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Healing takes a winding path: Doctor charts a different course, finds foes

Sunday, February 06, 2000

By Christopher Snowbeck, Post-Gazette Staff Writer

Correction/Clarification: (Published Feb. 7, 2000) Peter Shefler's name was misspelled in a photo caption accompanying a story about Dr. Lewis Mehl-Madrona in yesterday's editions.


Dr. Lewis Mehl-Madrona once witnessed an American Indian spirit called White Buffalo Calf Woman heal a prostate cancer patient by rearranging "electrical patterns" in the man's brain.

 
A fire heats up the rocks for a sweat lodge used by Dr. Lewis Mehl-Madrona. Bill Wade, Post-Gazette) 

The miraculous cure came during a sweat lodge ceremony, a prayer and purification ritual that Mehl-Madrona has performed dozens of times in a career that has stretched from California to New England to a post at the Center for Complementary Medicine at UPMC Shadyside.

But now, the story of White Buffalo Calf Woman and others he has published could cost the 46-year-old Stanford-trained physician his position in the University of Pittsburgh Health System.

With a national quack-watch publication questioning his competence, Mehl-Madrona has stepped down as medical director of the center, and, though he continues to see patients there, he is the subject of a UPMC investigation.

The probe is the latest bump on a medical path that, like alternative medicine itself, has created controversy and discomfort as it intersects the mainstream.

The clearest part of the unorthodox story surrounding Mehl-Madrona's time in Pittsburgh is the fashion that brought him here: Doctors and hospitals across the country are competing fiercely to offer complementary medicine services under their auspices.

In 1997, four of every 10 Americans used alternative medicine therapies ranging from acupuncture and biofeedback to relaxation techniques. And they spent at least $27 billion for professional services, herbal products, vitamins, diet products and books and classes, according to a study published last year in the Journal of the American Medical Association.

Hospitals have tried to tap into this market, with 8.6 percent of all community hospitals in the country in 1998 offeringsome kinds of alternative treatments.

One of the more significant developments came in 1992, when Congress created the National Center for Complementary and Alternative Medicine, a branch of the National Institutes of Health, to study what works and what doesn't.

UPMC Shadyside officials brought Mehl-Madrona aboard because of the combination of his credentials in the alternative medicine world and his western medical training.

The terms "alternative" and "complementary" refer to a variety of services that for years have been practiced outside mainstream American medicine.

At the Center for Complementary Medicine at UPMC Shadyside, practitioners treat patients with acupuncture, hypnosis, relaxation therapies, talk therapy and a technique called EMDR, in which patients use eye movement and other exercises to reprocess information stored in the nervous system.

Mehl-Madrona uses all these practices.

Critics say many alternative treatments lack scientific support, a claim that rankles Mehl-Madrona.

"I think the danger in alternative medicine is that we confuse the effectiveness of a treatment with the effectiveness of mind-body healing," he said. "Some of the things we do clearly work, have biological efficacy. Some of the things we do we have no idea if they have any biological efficacy ... but people believe in them and they get better."

But what really draws attention to Mehl-Madrona, both from supporters and critics, are the sweat lodge ceremonies. They aren't part of the center's services, but he discusses them at length in his memoir, "Coyote Medicine," which was published by Scribner in 1997. He's conducted about a dozen of them in Pittsburgh during his time here.

Alternative therapies

 
  Dr. Lewis Mehl-Madrona (Bill Wade, Post-Gazette)

Virginia O'Connor, 47, a breast cancer patient, for example, flew from her Long Island home in December to participate in one of Mehl-Madrona's sweat lodge ceremonies.

O'Connor was diagnosed with breast cancer more than three years ago and underwent a lumpectomy. After the tumor was removed, she refused additional therapy and the cancer came back with a vengeance, spreading from the breast to her bones, liver and lung.

According to science, the cancer is incurable.

But with a good sense of humor and a durable spirit, O'Connor calls herself "a poster girl for courage" and says she isn't afraid of death. She's a practicing Catholic, but believes she was an American Indian in a past life and is open to all forms of spirituality. When a friend offered to charter a plane from New York City to Pittsburgh for the sweat lodge ceremony, O'Connor jumped at the chance.

"I think I will be cured tonight," O'Connor said as she sat stringing pouches of tobacco into a prayer chain just before the ceremony. "I decided I should not be ill for the new millennium. Last century, I was ill. Next century, I shouldn't be."

From the outside, the lodge O'Connor visited in Gibsonia looks like a squat army dugout, a dome covered by a green tarp that stands about 4 feet above the ground at its peak. The structure is made of maple saplings that are placed at the 16 points of the compass and bent together like the spokes of an umbrella. More saplings are then tied around the edge of the structure so it can support the blankets and tarps that are piled on top for insulation.

Mehl-Madrona and friends built this lodge in March and have used it seven times.

A lodge provides a chance for strangers and friends to gather and pray for the health of someone who is ill. Participants sweat themselves silly inside the lodge, as water is thrown on the granite stones that have been heated in a fire for hours in advance of the ceremony. If the beneficiary of the lodge is in very poor health, he or she sits outside to be spared the heat - the people inside sweat on the patient's behalf. Others inside say that they, too, receive spiritual and physical benefits by participating.

Mehl-Madrona said that to American Indians, the sweat lodge symbolizes a return to the womb of mother earth from which all life begins.

"The placenta is there to doctor you and to take away the wastes and the toxins that you no longer need," he wrote in his memoir, quoting a friend. "You're going to sweat them out. The stone people get filled up with the energy of the sun when the wood is burned. Then they give that energy back to you. That's the medicine."

At the recent lodge, O'Connor and about 15 others met with Mehl-Madrona in a nearby house to sing songs and offer prayers. As they prayed silently, group members passed a smoldering bundle of sage in an abalone shell, blessing themselves with sweet-scented smoke. Prayers could address any purpose, but Mehl-Madrona cautioned against asking for distant abstractions - it would take a pretty fiery sweat lodge to bring about world peace, he said.

Mehl-Madrona handled the central prayers to the spirits. When he addressed each of the spirits of the seven directions - north, south, east, west, up, down and the center - he inserted a plug of tobacco into a sacred pipe. Tobacco is the most sacred plant, he said, because it absorbs prayers. When the pipe is smoked in the lodge, the prayers rise like smoke to the spirits.

Mehl-Madrona also prayed to the creator spirit called White Buffalo Woman.

"We know that it is just possible you could heal Virginia," he said. "We don't know what you will do or what you won't do, but we pray that she will be with us a year from now."

Trail of trouble

 
Gathering in Peter Shefler's home in Gibsonia, the group prepares for an American Indian sweat lodge by making prayer ties, sewing cloth pouches filled with tobacco which are hung inside the sweat lodge. At far right is breast-cancer patient Virginia O'Connor. (BillWade, Post-Gazette) 

There's no fee for the sweat lodge, but at the end of the ceremony, Mehl-Madrona asks participants to make a contribution to cover the cost of supplies. The collection can range anywhere from $50 to $750. If there is extra money from a lodge, he uses it to help patients pay for medicine.

"When I've done them, it's been for patients here who specifically wanted that and convinced me that that was a good idea," he said. "I go to Mass with some of my patients, too. To me it's similar. ... I have a feeling that [UPMC] would object a lot more to sweat lodges than they would to Mass, but I think that's racism."

Mehl-Madrona's words can be sharp, but his tone and manner are gentle - a style that matches his somewhat slight build. What's remarkable about him is not how he looks or speaks, but his candor in describing the troubles he has found at UPMC and throughout his career.

He lists his ethnicity as Cherokee-Lakota. Both his mother and father were half- American Indian, giving him "half-breed" status, he says.

When he was very young, he watched his great-grandmother, an American Indian healer in rural Kentucky, work with patients and observed that people could be cured through magical, miraculous events. He also learned that healers help patients by listening to them.

At 13, he gained a mentor in the sciences at the University of Cincinnati and threw himself into academics. He finished high school at age 15 and took medical and graduate school biochemistry courses at Indiana University as an undergraduate. At 18, he entered Stanford University Medical School.

At Stanford and during subsequent residency appointments, Mehl-Madrona found a medical system that he says didn't listen to patients and placed more value on money and physician prestige than good care.

During a residency at the University of Wisconsin, he said, he watched obstetricians act with indifference to their patients. Two doctors would routinely give their patients Caesarean sections at dawn so that the deliveries would not interrupt morning office hours, he said.

Mehl-Madrona agreed to leave Wisconsin after appearing on the "Today" show and "Good Morning America," touting a study showing that midwives performing births at home had outcomes comparable to or better than the results of obstetricians in hospitals. His superiors weren't impressed with the study.

He went back to Stanford to work in a university clinic and, again, clashed with his boss. Part of the problem was that he took students on field trips to interview patients who got better despite not following their doctors' orders. A colleague called the research project "pseudo-science" and Mehl-Madrona's contract was terminated early.

"Some of his colleagues thought that his approaches even to research were not very rigorous," recalled Dr. Bill Fowkes, a retired professor of family medicine at Stanford, who remembered the incident. "He's always been pushing the envelope and he's always been controversial."

It wasn't until the mid-1990s that he completed residency programs at the University of Vermont.

Dr. Wise Young, chairman of the department of neuroscience at Rutgers University, went to medical school with Mehl-Madrona and says the young student was brilliant.

He rubbed some the wrong way because of his outspoken support of home births and his practice of calling professors by their first names, but Young doesn't believe the clashes were what caused Mehl-Madrona to walk down so many different, incomplete paths throughout much of his career.

"Lewis could not decide what he wanted to do," Young said. "He was looking for a field of medicine that addressed the holistic aspect of people and he didn't find it. And this was sad in many ways. He would do something and abandon it, do something and abandon it."

"Yes there are quacks in this field ... but he's the wrong person to attack if one wants to attack quackery in alternative medicine," Young said.

Powers of belief

Mehl-Madrona's work with AIDS patients during the 1980s put him on an early path to controversy.

He was medical director of the Center for Recovery from Illness, a clinic which offered many of the same alternative treatments available at the Shadyside center, including acupuncture, Chinese herbs and nutritional therapies. But there was one option there that you won't find at Shadyside: prescriptions of the typhoid vaccine for AIDS patients.

The treatment echoed an approach to treating syphilis before the era of antibiotics - basically, if you could induce a fever you could kill the virus. And typhoid shots typically bring on a fever. While many patients responded positively initially, few had continuing success. Even so, Mehl-Madrona said, the significant finding was that the few patients who did well seemed to benefit not from the vaccine itself, but from their faith in the treatment.

"The ones who were doing well two years later were the ones who had the strongest beliefs in the treatment," Mehl-Madrona said in an interview. "To me, it shows there's this incredible untapped power of the mind that conventional medicine doesn't use."

Dr. Wallace Sampson, a retired oncologist from Stanford University and editor of the Scientific Review of Alternative Medicine, said of the typhoid vaccine example that the untapped powers of the mind might be useful in dealing with the common cold, but not in curing AIDS or cancer. Sampson's publication ran three articles in 1999 questioning Mehl-Madrona's credentials and practices.

E. Patrick Curry, of Squirrel Hill, the author of the three articles on Mehl-Madrona, has been similarly frustrated.

When Mehl-Madrona arrived at UPMC Shadyside, Curry, 55, a retired computer systems analyst, was concerned about a practice advocated by the center called therapeutic touch. The treatment, in which practitioners don't touch patients at all but assess their "energy fields" by moving hands just above a patient's skin, was criticized in a highly publicized article in the Journal of the American Medical Association in 1998.

Curry's concern with the Shadyside center grew with every page he turned in Mehl-Madrona's book. He was appalled by the stories of the sweat lodge as well as an account of how a patient with ovarian cancer was cured after a series of sessions with Mehl-Madrona. In one session reported in the book, the doctor massaged pressure points, moved energies and encouraged the patient to become aware of images rising from her pelvis. The result was she saw images of her brother molesting her and subsequent images of being beaten by her mother.

In summer 1998, Curry sent a letter to a department chairman at Shadyside complaining about Mehl-Madrona, but he wasn't satisfied with the response. So he got in touch with Sampson, wrote the articles that were published in 1999 and made his concerns known to other UPMC administrators.

"I'm very concerned that rational thinking not be undermined in our society," Curry said. "I think it's important that ... religion and science operate on separate planes."

If they don't, he added, people will be less and less able to distinguish between evidence-based medicine and charlatanism.

"Some doctors might give a rationale that these therapies would encourage the placebo effect, but I don't accept that," Curry said. "I think that you cannot justify selling placebo effects to the public. The procedures should have some kind of scientific rationale. They should have some kind of evidence behind them."

Missing spirit

But some patients seem less worried about placebos and prayer than a medical establishment that, at times, can seem lacking in spirit. Mehl-Madrona brings a personal touch and spiritual dimension to health care that those he has treated haven't seen in other doctors.

Eric Sutliff, 43, a financial consultant from Edgewood, met Mehl-Madrona during a weeklong session last year at the Shadyside center. Sutliff's family doctor told him he had high blood pressure and recommended he improve his diet and exercise more, but Sutliff thought the problem had a deeper cause.

Sutliff signed up for a "healing intensive" at Shadyside to learn about his options. Intensives last for a week, with patients meeting Mehl-Madrona and other practitioners at the center for a full five days.

Sutliff's experience seems to prove what many alternative medicine practitioners say distinguishes their care: They spend more time with patients. During the week, Sutliff met with Mehl-Madrona for three or four 90-minute sessions to talk about his health concerns. Then Mehl-Madrona visited him at his home one night during the week for an American Indian prayer and drumming ceremony.

At the end of the intensive, Sutliff decided to regularly visit practitioners who specialize in acupuncture, yoga and a Japanese form of massage.

"It becomes a personal quest to almost on a daily basis address the imbalance, to allow the body to heal itself," Sutliff said. "The science and the technology in the medical system as we know it today have done wonderful things to heal people and prolong life and to make better lives. I don't discount that. But on the other hand, so have these other [practices]. I think anybody who stands up and says this is right and this is wrong, that to me is an extreme position."

Sharon Gretz Lasky, 41, of Indiana Township, attended a healing intensive after surgery this summer to remove a cancerous tumor on her leg. Thinking the sessions would help her recovery, Lasky met with Mehl-Madrona and other practitioners to learn about hypnosis, relaxation and visualization techniques and biofeedback.

The results have been fabulous, she said. Mehl-Madrona helped her prepare for a subsequent exploratory operation, a procedure from which she recovered quickly, she believes, because of the alternative treatments. In addition to the weeklong experience, which cost about $2,600, she regularly sees Mehl-Madrona as well as an acupuncturist and a Shiatsu therapist for a form of Japanese massage.

"He's kind of like a conduit," Lasky said of Mehl-Madrona. "I think people could be threatened by him and I think that's sad because I don't see him out there making false promises. He didn't tell me I would never get cancer again. ... What he's offering people is hope and he's offering them active involvement in altering the course of their lives."

Both Lasky and Sutliff attended the sweat lodge in December to benefit O'Connor, the New York woman who flew to Pittsburgh for the 2 1/2 hour ceremony.

Saying she felt so refreshed by the lodge experience that she could walk all the way home to New York, O'Connor said that night she felt cured. Tests later this winter will help show if she experienced the sort of miracle Mehl-Madrona described in his book. Even if it doesn't happen, O'Connor said, she will remain happy about the lodge, where she prayed that the spirits help her accept whatever turn her illness takes.

Stepping aside

Mehl-Madrona stepped down as medical director of the Shadyside center last summer to make way for Dr. David Servan-Schreiber to take over administration there.

"Lewis is a bit like a consultant, at this point," said Servan-Schreiber, a psychiatrist who previously saw patients through the center. "He never really was interested in administration, he was much more interested in developing program ideas, setting a mood and tone and a way of practice. ... That's what he's great at."

Mehl-Madrona said he was happy to spend time doing research, seeing patients and teaching students rather than attending meetings. While he spends about 40 percent of his time at the center, he sees patients at a nearby family practice clinic and conducts psychiatric consultations with hospital patients.

After weeks of interviews with supporters and detractors, many of whom would not speak on the record, no one said Mehl-Madrona steered individual patients away from conventional treatments. Medical boards in the six states where he has licenses list no disciplinary actions or complaints against him.

Even so, it's unclear how much longer he'll be in Pittsburgh. UPMC officials are said to be considering removing him from his position as "program director" and taking him off the medical center's payroll. UPMC has not commented for the record.

In December, the health system established a task force led by Dr. Lauren Roth, senior vice president for medical services, and Dr. Richard Simmons, the health system's medical director, to investigate whether the services offered at the Shadyside center and other health system centers are backed by scientific evidence. The task force will inventory the programs being offered and make recommendations about what types of treatments UPMC should offer in the future. The group's work is expected to be completed before spring.



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