
Dr. Bernard Siegel defies the stereotype of a conservative,traditional surgeon.
At age 54, he's bald because he shaves his head every day.
He encourages patients to call him by his first name.
He strongly suggests physicians-in-training spend some time ashospitalized patients, lying flat on their backs hooked tointravenous lines.
And he firmly believes patients should be rule breakers,questioning their doctors and their treatments and - most importantly- sometimes focusing more on what's wrong with their lives than withtheir bodies.
Patients who break the rules - or exceptional patients, asSiegel prefers to call them - can sometimes beat killer diseases likecancer, he claims. And even if they don't beat them, they learn howto get more out of the days they have left.
Siegel, an assistant clinical professor at the Yale UniversitySchool of Medicine and a New Haven surgeon, describes dozens ofexceptional patients in his book Love, Medicine & Miracles.
There's Louise, an independent teenagerdiagnosed with cancer ofthe ovary, lungs and abdomen, given 12 months to live. Instead ofundergoing the recommended chemotherapy treatments, she left astressful family environment, got her own apartment and began helpingother cancer patients. On the day she was supposed to have died, shesent her doctor a note: "Where should I send the casket?"
Lois, diagnosed with breast cancer during her second pregnancy,underwent a mastectomy, learned to meditate and to put herself first.She gave birth and enjoyed a six-year remission.
Like several recent books, Siegel's volume explores the linksbetween attitude, disease and healing. Published last year by Harper& Row, the book zoomed to No. 1 on the New York Times best-sellerlist after Siegel's appearance in March on the Oprah Winfreytelevision show. More than 200,000 copies later, at presstime thebook is No. 9 on the New York Times list.
Although everyone has the potential to be an exceptionalpatient, only about 20 percent live up to that potential, saidSiegel. The majority - 60 percent - perform to satisfy theirphysicians, he added. And another 20 percent have a conscious orunconscious wish to die.
"Exceptional patients refuse to be victims," Siegel explains inthe book. "They educate themselves and become specialists in theirown care. They question the doctor because they want to understandtheir treatment and participate in it. They demand dignity,personhood, and control, no matter what the course of the disease."
Exceptional patients don't win many popularity contests withtheir mainstream physicians, Siegel emphasized: "These are patientsseen by the health care professional as difficult patients, ones theyoften have poor relationships with. They're the ones who want toknow why they're having all these tests done. They're never in theirhospital room. They disrupt the system (because) they're fightingfor their identities.
"Exceptional patients are fighters, but they also have aspiritual component to their lives. They can say, `Look, God, Ican't take care of this one, you'll have to handle it.' "
Discovering the concept of exceptional patients was an outgrowthof his own disenchantment with traditional medicine, Siegel said.Nearly a decade ago, he began feeling unsuccessful as a surgeon.
"You go to medical school and they fix you good," Siegelcomplained. "They don't let you meet people for a few years, soyou're disease-oriented. And they say, `Don't let anybody die. Soyou're immediately a failure (when a patient dies). They said, `Cureeverybody' and I said, `I can't.' "
Siegel began looking for alternatives to traditional medicine.Among other avenues, he explored the teachings of Dr. O. CarlSimonton, now director of the Simonton Cancer Center in PacificPalisades, Calif., and a pioneer in the use of imagery to fightcancer.
In a symbolic effort to uncover his emotions, Siegel said, heshaved his head. (He lhas kept up the habit partly because hisdaughter Carolyn says it's easier to find him in a movie theater.)And he became convinced of the importance of listening to patients -and of the powerful blend of positive thinking and modern medicaltechnology.
In 1978, Siegel and his wife, Bobbie, set up Exceptional CancerPatients, a support network that includes specialized group andindividual therapy to ease personal change and healing.
Siegel posed four questions to these and other patients newlydiagnosed with a life-threatening illness: Do you want to live to be 100? (Most patients, Siegel says, won'tanswer affirmatively without some guarantee of health.) What happened to you in the year or two before your illness? (Siegeland others contend that stress lowers the efficiency of the body'sdisease-fighting killer cells.) What does the illness mean to you? (Siegel tries to determine if adiagnosis of cancer, for example, is considered an automatic deathsentence by the patient.) Why did you need the illness? (The aim is to help the patientunderstand psychological needs the disease may meet, Siegelexplained. Sickness, he believes, "can make it easier to say no tounwelcome burdens, duties, jobs, or the demands of other people.")
Next, Siegel encourages patients to draw pictures depictingtheir feelings about the illness. One man drew his white blood cellscarrying away the cancer cells. A woman realized her despair overthe need for chemotherapy after drawing a picture of herselfreceiving the treatment.
Siegel also suggests patients learn to use meditation,visualization and hypnosis to improve their peace of mind - and oftenthe course of their disease.
"Some of these people who came to that (Exceptional CancerPatients) meeting were told to quit work and go home and die," Siegelsaid. "And what they did was come and get better.
Siegel tells his patients, "You can talk to your body. You canliterally tell blood to flow differently (in preparation for surgery)and it will stop bleeding. I know it works. Imagery works."
"What you find when people go through this (serious illness) isthere is an existential shift and that leads to healing. What'sscientific about it, you see, what's most miraculous is that if youstudy immune system activity, the chemicals or neuroreceptors in thebody, you will find they are altered by peace of mind and by love.
"If you study the same patient in a moment of despair, you willfind these (chemicals) are inactive. So I get back to the sentencethat all healing is scientific. Talk to an immunologist, a basicneuropharmacologist and I think they will find it very easy to agreewith me. The clinician, who never talks to the patient, hasdifficulty."
Besides teaching patients to help themselves, Siegel tries tominister to their psychological and physical needs simultaneously.Several years ago, he began playing music in the (Yale New HavenHospital) operating room as a way to soothe patients. He also begantalking to anesthetized patients. What did his colleagues think ofthis?
"They thought I was definitely a crazy fellow," Siegel said witha laugh. But no longer. "Music is played in every operating roomnow," he said with obvious glee. "And I'm invited to speak at grandrounds."
Siegel, the father of five, believes he can empathize wellpartly because of the problems and challenges he has encountered withhis own family. His son, Keith, for example, was once diagnosed ashaving an incurable bone tumor. (It turned out to be benign.)
Since the book was published, Siegel has received numerousletters from readers. "Many patients have written to me and said,`Thanks for telling me what I knew.' When others come across the bookthey say, `Thanks. Because a doctor said it, it gives us enormoussupport to confront the medical profession.'
"People need help in living with the experience of the illnessand in a sense healing their lives," Siegel said. "The illness canbecome a real motivator - God's `reset button' in a sense. Peoplecan be thankful for their illness."