Why is it that we, as a society, don’t pay more attention to stories of recovery? Why do we ignore examples of healing that don’t fit our paradigm of one cause, one cure? In his book Cured, Dr Jeffrey Rediger investigates spontaneous healing and recovery and examines the common denominators of those who have beaten the odds. What happens when we listen to these individuals and learn from their experiences? Is it possible to strengthen our defence systems, especially in this time of COVID?
Over the course of a seventeen-year search, Rediger met individuals who experienced an array of spontaneous recoveries. One was diagnosed with an aggressive form of pancreatic cancer, another a lethal brain tumour, while yet another was faced with the debilitating inflammatory arthritis known as ankylosing spondylitis. These recoveries are rare, but Rediger refrains from classifying them as flukes. Common attributes emerged. Each person profiled in the book chose to break with behaviours and patterns, and in one way or another discovered the body’s capacity to heal.
Rediger fluently conveys recent research, some of it yet to filter down into the A and Es and GPs’ surgeries. He describes these surprising cases with care, but without an undue sense of wonder, never abandoning the righteous suspicion of the qualified doctor. The individuals in the book are not superhuman, nor is spontaneous remission a ticket to eternal life. But instead of looking at them as lucky aberrations, Rediger argues for examination. In the history of medicine, we have almost never used the tools of rigorous science to investigate remarkable recoveries from incurable illnesses. Now seems like a good time.
Dr Rediger is an instructor in psychiatry at Harvard Medical School and medical director for the McLean SouthEast Adult Psychiatric Programs. Five Dials contacted him in Boston in mid-April, 2020.
How did this investigation into spontaneous recovery kick off?
In 2002 an oncology nurse at Mass General in Boston came to me and asked me to help tell her son that she had been diagnosed with pancreatic cancer and told that she had only months to live. We did that.
Then she went to a healing centre and began calling me, saying she was seeing some amazing recoveries and she wanted me to look into it.
I had just recently graduated from residency. I was a new medical director at McLean and on the faculty at Harvard. I doubted anything was going on, so I said no. But she was persistent.
She began having people call me from around the country and elsewhere saying they had medical evidence for their recoveries and did I want to hear their stories? I said no. But after a while, as these envelopes were mailed to me, I began to see that there were some stories I couldn’t explain.
It’s a complicated area of research. Many of the stories were complicated by chemo, radiation or other factors. But there were some stories I just couldn’t explain. Something mysterious was going on. So I began to look into it. It was a very slow journey for me. This has been seventeen years.
I had no idea how powerful the socialization method is in medicine. When you go through med school, they tear you down and rebuild you. You end up with a very specific and powerful way of perceiving disease and health. People who go to med school and into health-related fields are socialized into this process.
I’d been to Princeton Seminary. I have always been someone who asks questions. Questions have driven me my whole life. In med school, I would go up to a professor after class and just ask questions. I remember one response very clearly: ‘Don’t ask questions. Just memorize the problem set.’ That was very much the approach taken: ‘There’s a lot of information to absorb, and a lot of things to memorize.’
Certainly it’s true that becoming a physician is about absorbing and learning a great deal of information. But it’s also true that by learning not to ask questions very devoted, bright people are socialized into a process where we no longer examine assumptions or ask whether this is the best way to do things. It took me a long time to begin seeing this clearly.
In the book you examine other forms of healing alongside modern medicine. How important it is to acknowledge both the successes and limitations of modern medicine?
Modern medicine is brilliant in so many ways—in the acute situations, in keeping a person alive with coronavirus. I’m seeing everyday heroic efforts by doctors and nurses and respiratory therapists who are able to keep a person alive until they can recover enough to start breathing on their own again.
For example, at Good Samaritan Hospital, right now we have created a second ICU, a second intensive care unit, and transformed outpatient services into more inpatient beds. We have obtained more ventilators and are now using twenty-four of the thirty we have. All of our units are with COVID-positive patients at this time except one. We believe we are at our peak. We are keeping people alive who will survive, but who can’t breathe on their own right now. We’re seeing all kinds of things like that. So modern medicine is brilliant in that way.
One of the analogies I use sometimes is that modern medicine is a long line of ambulances at the bottom of a cliff. We are brilliant at picking people up and taking them to the hospital when they’ve fallen off the cliff and have an acute problem, whether it’s diabetic ketoacidosis or hypertensive emergency, a stroke, heart attack or colitis – all kinds of things.
But we’re not good at keeping people from falling off the cliff in the first place. The illnesses that consume most of our general medical costs are chronic illnesses. Heart disease, diabetes, cancer, autoimmune illness and lung disease—those five comprise over well over 70 per cent of the health-care dollar.
If we put guard rails at the top of the cliff, we would have a whole different system of medicine. That’s what Cured is about—looking at people who did fall off the cliff, but found a way to climb back up. They found ladders that work. The pillars of health and well-being that these people applied more intensely are the same principles that keep us from falling off the cliff in the first place. So that’s how my thinking has evolved as a result of being exposed to such incredible stories.
It seems you walk this line between deep respect for the established medical world and deep frustration that these cases of spontaneous healing are not being taken seriously.
It’s very true. I love medicine. I spend my days in both an acute care psychiatric hospital and an acute care medical hospital. I love that acuity and seeing people get better so fast. I love the intensity of what we can do with technology and medications to save people’s lives. But we are missing something. We have been taught to exclude the story of the person in order to penetrate through to the underlying signs and symptoms of illness that are present in anyone who has that particular disease. As a doctor, I’ve been trained to make a diagnosis and start a medication. But when you listen to people you see that understanding their individual story—what’s really going on in their lives—plays a massive role in making sure they get what they most need in order to genuinely heal.
How did the act of listening change for you as this process unfolded?
I have begun to understand that you need to see the person. It’s so meaningful to me to experience the person in their wholeness, not just, ‘We’re trying to go in and, in a matter of minutes, exclude the story, ask about symptoms, and then get out.’ It doesn’t take any longer to try to understand what the story is and understand who this person is. Underneath everything, what is really going on here?
The questions we ask are very important. Eighty-five per cent of what comes into a hospital is stress-related, but we don’t ask about that. If a person’s having a heart attack, they’re having a heart attack for a reason. The same is true if they’re having a stroke, or if their blood pressure is 200 over 120. Symptoms do not just come out of the blue.
When we ask, ‘It sounds like you’ve had a lot of stress in your life recently. What’s going on?’ patients relax, nurses then can relax and doctors are relieved because they can find a path to discharge. But these are not the things that we’re taught to ask about.
I recently spoke to a few nurses in New York who are involved in this current crisis. Because of the overwhelming number of patients coming in, the amount of listening they can do at the beginning of a consultation is so short. Instead of asking four pages of questions, it’s one page. They’re not getting a chance to hear about these people.
I bet so. But what we can do is just say, ‘You must be under a lot of stress. What’s been most stressful recently?’ That takes so little time and helps you understand what they’re dealing with. It often changes the complete approach to treatment. Then you can move on. This also establishes a critical connection with the patient and it’s much easier to make sure they get what they need.
Some of the stressors you describe in your book almost become characters unto themselves—a rogues’ gallery. One, of course, is chronic inflammation, which you define as a kind of erosion. How could you describe the ongoing effects of this erosion?
As doctors, we’re trained in body parts. If you’re interested in the heart, you’re going to become a cardiologist and study the heart. If you’re interested in psychiatry, you’re going to study the brain. Gastroenterologists will study the GI tract.
But it’s not the cholesterol that’s driving the problem. It’s not the blood pressure that’s driving the problem. A person doesn’t have a problem with diabetes. More fundamentally, it’s the chronic inflammation in the body that is wearing your body and immune system down. After a while, whatever part of your body is most vulnerable, either genetically or in terms of lifestyle, is the part that’s going to manifest disease first. And once one body part begins to wear out, more are often soon to follow.
Chronic inflammation is a lot closer to the real cause than we’ve been taught. When we stand back and look at the forest instead of just the trees, ‘Oh, we’ve got to reduce chronic inflammation in your body. That’s going to change the trajectory, not only of your diabetes, but also of your heart problem and all these other things.’
The book contains some surprising research. One line that jumped out for me was that forgiveness is actually good for your body.
Most of us live in chronic fight, flight or freeze. Any time that you’re in that sympathetic state on a chronic basis, you’re not going to heal properly because you’re going to be flooding the immune cells and all of the cells in your body with stress hormones – cortisol, norepinephrine and adrenaline, for example.
And what happens if your body’s getting flooded in these stress hormones? Your cells become numb and sluggish. All these brilliant cells and cell subtypes that want to kick out infections, kick out the coronavirus, keep your heart healthy, kick out the mutating cells that become cancer? For that to occur, your immune cells need to be healthy and vital. But that’s not going to happen if they are constantly flooded with stress hormones. Chronic inflammation is the immune system gone awry, which is the basis for most disease.
So getting out of fight or flight is important, and genuine forgiveness is one important way to do that. Doing so gets you out of fight or flight, and into a parasympathetic state that fires up your vagus nerve.
When you smile or when we make eye contact, it is the vagus nerve doing that. This helps move us out of fight or flight and into a state of connection, love and compassion. And that means your beautiful immune cells are bathed in a very different neurochemistry. Dopamine is the pleasure pathway. Serotonin is the feel-good antidepressant molecule that psychiatrists work with a lot. Endorphins also help with pain and mood.
This is a very different neurochemistry, and your body loves it. Your immune cells light up. They become active, healthy and vital, and are a lot better at kicking out infections. They eliminate inflammation instead of creating it.
I’m glad we’ve introduced another compelling character from the book, the vagus nerve.
Vagal nerve research is actually helping us see Darwin more completely. We talk about survival of the fittest and we think that’s the way we’re wired. Even Darwin knew that isn’t true. The vagal research shows us that our highest and most evolved strategies have to do with connecting with people rather than competing.
Our physiology wants us to connect, smile and light up when we see people. In Descent of Man, Darwin mentioned survival of the fittest twice and love ninety-five times. That’s really different. Even he understood it. But we didn’t get it. We just took the part of him that we understood.
Obviously, the spread of COVID is a tragedy. But we’ve also seen a flowering of kindness and solidarity. Neighbours are compelled to be there for each other. Is there a positive to what’s happening now for our vagus nerve?
I think so. This is a massive opportunity for all of us to improve many aspects of our lives, both individually and collectively. It’ll be interesting to see what the research is that comes out of this, but even my colleagues, we’re spending our nights, our weekends together. We’re busy moving the hospital and a lot of our doctors and social workers to telemedicine. So we are connecting outside of work hours. We’re doing Zoom and seeing each other’s homes and hearing the barking dogs, seeing what kind of books they read, all those kinds of things that we didn’t know before. We have a different kind of social contact over Zoom that’s very connecting and, I think, very loving.
In another section of the book you mention how our perceptions of placebos are changing. We take a placebo and, on some level, we feel cared for. A placebo pill is inert, but there’s this deeper unconscious part of us that feels cared for and the body responds accordingly. It allows us to tap into the idea of tacit knowledge.
Michael Polanyi was a philosopher of science and a chemist who wrote about how when you learn to play a piano or ride a bike you have to focus on learning all those little parts. But at some point that transitions and you focus on the meaning of what you’re doing. If you start to focus on the parts again, you’re going to get screwed up.
It’s so fascinating to me that with a placebo, even if you know you’re taking a placebo, you can still get better from it. Even if you know it’s a sugar pill. So that means that there are subconscious pieces to all of this, whether it’s that we feel cared for, or that it’s a tradition that we feel we trust to be used for our benefit. There are these unconscious beliefs that are very powerful, and that are just waiting to be tapped into.
Could you expand on the idea of the DMN?
Yes. The Default Mode Network. This is a new and growing area of research. We develop these very efficient lives where we have all of this tacit knowledge that we rely on. For example, I often will drive to work and won’t remember all I did to get there, all the times I used my turn signal. My default mode network gets me there because my neurocircuitry knows the patterns so well that I don’t need to focus on them.
This is all great, but when the default mode network becomes the neurocircuitry that keeps us from experiencing ourselves in a new way, then that’s a problem. One of the most common things that people have said to me over the years is that it took an illness for them to wake up and realize they needed to stop taking care of everyone else. They needed to stop responding to the perceived expectations of others and focus on a life that created wellbeing and authenticity for them, where they felt like they were living a life that meant something to them and not just responding to everyone else’s expectations.
What does it take to get out of that default mode network when we have this neurocircuitry that’s very accustomed to thinking about ourselves in a certain way? Or thinking about the universe in a certain way?
Sometimes to get better this has to change at a deep level. I can’t tell you the number of people I’ve talked to who changed at a fundamental level, sometimes to the point of changing their names, or walking down a street and realizing people no longer recognized them.
For them to get healthy, that’s what they had to do. Whether it’s leaving a toxic relationship or a job that was depleting them every day. Getting out of that default mode network and finding a more authentic way of being who they are.
Different things work for different people when it comes to getting out of your default mode network. Dance sometimes is really important. A spiritual practice can do that. Sometimes I tell patients to not use psychotherapy if it just reinforces all your biases and keeps yourself in the world that you’re used to because you’re afraid of finding a different way of experiencing yourself. It’s often used for that. We find ways to keep ourselves in the same world.
The worlds of the arts and science are coming together. People in the liberal arts, or people who have been meditating for years, or people who are into dance—they’ve known some things. Artists know things that are astonishing to me. It’s nice that science is finally catching up to that.
Why is it important to gain the mindset of conducting our own health experiments?
I’m interested in the democratization of medicine. And in the democratization of psychiatry. For thousands of years, we have had deficit-based views of being human in all of our major institutions.
In psychiatry we reduce human problems of living to neurochemical defects. And that may be part of it, but it’s not the whole story. In my experience, it’s not even the main story. In medicine we reduce everything to the disease model, to what’s wrong and missing with a person. In psychology we reduce everything to childhood deficits. In religion we’ve reduced things to original sin instead of emphasizing that every person has this divine aspect to them that is deeper and truer than anything they could possibly do wrong. I think the truth is every person brings something unique and good into the world.
After watching these stories for so many years, I am convinced that what it takes for people to get better is to begin seeing and experiencing themselves differently. See what’s right and focus on that rather than exclusively on what’s wrong. There’s nothing wrong with us that can’t be fixed by what is right and good about us. This galvanizes hope or something positive that can carry a person through a rough time to a point where they see things differently and make different choices.
Is a moment of crisis and pandemic a time when that process might be able to happen?
Yes, I think so. The human spirit is irrepressible. People are doing beautiful things. Someone left a package of surgical masks on my porch at home. This can be a time for reflection and renewal. A time for reordering our priorities.
But let’s face it. There’s also a lot of painful stuff going on. I see loved ones drop off their ninety-year-old mother and they can’t go in and visit her in the hospital. They don’t know if they’re ever going to see her again. Sometimes they don’t. Sometimes these people are too old or too confused to figure out how to use FaceTime, or even sometimes too weak to pick up the phone. People feel so alone. And then the doctors and nurses have to leave the door closed, and when they do briefly come in, they are all gowned, gloved, masked and goggled up, standing across the room. So the person can feel even more alienated and alone. So there’s a lot of tragic things going on. But there’s a lot of beautiful things going on as well.
Explain the image of burning your boats.
There’s an old story that a general and his army landed on an island with a mandate to take the island, even though they were vastly outnumbered. What did the general do? He told his officers to burn their boats. In this way, they had no choice but to either take the island or die. It changes the psychology and puts change in your favour.
This image is meaningful to me because I try to help people figure out how to change deeply ingrained patterns. We now know that 90 per cent or more of the major illnesses that cause suffering are more about lifestyle and choices rather than genetics as commonly understood. We now know that our choices even turn genes on and off. So much of our health care is not about the medication. It’s more about changing our lifestyles and waking up to our value and purpose. But the default mode network makes that challenging for us.
For example, if I’m talking to somebody who struggles with alcohol, I might ask, ‘What would it take to really close that door in the back of your mind that you keep cracked?’ You can tell some people genuinely want to change a habit or lifestyle. But you can also tell that many times they’re keeping a little door cracked in the back of their mind. If it gets stressful, they can go back through that door. One more drink. Just for one night.
But then it never is one night. It just opens up that whole door again. The same is true for the lifestyle issues associated with most of our major illnesses, whether that be heart disease, diabetes, obesity, cancer or autoimmune illness. The analogy of burning our boats helps us make that change. That’s why the analogy is important.
If you close that door for ever, if you burn your boats, you can tell. As a doctor, you can tell when someone burns that boat. You feel it. You can tell that they have closed a door and thrown away the key. They’re not going to go back through that door even if it kills them because they don’t want those consequences in their life any longer, whether it’s the diabetes or the alcohol or the heart disease or what it’s doing to their wife or their children. You can feel the shift. Sometimes the shift is so strong that the person feels disgusted by the old pathway, the old DMN.
You write that if people fully immerse themselves in healing patterns, great things can potentially happen. You write that scientific studies are often built around the mean, around what the average person does, and that we don’t study the outliers because we don’t notice them.
Yes. If I was ill, I would want to know what the average person does, but I would also want to know what the ultimate achievers in health do. They do things very differently. Tom Brady and Serena Williams are the ultimate achievers in sports, and Steve Jobs was an ultimate achiever in business. We study them. Studying them doesn’t mean we all are going to be them. But we can learn a lot from them. In the same way, I believe we should be studying the ultimate achievers in health. Many more of them exist than we realize.
What these people do is they drop themselves into a very different default mode network, either quickly or over time. Stepping into a new world takes faith. It’s kind of like when Indiana Jones steps off the cliff and the path appears under him. He couldn’t see it. He had to take a step of faith. We can’t see what the next step is immediately. Our default mode network doesn’t let us see it.
Sometimes we have to take a step of faith into a whole different world, trusting that the universe is fundamentally benevolent and for us, and hope it is the right step for us. We have to think that, well, this is the right thing to do. I just don’t see a way forward. A new default mode network then develops over time that is healthier for us.
So Spielberg was right? Don’t go in the water. Stay away from the sharks. Take a leap of faith.
Has this seventeen-year process changed your views of your own spirituality?
I grew up in a very violent environment. This has been a personal journey for me. I had a lot of questions, a lot of confusion. This has given me a path to ask those questions. And that’s why I’ve become very keen on building models in our institutions that are about what’s right with people, seeing what’s possible, rather than building on what’s wrong.
If you want to help an alcoholic or a person with diabetes or heart disease, you don’t help them so much by focusing just on the disease. You help them more by showing them the kind of life that is possible, that they’re not this disease, that they’re not this alcohol, that they’re not this 359 blood sugar, you know. That they have worth and value.
And then you help them focus on something that fills their heart and their soul at a deeper level with something positive and life-giving. That’s very different. It goes a lot further. And my personal journey around that has very much matched what’s helped me put together a whole different life than you would have expected, based on where I started.
In the book you focus on root cause. Do you think COVID-19 will force people to think more about root cause?
I hope so. I’m trying to understand the best way to respond to this too. Right now it doesn’t seem like there’s much being written or discussed about how to build a flourishing immune system. And ultimately that’s the best way through this. I very much want to help people develop strong immune systems that can take on all comers.
I purposely told the story in Cured about the lifelong debate between Louis Pasteur, the father of the germ theory, and Claude Bernard. Our approach in Western medicine is almost exclusively reliant on a particular appropriation of germ theory and its unexamined assumptions. It’s very powerful and is right in many ways. But there’s more to the story. ‘Nuke the germ’ is not the wisest or most powerful approach, and in fact has all kinds of dangerous downsides.
We’re all surrounded by millions of pathogens every day. These viruses, bacteria and fungi only become invaders when something is broken down in our system. They’re a symptom of the problem, not the cause of the problem. When we wipe out our microbiomes through poor nutrition, overuse of medications, or poor stress management, for example, we wipe out the hard drives of our immune systems.
I love the story of Claude Bernard saying, ‘No, you’ve got to take care of your microbiome.’ He didn’t use that word, but that’s what he meant. And if you take care of your microbiome, then all of the millions of unhealthy bacteria and viruses won’t overgrow or have a place to live. Is it better to keep waving flies away from rotting food, or is it better to remove the rotting food? Taking care of your microbiome instead of nuking the virus or bacteria is the same issue.
The story goes that Claude Bernard drank a glass of cholera in front of his students and said, ‘The germ is nothing, the terrain is everything.’ Now you can’t just do this without understanding what is really entailed in creating a healthy immune system. But this is where we need an entirely different paradigm, so that we are strengthening immune systems, and studying how to do so, instead of weakening them as we currently are. I’m hoping that we can get a discussion going along those lines, but it’s not there yet.
Personally, you know, I’m not worried about getting COVID. I’m in rooms with COVID patients every day for hours. I’m around this stuff a lot, but I think these stories have so deeply influenced the way I live my life, I’m able to work long days, do a lot of things, and be exposed to things and not worry. I’m a human being. I could get ill, absolutely. I could get stressed out and make mistakes and something could happen. But I do believe I’ve built a strong foundation and I want to help other people do the same. ◊