S02E03 – Understanding the Heart of Wellness with Dr Kavitha Chinnaiyan

Have we lost our soul to data? Professor of Cardiology Kavitha Chinnaiyan explores the art and science of deep human connection in medicine and how it contributes to wellness.

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Transcript

Speaker 1:

Welcome to Heart Based Medicine’s Heart of Healthcare podcast featuring Dr. Kavitha Chinnaiyan, Understanding the Heart of Wellness.

Jan:

Hey, everyone, welcome to this session of Heart of Healthcare live. Today this is a very beautiful possibility. We have a fantastic guest with us that I’m really proud to announce. It’s like meeting friends and I’d really like to introduce you to Kavitha Chinnaiyan, and she is a professor. She is a professor of cardiology and a professor of medicine. She is not only working as a cardiologist in a hospital, as we all know it with all the environment that we all know in a classic healthcare setting. But she is also the author of several books and I would like to mention here, The Heart of Wellness in particular. Today’s conversation to me is particularly precious because there are only very few people that I’m blessed to meet, who can bring together ciencia and conciencia, so science and consciousness. Those of you who have the luxury of already knowing Kavitha or having heard about Kavitha, you will already appreciate the depth of her sharing.

Jan:

We would like to explore today with you what it means to actually live in a world that provides healthcare in the allopathic classic training, as it is taught in universities, and what it means to align this with our purpose, and what it means to live and thrive in such a system so that we can show up as the best version of ourselves. So welcome Kavitha to this [inaudible 00:02:15].

Kavitha:

Thank you. Thank you so much, Jan. You are absolutely amazing, and it’s an honor for me to know you, and to be here with you.

Jan:

Thank you. So Kavitha, we’ve already talked about this many times in different and we’ve taken different angles. Today we’re looking at training and we wanted to explore what is it that it would take if we had the opportunity to change the way that we train medical students? Also, what would it take for us who have been to medical school quite some time ago and have been on the road for a while, but we’re still in a process of learning in many ways? So what might it take to change our training, whether as a student or as a senior physician? What would it take so that we are supported to bring consciousness into our practice?

Kavitha:

Yeah, that’s such a great question. I think, the problem here is of fissuring. It’s a splitting off of really why we come into medicine in the first place. Most of us who come into medicine and to become doctors or healthcare providers, it’s because we are moved by this consciousness, so to speak. We are moved to explore this very deep human connection in a very particular way. I mean, that is the purpose of all of us, no matter which field we choose. But in medicine, what happens is we come to it because we want to connect with other human beings at this very deep level. Which is through their illness, and through their wellness, and through the phases of their life that our patients go through.

Kavitha:

But then when we come into medical training, what happens is in Western medicine, we have really sold our soul, so to speak, to evidence-based medicine, where everything is about data. It is really about what works for this disease. It becomes really disease specific, which means it is body specific. When we are talking about you or me in medicine, we are essentially talking about either your disease, or your body parts, your organ systems, or particular systems within that. If we were to talk about your mind, it would be only in relation to how you are perceiving your illness, right? And that’s it, that’s where it ends, right? So this conflict we tend to have later as we start with our careers and go about our careers is that purpose for which we were drawn to medicine, it gets buried under the layers and layers of this drive to be very specific about treatments, and therapies, and things which trial has shown what, and we remain there. So we get really good at the science of medicine.

Kavitha:

We are even good at the art of medicine because we have to cultivate a bedside manner, we have to cultivate relationships. But the fissuring happens because fundamentally, we want something. It’s that deep spiritual connection with the other. I’m calling it spiritual, not from any religious standpoint or anything like that. It is this connection that what you are, is no different than what I am, at the most basic fundamental level, at the level of consciousness. You and I are the same. It is me talking to myself is me talking to you. But that remains unexplored.

Kavitha:

That is the thing that we come to it for, but that remains unexplored in the noise of everything else. Because in these countries, for instance, in the US you also practice under the fear of litigation, right? That if you don’t do things well, you can be sued. You don’t want to go there, right? So you bind yourself, and so that fundamental thing remains unexplored, remains buried and the dissatisfaction continues. That is, I think, in my opinion, a big reason for also physician burnout, because the juices drying up.

Jan:

That is beautiful. Yeah. It is unexplored within our profession. I mean, there are some domains in which this is actually really well explored. Yeah. There are traditions, there are healing traditions, there are religious traditions, there are spiritual traditions in different realms where this has been studied very closely. But the scientific process used is a different one. The process of exploration is not the one that meets the criteria of what we would call scientific method today in the Western world.

Kavitha:

Yes, absolutely.

Jan:

There’s a lot of value obviously to go down that scientific method as we have it in the Western world, as what is taught in medicine and medical schools. Yet, as you said, it’s limiting this and we haven’t explored this part from the science point of view. Yet everybody knows it, isn’t that the case? I mean, I don’t know your environment, whenever I talk to a colleague, everybody says, “I know what you’re talking about, but shh.” It’s like, we can’t really talk about this in public, right? So these things are talked about in small groups, but not openly, is that similar in your environment?

Kavitha:

Absolutely, because these things are soft. They’re not hard evidence-based things that can be measured objectively. The other thing that happens, when you talk about the application of this in medical care, for instance, right? The application of, I’ll just loosely term it as the mind, body therapies, right? Which could be consciousness based as in, why don’t we explore something deeper in you, right? The problem happens even when you look at trials, or studies that have looked at the application of yoga, or whatever it may be, meditation, or whatever. We are so deeply conditioned as scientists in the physician community, to look at these studies and say, “Okay, if you do that, what’s the benefit going to be on whatever, on your blood pressure, on your mortality, on your disease process?”

Kavitha:

So we are so used to looking at things objectively and in measurable ways. But you see, this consciousness that you’re talking about is not measurable, because it’s not a thing that can be measured. It is the subjective experience of life that changes with the cultivation of this. There is no measure for that. In fact, it may have absolutely no effect on your disease whatsoever, but something has changed in you, right? That subjectivity is something that, because we can’t lay a finger on it, it becomes dismissed. It doesn’t exist.

Jan:

Yeah.

Kavitha:

Yeah.

Jan:

Which is understandable if I’m a researcher, I’m always a little bit scared of big questions that I can’t really solve. They feel like daunting. It’s like, I can’t really get to that. So I’d rather let me have a question that I can dare to answer. Okay. Let me have a question that’s simple enough, or trial design that’s simple enough that I feel likes, okay maybe this tiny little question I can actually have clarity on. So this is understandable as a process with a really long-term vision. But I guess what I understand from you when I listened to you is that, that’s one way of traveling. We could actually say, why don’t we just have this image? In Switzerland there’s this huge mountain Gotthard. At some point they plan to have a tunnel through that huge round and very long tunnel.

Jan:

So one team was starting from Switzerland and one team was starting from the Italian side, if you like, okay. So the idea is, can they actually meet issues? Can we explore, can we widen the scientific process by saying yes, evidence-based science is fabulous. We’re coming from our work is based on the paradigm of brain and matter is the starting point, and is the seeding point, the source of action and speech. At the same time, we’ll have another team starting from the consciousness point of view saying, okay, based on the assumption that consciousness is, or the unifying field is what exists, and then matter emerges from that, we’re actually starting from this point of view. Then see where’s the overlap, where’s the meeting point?

Kavitha:

Yeah, exactly. When it comes to training, which is to go back to your original question, it is to present these possibilities, that’s the first step. That maybe there’s something more to this than meets the eye, and asking questions that there are no answers for, for instance, right? I remember when I was in high school, then we were studying embryology. I was really fascinated, I mean, in medicine and all of medicine, I feel there’s nothing more miraculous than embryology, right? If that doesn’t move you, then-

Jan:

What?

Kavitha:

… what, right? So I was really fascinated. This is what really started my whole quest is, how does this one cell, fertilized cell, undifferentiate itself, know to differentiate into all of these different organs? What is that driving course, right? You can say, well, DNA. Yeah, but how does the DNA know how do meet up the base pairs? How does that happen? Where is that intelligence? What is the source of that intelligence, right?

Kavitha:

So you keep going back asking these questions until you arrive at this place where I don’t know, I don’t know. That mysterious place, if we can go there, and have that be our inspiration. It will always be awe inspiring, right? That place of not knowing, because when you’re in the place of not knowing you can’t be cynical.

Jan:

So let me ask you, you’re a professor, you’re training residents, you’re training students. You’re part of the body that represents Western medicine and teaches that?

Kavitha:

Yes, and I also publish papers and trial [crosstalk 00:14:58].

Jan:

Exactly. That’s all part of this game.

Kavitha:

Yes.

Jan:

At the same time, I guess that in a way, because of your own, not just your own curiosity, your scientific mind, but also actually being ready to open your mind and heart to the degree that you’re allowing to experience a vastness or a consciousness that is beyond the deductive Cartesian world model. I guess this somehow sneaks into your student teaching. Are you willing to share some of this? So basically what do you see? What are ways or how do you see possibilities to inspire this curiosity that goes beyond what we call the scientific method, that actually is a little bit outside that frame?

Kavitha:

Yeah. Yeah. This happens in the day to day clinical teaching, for instance. If I’m seeing patients in clinic and that are residents and fellows seeing patients with me, then it is really that the way that you connect with that subject, and you connect with that patient, or you connect with the disease itself, the process, and you demonstrate an interest that goes beyond okay, what do we need to do for this? It’s like, why is this happening in the first place? I mean, what is this beyond the pathophysiology? Can we talk about that? What’s causing this? The more you demonstrate that curiosity and excitement, and we awe off it all.

Kavitha:

It’s like, how does one rogue cell become a cancer, right? I mean, that’s fascinating, right? How does that happen? So remaining in that awe is something that can’t be taught in so many words as it’s a stance that becomes absorbed when other people are working with you. Also it’s not that students, and residents, and fellows appreciate that because a lot of them are already conditioned to be cynical. So for some of them, it may be just what is she talking about? Let’s move on, right? Yeah. It can be that too.

Jan:

You mentioned the cynicism, the learned cynicism before.

Kavitha:

Yeah.

Jan:

So what happens there? So that’s really a key thing that comes into the way.

Kavitha:

Yeah.

Jan:

What happens there?

Kavitha:

It’s like you have lost the ability to wonder, that is cynicism. The wonder that medicine held for you, it somehow, somewhere changes into a little bit of familiarity, a little bit of contempt, a little bit of resentment, a little bit of, because it’s hard work. Then we have so many things that are not in our control, such as the standards that are set by insurance payers, hospital administrators. All of that contributes to this the cynicism, and not being appreciated, and this fear of litigation. All of this adds to this cynicism where that wonder that brought us to medicine again, gets suppressed because of all these very practical issues.

Jan:

So given that this curiosity or this wondering isn’t really, or may not necessarily be taught in medical school, or let’s say it’s not structurally taught, but it depends on whether you’re lucky to have a teacher that it’s depending on an individual to actually inspire this in students. Probably even more so during residency where there’s long hours and it’s a bit of a survival [crosstalk 00:19:34] of the training. Do you have an attending? Do you have a supervisor that really takes you into this exploration and maintain, kindles the flame, or doesn’t? Why is it left? Why do we, as a healthcare system, as a faculty at the university, why do we leave it to the individual? That’s the law, when I look at the various faculties that I looked at, or that I talked to, university faculties, this is the content, this is the syllabus, this is what students need to learn, this is what we check in the multiple choice test. Then the rest is, it may happen, or it may not. Why is it not given, given that every senior actually knows about the value, why is it not taught?

Kavitha:

Yeah. I think it’s much broader than medicine. This is what we were talking about earlier. So one thing that has been shown in many studies actually, is that physician implicit bias, for instance, is a real thing. It’s real, right? So whatever we have, whatever our outlook is, that has been shaped by our childhood, and by the society, and our peers, and our parents, and our upbringing is what we bring to medicine. Because by the time we come to medicine, that part of our developmental psychology, that is done. It takes a lot of conscious effort to continue to shape ourselves beyond the adolescent years right? So how we come to the training of medicine is going to determine how we are going to practice medicine. As whatever has the biases, the concepts and the things that we have within ourselves, our religious beliefs, our spiritual beliefs, whatever it is that has shaped us.

Kavitha:

It’s not that we can’t continue to change, of course we do throughout our lives. But that thing that has happened early in life remains really very strong. So if we were to talk about bringing in consciousness, for instance, into training or into the practice of medicine, that has to become the default of society, right? Because it is going to have to be how we raise our children. For that, if we have to raise our children in a certain way, we as parents have to, first of all, have some experience of that, right? So it’s more of, whatever happens on a societal level is reflected in the medical field. For instance, the racial bias, and gender bias, and all these things that happen in society are reflected in medicine, in how we provide care for our patients.

Jan:

Yeah. So is there a way for the healing profession, is there a way for healthcare professionals to actually take a stand here? Because we are in this very peculiar situation of living a life as an authentic human being and having to deal with everything that comes with it. Coming to terms with our own lives, and our own stories, and our own experiences on this planet. Then actually meeting professionally with other human beings who live their authentic lives. So we actually get to meet, but yet our role is to provide a space that is authentic enough so that they feel this is a trusted healing space. So is this, if you like, one-on-one healing encounter, could this be like a model or yeah, a case study, if you like? If we understand this relation really well, to what degree can we understand it better so that it actually serves as a role model for a societal shift?

Kavitha:

Yeah. That could happen, but again, the thing here is there has to be a willingness and a wanting on the part of the physician with regard to this kind of an outlook. As with everything, we have to want it, because the realization, for instance, that my deepest truth is not my story, it’s not my body, it’s not my mind, what I am is beyond all this. For this realization comes spontaneously to many, but more often than not, it’s not a spontaneous thing that happens. You have to want it, you have to seek it. So it is in the medical field too, if physicians are, for instance, take for instance, ambitious physician scientists, or they are very clear about what they want in life. They want to achieve this, they want to do this, they want to do it this way. They’re not interested in all of this, so you can’t push it on them, right? Because you have to want it.

Kavitha:

How can we do that? Right? We can’t make anyone want anything that they want. For me, coming from my interest in these ancient traditions is that, that is the gift of grace. To want that is really grace. It happens whenever it happens, and when it does, then that interaction, even in an encounter with a patient, for instance, and I have seen this so many times in my own medical practice, it’s the same patient I’ve seen for years who does not want to change, doesn’t want to do anything different. Then bam, one day something is different, they’re like, “Tell me what I need to do, I’ll do anything.”
Kavitha:
Then you know grace has descended, right? Then the communication, the way I connect with that person is entirely different, even though we’ve known each other for years, right? It’s an extraordinary connection because now we’re in the same place. I think here is where the humility comes in, that there are a lot of things that are beyond our control.

Jan:

Yeah. Yes. Yeah. Yeah, I guess everybody in healthcare, I think can really relate to this moment that you’re referring to when you suddenly feel there’s a therapeutic alliance that is beyond the role we play, that is much deeper than that. Then things start shifting at a different level of quality.

Kavitha:

Yes, absolutely.

Jan:

If this person, if this patient that you’re describing, met the scientist who might not have opened himself up for receiving the call that you described, there might still be a misfit.

Kavitha:

Yes, absolutely. Because the patient is at a different place, but we haven’t grown to that place, so it happens both ways, right?

Jan:

It almost sounds like as a healthcare professional, we need to make a decision here. A choice where we’re saying, “Okay, I’m willing to meet those who are interested in the currently available science. I’m willing to help those who are willing to accept the limitations of this process, and not everybody agrees that this is a limited process, and it goes as far as it goes.” Or am I willing to absorb what can be absorbed from this limited process? I’m ready to open myself to something unknown, to an unchartered territory, to insights that he may evolve at that very moment that you’ve just described, where I don’t know the answer, the I don’t know, and the curiosity that then comes in. So here’s somebody asking for help. Here’s somebody actually not knowing, and in this shared space of not knowing, we’ll actually see what emerges through this therapeutic alliance.

Kavitha:

Yes, absolutely. It so happens that and I’ve seen this a lot, is something happens to us around in our middle age. Because we come to this point and then suddenly realize life is limited, that our time is limited, that, okay, I’ve accomplished so much, but then have I really? Is there more to life? It is when that kind of questioning begins that big things happen, big shifts happen. Then we are okay with becoming of that tunnel you were talking about. We are okay with accepting both of that, and exploring it for ourselves, and saying, “Okay, this may be the case, but where am I, and what do I need to do?” Again, that’s the play of grace.

Jan:

So if somebody feels at the brink of that, so somebody has that hunch, somebody has that notion of I’m missing something, or I’ve lost something, but somehow I’m not actually expressing [inaudible 00:30:52] that I could?

Kavitha:

Usually what happens is you just go buy a Ferrari. Or-

Jan:

Yeah, usually.

Kavitha:

You go on a vacation.

Jan:

[crosstalk 00:31:03].

Kavitha:

You know? You go on vacation, or you start a new relationship, or you do something like that. Because we don’t know where to look. When that sense of dissatisfaction comes up, which is really the driving force for all seven plus billion of us. When that sense of dissatisfaction comes up, the question is, where do we look for it? Because we are always looking for satisfaction in things outside of us, whereas that’s the wrong place to look it should be within us. Because that’s the only place where we can find completion.

Jan:

Yes. So this journey, I would love to see as part of medical training to be offered. Just as much as I was offered by the histology classes to admire the miraculous expression of cells and tissues, and just as I was offered a physics equation explaining the flow, the resistance of flow through a tube that leads to the, “Ah okay, now I understand this breathing and obstructive and not, and restrictive. Okay, now I understand the cardiovascular. Oh, okay.” So these aha moments that we get through knowledge that is delivered. Now we’re talking about a different mechanism. Now we’re not talking about knowledge. Now it’s more experiential.

Kavitha:

Yes.

Jan:

So do you see that this is something that we could actually include in medical training or part of residency maybe at a later stage? Or could you see that?

Kavitha:

Yes. In fact I feel that. I have teenage daughters and I tell them, in college, if there are three things I would recommend you take, one is Quantum Physics. Everybody can benefit from really studying Quantum Physics, right? The other is Psychology, Developmental Psychology, and really study that. The third is the fundamentals of the [crosstalk 00:33:39] and the intro traditions, in fact, any tradition, right? If you look at the fundamental thing of any tradition, any spiritual tradition, any religious tradition, don’t go into the religious aspect of it, the institutionalized part of it, but look at the fundamental aspect of it. Then you will learn a lot more about yourself. I think, if we can teach this.

Kavitha:

Ayurveda is the the medical science that I’m also trained in. This is why I like Ayurveda so much because it gave me what modern medicine wasn’t giving. That is this holistic view of where we fit into the whole scheme of things. What does wellness really? What is health? From which broad standpoint can we look at health and disease? So Ayurveda starts with this fundamental thing, how you have come to be. How the universe has come to be, it starts as consciousness and matter comes from consciousness. So teaching those kinds of things, and a lot of medical schools are doing that actually. I give a talk every year at our medical school on the Fundamentals of Ayurveda. You should see these medical students, and their eyes just open wide and they light up, a lot of them. It’s like, what? This doesn’t even make sense. What do you mean we came from consciousness right? So I think that training really, at least gives you the possibility that there’s something more than maybe your limited world view.

Jan:

Yeah, and it could be, I mean, could it be taught as part of a scientific process? As you’re saying, this is a subject that may lend itself to some o-logy or o-sophy, if we actually do not want to go down that route. If we actually want to not end up in another mental framework around us. But could we keep it like a scientific hypothesis, if you like, for the next generation of students? Where we’re saying, okay, so here’s something for you to explore, and it’s not about whether the world started with some DNA by chance reassembling itself. Or whether there’s some God sitting on a cloud with a big white beard, whatever you’re coming from. Or there’s a whole host of gods doing some magic things. We don’t even need to go there, so just ask the question for scientific pursuit. This scientific pursuit could be following the scientific method as we know about it in Western philosophy of science. But it could also be an individual subjective exploration.

Kavitha:

Yeah, yeah, exactly. For that it needs to be taught with really concrete techniques and methods. You can’t just ask somebody, here go explore yourself. Nobody knows what that is, right? There has to be a methodology to it. There has to be various steps. You start with this, and then as depending on the individual proclivities, you do the next thing and you do the next thing. That is really how the spiritual traditions have it all designed. If that could be brought in with a very simple, practical way of putting things into practice of even how to explore yourself, I think that would go a long way.

Jan:

Wow. That’s amazing. That sounds almost like you would be ready to develop a little training course, or syllabus bringing consciousness and science together. Ciencia and conciencia together and see how can we actually make them meet in our profession. Not just as a spiritual exploration, but actually very concrete, very tangible, in the morning, getting up, getting ready for the day, preparing for the day, walking through the door, the main gate of the hospital and actually following our professional pursuit. Yeah.

Kavitha:

Exactly.

Jan:

Wow. Amazing. Okay. Should we do that? Yeah. I think we should do that. I think we should call for our colleagues. Let’s put out a call for our colleagues here. Whoever feels willing, whoever is willing and ready to join a group of physicians who feel that need and have explored this route, and would be willing to see what is it that it takes so that we can bring consciousness as a possibility into our healing practices, and see how we can explore this together and how we can build methods in integrating this in our daily life.

Kavitha:

Yeah.

Jan:

Beautiful.

Kavitha:

That sounds great.

Jan:

Two people on the faculty, [crosstalk 00:00:39:21].

Kavitha:

That’s hilarious.

Jan:

Thank you so much. If you’re a student or if you’re a resident, and you want to meet a teacher inspiring, and teaching awe and bring heart into medicine, here’s Professor Chinnaiyan for you. Thank you so much for taking the time, Kavitha.

Kavitha:

Thank you. Thank you so much for having me.

Jan:

Great pleasure. Thank you.

Speaker 1:

This has been a Heart Based Medicine production. Thanks for listening.