that my other son is — and the people that they came to be. In a personal way, I think that’s one of my greatest accomplishments. 

In terms of professionally, I’m the kind of person that I find I need to do something a little different every 10 years or so. About 12 years ago, I started doing a lot of healthcare improvement, teaching people about tools and skills to use, to improve healthcare. We have a lot we need to do to improve healthcare. I teach a course at our institution now. We’ve trained 800 people and done almost 300 improvement projects through the course.

Doria: Wow.

Jan: I’m very proud of that because I feel like those people who have been trained can go on and make a difference in healthcare, whether they stay at our place or other places. 

I’m also proud of this integrative medicine program that we’ve built at the hospital. We have an integrative medicine consult service now. Of course, everybody is stressed when they’re in the hospital, but some patients, in particular, have problems with anxiety, pain, or nausea. We’re asked to see them and help. They’re very grateful. It’s nice to be able to go into a hospital room and do something pleasant — essential oils, breathwork, guided meditations — for someone as opposed to giving them medicine, poking them, or doing a procedure. We’re doing something a little bit different. I’m very proud that we’ve been able to start that program. 

Doria: That’s wonderful. I feel like so much of your work is about prevention. These are all things that we can integrate into our life that don’t really cost us anything monetarily, but have incredible benefits in terms of health and preventing so many things from going awry in our bodies and minds.

Jan: Yes, you’re right. That’s one of the problems with healthcare in the U.S., is that it’s much more reactive than preventative. Some countries in Europe are more focused on preventative things and better lifestyles. For instance, better eating habits and better movement habits. Whereas in our medical system, we see people come in and they’re already trainwrecks. The time for prevention is way past. I think the more that we can do about healthier lifestyles and doing things that we can for ourselves — that’s largely the preventative things — the better shape we’re going to be in, not only as individuals but as the healthcare in our country. 

Doria: Before we tell listeners where they can find your book, I wanted to ask, if there is one health or mind shift that SheVentures listeners could make today, what would you recommend?

Do Simple Things

Jan: I think the simplest thing that can have the most benefit is breathwork. Taking deep, slow, and regular breaths. When we’re stressed, we’re taking rapid [and] shallow breaths, breathing only with your chest. There are some breathing exercises that we recommend in the book. As we’re taking slow, deep, regular breaths — holding our inhale and then a long exhale — that’s actually telling our body to relax. We can get out of the fight or flight stress response and get into the relaxation response. If there was one thing I could tell people that’s simple, I would say to take slow, deep, regular breaths. If you’re stressed [or] anxious, take some slow breaths. 

There’s a particular breath called the 4-7-8 breath that we talk about in the book. You inhale for four counts — it doesn’t have to be four seconds, just four counts — hold the breath for seven counts, and then exhale with a “whoosh” for eight counts. That can be done in sets of four, twice a day. The more you do it, the better you get at it and the more effective it is for you. There are other breathwork exercises out there but the main thing is to take slow, deep, regular breaths.

Doria: I always am told you have to breathe through your nose. Does that really matter?

Jan: It’s helpful to do that if you can. Not everyone can breathe through their nose, but if you can inhale through your nose and do the long exhale through your mouth, that’s what we recommend.

Doria: First of all, I want to thank you for showing up so authentically today and speaking about your life and career. You have done so much, and I’m in awe of you. I was hoping you could tell listeners where they can find out more about not only your book but your integrative medicine and anything else you’d like to share. 

Jan: You can find out more about me and my book at my website, which is drjanpatterson.com. Our book, Breath for the Soul: Self-Care Steps to Wellness, is available on Amazon or barnesandnoble.com. You can also order it from your local bookstore.

Doria: Thank you so much for coming on SheVentures today! 

Jan: You’re welcome!