The paradigm-exploring brilliance of the “whole person health” focus National Center for Complementary and Integrative Health (NCCIH) director Helene Langevin, MD chose to kick off public comments on the agency’s 2021-2026 Strategic Plan sneaks up on you. In her virtual keynote, Langevin engages her audience with a fireside chat type conversational tone. She shares concepts under consideration since she left the directorship of the Harvard Osher Center for Integrative Medicine for her NIH post 17 months ago. The highly-regarded basic science researcher starts, indeed, with basics. She shares that she and her staff are re-examining what they mean by the key words like “complementary” and “health” in the agency’s name. One slowly realizes that Langevin is quietly opening what may be the most significant exploration that the $33-billion NIH should be engaging in the present era in which even an acute challenge like COVID-19 reminds us is fundamentally damaged by chronic disease.
On May 4, 2020, the Africa office of the World Health Organization (WHO) issued a statement on COVID-19 deeply at odds with policies in Europe and North America. Of the hundreds of millions of dollars with which governments and foundations are spending on research, virtually nothing is directed toward potential traditional, complementary and integrative contributions. Media coverage of the widespread interest in such approaches, when it occurs, focuses on extremes. The Wall Street Journal led with cow dung, garlic and prayer and Nature with “cow urine, bleach and cocaine” together with the broadly dismissive “pseudoscience” and “bunk”. Scores upon scores of in vitro and other trials showing antiviral activity of herbs are dismissed. In contradistinction, WHO’s statement models calmness and reason. The agency calls for research while warning about over-claims. Should WHO’s integrative, inclusive statement be actively endorsed by natural health and integrative organizations?
The surprising news last August that Tracy Gaudet, MD was leaving the Veterans Administration where she birthed the transformational Whole Health program was leavened on learning that Gaudet would partner with the world’s wealthiest woman, Alice Walton. Together they would form the Whole Health Institute with a goal of nothing less than to translate and build off the VA model in civilian health and medicine and spread it globally. Other than a brief announcement at kick-off, plans have not been public. Last week word arrived that the professional with the most significant experience in developing integrative strategies in civilian medical institutions, Lori Knutson, RN, BSN, HNB-BC, is joining Gaudet. Knutson will serve as the Institute’s senior director for health system redesign. I communicated with Gaudet and Knutson on this development. Gaudet shared additional insight into evolving plans that, like the rest of life, have been shifted by COVID-19.
The polarization in US medicine has never been so front and center as it is with COVID-19. Natural agents are off the table. Despite early clarity that the state of the host matters big time in susceptibility to the virus, natural strategies focusing on host susceptibility are routinely denigrated and dismissed. So it was remarkable that within the course of 24 hours in late April, two colleagues independently sent news of a formal medical center protocol associated with a medical school that includes multiple natural agents. These are inlaid with conventional measures into a series of stages that the institution’s medical staff is following. Who are these people and how did this come to be? I was able to reach the primary author of the institution’s Critical Care COVID-19 Protocol, a South Africa educated internist, Paul Marik, MD, FCCP, FCCM. Marik is a professor of medicine and chief of pulmonary and critical care medicine at Eastern Virginia Medical School (EVMS) who has previously stirred controversy for unorthodox approaches. The non-conventional reasoning that drove the COVID-19 protocol Marik calls “uncommon common sense.”