Thursday, October 30, 2008

Important Work

October 30, 2008
In One Section of Beth Israel Hospital, Some Patients Are Saying ‘Om,’ Not ‘Ah’

By ANEMONA HARTOCOLLIS
Medical advances sometimes happen in strange ways. Someone finds a fungus in dirty lab dishes and — eureka! — penicillin is born. Now a premier Manhattan hospital is turning a cancer-treatment floor over to a world-famous fashion designer in the hope that serendipity, science and intuition will strike again.

A foundation run by Donna Karan, creator of the “seven easy pieces” philosophy of women’s wardrobes and founder of the much-imitated DKNY line of clothing, has donated $850,000 for a yearlong experiment combining Eastern and Western healing methods at Beth Israel Medical Center. Instead of just letting a celebrated donor adopt a hospital wing, renovate it and have her name embossed on a plaque, the Karan-Beth Israel project will have a celebrated donor turn a hospital into a testing ground for a trendy, medically controversial notion: that yoga, meditation and aromatherapy can enhance regimens of chemotherapy and radiation.

“While we are giving patients traditional medicine, we are not going to exclude patients’ values and beliefs,” said Dr. David Shulkin, the chief executive of Beth Israel, noting that a third of Americans seek alternative treatments. “To make care accessible to these third of Americans, we’re trying to embrace care that makes them more comfortable.”

On Wednesday, Dr. Shulkin, who had never done yoga before, joined Ms. Karan and about 60 Beth Israel employees on the floor of her late husband’s West Village art studio for an hour of yoga poses, finishing off with “om” and the recorded sound of bells.

“They didn’t teach us that in medical school,” Dr. Shulkin said afterward, still sitting barefoot on his black mat, swearing he had put his BlackBerry on “meditation mode” and had not checked it. Asked if the yoga had worked, he formed his answer carefully: “I think the personal touch and the personal attention to a patient absolutely works.”

The husband-and-wife team leading Wednesday’s session — Ms. Karan’s yoga masters, Rodney Yee and Colleen Saidman Yee — will oversee the experiment. Fifteen yoga teachers will be sent to Beth Israel’s ninth-floor cancer ward starting in January to work with nonterminal patients, and nurses will be trained in relaxation techniques. Their salaries, as well as a cosmetic overhaul of the ward, are being paid for by Ms. Karan’s Urban Zen Foundation, created after her husband and business partner, Stephan Weiss, 62, died of lung cancer in 2001.

While other hospitals in New York and across the country have dabbled in yoga, the new Beth Israel project is broader, better financed and more integrated into the medical protocol, and because of Ms. Karan’s concern that it might be dismissed as touchy-feely nonsense, it includes a research component. Ms. Karan hopes to prove that the Urban Zen regime can reduce classic symptoms of cancer and its treatment, like pain, nausea and anxiety (thereby cutting hospital stays and costs) and serve as a model for replication elsewhere.

But Dr. Benjamin Kligler, the research director in integrative family medicine for the Beth Israel-affiliated Continuum Center for Health and Healing and the research project’s principal investigator, acknowledged that the experiment of yoga teachers and their interaction with patients did not lend itself to the random, double-blind placebo trials favored in the medical world.

“The truth is, from a very traditional research perspective, that’s a problem,” Dr. Kligler conceded, adding that it might be time for the medical establishment to consider a new research model for what he called “lifestyle interventions.”

Organizers are also wary of the halo effect: Will Ms. Karan’s fame taint the experiment? But they are cognizant of the value of stroking people with deep pockets and of celebrity branding: Someday the cancer ward’s plaque reading “Leo and Rachel Sussman Division of Hematology/Oncology” will be joined by one honoring Ms. Karan.

“You have your right-column energy and your left-column energy,” Ms. Karan said, suggesting that there is room for both.

She traces her commitment to integrative medicine to what she saw as the narrowly limited treatment of her husband, a sculptor, and of Lynn Kohlman, a photographer, model and DKNY fashion director who was still ravishing and dignified despite the staples in her head and scars on her chest when she died of brain and lung cancer in September.

Ms. Karan longed for the help of a Marcus Welby, the kind of friendly, wise doctor who seemed possible only on television, and even then in a more innocent era. “Today everybody’s a specialist,” she lamented in an interview. “We’re only one person, even though we have a lot of parts, but everybody takes a piece of us.”

Despite all his high-tech medical treatment, her husband could not breathe, she recalled, until a yoga teacher taught him to “open his lungs.” “He went from ah-ah-ah,” she said, mimicking his gasping for breath, “to aaaaahh.”

“Everybody was dealing with his disease,” she said of the doctors. “Nobody was looking at him holistically as a patient. How do you treat the patient at the mind-body level? Not only the patient but the loved one?”

Ms. Kohlman apparently sensed her illness before her doctors did. Lying on the floor during a yoga session at a beach resort on Parrot Cay, a tiny Caribbean island, she began to shake. “You’re having kundalini rising,” Mr. Yee, the yoga master who is partnering with Ms. Karan at Beth Israel, yelled, running to her side. Ms. Kohlman, who wrote about the experience for Vogue, insisted, “I have brain cancer.”

She intensified her yoga. “She asked for it in the hospital,” said Ms. Karan, who practices yoga daily. “She needed it, she wanted it.

“This works,” Ms. Karan insisted. “Now we have to prove it in the clinical setting.”

To do that, she turned to Beth Israel because it is among the handful of hospitals nationwide with full-fledged integrative medicine departments. Beth Israel’s department is headed by Woodson Merrell, known as Woody, who rides a silver Vespa to his Upper East Side office and who made the obligatory pilgrimage to India in the 1960s. Beth Israel has experimented with integrating mainstream and alternative therapies for eight years, mainly through the Continuum Center, which employs 10 doctors. In the spring, integrative medicine was elevated to department status, just like surgery, orthopedics and the rest.

“A lot of other hospitals have integrative medicine, but it’s kind of stuck away in the basement,” said Dr. Merrell, who, not coincidentally, is Ms. Karan’s internist. “People like to think it’s not there.” Starting in November, the cancer ward will be renovated by Ms. Karan, the architect David Fratianne and Alex Stark, a feng shui master. The dull beige walls and green linoleum tile floors will be replaced with bamboo wallpaper and cork floors. Nooks and crannies now used for brown-bag lunches and naps and crammed with a desultory selection of dusty books will be turned into yoga, prayer and meditation retreats for patients, their families and nurses.

Urban Zen will cover the salaries of a patient “navigator,” a sort of cancer-ward concierge, and a yoga coordinator. The Yees and Dr. Merrell expect that about half the eligible patients will decline to participate. Those who do will find a flexible definition of yoga, with some who are very ill simply getting help to breathe from a yogi who will also manipulate their limbs, rub their feet or simply listen to them.

Last week, two yoga teachers in Karan-designed black T-shirts printed with white block letters saying, “The Unstoppable PATH/Patient Awareness Towards Healing,” approached several patients for an impromptu workout.

Looking like a radiantly healthy creature from another planet, one of the teachers, Shana Kuhn-Siegel, sidled up to the bedside of an emaciated 34-year-old patient, Natoya Harrison, who insisted on eating her meal of chicken and potatoes before embarking on yoga. Ms. Harrison, who was formerly obese, was hospitalized in a coma caused by complications of a gastric bypass performed elsewhere. What did she miss about life outside the hospital? Ms. Kuhn-Siegel asked. “Not being able to participate in sex, church,” Ms. Harrison said, adding, “I shouldn’t have said those two things together.”

“You can say whatever you want,” Ms. Kuhn-Siegel replied. She prompted the woman to talk about her 15-year-old son, and asked if she would like to close her eyes. “I thought you were going to ask me questions,” Ms. Harrison said nervously. “Why are you trying to put me to sleep? What’s your M.O.?”

Noticing the T-shirt, she perked up, asking: “Where can I get one of those?” Ms. Kuhn-Siegel promised to tell Ms. Karan that Ms. Harrison would like a shirt, and tried to capitalize on the connection.

“There’s a position I can put you in to relieve the pain in your abdomen,” she said. “It’s a position called ‘bound angle.’ ”

Ms. Harrison let Ms. Kuhn-Siegel manipulate her scrawny limbs, bending and straightening her knees, propping up her head. “How about a cup of green tea?” Ms. Kuhn-Siegel asked.

“Nope,” Ms. Harrison said. “I think I’m going to throw up.”

Ms. Kuhn-Siegel handed her a wastebasket and backed away.


Copyright 2008 The New York Times Company









xo

7 comments:

Anonymous said...

I applaud Donna for making this contribution, but perhaps providing donations to save the OB/GYN Department of BIMC sibbling Hosiptal in Brooklyn, Long Island College Hospital might be a good way of saving this 150 year old Hospital from the bad management that brought it to this condition under the Contiuumn Health Partner Group has caused, which BIMC has the most influence.

Milk Money said...

Perhaps. But I think Ms. Karan's mission is not to save hospitals, but to bring a holistic approach to non-terminal cancer patients. I would imagine there is a foundation that could be petitioned to contribute to LICH's OB/GYN dept. I'm curious: Are they suffering b/c of the extremely expensive malpractice insurance they must purchase?

Anonymous said...

Your right, Ms Karan mission is a good cause, and it has nothing to do with the saving a failing Brooklyn Hospital. What I failed to explain was perhaps BIMC isn't the wisest choice for placing a large donation for such a great cause, since CHP the parent company has drained the donation that a Mr Donald Othmer left LICH back in the 1990's in the tune of nearly $200 Million. Ever since LICH joined the Continuum Health Care group which has under it BIMC, St. Lukes Roosevelt and LICH, the Brooklyn Hospital seemed to be treated as the step child of the arrangement and is now just a skelton of its former self. Along with BIMC's past troubles with the State of double billing Medicaid in the 1990's and having to pay back almost 100 Millions, those from Brooklyn wonder if that's were the Othmer monies went. It is apparent to most that have been involved that CHP looks at the revenue from the three Hospitals to ensure the continued life of its best child, which BIMC is in their eyes. Brooklynites will suffer for this arrangement for years to come.

Milk Money said...

Thanks for elaborating--your intitial comment seems a bit less random now. ;o)

SEEMA said...

I am glad that an awakening regarding yoga and meditation has begun in the West. Yoga and meditation definitely have healing effects. This has been proved time and again in India by realised masters like Anandmurti Gurumaa (www.gurumaa.com, www.yogawonders.com and www.spiritualguidedmeditation.com). Swami Ramdev has also proved that yoga and pranayam helps to cure even fatal illnesses like cancer.

Anonymous said...

This is such a great use of her energy, skills and vision. I hope her high profile encourages other hospitals to open up to yoga. My first class was a free wellness center offering at Harvard, and it was full of chronically stressed out people who could barely touch their toes. My last workplace offered free weekly yoga, and it drew 50+ people. It's not just for hippies anymore ;-)
--Julia O.

Milk Money said...

Ditto and ditto, Seema and Julia. Basic pranayama does wonders for the mind and body...we've only begun to scratch the surface of the benefits of yoga. Fortunately, Western Medicine is finally starting to embrace it....not with big hugs, but at least with respect and with the idea that yoga PLUS conventional medicine can really work to heal the whole patient, and not just treat the disease.

Still, we yogis have to continue to bring yoga as a preventative option in medicine as well.

Namaste!