I Am Biped.

Inspired in equal parts by laziness, a fondness for offbeat experimentation, and personal growth, I have been walking to work for the past two months. It's not a very long commute by any standard, a pinch less than a mile, although the 8% road grade is relatively indisputable and I can't quite decide if it is in the wrong direction. As things stand now, I have a sprightly downhill jaunt in the mornings, and an uphill slog at the end of the day. And since it's so short, I've been walking home for lunch as well. Sometimes I insist that the directionality, or at least temporality, of the slope be changed, but at other times it seems perfectly fine. I suppose with regard to the kerfuffle that is local geography, the gods in fact do know their business, and I should leave well enough alone. I started foot commuting by fiat one morning, when bike #1 had a flat tire and Bike #2 was on the repair stand for cable replacement. (Of course, I also have bikes #3 and #4, but we really needn't delve too deeply into my transportational quirkiness here). I have a difficult time justifying using an automobile for such a short distance, unless I'm coupling it with other errands. To me, such sloth smacks of an immorality commensurate with unfiltered Chesterfields,  pool halls and Hudepohl beer.  It also hasn't been that long since I finished reading The Old Ways, a book about walking the ancient paths of the U.K., which seeded my mind with the desire to see what a walker sees and experience the world from a walker's perspective. So I slapped on my office clothes and perambulated my way to work.

Let me note at the outset that I am not unfamiliar with walking, having been an avid hiker and backpacker for most of my life. However, I've never really integrated walking into my daily life to any great degree. So while the physical act was familiar and comfortable, the psychology of walking to places to which I once would only have cycled  proved to be entirely novel.

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If you search the term "walking" on DuckDuckGo (that's a search engine like Google only without the massive invasion of privacy), the top ten results are dominated by walking as a health measure. Fitness walking, walking your stress away, walking your weight away, walking your heart to health...those are all well-accounted for and seem to be at the top of most pedestrian's minds. Less sought after is information on commuter walking, or utility walking. or walking #justforthehellofit. I suppose as a doctor focused on wellness and prevention, I should be happy about people's interest in being healthy. And it is true that programmed health measures are necessary to help people recover from chronic illness. However, these days, I am much more interested in the integration of exercise into our activities of daily living, as it makes the exercise more effective. I mean, when was the last time you saw someone stay on the treadmill for an extra 10 minutes just for the fun of it? But if you're walking home from work or the store, you might extend your walk that much just to enjoy a beautiful sunset.

Which brings me to perhaps the best reason for putting walking into your life: It fundamentally changes the way you see your world. Call it the time dilation effect. When you walk on a daily basis, your entire perception of time becomes altered. This is very strange, and could be very uncomfortable, for people brought up in car culture. When you go places by foot, you have to account for the time it takes to get there, something we rarely factor in when we travel by car. "Oh, it's only a 10-minute trip," we say. Two or three 10-minute trips later, and all of a sudden a half-hour is gone and you're rushing to pick the kid up from baseball practice on time and you *still* haven't finished all of your planned chores.

Walking forces you to reformat that process. You are impelled to add travel time to your calculations, as it no longer appears negligible. It isn't negligible. It's now 20 minutes to here, 35 to there. So you plan ahead, leave enough time to get there. And then the magic happens. All of a sudden, you're not in a rush. You check your watch once during the trip, yeah, you'll get there on time. The rest of the time, you are focusing on the journey itself -- the heat, the cold, the sun, the wind, the temperature. Instead of being literally bound and locked into a tiny, plastic, unchanging room with windows, you are engulfed by the endlessly changing panorama that is our world. Rather than rushing through your environment far faster than your senses can process it, you are savouring your surroundings. You are shockingly in touch with your environment in a very intimate, comfortable way, especially on routes you frequently walk. I've identified two medicinal herbs growing in the wild on my way to work that I'm going to harvest for making remedies. In a car, or on a bike, I never would have even known they are there. And the smells -- oh, my, does anybody remember what a summer night smells like? Not just when you're on vacation, but every night. And how the smells of the day and evening change throughout the year as plants bloom and die, and streams rise and fall.

The richness of sensory stimulation that occurs when you're walking makes the average automobile seem like a deprivation tank by comparison. Actually, let's be clear about it: An automobile is a roving sensory deprivation device. No wonder we are so eager to fill our cars with technological auditory and visual stimulants. Every time we get into an automobile, we are starving your senses, and we are replacing the sights, sounds and scents of our richer natural environment with the equivalent of sensory junk food.

Speaking of sound, what most pedestrians and cyclists also learn is that automobiles are extraordinarily loud. Road traffic is regularly measured at 80 dB; hearing damage commences at 90 dB. The intermittent traffic along my pedestrian commute highlights the extreme noise of the average automobile. Within seconds, birdsong and peepers are snuffed out by the roar of a passing car, or three. When you are subjected to those extremes frequently, you begin to realize also how damaging it is, not just physiologically, but psychologically, and it is reflected in our culture.

Even within an automobile, the noise level is typically around 70 dB. And what is the logical result of isolating ourselves from our  environment and then filling it to the brim with artificial sights and sounds? If you can't hear your environment speaking to you, then it becomes unimportant. We have replaced the dialogue between ourselves and the world around us with a constant monologue in the echo chamber of humanity. All other voices have been drowned out to the point where most of us do not know how to listen to them even if we could hear them.

No wonder Mother Nature is screaming. We are unable to hear anything less.

So as we hear and see better when we are walking, so are we able to express ourselves more richly. Road rage is, in part, a result of being effectively gagged when we are in our automobiles. We communicate with others only through our brake lights, turn signals, headlights and horns. These are poor tools, effective only at communicating the coarsest of concepts. We can express only our direction of travel and various levels of concern, from a warning (a short beep-beep) to full-on anger (HONK!). Hand gestures, even friendly ones, are often lost to window glare, and you can forget about eye contact. Even if you are able to achieve it, the significance is almost null. Every cyclist and pedestrian can relate more than one incident of making eye contact with a driver before crossing an intersection, then having the driver almost plow into them because they had no idea that the other person was there. Inside a car, eye contact is as meaningless as a friend's description of a blind date.

Communications on foot is a different story entirely, and this was perhaps the first thing that I noticed as I began my bipedal commute. In a hurry, I thrust my body forward and step purposefully; when at ease, when enjoying my trip, I saunter. Between those extremes are shades of mood and attitude. I swagger, I hesitate, I plod through weariness and I walk with pride and strength, each step resounding through the earth. My gate changes with my mood, and with my entire body I can communicate my emotions to the world about me. And, yes, I have even danced from time to time. I had forgotten just how expressive the simple act of walking can be, and it is a joyful relief to be able to communicate so richly and so honestly with the world. Even on a bicycle, my thoughts could not be expressed so clearly as they can when on my feet.

Sometimes I think we have a world turned upside down on its head, where safety is in a speeding machine that kills 30,000 people per year, and danger is being on your own two feet.

It is truly a shame that walking should be such a forgotten activity. To the world at large, walking any distance for purpose rather than pleasure, has been delegated to the realm of the poor and the chastised. Why would anyone walk instead of drive, unless they couldn't afford a car or had their license confiscated for driving once too often after one too many? I'm sure that has been the assumption of more than one person who has driven by me over the past couple of months. I have even been stopped by the police, on the presumption that someone on foot must be engaged in some nefarious activity -- or at least have a couple of priors.

It was late, and dark, and I was slogging my way home. I saw the squad car pass and suddenly whip around in front of me, spotlight full on and blinding me. I heard a car door open and shut. A silhouette approached me.

"Good evening," the officer said. "Where are you going?"

"Home," I said.

"Where's that?"

"The top of the hill," I said.

He blinked.

"Where are you coming from?"

"Work," I said.

"Where's that?"

"Bottom of the hill," I said.

He looked at me. I looked at him. I smiled. He didn't.

"You have some ID?" he asked. I handed him my driver's license.

After fruitlessly checking my record on the computer, he returned from the cruiser and returned my license.

"Be careful," he said.

"I'll be ok," I said. "Just going to the top of the hill."

He shook his head and left.

As encounters with police tend to go, this wasn't unpleasant. But it did shake me loose from my personal point of view and realize how odd, and perhaps how dangerous, what I have been doing on a daily basis must seem.

I truly wish it wasn't that way. Sometimes I think we have a world turned upside down on its head, where safety is in a speeding machine that kills 30,000 people per year, and danger is being on your own two feet. Where comfort is defined by your insulation from your environment rather than your enjoyment of it, where noise is silence and the faster you go the more you have to rush.

Walking has its health benefits, and perhaps as a doctor, I should have written about that. How frequent walks strengthen your heart, clear your arteries, improve your digestion. All true. But the more important benefits of walking cannot be measured by cholesterol values or blood pressure. Walking is exercise for your body, but rest for your psyche. It brings you in touch with the Earth and lets your mind soar with the birds. Being bipedal is one of the most complex tasks we undertake as human beings, and when we cease to walk, we begin to lose our humanity.

Reflections from the shallow end of the pool of knowledge.

All creatures, simple to complex, have a limited level of understanding about this world. It is those limitations which make their life bearable, given the manifestation of their form. A dog cannot conceptualize much beyond his immediate environs; the hand of his master caressing his head, the full bowl of food, the warmth of the hearth upon which he lies. To have knowledge beyond that, of the atrocities which exist beyond his ken, would make his life one long terror. A dog is not equipped to cope with such knowings.

Conversely, this same limitation of understanding is a blessing to the dog afflicted by a cruel owner. To know of a better life, to be able to see and understand it and to know it exists, while daily experiencing the inhuman treatment of a heartless master --- that understanding, too, would make the poor mastiff's life even more of an unendurable hell. His ignorance protects him from even greater pain.

Man is no exception to this rule. The limitations of our insight befit our admittedly extraordinary ability to manipulate the world around us. From stone, sand and water, we create objects to extend our knowledge and presence to realms once unimaginable. Nonetheless, our understanding of the universe remains constrained by fetters we cannot see. They are so hidden that, like the dog, we don't even know that they are there.

To attempt to step over these boundaries is to dance toe-to-toe with madness. Those that can expand their horizons and absorb the chaos and heartbreak of fuller understanding yet retain their humanity are few and far between.

But from time to time, it does happen. And what then?

They return to us with their greater knowledge, and we immediately re-encumber them with the handcuffs of our own sad vision. We give them a name — Christ, Buddha, Moses — and anneal their message of dangerous freedom into a form which, by making it comprehensible, strips it of its meaning. The next thing you know, we are baptising, circumcising or prostrating in the pursuit of a reflection of the moon on a pool of water.

Knowledge becomes dogma, perception becomes ritual and teaching becomes liturgy, because we find no way to fit the larger picture into our smaller box.

However, if we discard the playthings of the ignorant worldlings that we are and look at the messages that these teachers have brought back, there are, as others have pointed out, universal truths that stand what we believe to be true on its head.

• Less is more.
• There is no I, only we.
• Belief is the fundamental act of our existence.

These spiritual truths are no less valuable from the perspective of health. How often have I suggested to a patient that they are partaking too much of a good thing, whether that thing is pizza or pantothenic acid? How many hours have I spent explaining that the very microbes that live inside of us are not only critical for our digestive health, but also our immune health and our mental health, and that without our microbial friends or each other, we would die? How often has a patient improved solely because they have confidence in the doctor treating them?

We truly create our health, and the health of the world around us, by our thoughts and our actions. Chronic diseases in particular are susceptible to the metaphysical, and it is here that the future of chronic disease treatment lies.

We have such good tools to create vibrant, healthy selves. But using them means dropping our attachments, and facing the veil of our unknowns without fear or desire. Though the path has been trod, it is a hard path to follow. And you don't have to win to succeed.

Just take a step. And breathe.

The secret of my success: Three principles of disease.

When it comes to understanding health and disease, there are three fundamental precepts which must be acknowledged. These principles fly against much of what passes for common wisdom in medicine, but understanding and utilizing these principles have been the secret to my ability to find solutions for my patients where others have failed.

The first tenet is that a disease cannot exist in isolation. The way we structure our language about disease has always bothered me, because it reflects the outdated  view that a disease is a thing, an entity that we must combat and control. When we are ill, we say that we "have" the disease; "I have a cold," or "I have arthritis," as if our ills were something that we pick up and plop into the shopping bag of self.

Nothing, of course, could be further from the truth. Diseases are not isolated entities, they are ongoing processes in which we play a part. Even with infectious diseases, illness cannot exist separate from our participation in the process. How can a fever exist without a body to become hyperthermic? Where is a headache without the head? Where is the bruise without the swelling? How can a cancer exist without the  cells to grow into a tumor?

There is no I, only We.

As I keep telling my patients (and anyone else who will listen), there is no "I", there is only "we". As I type this, millions of commensural bacteria are helping me to digest my last meal, eliminating the detritus on my skin, and challenging not-so-friendly bacteria that want to get into my lungs. Without them I would be dead. Extending the sphere of my existence outward, the air filling my lungs and the food filling my stomach are all part of my health environment, and exert profound influences for good and ill.

What it comes down to is that any disease is a dance between ourselves and our external and internal environment. For better or for worse, we are full participants in our disorders. Unfortunately, the culture and custom of medicine leads us to distance ourselves from our illnesses, thereby putting many of our tools for healing out of reach as well.

The second tenet is that, disease, as well as health, is not static. The fluctuation from healthy to ill, and back to healthy again, even within the limited range of a chronic illness, is a constantly changing process. But again, our language reflects a fundamental disconnect with this particular nature of illness. Labels that allegedly describe a disease, such as arthritis, or irritable bowel syndrome, attempt to tag and bag something which exists only as a process. Arthritis isn't a thing; it is the gradual erosion of joint surfaces as the body fails to create new joint material to replace what is worn away. Irritable bowel syndrome isn't a bucket full of symptom post-it notes, today presenting as diarrhea and fatigue, tomorrow as constipation and depression. IBS is the process of opportunistic bacteria overtaking the intestinal milieu, altering the environment to better suit their needs.

Again, by misrepresenting diseases as static entities rather than ongoing processes, we lose the ability to alter them. You can only change a "thing" by cutting away at it, or attaching things to it, or by removing it; a process, however, has multiple points of entry where  changes can be introduced, any one of which that can result in an altered process with an entirely new outcome.

A disease is only a disease because we make it so.

The third tenet is the most important, and perhaps the most difficult to grasp, because to understand it we have to step outside of our cultural predispositions. The essential fact is that any disease is primarily a social construct. That is, we have decided to connect disparate data points together, each point representing a symptom, or lab value, or observation, and give this conglomeration a name, not unlike the ancients would look at the night sky and create pictures from points of light connected only in the imagination of the astronomer. These constructs are created at the convenience of the tools we have on hand; in the case of a disease, it reflects the tools which we have to address it, whether that tool is a drug of unknown mechanism in the case of the modern MD, or the pantheon of gods and their consorts, in the case of the ancient astronomer. Were it not for the story of Orion, that constellation would not exist; similarly, were it not for the existence of the microscope, there would be no such thing as a Staph infection. Our tools of observation and correlation are what make diseases possible.

Which is why different cultures, with different analytical systems, have different diseases. The Western diagnosis of clinical depression does not exist in Chinese medicine. Multiple Eastern diagnoses partially overlap the clinical entity we call "depression," but none are an identical (or even close) match.

The same culture will also alter diseases with the progress of time. What we now call fibromyalgia has a long and storied history going back over 100 years. But back then it had a different name, and different aspects of it were emphasized according to the prevailing views of biology at the time. What you have today is certainly not your grandfather's fibromyalgia.

Interestingly, I think that this is one of the reasons that the chiropractic profession proved to be such a threat that the AMA has spent over 100 years and millions of dollars trying to quash it. For the first time in the history of Western medicine, the chiropractic paradigm of illness focused on the key intersystemic command and control system of the body -- the nervous system. To do this, early chiropractic researchers developed a new language and a new allegory to explain an individual's health status. This was during the time when medical doctors were still bloodletting their patients and dosing them with arsenic in the race to rid the body of "vile humors," and such an entirely different way of thinking posed an intolerable threat. It had to be stopped.

The man with the empty fire.

Politics aside, consider for a minute how applying these fundamental precepts of disease can dramatically alter our approach to health problems.

Let's take, for example, a possibly fictional patient sitting in my exam room. He has come to me with a history of uncontrollable high blood pressure. He has, per his MD's instructions, dropped excess weight and engaged in a regular exercise plan. For the most part, he is eating what the medical profession calls a "heart healthy" diet -- lots of vegetables and grains, and avoiding "unhealthy" fats and cholesterol-containing foods, like eggs.

Despite his efforts, his blood pressure remains high, and is only precariously controlled by an unhealthy brew of anti-hypertensive medications, providing a dose of fatigue and flat-lined libido on the side. This patient is not a happy man.

The process of figuring out what is wrong begins with a recombination of the data. For the most part, I am not availed of any secret information that wasn't also available to the physicians preceding me. But perhaps I look at it in different ways.

For example, I've noted over time that the majority of people with high blood pressure have a very distinctive feel to their pulse. So why is it that the patient in front of me presents with uncontrollable high blood pressure, yet his pulse lacks that unique signature? My further examination, while not necessarily uncovering anything new, will occur in the context of trying to answer that question. And slowly, the dots will connect in a constellation that hasn't been seen before. I note a ruddiness to his complexion. He complains of fatigue, yet speaks in a loud, emphatic voice and exercises regularly. He is a large man, and despite his controlled diet, demonstrates a rotund abdomen. He is firm, with a layer of cutaneous fat overlying muscle. In my midwest childhood, we called people like that "milk fed." Everything about this man speaks of paradox.

So what's going on here? Let's ignore the diagnosis that the man walked in with, and think about the person himself. The most obvious thing about this man is that he is on fire. He is active, engaged, refusing to sit still, and refusing to accept his condition. Yet underneath that, there is...not much. An empty stomach. Fatigue.

What else in the world is like this? My mind is immediately drawn to the image of a cup of alcohol burning. The flame is hot, but not long lasting, and the flame is difficult to see. Unlike a wood fire, long lasting, even tempered, creating coals and ashes as it burns, this fire is empty underneath. And that -- an "empty fire" -- is what describes the man in front of me.

So what would cause that sort of blaze in a human? Well, an empty fire depends upon ready fuel that is easily combusted and leaves nothing behind. Which is exactly the sort of fuel that this man has been using. His "heart healthy" diet is dependent on grains -- in other words, easy-to-access carbohydrates, which are burning and leaving nothing of value behind.

So I tell my patient that we are going to modify his diet. For him, a paleo diet makes more sense, with its slow-burning fats. We discuss the particulars of his plan, and send him off with instructions to monitor his blood pressure daily. And, sure enough, a month later, his blood pressure is out of the danger zone and stabilizing at a healthy level. He owned his involvement in his disease process, and danced with it, eventually leading it off the dance floor altogether.

Do not mistake this approach to finding solutions for an intuitive one, because it is actually highly analytical. As I go through my day, I am constantly reminded of the words of scientist/philosopher Alfred Korzybski.

"The map," Korzybski said, "is not the territory." And when it comes to human health, it is important to have a variety of maps on hand; where one shows impassible mountains, another might show a lowland path.

25 Things You Didn't Know a Chiropractor Could Do: #1

In my 15 years of practice, there is a comment that I have heard all-to-frequently from my patients. It is not meant unkindly, nor as a slight, but evidences surprise at my hitherto unbeknownst powers, as if I had just unbuttoned my shirt and unveiled a Superman logo on my chest. This remark is often uttered as I say something that I think is relatively innocuous, like, "Yeah, we should probably do an EKG, just to be sure."

The patient will look at me, with eyebrows raised, and say, "I didn't know you could do that!"

The problem, it seems, is that the majority of the public have been trained to see chiropractors as one-trick ponies. Good for spinal adjustments, but little else.

This distorted image stems largely from the disinformation campaign mounted against the chiropractic profession by the AMA. 100 years of lies takes a while to untangle, especially when the bigotry is backed by a few billion pharmaceutical dollars.

And it is complicated somewhat by state laws, which vary widely. In some states, chiropractic physicians can inject substances and perform minor surgery. In others, they are not allowed to treat anything except the spine.

Throw into the mix the fact that most insurance companies will not reimburse a chiropractic physician for many of these procedures, and you get a large number of chiropractic doctors who will simply will not do them, simply to survive financially. It is difficult to justify spending several thousand dollars on an EKG machine if you'll never get reimbursed for its use.

But the fact of the matter is, chiropractors are trained in how to perform and read EKGs, as well as a number of other things which might surprise you as much as it has my patients.

Which is all a very long-winded way of introducing a new feature here at DocAltMed.

Every other Friday for the next year, I will post yet another example of the many ways your chiropractic doctor can serve you that you may not have heard of. And this week, we'll start with the basics, beginning with:

Your Annual Physical Exam

This, to me, is the real shocker. That people would not realize that they can use their chiropractic physician to do get their physical exam. My physical examination is every bit as complete as that you would receive in a medical doctor's office. Actually, I would argue that it is more complete, because my exams are not only looking for signs of pathology or disease; I am also illuminating areas of nutritional or physiological imbalance. It is those latter factors which are the true harbingers of health problems.

Yes, I listen to the heart and lungs, look into your eyes and ears, and peer intently at your mouth. As you might have guessed by now, we do an EKG, and I order the same blood tests that any other doctor would order.

But when I or another chiropractic physician performs your physical exam, you get two distinct advantages. The first I've already mentioned -- we are trained, as MDs are not, to spot dysfunctions before they become pathologies. The second is that when we do find a problem, you are far less likely to end up on a prescription drug.

In fact, studies have shown that patients who use their chiropractic doctor as their primary care physician end up in better health over the long term. They have fewer hospital days, they need fewer drugs to be healthy, and for older people they maintain physically active later in life.

So when it is time for your next annual physical, think hard about what you want -- better health, more active life -- and who is more likely to be able to give that to you.

Cosmo Unveils The Secret Behind Good Health. Maybe.

That fount of modern female wisdom, Cosmopolitan magazine, inadvertently highlighted the fundamental problem with modern healthcare in its recent online article, Hairstyles Men Love. Next to this picture of an undeniably-photogenic Anna Faris:

The article notes that "From an evolutionary perspective, guys subconsciously like hair that looks clean and healthy, like Anna Faris's blond locks. "Hair that's in top condition shows that you have a balanced diet and good health — signs of an ideal mate," says biological anthropologist Helen Fisher PhD."

So far, so good. Sociobiology, or the description of human behavior from a evolutionary perspective, has come a long way since its introduction 40-odd years ago, and is now a widely accepted (if oft-misused) theory. It is quite probable that in matters as fundamental as procreation, we are hard-wired to respond in certain ways just as much as the female Western Tanager will always go for the guy with the big red top.

But then Cosmo blows the lid off of the secret behind looking healthy:

"Work a silicone-based straightening serum through damp hair before blow-drying," Cosmo advises. "Clip locks in 4-6 sections depending on how thick your hair is. Then tackle one at a time with a paddle brush and a blow-dryer equipped with a nozzle pointed straight down. Finish with a light shine spray."

Ok, let me see if I've got this right. The secret to attracting guys, Cosmo says, is to develop that healthy glow, which presumably indicates a fecund future of healthy, bouncing babies to carry the genetic line forward. And the secret to attaining that health is a silicon-based straightening serum?!?

Not a word about the things that I associate with good health, like, maybe, good nutrition, exercise, sanitation -- all that stuff that actually does give a person that healthy glow, instead of simply imitating it.

In the same way, mainstream medicine mistakes appearing healthy for looking healthy. Instead of looking at the person, they look at the numbers:

Cholesterol low?                   Check.

Thyroid hormone normal?     Check.

BMI "normal"?                      Check

All well and good. But the fact of matter is, manipulation of the numbers does very little to change a person's health. You can have a normal body mass index and still be highly prone to cancer and heart disease. You can have normal thyroid hormone levels, yet still have a thyroid that is dysfunctional. And don't even get me going on cholesterol. Cholesterol levels are no indicator of any kind of health whatsoever.

So, by manipulating the numbers, the modern MD thinks they are creating health in their patients. But, like the two ounces of straightening serum, they are only creating the appearance of health.

Reducing your cholesterol level has no effect on your overall lifespan. None. Zero. Zip.

Normalizing your thyroid hormones does not mean your "thyroid" symptoms will go away.

A normal BMI does not mean you are fit.

Just like two ounces of straightening serum will give the appearance of health without the reality, the statin drug or the synthetic hormones will make pretty pictures -- but, in the long run, won't change your health for the better.

Expertise, recognized.

I've just been selected as one of the on-line experts at MDinfo.com. Don't be confused by the name. There are a lot of smart doctors on there handing out good advice.

If I do say so myself.