Use Difficult Challenges as an Opportunity, with Dr. Patrick Hanaway

It's until there's something that requires change that people become motivated to be able to make the change.

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I'm Dr. Ed Levitan. Welcome to the Five Journeys podcast, where.

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Hello, and welcome to another episode of the Five Journeys podcast, Live like youe Matter. I'm Dr. Wendy Trubo. My host today is Dr. Edward Levitin, and our guest today is Dr. Patrick Hanaway. Dr. Hanaway is a family physician who works with his wife, Dr. Lisa Lichting, in the clinical practice at Family to Family, your home for whole health care in Wetherville, North Carolina. Patrick's work history includes being Chief Medical Officer at Genova Diagnostics, chief Medical Education Officer for Institute for Functional Medicine, and the founding medical Director of the Cleveland Clinic center for Functional Medicine. Holy moly Wicket's Matt. His current work integrates research, education, and patient care, focusing on nutrition, the microbiome, and evaluating the value of functional medicine. In addition, he's been initiated as a traditional healer, guiding pilgrimage, ceremony, and healing. Welcome, Patrick.

Thank you, Wendy. Thank you, Ed. I'm really glad to be a part of this conversation today.

And Patrick, you are truly, truly, truly one of my favorite people on this earth. And it's just a privilege to have you on. And yeah, true privilege.

Thanks. Thanks so much.

Patrick, can I ask you something rather personal?

Anything.

I know that you were diagnosed with cancer a number of years ago.

3.

As you approached the diagnosis and then got the diagnosis and then went for your healing, how did you really specifically meld. I always say to people when you have a mechanical issue, functional medicine might not be your source. Right. If you have. If you have a baby in that needs to come out, it's not a functional medicine approach. It's simply a mechanical behavior. So if you had a tumor that needed surgery, but you also approached it, how did you approach it? What happened? Well.

There are many layers to the story, so I'll try to be succinct. It is not lost on me that we had two Native American elders, Dakota and Anishinaabe, teacher at her home. When I felt a mass on my left neck, you know, and it was hard and it was. And it didn't hurt, and I thought, this is not a good thing. We had a gathering of about 100 people. And I'm like, I can't talk about this. It's. I don't want to make it be about myself. But it happened while they were there. So I went and got it biopsied and literally there wasn't a whole lot of time because, you know, we as doctors can pull the doctor card with friends and colleagues and, you know, so the next day I had a diagnosis that. That the lymph node was squamous cell carcinoma. And the next morning I had a PET scan that showed that I had a mass on my larynx. And then it was like, where do we go? And that was the day before Thanksgiving. And during that time, I was fasting for pilgrimage to go to sacred sites in Mexico. And the doctor said, like, we' not going to do anything before that anyways. Why don't you go down and do that? And so I did. And that was part of the journey. But in it, there was an awareness of I need to do whatever I can to be able to live my. Continue to live my life. And that was something that my eldest son at the time, so he would have been 27 or just turning 27, you know, said, look, I'll help you if you. If you really want to live, but if you're looking at this of like, you know, well, I might live, I might die, and I'm accepting, then he says, then I'm not going to help you because you don't actually care about living. And it was kind of a kick in the pants that I needed from him in a way that said, okay, I'm going to do this. So I studied and looked at what we could and talked to, you know, had the opportunity to talk to major thought leaders. And it's like, oh, you know, and because it was a stage four cancer, I sometimes say, like, it had to be right in my face. You know, that is like, you know, this is not. I didn't, you know, in terms of that diagnosis, I didn't have hpv, which is the common thread. I wasn't a heavy smoker, heavy drinker. So I kind of fit the 3% category of a relatively uncommon cancer. And within that 3% category, it doesn't tend to do as well. So the idea of a 50% survival at five years was considerably less for my diagnosis. I'm like, okay, I'm going to do. I'm going to do the radiation and I'm going to do the chemotherapy. They don't do surgery for that anymore because it disrupts the anatomy Too much. But I'm going to do acupuncture to help my overall health and well being. And I had done shamanic healing while I was in Mexico with my teacher. And I, you know, really focused on nutrition aggressively with a ketogenic diet and fasting before chemo and using, doing craniosacral therapy and doing frequency specific microcurrent. So a lot of different things. But I, you know, even within that, you know, and I had a feeding tube, you know, we, my wife had to figure out how to make Lisa and my niece how to make, you know, keto. Keto tube feeds. They don't, there's no such thing, you know, so. And even within that, it was incredibly difficult to be able to go through. And there were times where I felt like I don't know if I want to keep living because it's really hard. And it was the relationships and the connection with other people and, you know, and asking for help, not my usual way of doing things and finding out that there was much more help and support than I could have ever imagined from many different realms.

So.

You know, it's integrating and synthesizing and within that there's 100 things I didn't do. And there are people who said, well, you should do this or you're stupid or you should, you shouldn't do this because you're killing yourself and you're wrong. You know, I'm like, really? I didn't even ask your opinion. You're a doctor friend of mine and you're telling me what I should do, but you're not talking to me. It was an interesting dance, but, you know, I had radiation daily for seven weeks, what's called 70 gray of radiation to my left neck, which is the equivalent of about 70,000 chest x rays and 56 gray to my right neck. And, you know, I still have some pain in the neck from the fibrosis because radiation therapy is kind of the gift that keeps giving. But, you know, when I look at, you know, the alternative, I'm pretty pleased I'm accepting of that and continuing to work with it. So that's a, that's about as succinct as I could be. But there's many other emotional layers to that. And, you know, I want to just. When I've talked about this, I've, I've often used Mary Oliver's the Journey. And I'm just going to say that real quickly here, if I may.

Please.

You know, one day you finally knew what you had to do and began though the voices around you kept shouting their bad advice, though the whole house began to tremble and you, you felt the old tug at your ankles. Mend my life. Mend my life. Mend my life. Each voice cried. But you knew what you had to do. You didn't stop, though the wind pried with its stiff fingers at the very foundation. Though their melancholy was terrible, it was already late enough and a wild night, and the road full of fallen branches and stones. But little by little, as you left their voices behind, the stars began to burn through the sheets of clouds. And there was a new voice which you slowly recognized as your own. It kept you company as you strode deeper and deeper into the world, determined to do the only thing you could do, determined to save the only life you could save. So that's the journey, and I think it's the journey for all of us in finding out how to do that. And we as caregivers want to understand how we also need to give care to ourselves in the process of this journey. And. And I recognized this is sort of a hard thing to say, but I'll. I'll say it. I recognized that a lot of my caregiving had to do with that was how I could feel good about myself and that instead. And then that was actually a selfish motive to doing what I was doing. And it's like, oh, no, like, take care of yourself. Give yourself what you need so that as you are. Then offer care to others. It's from that place, that of. Of a pure. Offer a gift, if you will, and allow that. And that's a continued edge of learning for me.

Yeah, I think that's true for most of us in this field anyways, that love. It is. We do it. We say it's altruistic, but we do it because. Makes us feel good, which is not a bad place to be.

It's mutually beneficial. Right. It benefits people and it's benefiting because I'll say for myself, I'm here to make a profound difference in the lives of others, in their experience of life, their vitality, their relationships to themselves and others. And so that practice that we do allows me to make that difference, and then it allows people to receive that. I mean, I think it's mutually beneficial. And the danger lies in being arrogant about it. Like, oh, look what I did. It's not about that.

Right. Exactly.

I'm assuming that the listeners are wondering, like, I'm wondering, where are you now? What happened with. Because you referenced stage four cancer. What's happening right this minute?

I've Had PET scans each year for the last three years. There's been no evidence of disease since. Three months out from my chemotherapy, which ended right about this time of year, three years ago, or my first PET scan. And I've had a fault. The most recent one was in February of this year, which again showed no evidence of disease. You know, I look at my various nutritional markers and inflammatory markers and I'm doing, doing well. And you know, I feel really, really fortunate and blessed. The ENT doc says, you know, at five years it's considered a cure. So we'll see. But you know, I will always have that, that aspect of cancer. To me, cancer is about transformation. It's about, it's about. There's something in my life that was growing out of control and I got a, I got a reasonable handle on what that was. In addition to the cancer. The cancer was sort of the physical manifestation of it. But, you know, my life has changed, my priorities have changed and my, my attitude towards myself and others has changed. I'm sorry it took that to learn, but you know, I feel like I'm a better human being and a more, more compassionate as a healer.

So. So you bring up a point that I always struggle with, which is cancer, heart disease, heart attacks, things of that nature are usually a wake up call and for some of us are necessary to wake us up for whatever reason. My question is always, how do you get a person before that? How do you help people wake up? Everybody's gonna make. Have their own journey. How do you help people wake up so that they don't have to experience that? Some people will.

Sometimes people need it like that. It's only bad enough when that they can't intervene until it's what I call bad enough. It's bad enough, all hands on deck. But until it's bad enough, don't bug me, right?

And that's why I said, even like if they said a stage two laryngeal cancer, I'd be like, I got this.

You know, it got your attention at stage four.

Totally, totally in a big way. And you know, when I was in, in med school, I was involved with the prevent the first prevention meetings at the cdc. I ended up doing a little internship in the division of nutrition there. And I, I was very, very interested in the same thing that you speak of in terms of, of clinical prevention and how do we help people. But what I've observed as a clin, as Wendy just alluded to, it's until there's something that requires change that the people Become motivated to be able to make the change. One of the beautiful things to me of functional medicine and the approach is like, it's the same for helping that Olympic athlete to optimize their performance as it is for that person in the ICU to be able to make the shifts necessary to move back towards, towards wellness. The same concepts, not the same tools, but the same concepts are applied. But even with that high level athlete, like they're doing something where they're already motivated, they're not where they want to be. And so they've got that built in. And I don't think that we can intrinsically give that to people. I think that I used to feel that it's more important to, if I just educate them enough that they'll get it and they'll make the shift. But where I am now is more about deeply listening to where the person is at to find out what those levers of motivation are for them and be able to, to move in that way. So it's about deeply listening to where people are at. Because all of us yearn to be able, in some way to be able to bring our best self, our authentic selves forward.

Yeah.

Yeah, that, that definitely struck a nerve in terms of as a caregiver, I always want to fix people. And a lot of people don't want to be fixed or want to be intellectually want to be fixed, but want to do everything that they do and just feel better. It doesn't always coincide.

I always love when I do my first workup on people, I say I'm doing a dual track. It's hard to get in to see us, we're full. People wait a while. By the time they came, they were motivated for some problem that they want to fix. But I always say we're also looking at what are the things that are going to put you at risk for cardiometabolic disease, cancer, degenerative disease, because those are, those are reversible now. And if you're interested, that's a game we can play. Because on my watch I don't want you to get those things. You know that my goal is that that not happen on my watch. So we can play that or we can just deal with like you got a stomachache and gas. Just depends what game you want to play. I think a lot of people want to play the game if they recognize, oh, I have, I have a say in this.

How are you spending your days these days in terms of, are you seeing patients, are you doing leading ceremonies? How. What's Kind of your milieu.

A day in the life.

Day in the life. It's more like a week in the life. But, you know, so I, because I. Things each day is really quite different from the rest. So for example, to, you know, yesterday I did some personal healing work in the morning and then worked on our business practice in the afternoon, saw a couple patients and focused on that. Then in the evening time, I spent time with my wife. This morning I've been preparing. We have a gathering of 15 traditional healers who are coming here for training and working for a couple days and then having a gathering of about 100 people with a teacher this weekend and then doing some traditional healing work at the beginning for a couple days next week. So I do new patients, new clients. It's all traditional healing work. Current, current clients. It's, it's, it's functional medicine and other aspects. So I've got patients with, you know, cancer and long Covid and autoimmune disease and, you know, different kinds of things. And so I continue to see them as part of the practice. But really that's, I could say winding down, frankly, the, the burnout of, of prior authorizations and pharmacies and insurance companies is something that, you know, it's not why I went to medical school. So, so I. And then I do some consulting working in the area specifically around the gut microbiome. I continue to do that both on the diagnostic and therapeutic side of things, of how do we bring balance. And, you know, that, that continues to be both a knowledge base, but something that I feel is like a great representation of, you know, the macro and micro, how we are inside and how we are outside in terms of, of diversity and expression.

Do you have any perspective when somebody, when a patient is looking for a physician or a functional medicine physician, what should they look for? How would they identify somebody? Was it really.

Yes. Oh, see, it's really kind of creepy. Patrick. We've been married almost 19 years and sometimes I'm like, wait, I was going to say that.

So I think that there's, there's a couple different levels of the question. One is around practitioners and finding someone that you are able to resonate with that is not arrogant. I would not recommend someone go to a know it all doctor because if the doctor knows it all, then they can't actually learn from you. They can't, they can't find something new. They don't have the level of curiosity and empathy and wonder that is going to help them to really connect with you as a person. You know, so find someone who's got training and who's open and curious if they, they have the answer. They have a, you know, like this is the answer. Like it's on my website and this is the answer and these are the stuff. Just do this program and you'll be 100 exactly. You know, they, we want someone who will be able to connect to you as an individual. And the thing is too is, is finding someone who's actually been practicing at least a couple years because, you know, I, I find that two to three years of full time practicing functional medicine is the minimum that you need to begin to understand it. And so even as I'm training new people, it's like, no, it's going to take a couple of years of doing it every day and then kind of like a light bulb or a switch is flipped and, and people get it and it's, it's beautiful to see it and watch it unfold. So, you know, those are the kinds of things. But I think more of where I'd like to talk about it is about the individual. Not about, you know, connecting to the doctor, but you know, in terms of the individual. And that is that, you know, we, we have these opportunities in our lives to be able to really slow down and listen and connect to the world. Too much of our lives are on the news and on what's happening in the world and getting stirred up and stressed. And I think that the decreased vagal tone from the increased fight or flight response from the, all the various things, whether they're social media or computer news or the various tribes that people are identifying with, is actually preventing us from slowing down and connecting to ourselves, to each other and to the natural world. And that's really where the opportunity for healing is the greatest. And that, you know, reminding your listeners of, of that aspect and that in, you know, mentioned the idea of diversity before diversity in the gut and diversity in the gut microbiome, but it's also diversity in, in who we connect with and how we move in the world of being able to hear and allow many different kinds of, of voices and perspectives in our lives and creating an opportunity for dialogue. So the culture of genius, if you will, is predicated upon diversity of views and opinions, a dialogue of those having conversations and then having the discernment to be able to take those ideas and move forward. That is the way in which we have the opportunity to be able to, to grow. And for me, you know, having this holistic view that is allowing for many different kinds of perspectives to Be included is something that helps to, that helps to ground that it's like I am not right and I am losing some of my righteousness in being able to really be curious about where people are at and listen to their stories and connect to their lives and care about them as human beings.

So are there specific. Besides curiosity, which is I think probably the most important thing, are there any practices that you do or you recommend from turning off the phone for four hours to whatever it is, is there anything that. But you would say that just to be practical, that that allows you to be the person you were, you have been and that you continuing to be.

Well, there's a lot of different kinds of, you know, I have a daily practice that, that helps me to be able to ground. I have a practice of focusing on gratitude at the end of the day that helps me to remember. A simple practice that I ask patients to do is to say, take your cell phone, turn it off, all the way off, power it down, you know, and go and walk in nature for 15 minutes alone, not with someone, not talking to someone, just being in nature. You know, 15 minutes is, is plenty of time and you know, if you can do more, that's great. But you're not doing it to get your steps in. I mean, you're doing it just to be able to listen.

Do you find people going to withdrawal?

Not, not for 15 minutes. But there's a lot of resistance to even doing it in the first place. And you know, I, it's the, you know, well, what if I get lost? I have to have my phone on. Like, okay, well if you want to carry your phone and, but you make a commitment that you're not going to answer, you're not going to talk on it, you're not going to text while you do that and I encourage you even don't even pull it out to take a picture of something that's going on. Just take a picture with your eye and remember it, you know, remember how beautiful that was. So that's the simplest kind of thing. Another simple thing I'll say is like, you know, sit with a candle for 10 minutes, just light a candle and just sit with it. You know, if you can't go outside, that's another simple way to be to able, able to do it. These things are non denominational, you know, the connection. There are many different spiritual traditions that you can deepen into and I'm, I think it's important if, if interested to find one that resonates with you and find a teacher that that you connect with and, and deepen in that. I'm not a big fan of the smorgasbord, kind of a little bit of everything, you know, like, but they take a practice and deepen in it. So those are some, some initial thoughts, but it really comes down to, you know, being able to open your heart.

Can I just say, that was like, like your illness was terrible. And for us, the worst part was the lack of connection, you know, like that, you know, of course, when that happens, you have to. All hands on deck, pull it in, narrow the focus. But it was like a hole, like, where's Patrick?

And.

And that was. It was really so impactful that you weren't there. And I didn't mean to totally take us off, but I just had to acknowledge that. And so it's so nice to see you sort of back, you know, back new and improved Patrick. So as we wrap up this episode, I'm sure people are thinking, okay, well, he's cool. I want to find him, follow him, listen to him more. How can people find out more about you?

So there's two ways. One is through our practice, familytofamily.org and there's things that they can learn about the traditional healing work. There's some videos and some podcasts of different, different aspects, you know, some of which we've talked about today. And then we're developing right now it's just as a landing page, but it's called your healing roots. Your healingroots.com. and that is where Lisa and I are wanting to be able to move more deeply into doing retreats and education with people. We sit on a beautiful 38 acres with a river running through it and have places for retreats to occur. And we, you know, so we're beginning the developmental processes of, of being able to do that. So those are the, the two, the two best ways. And people tell me they see lots of things of me on YouTube as well. So there's the. There's the usual suspects.

Got it. Thanks for being here, Patrick. And you're listening to another episode of the Five Journeys podcast, Live like youe Matter. Thanks for listening. Inspire and empower someone else by leaving.

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