Serenity and Health: A Physician’s Evolution in Health Care

Welcome to the Living to 100 Club Podcast.

Here's our host, Dr. Joseph Casciani. Well, good day to everyone. I'm Joe Casciani, your host for the Living to 100 Club Podcast. Our conversations are all about aging well and doing what it takes mentally and physically to live longer and healthier. Our guests share insights and recommendations about successful aging, stories of perseverance, and inspiration about our future. In today's podcast, we talk with a retired physician who has developed a keen insight into the links between body, mind, and spirit. Dr. Donna Chako is the author of Pilgrimage: A Doctor's Healing Journey, a book focusing on her life experiences involving faith and health. We discuss her evolving views on healthcare within the context of her program Serenity and Health. We'll also explore how her work with immigrants and the homeless in Washington, DC influenced her thinking about body, mind, spirit suffering. This is an honest, heartfelt conversation about the many paths towards spiritual and personal fulfillment. Be sure not to miss this podcast. A little background first. Dr. Cheko, the author of award-winning Pilgrimage: A Doctor's Healing Journey, is a wife, mother, and grandmother. She practiced medicine for decades, first as a radiation oncologist and later as a family medicine doctor caring for the poor in Washington, D.C. Now Donna works in the ministry she founded, Serenity and Health. She speaks, offers programs, and blogs at serenityandhealth.com to encourage health of body, mind, and spirit based on a foundation of faith. Anna, welcome to our program today.

Thank you for having me, Joe. I'm really thrilled to be here.

Great, great. You're very welcome. You're very welcome. So I always like to open by asking our guests to tell us a little bit about the journey that brought you where you are today.

Okay. Well, I became a physician actually in 1974, a long time ago, and practiced radiation oncology and, uh, later made a career change that you mentioned into family medicine. And during that time I had a family and raised children, and I learned a lot going through a very difficult, long marriage. And that really created a pivot point in my life. And I started changing, and my view of healthcare even started changing. It, it had a lot to do with trying to achieve more emotional health and especially with my spiritual journey. So that as this all percolated and I matured through the decades, After I retired, then, when I was 63, I started this ministry that you mentioned. And I call it a ministry loosely. I love to walk with folks and encourage this whole journey of health from a broader perspective. So that's kind of what I'm about. But I chose to do it through a focus on my faith and through my church because that seemed like a good place to start for my target. So I speak broadly about all these things, but that's how I got to where I am now.

Mm-hmm. Sure. How do you spend your time now, Donna?

Well, I'm remarried, so I live with my husband. So we have all that kind of activity that goes on maintaining a household outside of Washington, DC in Maryland, near University of Maryland. It's a beautiful area.

Sure.

And you know, I do all the usual things that a retired person would do with reading. And I started playing the piano and I have friends, but I spent a lot of time working on writing. I mean, I took 6 and a half years to write my book. Mm-hmm. And it was a just a tremendous journey. Journey of personal growth for myself in so many ways I can't even begin to tell you.

Wow.

A whole nother topic, right? So I write on my blog and I have some programs at my church. We have an ongoing women's group and, you know, talk to anybody that wants to talk to me about these kinds of issues because I'm just passionate about it.

Good. Yeah. Well, we'll get to your book a little later on. I'd like to talk more about that, but let me ask you, I'm curious, you shifted from oncology to family medicine. Was there any particular reason that drove that decision?

Yeah, there were several reasons. It was really a huge decision because I was 51 when I started my residency in family medicine, and any doctors out there who are listening know that that's kind of a grueling thing to do at age 51. But by that time, my first husband had died and the children were just, uh, starting— they were out of the home, all in college, and I felt this sort of freedom. And I loved radiation oncology, especially in the era of medicine that I practiced in. You know, they— we didn't have to deal too much back then with referrals and managed care and things like that. Uh, just so meaningful to be that close to people going through hard times in their lives. But the downside was, you know, it's very narrow specialty and I often didn't feel like a real doctor in terms of understanding normal kind of health problems, you know? And because of my own journey, my spiritual journey, my emotional growth, all those things, I really felt more calling to give back, to do some volunteer work or something, right? But you're not very portable as a radiation oncologist to do volunteer work or go on mission trips or anything. So all this was sort of on my mind. And there were practical reasons too. There were changes in my community, in my hospital, and I wasn't so sure of the future of the particular center where I was working. So I just put that all together and made this gigantic leap to do that. And I don't regret it, but it was very hard. It was, uh, very humbling to go from a competent, experienced specialist to a kind of slow generalist. I mean, I did fine, but it was challenging.

Sure. Yeah. Difficult transition. Now, were you working as a family medicine practitioner when you were doing the work with homeless and immigrants.

Yes, so what happened was, right, my radiation oncology and family practice training, that all took place in Florida. I then relocated to Washington, D.C. when I completed my training, and that was an education in and of itself to live in our nation's capital. And I actually was affiliated and lived with an organization called Christ House. They have a medical recovery facility for homeless people So that means people who don't have a home but might be discharged from the hospital or might be found on the street and not really sick enough to go to a hospital but no place to go for their frozen foot, for example, you know, or whatever awful problem they might have. And I had a rapid introduction to mental illness like I'd never seen, and drug addiction, and just hopelessness, and really injustice, poverty, lack— uh, it's just, it was incredible to see that because I'd never been exposed to that before. And I simultaneously worked at a community health center. And, you know, the listeners may not know, but community health centers are like the safety network, uh, partially federal-funded, not exactly public, but public-private clinics across the nation. And so there was one in Washington— there's several in Washington, D.C.— and I worked there, and that was mainly immigrants. So then I saw that side of difficulties, really, that the new immigrants faced. And all of this was my introduction really to, other than my own experience, to how people's health can just be devastated by hopelessness and stress and poverty. I mean, it's really very challenging to be healthy under those circumstances.

Sure, the feelings of helplessness, feeling so discouraged, that's gonna spill over onto one's health and obviously their well-being. So when you and I spoke, you said that this work, and it sounds like just a lot of personal connections to that work, It opened you up to the full breadth of body, mind, and spirit suffering. I mean, how do you understand this and how did that kind of inform your work as a physician?

It was really, really dramatic to see the health problems I just mentioned and the deprivation, and then to see the turnarounds and the healing that came about when those individuals started to have hope. When they started to feel respected. And I saw that in both facilities. In Christ House, it was a residential facility, and most of the guests were men. And they would come in there with, you know, a problem list of 12 things, and among them being homelessness, and maybe not having had a warm, soft, clean bed for who knows how long. But to all of a sudden have a shower and a your own bed and somebody caring for you with love and respect, which is what they got even before they got one medicine or one referral to a specialist, so they already started healing. It was so obvious that was a powerful influence on them. And I saw similar kind of effect in the clinic repeatedly. I'll just describe a lady which kind of just encapsulates what could happen.

Sure.

Envision a youngish woman, Maria, new immigrant, hardly any English, living in the corner of her auntie's. And here she is. So she starts coming to the clinic because she doesn't feel good. She can't sleep and she's anxious and she has headaches and her menstrual periods are all messed up. And each time she comes, it's very difficult. She doesn't feel good at all. You know, you have a few minutes with patients like this, you do your best. We had tremendously valuable social work/counselors to help these folks. And we also, uh, Washington, DC has a charter school for English as second language to help new immigrants and also a vocational aspect of it. So Maria, unbeknownst to me, got started at that and she stopped coming to the clinic for like 6 months. And all of a sudden she turns up and every one of her ailments is cured and she actually looks like a different person. You know, she started to learn English, she's made some friends, she has some hope that she will have a future. It's very powerful to see that repeatedly.

Yeah, without having to struggle with basic survival, we can get a chance to look at turning that mood around, going hopelessness to hopeful, hopelessness to hopeful. And I can see your impact on some of these individuals, um, kind of spotted that right away. I, I, I can understand that cuz you know, we talk about Maslow's way back years ago. He, you know, would talk about when we're worried about our basic survival needs, we can't begin to think about, you know, higher levels of concern and awareness and, uh, self-respect. So. That shows time and again that a little respect, that, as you say, kind of lifting that person's sense of dignity, can take a lot of the pressure, pressure off. Yeah.

You know, it's interesting though, Joe, in a family medicine clinic, someone with a number of health problems— I'm not talking about someone with poverty and barely existing, I'm just talking about somebody who maybe unfortunately become overbe— overweight, and then their arthritis got worse, and then they got diabetes and next thing they had blood pressure problems, and by now they're on 4 or 5 medicines, and then the medicines have side effects. And that creates a kind of hopelessness too that makes people feel stuck. I mean, I was stuck in a bad marriage, a difficult marriage. We all get stuck in different things, and whichever is our problem of choice, right, or of however it works, I think there are things we can do to pull ourselves out. And that's, that's kind of one of the reasons I do what I do.

Sure, sure. So in terms of lifestyle choices and habits, how much of this— I mean, aside from all the external circumstances that some of these individuals were facing— how much choice does someone like that have about lifestyle and, you know, improving health habits?

Well, it's probably worthwhile for this conversation separating out those people in extreme difficult circumstances because they definitely have extra challenges trying to eat right and exercise. But even in those very difficult circumstances, they can definitely do some things that will make a difference. They cannot smoke. Not easy to quit, but the number one thing that would make a huge change. And we saw people who had very challenging lives start to understand the importance of doing their best they can with their diet and their exercise. But if you take a more middle-class population, they still have to deal with all these same things. It's still very difficult to make these changes if you, if you're in one of these stuck positions and you feel lousy and, you know, it's just, it's challenging. So I always like to emphasize that, yes, it's challenging, but it's also extraordinarily beneficial because, you know, just like I do, the statistics are just really shocking that something like 70% of all chronic illness, all that misery, can be improved or cured with lifestyle change. I mean, that just to me is shocking. So that means we have this opportunity. Yes, it's difficult, but it's doable, you know, to make huge change in how we live out our life.

Yeah, I agree. I agree totally, Donna, because we are learning so much about how much control we have over these chronic conditions. And 70%, I mean, that's huge, right? I mean, that's huge if we look at diabetes and obesity and congestive heart failure and emphysema and breathing conditions. And so much of that, not only— I, I think it's of course preventable based on lifestyle factors, but once does have its onset, there are so many things that we can do to mitigate, reduce some of that. Sure.

Right, right. I mean, I look at myself as an example of one small kind of problem that can happen. One of my difficulties in my life is that I was too busy and I really didn't take care of relationships or my own self or my health or spend time. I was from an era that didn't really emphasize going out and jogging or whatever and sports. I didn't do it. And then when I hit middle age, I started to have musculoskeletal ailments. I mean, to the point that when I retired, I was really having major troubles walking. And this was my moment of truth in terms of my own having to follow what I believe, right? I realized I had to do something or I was going to have some major, major problems. And anybody who has arthritis knows it's not so easy. It comes, it goes. You think one area is better. And I finally dragged myself to the swimming pool, which was the worst thing that I would ever want to do because I just thought, oh my gosh, cold water, hair, all that. Who's gonna, you know, you have to, but it was really my turning point. It got me moving better and I ended up with a hip replacement and that's been some time ago. But since then, because of this scare, now I understand how critical it is that for me and my body, I have to exercise. Now I wish I had 10, 20 years earlier. 30 years earlier. I might have saved myself all that grief. But, and everybody has their own story. I mean, maybe you have a story, I don't know, but it just is a perfect example. I know that if I, if I wasn't really persisting now, I would have a lot of problems because intermittently I still do. And then I, you know, modify the program, change the exercise, stop something, start something else. So anyway.

Yeah, but it stays, remains a big part of your Well-being, right. And continuing.

Yes. And it has to be now. I, that's what it took me to believe, you know, to understand. Yeah.

Yeah. Now I know that you and I spoke and I've looked at your website. I know that your faith is a big part of your, your world, your personal world, professional world. How did that, how did your faith influence your work as a physician? Do you, do you think it came into the picture?

Yes, I do. I mean, I was raised. As a Christian, I didn't pay too much attention to the practice of my faith for many years, but I know that for the early part of my career, I was trained to try and be kind and patient and virtuous in the care of my patients. So more general influence. And then as my own spiritual journey continued, it got more specific. You know, like there's a very beautiful prayer by Saint Francis of Assisi, "Make me an instrument of your peace," and One part of it is in, where there is sickness, let there be healing. And, you know, I felt that like, oh my goodness, what a, what a privilege I have to be an instrument of healing. So I wanted to— I tried to do that with grace, thinking of it like that. But what really changed, how my faith really affected my practice of medicine, was this broader understanding of the health of body, mind, and spirit, and how they're all connected. And I saw in my own faith journey how different prayer practices, for example, that I began so that I would be closer to God. Sure, I didn't do them as health practices, correct?

But yeah, well, of course it's all interconnected and it's hard to tease out one element from the others. I can see that. How about, um, let me ask you, where does a person's mindset come into the picture in terms of positive or negative mindset? How does that influence their their health and their decisions about staying healthy.

Yeah, well, I guess the, the clear example I already mentioned about a negative mindset without hope, you're not going to be healthy because who cares, why bother, you know? And plus all the physiological effects of the stress that would come from living like that. And the other direction, some sort of a positive or growth mindset would make you able and willing to be open to people, to beliefs, to taking the steps necessary to care for your body and health and other people. So yeah, I think it makes a big difference.

Yeah, I've been hearing a lot of research lately about our attitudes about aging, and people who are more favorably disposed or have a favorable attitude toward getting older actually cope better with stress and medical conditions and perform better on cognitive tests compared with those who have very negative attitudes about getting older and kind of dread it and, you know, don't wanna look at it. And these folks tend to less well managing stress and difficult events. So that mindset does really pay such an important role in how we fare in life. Yeah. Well, tell us about your book, Pilgrimage: A Doctor's Healing Journey. You said it took What, 5 years? And how did you—

longer, longer.

How did you, how did you choose that title and what's the message in the book?

Okay. Well, after I retired and got through my medical issues, I decided I would write a self-help book. So for 2, 3 years, I worked on a self-help book with more just medical advice, guidance, and stuff about health habits. But it just, as I was moving on my journey and seeing the psychotherapist and trying to understand a lot about my past and my difficult marriage, I just realized that I, I needed to write a more personal book and tell my story and explain how I got from where I was to what I am now trying to preach about, I guess, about health of body, mind, and spirit. So I share a lot of real yucky stuff about my earlier life and my marriage, and I, I learned so much about myself in the process, and then try to weave into the book what I learned that I think other people can do and follow and maybe learn from, or maybe be inspired, or maybe conclude that, oh my goodness, I want to do this now. I don't want to wait 20 years and suffer like she did. Solve the problem earlier. So anyways.

Yeah. So sharing your, your personal journey, your personal experiences, as well as the insights that you gained from those years, and then trying to impart that to others. And maybe if there's some, some opportunity to pick up some new ideas or new strategies or tips. That's, that's what you hope the readers will gain from it. Sure.

Exactly. To inspire and encourage and give them very specific ideas about simple steps they might take to move ahead on their own path to serenity and health.

Sure. Sure. So you have a website, Serenity and Health. .com. Can you tell us about it? You have several programs offered there and different resources. Tell us about the website.

I started the website as an adjunct to go with a group that I started at my church because I was being very repetitive in making paper copies of things, and I thought I need to have a central repository. So that's how it got started, and it includes my monthly blog where I talk about various topics dealing with mind, body, or spirit health. It includes a link to a program I have called Your Path, which is an online self-directed program to, to try and give you some ideas on directions you can follow yourself, each reader, each listener, to what best suits them. If they are especially in some stuck place and just need to get out of there, there's a signup place to get my blog By the way, I should say everything I do is volunteer. There's no charge or there's no ads, there's no nothing. So, you know, I love it if people would sign up for my blog. They might learn something. It might help me be in a position to reach more readers. If you sign up for my blog, I'll send you my guide on 3 keys to a holy, happy, and healthy life. And yeah, I'd love to hear from anybody who has any questions about anything. My email, I think you have it for the show notes and it's on my website. Website you can reach me?

Sure. So, uh, your website is serenityandhealth.com. Yes. And people can reach you, um, by email at— that was it, Donna? It's—

no, the email is dc@serenityandhealth.com.

Okay, DC initials at serenityandhealth.com.

Mm-hmm. Mm-hmm. And the book is available on Amazon and Barnes Noble. Pilgrimage: A Doctor's Healing Journey.

Okay. I'll be sure to put that in the program notes so people can click on the links and go to your website. I took some time perusing it. I really like the kind of the feel, the welcoming kind of inviting quality of the site. It's got some really nice, nice touches to it.

Yeah. Thank you. Thank you, Joe. That's coming from you. I really appreciate that. I mean, you're deep into this field of helping seniors. I think both of us, we just don't want people to suffer, you know, just for us to see a change. We have to, each of us, we have to make a change. It's not so easy, but just start little.

That's right. You start little.

Start little.

And, um, I always like to say, we know so much today that our earlier generations did not know, parents, grandparents, and how can we use this information? Mm-hmm. How can we share with others? How can we help people learn about lifestyle changes and attitude and thinking patterns and all of that? Because it makes a difference. Years ago, the attitude was, Reggie, I'm going to turn 70, 80, 90, not much I can do. Well, those days are over, right? I mean, we know there's so much more that's available now and so many more doors we can open.

So, right. Absolutely.

Yeah. Yeah. So I'll be sure to put that on the, uh, on the program notes when it gets out. So let me ask you, Donna, what's one thing you'd like our listeners to take away from our conversation today?

I mean, the biggest thing is for each listener to— you hear me— you have tremendous power over your health and how you feel and how you will feel in the next 5 or 10 or 20 years. You have way more control over that than I did in my 15-minute visits with you in the clinic. And it just involves taking the steps and little by little thinking about, are you eating fruits and vegetables? Are you getting any exercise? If you smoke, you have to stop. Those 3 things just there would move you way ahead on the game. And all the other things that I know you talk about, Joe, in your work and that are in my book and on my website. And I mean, most of us kind of know the things we're supposed to do. It's just that we don't sometimes take the time and effort to put into it. Yeah.

Behavior change is hard. We know that. And as you said, those tiny steps, little turtle steps and Eventually we start to see some, some reward, some benefit from that new behavior I'm taking on, from that change from what I used to do a year ago. And when we get that momentum, we also build a confidence in that, what I call self-efficacy. We do have that influence over what goes on. I like what you just said about, you know, what we can do and how much control we have over our lives. This is so much more profound than the 15 minutes somebody has with their MD. Consultation. So, mm-hmm. So that's a nice way to put it. Well, good. It looks like we're about out of time for today, Donna. Before we wrap up, I just wanna remind my listeners to visit my website, livingto100.club, sign up for my email list, and download a free copy of my 9 Tips to Make Living Longer Enjoyable. While you're on the website, be sure to peruse my library of blogs and podcasts Thanks so much. We've been talking today with Dr. Donna Chako. Again, Donna, um, your website is serenityandhealth.com, and for people that might want to contact you, your email is dc@serenityandhealth.com. Yes, great.

Yes.

Okay, well, thanks so much for being a part of my program. I really enjoyed the contribution you're making to this important conversation.

Well, I'm happy to participate in your good work, Joe. Thank you for having me.

You're sure welcome. And thanks to all of our listeners for tuning in. Hope to see you again next time.

Hi everyone, this is Meredith from the Senior Fitness with Meredith podcast where I discuss all things for seniors, from fitness, your health and wellness journeys, how to be all over strong and beyond. I also have my mini podcast called Motivation with Meredith. It's a great quick motivational pick-me-up for your days. Join me, listen now, search for Senior Fitness with Meredith on your favorite podcast platform.