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The University of Bridgeport Health Sciences 2012 Commencement Address

Peter J. D'Adamo, ND

President Salonen, vice-provost Brady, administration and faculty, distinguished guests, friends and loving families, and most of all, the University of Bridgeport Health Sciences class of 2012.

I am deeply honored to be here and it is a tremendous privilege to be addressing you today.

They call these types of ceremonies 'commencements,' a fact that I find rather amusing, since to commence is 'to begin' but to 'graduate' of course celebrates completion. My most recent 'commencement' occurred a few years ago when, after a rigorous four-year journey, I received my first black belt in martial arts ---only to hear my teacher congratulate me with the phrase, 'Good. Now I can teach you something.'

For many of you, the journey into healing began at UB, but it will not end here. Important new beginnings await you. I usually describe UB to others as 'the little university that COULD' ---a school that has pulled itself up by its own bootstraps by the imagination, pluck and skill of its administration, faculty and student body.

Look at how the both of you have grown in these past few years!

Remember to give back as soon as you can, and like the Beach Boys sang 'Be true to your school.'

As I began to think about what I wanted to say to you today, my mind keep returning to another beginning, now long ago, when our daughter started pre-K at a Montessori school. The first task these little children were assigned is called 'polishing work' --and polishing work it was. Each was given a little bottle of non-toxic polish, a small piece of cloth and directed to a surface, where they would diligently rub and polish away.

When I asked about the motive behind this exercise, and why it would constitute the beginning of a Montessori education, the teacher explained that the exercise helps the child develop their ability to focus on the process as well as the outcome. However the real point of interest for the child was their observing the surface become dull with wax and then shiny with rubbing.

One of the concerns I had about speaking to you today is the diversity in focus of the various programs that constitute UB Health Sciences: Acupuncture, Chiropractic, Dental Hygiene, Naturopathic and Nutrition. Do these programs share any philosophic similarities?

I believe that we all share a common ground in the desire to 'look a bit deeper' at the HEALTH of our patients, our society and our planet. So then I thought I would come here and start this talk looking deeply into the subject that I know best.

Me.

I'm a second-generation naturopathic physician. I've been in practice now for just about three decades and I'm probably best known for my work with the genetics of the human blood groups.

I graduated Bastyr University, then John Bastyr College, in 1982 as part of the first graduating class of that institution. Many of us were drawn to this profession because of its roots in traditional healing, and a desire to bring medicine back to a simpler, more health and lifestyle-focused approach.

Our goal was to rediscover the SCIENCE behind natural medicine. And so began the odyssey of textbooks, journals, citations, peer-review and the healthy skepticism that constitutes the basis of rational medical science. Recently however, a few of us have been getting the feeling that we are trying to force a square peg into a round hole, and even worse:

Those poor brutalized corners seemed to be where all the interesting stuff was!

You see, we hold strongly to a belief called the 'Vis Medicatrix Naturae,' which most of us just shorten to 'Vis'.

The Vis is the idea that organisms, as complex adaptive systems, contain inherent healing capabilities. In other words, an organism is not passive to injuries or disease, but rebalances itself to counteract them. The capacity to correct imbalances is what distinguishes living organisms from that which is non-living.

The Vis may sound mystical but it is not. Any microbiologist will tell you that antibiotics never completely kill all the bacteria in an infection. They kill the vast majority, and slow down the growth of the rest, so that the white blood cells of the immune system can catch up to the infection. At that point the body finishes the job. The Vis is not limited to naturopathic medicine. It transcends all fields and it is a common bond that unites our professions.

No school of medicine has an exclusive on the Vis. It is a critical part of all healing traditions. It's even making its way back into the portals of conventional medicine. Biomedicine has long held to the paradigm known as REDUCTIONISM. In this paradigm of reasoning, whose origins date back to Descartes, we attempt to understand complex things through the continual process of breaking them down--or reducing--them to simpler and simpler entities. Reductionism has served science exceedingly well, a fact exemplified by the enormous leaps in our understanding of biology, chemistry and physics in the last two centuries.

But many scientists are beginning to sense that reductionism has its limitations.

For example, I enjoy repairing clocks. One can easily pull one apart into its springs, gears and levers and get a pretty good idea about how it works. However nothing in the mechanism of a clock will give us a clue about what 'time' is, or why anyone would possibly want to use a clock for that purpose. You see the ability to 'tell time' is an EMERGENT property of the complex system known as a 'clock'.

When we say 'the whole is greater than the sum of its parts, we are describing EMERGENCE.

Emergent behavior is often unanticipated and even counterintuitive. A molecule of water does not have a temperature, but a glass of water certainly does, because the molecules in the glass can interact with each other to produce friction.

Many neurobiologists now consider what we call consciousness to be an emergent property of brain network electrochemistry. Indeed over a century ago the biologist T.H. Huxley wondered 'How is it that anything so remarkable as a state of my consciousness could come about as a result of simply irritating my nerve tissue?'

In the past using the word HOLISTIC in the company of scientists would have produced paroxysms of throat clearing and eye rolling. However new disciplines such as systems biology and network genomics, which try to unlock the dynamic secrets behind living systems, now openly speak of 'holistic' interactions and 'web-like' relationships. It was with this in mind that we created the new Center of Excellence in Generative Medicine at UB; the first such institution in the world.

Now, to me, 'generative' is a most interesting word. We have 'regenerative medicine' and 'degenerative disease' but we have no everyday use the basic word GENERATIVE. Yet it is the very best word to describe how emergent behavior spontaneously occurs in living systems. It takes us out of the prior paradigm of pure determinism and puts us down gently into a new world of developmental possibilities.

It provides the basis for new metaphors and roadmaps to the emergent and spontaneous.

The science writer Philip Ball put it this way:

'Everything is what it is because it got that way.'

If I could live my life over, I'd love to learn to really read music. Not simply to play an instrument, but as like a traditional orchestral composer. To be able to look at a complex music score and actually hear the music in my head.

Most music is constructed of motifs, the smallest element of a song, usually a collection of 3 or 4 notes that sparks an idea. The most famous motif is probably from Beethoven's 5th symphony.

I'm sure you've heard it...du du du DUUUUhhhh.

Like passages of music, molecular networks have motifs, little recurring themes and ideas that have symbolic significance. And like musical motifs they do very simple things, like filter out noise, or cause something to pulse. In biological networks these molecular motifs animate and provide information to living things. Understanding where they are, and their simple functions, turns the dots and lines of molecular pathway maps into beautiful music.

Always be on the lookout for the motifs in your life and in your art.

The Generative paradigm will catalyze the transition from reactive to proactive medicine through combining systems biology, personalized genomics, bioinformatics and social networking into what I call 'anticipatory medicine': the scribing of an arc, the trajectory of a patients 'life to come' and the development of a strategic base of action in the anticipation of those future needs.

Your careers will extend through this paradigm change and many of you will be at the forefront of this revolution.

And while it occurs, just remember to look for the motifs.

Finally I'd like to introduce two concepts that are so basic that one might consider them self-explanatory. But I'll talk about them anyway. The first is called ROBUSTNESS. Kind of an old-fashioned word, along the lines of 'hale and hearty.'

Robustness means something very important when we talk about biological networks and living systems. It defines just how resistant and responsive a system is to disturbances, both external and internal. To understand just how important and basic this concept is, I'd like to share a pair of very interesting word definitions with you. They come from KEGG, the Kyoto Encyclopedia of Genes and Genomes.

KEGG defines DISEASE as 'a perturbation of the molecular system.' In other words disease is a disturbance that the organism was not 'robust enough' to adapt to, or correct.

KEGG defines DRUG as a 'perturbant of the molecular system.' In this definition drugs are effective if they further perturb a disrupted system, ---hopefully on to a place more robust than before.

The corollary of robustness is the notion of FINE-TUNING. It seems to make good sense: a system that cannot deal with disturbance is probably in no position to be fine-tuned as well.

Fine-tuning usually helps a system deal with noise and uncertainty. To see an experienced SAILOR hold the tiller in their hands describes it all. Once a boat is stable on its course, the experienced helmsman moves the tiller imperceptibly one way or the other, reading the winds and currents and anticipating their actions. The inexperienced helmsman reacts to events by large swings of the tiller, back and forth, never enhancing the robustness of their course, and never getting to the fine-tuning stage.

How can we increase our patient's robustness and thus get to the 'promised land' of fine-tuning? Well, there are drugs, and they can be important agents in the mix, especially if the system is heavily disturbed. However the best strategies break down into 'things not to do' and 'things to do'.

Never give a complex system what it does not need: that will only increase its FRAGILITY. Just like having someone do your trigonometry homework does nothing to prepare you for the SATs, giving a system things it doesn't need, 'because it may be good for it' makes the system more dependent, not less.

Remember: No free lunches. No panaceas.

Rather, concentrate on the fundamentals: diet, exercise, hydration, rest and happiness. These allow living systems to sort themselves out and self-organize.

A question I try to ask every patient is 'how much expression is in your life?' The responses can be very interesting, since you'll usually get their estimate of the level of expressiveness in their lives, PLUS their definition of what the word 'expression' means to them.

To me, expression, artistic or other, is the ancient fundamental drive within all living things to 'do something,' to 'know I am here.'

Expression resets the system. This is critical to remember for your patients, but also for yourselves, as there will be times when you will need to reevaluate how you practice, and how you express yourself in your practice.

I'd like tell you a story about an encounter that I had with one of my patients this last month.

When I first met Wes over twenty years ago, he was your typical Greenwich finance mogul: Blow-dried hair, loud tie, big cufflinks, and suspenders on pants that did not appear to really need them.

Wes had a positive, charming personality, if in a rather superficial way.

He was there because his wife had come in as a patient, and had seen some benefits, though I doubt he thought much of the whole thing.

However Wes did see some improvements in his allergies and over the years we kept in touch as his life went into somewhat of a tailspin. He lost his job and discovered that at his pay-grade new jobs were few and competition was fierce. He went into consulting and lost more money. His two sons had developmental issues with delinquency and drugs.

His wife Lanie is an amazing woman. Throughout all this she stayed with him: Going back to work, cheerfully downsizing their Greenwich Macmansion into a smaller home in Norwalk, keeping his spirits up and making sure the kids came out OK. Always doing more with less. Wes on the other hand seemed to drift directionless, his self-confidence gone. Gone were the power-tools of the capitalist. Now he schlepped into my office, eyes to the floor, typically wearing a beat-up track suit.

About six months ago he began to develop chronic pericarditis, a very painful inflammation of the thin tissue that surrounds the heart. We treated him with naturopathic agents and his attacks became less frequent, but he still required steroids. My colleague met with him and asked me to come upstairs and join the consult because he was 'not good.'

When I entered the room, he was sitting slumped in a chair looking exhausted and beaten. As my mind started to think about what we could do for the man --in addition to what he was already doing-- I remembered that the emotion allotted to the heart in Traditional Chinese Medicine is 'joy'.

'Wes' I said, 'you need to get happy. In Chinese philosophy a lack of happiness is bad for your heart.'

After he recovered his composure from this unexpected recommendation, he replied 'It's true, isn't it? I am a most unhappy, sad man.'

'Let me cheer you up,' I told him. 'Take a good look at the person next to you. How many of your well-to-do-friends have a partner such as Lanie? Look at the love and trust and belief she has for you. Now, everytime your heart starts hurting I want you to think of Lanie.'

My colleague and I could see his face change and soften as the love he felt for his wife began to subsume him.

"I am a very rich man, aren't I?' he said.

Last week he wife called to report that he had not had a pericarditis flare up in the last two weeks and his cardiologist has been able to cut his steroid dosage in half.

Now, will this simple prescription cure the pericarditis that Wes has?

Perhaps.

But it does appear to be curing the pericarditis that has Wes.

I close by harkening back to the image I first shared with you, that of my daughter learning to polish furniture. I've used that imagery because I felt that it encapsulated every concept that I've been privileged to share with you.

For from today, you go on to your own polishing work:

That you should experience the joy of a shine emerging from the dullness and to know that your ability to shine is directly related not only to the effort you provide, but commensurate to the amount of care you give.

To observe the motifs that constitutes the music in your patients, in your practice, and in your life

To express yourself in the artistry and craftsmanship of your work.

To be generative in your strategies, always looking for new ways to strengthen your connection to the Vis.

To know that strength is a critical to change, but only the first step in the fine-tuning of the end product.

And ultimately, to remember that you, most of all, are that end-product.