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You may not know the name Lance Luria, but there’s a decent chance you’re familiar with some aspects of his life. After all, his experiences as a physician inspired the creation of two television series: St. Elsewhere and Northern Exposure.
Dr. Luria certainly is an interesting “character.” He was the first licensed physician to join the ranks of the New York City Police Department. He was a uniformed officer in Manhattan for three years, even working undercover at times. When he left the city’s police force and moved to rural New York, he practiced medicine and served as a deputy sheriff. Eventually, he came to Springfield to head up health programs for the U.S. Medical Center for Federal Prisoners. He started working for St. John’s in 1997 and became Executive Director of St. John’s Integrative Medicine program in 2008. Dr. Luria recalls that a session at a nutrition conference sparked his interest in integrative medicine.
“At that moment, I got this kind of queasy feeling in my gut. I said to myself, ‘This is what I want to do.’ This is the kind of thing that has a huge amount of humanness, humanity.”
Dr. Luria says the integrative approach to healing is quite different from the traditional medication-based approach to dealing with chronic conditions.
“Medicine cannot heal. They give medications that help the body heal. If you’re in an accident and break your leg, they do a great job with acute (care). But a lot of the chronic conditions are too complex to be fixed with a medication. So, how do you deal with that? The idea with healing is that you jump start the body’s internal ability to remodel and fix itself.”
Helping the body do that can be a bit tricky. Dr. Luria and his team meet every week to discuss their patients and which approaches are and are not working. They use a wide range of modalities, such as acupuncture, hypnosis, massage, meditation, guided imagery, yoga, and others.
“We don’t give medications. We don’t do anything invasive. We don’t give injections. But we have a combination of modalities that singularly may not work, but when you package them together, miracles happen. It’s magic. Integrative medicine is the synthesis of multiple modalities, all working in this synergistic, magical way, that, individually, may or may not have a benefit, but when working together, has a tremendous impact on the patient.”
And Dr. Luria says the patient is a key player in this approach to healing.
“We put the locust of control back on the patient. These are the options. These are the things we recommend. You don’t have to do any of it, but if you do it, you have to be engaged. It’s not like learned helplessness. It’s not like I give you a pill, and the pill does the job.”
To get a patient engaged, Dr. Luria looks for the right motivation. He says traditional medicine attempts to get buy-in from patients by providing them with information.
“There’s this idea that you motivate people by information, that information itself is an inherent motivator. I say that works for 10-15% of the group, but for the rest, it doesn’t work that well. So, it’s like telling a 25-year-old, ‘If you smoke cigarettes, you’ll get cancer 40 years from now.’ That’s not a motivator. So, what we do is try to find those things that motivate the patients themselves.”
Finding motivation and helping the body heal itself involve the brain. And Dr. Luria says getting the brain involved is not a “fluffy” concept.
“When the mommy kisses the boo-boo, it actually does something biochemically. There’s lots of data to show when you get massage, you get an increase in certain chemicals, neurotransmitters in the brain. So, all this magic actually happens. Stuff happens.”
To make the point another way, Dr. Luria describes a study where women were placed in an MRI machine and faced the threat of an electric shock. The researchers compared their brain activity under three different scenarios: when they were by themselves, with an unknown person holding their hand, and with their spouse holding their hand. Indeed, brain activity changed when the patient’s hand was held.
“So that means there were biochemical and neuronal things going on in the brain that changed just because of how the patient “felt.”
Much of the program that Dr. Luria oversees at St. John’s deals with people who experience pain.
“We have an 85% success rate over the last three years of patients who were supposed to get spinal cord stimulators, who had failed backs, were at the end of the line, and 85% of our patients after completing our program did not have to go back for a spinal cord stimulator. They were proverbial refurbished.”
Even with that kind of a success rate, Dr. Luria says there’s another way to measure patient outcomes.
“I no longer think of pain as the final arbiter of success. I know people who have pain and they live happily. They get joy out of their lives, they hobble around. Then, there are people who have no basis for their pain that we can figure out, yet they’re miserable. So, I think finding meaning, getting a sense of what your role is to the world, to yourself, these areas you’d consider psychological, they’re very valuable. With the patients we see, it’s a package deal. So, when they leave here, and if we’re lucky, they are better off as humans than when they came here.”