Dr. Bernie Siegel, The Art of Healing
March 2, 2008

Welcome to Yale Cancer Center Answers with Drs. Ed Chu and Ken Miller.  I am Bruce Barber.  Dr. Chu is Deputy Director and Chief of Medical Oncology at Yale Cancer Center and Dr. Miller is a medical oncologist, specializing in pain and palliative care. He is also Director of the Connecticut Challenge Survivorship Clinic.  If you would like to join the discussion, you can contact the doctors directly.  The address is canceranswers@yale.edu and the phone number is 1-888-234-4YCC.  This evening Dr. Miller welcomes Dr. Bernie Siegel, the author of several books focused on spiritual healing including the best selling, Love, Medicine and Miracles.

Miller
You are a surgeon and you practiced for many years. How did you then get into writing?

Siegel
I'll tell you this interesting story.  I went to Colgate University as a science major living in my head. I took a course in creative writing and got a C. That's the only C in 4 years of college.  I have asked the college to raise the grade because of what I have done, but they refuse because I would get high honors if they gave me a B. But the difference in those days was that I was living in my head, not in my heart. I think what explains it best is a story from William Saroyan. There is a man who is a writer with a young man helping him.  They are in the army and they are writing about the war, and the writer comes in the office one day and says to the kid, "Hey, you are really a good writer," and the kid says "What are you talking about, I haven't written anything."  He says, "Oh no, what is that on your desk?  He says, "That is a letter to my father."  The writer says "All right then write a letter to everyone." And that's what I tend to do now. It is coming from my heart, I am writing about my feelings to everyone, and so I started writing a book.  It wasn't my idea.  People asked me if I ever thought about writing a book and I would say, "Hey, maybe that would save me time and trouble," because I was talking with so many different people.  I found out that it makes life harder if you write a book, because then everybody wants to talk you. I literally talked into a tape recorder and then had somebody edit it and make it into a book.  Yes, I can write now because it is coming from my feelings and experience and not what I am thinking about.

Miller
Bernie, you did a lot of cancer surgery during your career.  What was the transition like between being a surgeon who's primarily focused on operating and taking out tumors, to being a healer?

Siegel
I did not realize that my problem was that I liked people.  I went into medicine you might say for the wrong reasons.  There are a lot of kids who do it because the human body fascinates them.  Then they get into trouble because people show up, but I like people and I realized that you can't cure and fix everything.  As a medical student, I used to pray over sick kids in the dark and would be totally embarrassed if anybody found me in there. I never said that I was praying for the kids, that I did not know why God would do this. What was interesting, Carl

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Simonton came to Connecticut back in 1977.  He was doing work on imagery and cancer and based on the title of the talk I thought it was just for doctors.  I thought maybe it would give me more to offer my patients so I signed up for it.  When I got there, there were literally about 125 people, three of them were doctors.  Two were psychotherapists and I was a surgeon sitting there. All my patients were in the room and the one who literally transformed my life was the one who said to me "You are a nice guy and I feel better when I am in the office with you, but I can't take you home with me.  I need to know how to live between office visits." That's when I thought, what are we taught, we are failing.  So I could stop being a failure.  I can help people live. I sent 100 letters to patients with cancer saying, "if you want to live a longer, better life come to a meeting."

Miller
How many came?

Siegel
Me, expecting 300-500, I was a total wreck saying, "You didn't write don't bring friends and family." Less than a dozen women appeared and I realized I don't know the people I am taking care of. That's when I began to talk to them about their lives and some actually said to me "Yes, I would like to die if you just make it comfortable."  There were so many things I heard. On the other side of the coin, when I began going out lecturing to schools, synagogues and churches, patients I thought were dead came up to say hello. I was like, wait a minute, and I pulled their charts and everybody said they'd be dead in two months, six months. They all have stories to tell about lifetime transformations. I began to put things together and they tried to share with people that they did not die when they were "supposed to".

Miller
I remember you lecturing and talking about how doctors write prescriptions. People ask their doctors how long they have to live and the doctor says you have got six months.  What are your thoughts on that now?

Siegel
It kills, it literally does.  One of the things I also realized from studying communication is that we are not taught how to talk to people. One of our kids, and I don't think this was an accident, wrote the word "words" on canvas.  This was an art project at school, but leaving no space between the words "words" they became, "swords" if you write, words, words, words, words. I thought, so I can kill or cure with words, kill or cure with a scalpel. The other interesting thing is that this is not a part of medicine.  I wrote articles for medical journals and they all came back saying it is interesting, but it is inappropriate.  So I sent it again as appropriate.  It came back again, but this time it said it is appropriate, but is not interesting.  They were saying, we know this, and those were psychotherapeutic journals.  I got a wonderful letter from Karl Menninger. He wrote, "I was about to write a book called Twelve Hopeless Cases about 12 people who were supposed to be dead, but who are all walking around fine today, but you have written the book so I am not."  When you read the work of another psychiatrist, The Will to

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Live, by Hutschnecker, or You Can Fight for Your Life by Lawrence LaShan, these are people who helped others transform their lives and suddenly they did not die, and it has taken all these years to realize the age old message to be "born again".  Getting back to science, I mean it is genetic.  Bacteria, viruses and plants alter their genes to survive and are intelligent, it is not by chance.  It happens too quickly.  I've always said that we have a hell of a lot more complicated life than bacteria, but I think that when a disease disappears it is because we make a genetic alteration. What I found fascinating was Solzhenitsyn's book Cancer Ward.  He has been there.  He has had cancer, but he is not the man saying there are miracles and spontaneous remissions.  He finds this medical book.  It says there are cases of self-induced healing, not recovery through treatment, but actual healing. The symbol of it was a rainbow-colored butterfly and that says everything you need to know; butterflies are the transformation and the rainbow is your life in order.  So, get your life in order, transform yourself and it will happen.

Miller
Just like a butterfly.  One of the concepts that you have talked about for many years is the exceptional cancer patient. Who is the exceptional cancer patient and for you as a doctor, and as a person, what have you learned from the exceptional cancer patients?

Siegel
First of all, my wife came up with the name because I didn't know what to call the organization of these patients.  She said they are exceptional. I was looking for words like hope, and then would play with the letters, but I found I was in the minority. I was brought up by parents who loved me, I did well in school and my grandfather was my religious teacher so I didn't have trouble with God. I did not realize this until I began this work. Patients would say, "Oh, I am not exceptional," and I realized that wounds from parents, educators and religions, had made them afraid to take on a challenge.  The exceptional patients were willing to take on a challenge, to see the fine coaching and guidance and transform their lives. Most of them have what I call the inspiration, but you have got to give them the information. When put together some wonderful things happen.  But the ones who were brought up with their mother's words eating away at them, or maybe they think she gave them cancer because she only dressed them in dark clothes or something, that is why I have written books about parenting. When I realized how these wounds are hypnotic I began to study people like Milton Erickson, a psychiatrist and hypnotherapist, who as a child had polio. He heard a doctor in the hallway say to his mother, "He is not going to see the sun come up."  Hearing this he got angry.  He was exceptional.  He said I am going to watch the sun come up.  He did not say, "Oh well, I will die at 2 in the morning because of what the doctor said."  He knew how to talk to patients and he would talk in terms of stories about surviving and other things. You have cancer, you're sitting in the office and the doctor writes down something and then says excuse

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me there is a phone call I have to answer and walks out. What do you do?  You read the paper where he would have written that you are doing well. What an impact.  He comes back and you are sitting there thinking about how well you are doing and you go home with a different attitude.  I used to work at deceiving people into health.  I realized it is not as effective because I don't want to get sued.  I would talk to the family and explain that they have extensive cancer that I probably can't cure, but we want to keep them positive.  We have them come in the office every couple of weeks, give them a good painful shot and talk for awhile. Then they go home and I have watched people literally live for years, not getting any specific treatment but living with hope.

Miller
I remember the story about a man with stomach cancer, gastric cancer….

Siegel
Yeah, John.

Miller
...who showed up back in the office 10 years later…

Siegel
It was 4 years later.  He refused treatment.  Thank God it was springtime because he was a landscaper and had gone to make the world more beautiful. They do not deny their mortality.  People say that they give away their treasures and make out a will, then start doing what they love to do. John went home to make the world beautiful.  He refused chemotherapy and radiation and 4 years later he came back saying he had a hernia from lifting boulders in his landscape business.  He died at 92 and I gave a talk at his 70th wedding anniversary. I got to tell the world what this man was like and what he taught me about the world and how beautiful it is.

Miller
Let me ask a question about truth telling, because there is always a fine line between laying it all out and on the other hand not.

Siegel
I do not use statistics as the truth.  If more people live doing this, then let's do it.  My wife has breast cancer.  Yes, she has had surgery.  She is on medication, but if people had suggested some things to me, I might have said no thank you, that may change the quality of life, I do not want to do that.  I call life a labor pain.  What are you willing to experience?  This is the end of a poem a woman wrote comparing 9 months of pregnancy to 12 months of chemotherapy and radiation.  "One is worthwhile, you give birth to your child, the other is worthwhile, you give birth to yourself."  What I found was if I helped people make the right decisions, they had fewer side effects. When you say to somebody, draw yourself getting chemotherapy, and they draw the devil giving them poison, you got a problem.  When they draw it as a gift from God, which some people do, they do not have the side effects everybody else is having.

Miller
It is true.  When I talk to people about chemotherapy, I try to send a positive

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message. I want them every morning they wake up and take a pill, to think about how it is good.

Siegel
I put what people are given when they get the drug adriamycin in one of my books. If you think of Erickson trying to help people, you want them to know what it means when I say I am going to give them adriamycin.  It is like the ads on television, they speak as fast as they can, it can make your hair fall out, or you'll drop dead, there is a whole page on what can go wrong if you take it.  It would be nice if they put a sentence in saying this drug is helpful in the treatment of… but there are side effects associated with it. 

Miller
I agree with that.

Siegel
When you read about adriamycin and what goes wrong, you start shaking your head, no, and when somebody says it will help you, your reaction is still a negative one. But if they had started out with, this is helpful," oh good" your head is nodding, and then you do not have the side effects because you would say "No, that's not going to happen to me, it's good for me."

Miller
We would like to remind our listeners to please e-mail questions to canceranswers@yale.edu.  We are going to take a short break for a medical minute. Please stay tuned to learn more about the art of healing with Dr. Bernie Siegel.

Miller
Welcome back to Yale Cancer Center Answers.  This is Dr. Ken Miller.  I am here with Dr. Bernie Siegel, a very well known physician and author of several books on healing, spirituality and also on parenting.  Let me ask you about parenting and cancer.  They sound different, but how are they the same?

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Siegel
I get criticism.  Somebody showed me that there was an article recently in the New York Times criticizing me, but it is misinterpreting. Karolin Thomas, a psychiatrist down at John Hopkins, years ago had the medical students fill out a personality profile and draw a picture of themselves.  Her statement was that she could tell who is going to get what disease by how they drew themselves.  Cancer patients more often put their arms in different positions.  They were ambivalent.  Heart attacks were supposedly wide-open arms, making them vulnerable. She also said cancer patients had a low closeness to parent profile. Now, she did not make all of that public, if you know what I mean, she told me this over the phone.

Miller
It is a little scary.

Siegel
There was a study at Harvard.  While students were at the college, they were asked if their parents loved them.  35 years later about 1/4 of those you had said yes had suffered a major illness; those who said no, over 90%.  In the book Biology of Belief, by geneticist Bruce Lipton, he makes it very clear that children's brains up to the age of 6 have a Brainwave pattern of the hypnotized individual.  So, what your parents are saying to you is totally destructive. I always say that people, well, just read the headlines now, this 15-year-old who kills his parents and his siblings, that is about rejection.  The opposite of love is indifference.  I always say information is not the problem. In other words, if you are a drug addict, or smoking 2 packs a day, or you weigh 400 pounds, that is not stupidity, that is lack of inspiration, lack of self esteem and love. I found with my patients that if they think you don't care, what's the point of them coming back?  No more appointments.  I always say, see you next week and let me give you hug before you go.  There was one woman, who did not take care of herself and her husband was an abusive alcoholic.  She came in one day looking wonderful, telling me she had gotten a job, gotten her husband out of the house, but why?  She saw that I cared about her and I persisted.  She realized one day that she was worth more.  I have done this with high-school students.  I stood on the platform and said to all of them that I love them all.  If you need a father you got one.  Here is my phone number, here is my e-mail address.  It is called the "chosen dad".  That's the name a suicidal kid gave me, she called me her CD.

Miller
For, chosen dad.

Siegel
Some would say, how can you do that?  Now they know somebody loves them.  I got 3 phone calls and e-mails.

Miller
And I bet that there was a reason.

Siegel
They went home and said, "Hey! He cares, we must be worth something.  I do not need to call him up."

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Miller
Let me ask you, for physicians and for people who are treating patients with cancer, and for those who are exceptional cancer patients, what can we do to make that interaction more meaningful? How can I as a doctor be more helpful to my patients?

Siegel
I think it is being human on both sides.  I was going to become a veterinarian because of the pain of being a doctor, except one of my patients was a veterinarian and I told him I needed guidance.  He said do not change.  I said why not.  He said people bring the pets in. He helped me to focus on the people.  That does not mean you do not focus on yourself.  When I painted a self-portrait and my family and pets got tired of sitting for me, I painted myself with in a cap, mask and a gown hidden.  I did not know how disturbing that paining was until a couple of years later when I looked at it and thought how could someone paint themselves totally covered up, well I was in pain. I drew a picture for Elizabeth Kubler-Ross one day because she became my teacher, and she said, "What are you hiding, what are you covering up?"  I said, "What are you talking about?"  She said, "You drew a mountain, there is snow on it."  I said, "Yeah, it is snow."  She said, "The page is white.  You do not need a white crayon, you have added a layer." Then I started talking to her about my feelings and pain, and she helped me. When I say to a patient "I need to hug you," I did not hear that the first two words were "I need." When I began to realize this I started saying to patient I want to thank you. Alan Merman, the former pediatrician in Guilford, went to Yale and became a Chaplin at Yale. It was great while he was there because I did a lot of things with him.  He asked every surgeon how it feels to be a surgeon and he published an article.  He said that everybody answered with "I think". Once they realized he really wanted to know how they felt, the pain of not wanting to get close to patients came out.  Patients die and it hurts more and more, and these are things we never discuss in any conferences.  Here is a sick line from the pledge if you are a surgeon.  The second line is, "I will deal with my patients as I would wish to be dealt with if I were in the patient's position."

Miller
If you rewrote it today….

Siegel
I wrote it then, but now I would say I care for my patients. It took them a long time to publish my article, and the painting I just described you, I stood in front of that so you could see the two people at the end of the article.  They cut that out.  All you see is my beaming, smiling face.  They could not deal with it. 11 years later, the American College of Surgeons has finally had meetings on end of life issues.  I called up to the people sponsoring it to say "Bless you and if I can help, let me know."

Miller
How do you use meditation and dreams to understand people?

Siegel
Carl Jung, 80 years or so ago, interpreted a dream and made a correct physical

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diagnosis of a brain tumor.  I have yet to meet a medical student who has ever been told that in medical school.  I began to ask patients what they dream and have them do drawings. I saw diagnoses as well as other things and so it helped me get more knowledge. Patients have the conflict of, my intuition says this is not good for me, but the doctor said I should have it.  If you go in with conflict, you have more trouble.  I present people now with a list that psychiatrist George Solomon made up called Immune Component Personality. When he was working with AIDS patients before there was really any treatment for it he would hand them this and have them fill in their answers.  It is expressing feelings. He said that it is a simple list that saves him a lot of trouble. Rather than 20 pages of a psychological personality profile, he knows by this list if this is part of their makeup, and they know for themselves. It is especially good for expressing anger.  I find that it is a really vital thing that you do not internalize your anger to make everybody else happy, but you express what I call a righteous indignation of appropriate anger.  If you are not treated with respect in the hospital, you speak up.  Medical errors are in the top 10 causes of death in this country.  If you are what I called a responsible participant, who speak up when you think a mistake is being made.

Miller
Right, right….

Siegel
I have found that some of the lists doctors make up after they get sick, you have to laugh, because they are all the things that I have been telling everybody. Then they write a book saying "I apologize to Dr. Siegel for what I used to think about him.  Not that he ever caused me any trouble but what he said is a big help." This is literally a sentence in a book by a doctor whose wife developed cancer.

Miller
It is very nice.  What advice do you give to patients if they want to change?

Siegel
I say do what will make you happy. Pay attention to feelings. To quote somebody who went from HIV positive to negative, "If you live in your heart, magic happens." I would say that when you are making decisions about change ask yourself if it is coming from your heart or your head.  When it is coming from your heart, you will be doing good things for yourself and living your authentic life.  The biblical line is, "He who seeks to save his life, will lose it."  If you try to please everybody else, you are in big trouble.  I think that is why teenagers commit suicide.  The next line is, "He who is willing to lose his life, will save it." But what you lose is the untrue self.  I always say to people, eliminate what is killing you.  If they have cancer, I would ask them what the experience is like having cancer. The words that come out of people are about their life.

Miller
Like what?

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Siegel
There is a group that will say it is a blessing, a wake up call and a new beginning. Most will say it is a failure, roadblock, sucking, draining, and when I ask how this failure fits their life, a woman once said to me that her parents committed suicide when she was a child so she must have been a failure as a child.  Things are sucking the life out of them.  Once they realize this they go home and they heal their life. As a rabbi said, sometimes a curse can become a blessing.  One woman at the end of her poem said, "I looked for an answer, it came, cancer." I have to share with you, this woman came in with breast cancer and she had a mastectomy. She said it had been a blessing because she had a mastectomy and a divorce so she got rid of a tit and an ass. And that's survival behavior. I have a poem that says if bilateral mastectomies cannot be fun, they are not worth having.  It finishes with, felt good to get that off my chest. If you read with an audience you cannot be afraid when you are laughing, I have learned that.  The American Psychosomatic Association said that the cancer patient with a sense of humor, or who can laugh even if there is nothing funny, will live longer. All these things make a difference.

Miller
That was a wonderful, wonderful way to end the program. I want to thank Dr. Bernie Siegel for joining us on Yale Cancer Center Answers.  Thank you Bernie.  Until next week this is Dr. Ken Miller from the Yale Cancer Center wishing you a safe and healthy week.

If you have questions, comments, or would like to subscribe to our podcast, go to www.yalecancercenter.org where you will also find transcripts of past broadcast in written form.  Next week you will meet oncology nurses Judy Graso and Maryanne Davies.