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Establishing an Integrative Practice

Primary care is a mess. Doctors are beholden to directives from insurance and pharmaceutical companies, and it’s difficult to practice alternative medicine within this framework. Holistic practice requires real engagement with patients and this cannot be accomplished through the rigid, formulaic diagnostic tools mandated by insurance companies. Doctors with an insurance practice can only afford to give a limited amount of attention to their patients. Additionally, their exposure to non-allopathic fields is likely minimal. This is slowly changing, but in order for a true integrative paradigm to emerge the conceptual model of what constitutes a human being must be re-explored in light of modern physics and a more serious consideration of other cultural models of medicine.

In allopathic medicine, the primary care doctor initiates a diagnostic assessment with the goal of determining if there are behaviors, functional imbalances, or tissue changes that need to be addressed in order to better understand a client’s complaints and provide some relief. This is no less true for the holistic, or integrative, physician. The difference lies in the scope of the exam and the emphasis on establishing optimum functioning.

Integrative medicine gives practitioners the ability to cast a wide net. Depending on the practitioner’s skill set emphasis may be placed on diet, electromagnetic field (i.e., meridians or chakras), the integrity of the myofascial and spinal alignment, cranial sacral system, or level of awareness. For instance, a client complaining of a migraine headache, instead of being directed to the pharmacy might be treated with something as simple as magnesium, acupuncture, a cranial sacral adjustment, or Chinese herbs. From the integrative physician’s standpoint, the goal and art of practice is to figure out the most non-invasive way to bring relief and prevent reoccurrence. This type of practitioner does not shape their therapy based on a diagnosis but rather seeks to understand the pattern of the client’s complaint within the fuller framework of his or her life.

Healthcare workers who practice integrative medicine will have their own conceptual models, defined by their culture, training, and experiences. For every assessment, the practitioner must determine if his or her way of thinking and healing is mirroring enough of what is going on in the client to make a difference. When I started practicing medicine, I realized that the diagnostic boxes that I was trained to recognize and respond to were really limiting in terms of how I came to understand the nature of the client’s problem. I could make a conventional diagnosis but my treatment options were sorely limited. In 1979, during a year’s leave from medical school, I had the experience of seeing clients who were largely treated with diet, acupuncture, and homeopathy. They responded to these therapies in ways that seemed outside of the mechanisms for body functioning that I had been taught.

My own education and training

As an undergraduate student at Cornell University, I received high marks. I was a college scholar and was accepted to both Yale and Harvard medical schools; I also received a full scholarship to Duke Law School. I had no idea what I really wanted to do and while I was abroad in Africa, paying little attention to what was going on back home, schools were waiting for me to respond. My mother eventually stepped in and told Yale that I would be attending.

I couldn’t shake the ambivalence I had about this choice. I walked out during my second month of school. After a few days of soul searching I returned to Yale. But there was something missing for me in formal medical training, and I vowed to take time off in order to explore the gaps.I was probably more predisposed than most students to be critical about the nature and quality of medical education in 1977. I remember questioning my preceptors about whether they really thought

I was probably more predisposed than most students to be critical about the nature and quality of medical education in 1977. I remember questioning my preceptors about whether they really thought breast-feeding was better for infants after watching a film about breast-feeding extolling its benefits. I asked the question because in the clinic downstairs all I saw was formula being pushed on new mothers. The result of this exchange was a preceptor evaluation stating: “Student does not seem capable of learning.”At the time, I was a strict vegan and a martial

At the time, I was a strict vegan and a martial artist, and had a growing understanding of how diet profoundly affects health. Additionally, as a martial artist I had seen expressions of Qi or life energy that were beyond anything that could be explained by the basic sciences I had been taught. I knew there was more to the human being than an amalgamation of chemical systems and body parts.It was also clear to me that the pathological boxes in which we tried to place human suffering were of our own creation, and while they were useful as diagnostic and therapeutic constructs, they severely limited our therapeutic approaches. The benefit of attending an institution like Yale was that it was assumed that we had the brainpower and educational habits to master the basics, so we were given time and opportunity to explore without weekly pop quizzes. I relied on my memory to get me through the basics while I read Carlos Castenada and his explorations into various shamanic realms.

It was also clear to me that the pathological boxes in which we tried to place human suffering were of our own creation, and while they were useful as diagnostic and therapeutic constructs, they severely limited our therapeutic approaches. The benefit of attending an institution like Yale was that it was assumed that we had the brainpower and educational habits to master the basics, so we were given time and opportunity to explore without weekly pop quizzes. I relied on my memory to get me through the basics while I read Carlos Castenada and his explorations into various shamanic realms.Halfway through my third year of

Halfway through my third year of school I decided to take a year off in order to explore holistic medicine. I began a serious study of classical homeopathy and Chinese medicine and worked in the office of a nutrition-oriented doctor, Ronald Davidson, who had a very talented acupuncturist, William Wade, on his team. We would start many days chopping wood for the boiler so we would not freeze in his west 39th street Manhattan loft.Dr. Davidson would extol the virtues of fermented drinks, and I was able to see a doctor assume the role of teacher and educator with his clients. I watched Dr. Wade treat people suffering from all manner of chronic complaints with excellent results. Even my father became a regular client. I felt really fortunate to have had this contact with acupuncture back in 1979. It was not a hard decision to begin studying it that year.

Dr. Davidson would extol the virtues of fermented drinks, and I was able to see a doctor assume the role of teacher and educator with his clients. I watched Dr. Wade treat people suffering from all manner of chronic complaints with excellent results. Even my father became a regular client. I felt really fortunate to have had this contact with acupuncture back in 1979. It was not a hard decision to begin studying it that year.I also experienced the work of a lay homeopath, Rojelio Straughn. One client forever changed my perception

I also experienced the work of a lay homeopath, Rojelio Straughn. One client forever changed my perception about what was possible with this form of medicine. A member of a cultural group I was affiliated with came in to seek some advice from Mr. Straughn, who was also the head of this same African cultural community which later came to be known as the Ausar Auset Society, and he the Shekhem Ur Shekhem, Ra Un Nefer Amen. At the time, she had a very severe eczema condition; her swollen legs oozed fluid. She was given two doses of homeopathic mercury and told to come back in two weeks. I was thinking she needed to get to a hospital. But in two weeks she came back and her legs were back to normal. I questioned her—there were no other drugs that she had taken. Right then I decided that I had to explore homeopathy, and I’m still at it 36 years later.How much better off would people be if they could experience this kind of result from such a simple therapy? At the time, I did not fully understand how homeopathy worked. But I had direct experience with this case and many others so I knew there had to be something to it. During this year off, seeing food used as a medicine, acupuncture, and homeopathy helped me to make the decision that I could not make before I started medical school—I wanted to be a doctor.

How much better off would people be if they could experience this kind of result from such a simple therapy? At the time, I did not fully understand how homeopathy worked. But I had direct experience with this case and many others so I knew there had to be something to it. During this year off, seeing food used as a medicine, acupuncture, and homeopathy helped me to make the decision that I could not make before I started medical school—I wanted to be a doctor.When I returned to school I began work on my thesis, “

When I returned to school I began work on my thesis, “Where Philosophy Meets Medicine: Acupuncture and Modern Physics,” and I turned to physics as a way to understand how the homeopathic and acupuncture interventions I witnessed at Davidson’s office could produce such significant results. At the time books like the Tao of Physics and The Dancing Wu Li Masters were appearing on the market so I had much inspiration for my writing.In my fourth year in medical

In my fourth year in medical school I pursued electives with doctors practicing homeopathy, including a 94-year old homeopath still practicing across the street from St Rapheal’s Hospital in New Haven. He had hundreds of vials of various homeopathic remedies in his office. Despite his advanced years he was very sharp and this was my first exposure to the professional practice of homeopathy. Homeopathy, I learned, used to be practiced by many physicians in this country in the early 1900s. With the efforts to upgrade medical education and align medical school with various pharmaceutical interests, homeopathic schools and departments lost their funding. This was one of the last practitioners of a generation of doctors that respected and employed homeopathic therapies.I also completed an elective and spent a considerable amount of time at Bronx’s Lincoln Hospital, which was home to the largest acupuncture clinic on the East Coast. It was generally packed, but a kind of surreal calm filled the room. It was a huge space—fifty to one hundred chairs, acupuncturists would walk around the room assisting clients. While the main focus of the clinic was to help people overcome substance abuse, all kinds of treatments were performed for a variety of ailments: Walk-in clients were administered ear acupuncture treatments. This clinic went on to become the flagship treatment center for an internationally recognized acupuncture detox program (NADA) that is used around the world.

I also completed an elective and spent a considerable amount of time at Bronx’s Lincoln Hospital, which was home to the largest acupuncture clinic on the East Coast. It was generally packed, but a kind of surreal calm filled the room. It was a huge space—fifty to one hundred chairs, acupuncturists would walk around the room assisting clients. While the main focus of the clinic was to help people overcome substance abuse, all kinds of treatments were performed for a variety of ailments: Walk-in clients were administered ear acupuncture treatments. This clinic went on to become the flagship treatment center for an internationally recognized acupuncture detox program (NADA) that is used around the world.In 1985, I became the second doctor to receive New York State acupuncture certification from this institution. In my efforts to shape my medical education and have as much time as possible to pursue alternative

In 1985, I became the second doctor to receive New York State acupuncture certification from this institution. In my efforts to shape my medical education and have as much time as possible to pursue alternative medicine I chose a low key family practice residency at a community hospital in Brooklyn.Internship and residency were a blur as I survived and used my spare time to get more exposure to alternative therapies. With the completion of my residency in 1985, I became the medical director of a substance abuse center in

Internship and residency were a blur as I survived and used my spare time to get more exposure to alternative therapies. With the completion of my residency in 1985, I became the medical director of a substance abuse center in Bedford Stuyvesant, Brooklyn, where I ran an acupuncture clinic. Because there were a limited amount of beds and chairs and so few facilities offering acupuncture, there was always a line of people waiting to receive acupuncture treatment. Acupuncture was proving to be an effective treatment for prolonged abstinence syndrome, particularly in alcoholics, cutting down the frequency of relapses. Later, I worked out of the acupuncture clinic at Kings County Hospital, where I was medical director for their acupuncture program for 13 years. During that time, I studied Chinese herbal medicine and traveled to a trade fare in Guangzhou, China to set up trade agreements. At my Brooklyn office, I opened an herbal pharmacy with 100 different herbs. I was amazed to see people from all over, including affluent communities, flood my office on the weekend.In addition to developing and honing my acupuncture skills, I also pursued homeopathic training. I traveled back and forth to Europe for training with a world-renowned homeopath, Jeremy Sheer. Of great help was The New England School of Homeopathy, under the leadership of Drs Paul Herscu and Amy Rothenberg, which still offers excellent programs.

In addition to developing and honing my acupuncture skills, I also pursued homeopathic training. I traveled back and forth to Europe for training with a world-renowned homeopath, Jeremy Sheer. Of great help was The New England School of Homeopathy, under the leadership of Drs Paul Herscu and Amy Rothenberg, which still offers excellent programs.My basic family practice skills were now augmented by my skills in Chinese medicine and homeopathy. I was able to treat most primary care problems with alternative therapies while still providing clients with an allopathic prescription when necessary. I remember a client with sarcoidosis, a disease where knots of tissue, called granulomas, form in various places in the body.

My basic family practice skills were now augmented by my skills in Chinese medicine and homeopathy. I was able to treat most primary care problems with alternative therapies while still providing clients with an allopathic prescription when necessary. I remember a client with sarcoidosis, a disease where knots of tissue, called granulomas, form in various places in the body. In this case the woman’s lungs were severely compromised. I gave her a homeopathic remedy, phosphorus, taken three times a day in a low potency. When she saw her pulmonary doctor and the x-ray confirmed that her lungs had indeed cleared, he attributed her improvement to the steroids, which he had prescribed and she had not taken. What was more telling for me was that she decided to stop the homeopathy remedy on her own and her condition returned. When she restarted the remedy her condition abated, and she followed through with the therapy to full remission.

The trick with homeopathy is that ten people may have the diagnosis of sarcoidosis, yet ten different remedies may be needed because the remedies are prescribed for people with a particular ailment, not the ailment in and of itself. This is true for chronic disease and not necessarily for the treatment of acute disease. This requires the homeopath to work a little harder than just arriving at a tissue-based diagnosis.Homeopathy has proven a useful tool for my practice in many ways. A homeopathic intake is probably the most comprehensive one that I have come across in medicine, not because of the inclusiveness of the review of systems, but because of its openness to

Homeopathy has proven a useful tool for my practice in many ways. A homeopathic intake is probably the most comprehensive one that I have come across in medicine, not because of the inclusiveness of the review of systems, but because of its openness to go where you are led by the case and the emphasis on understanding the complaints of clients in their own simple language. The actual wording used by a client to describe their ills, and the context in which their symptoms are occurring, will in most cases provide a diagnostic framework.I remember one perplexing case where I was trying to assist a client with a terrible rash that had her

I remember one perplexing case where I was trying to assist a client with a terrible rash that had her arm black and blue. She described it as “violent.” After going through all my review of systems and coming up with nothing I asked her where in her life did she experience this kind of violence. She thought about it for a minute and then said “in her dreams.” It turns out in her dreams she was constantly being threatened and bitten by snakes. When I provided her with the appropriate homeopathic remedy, Lachesis, made from the bushmaster snake of South America, her rash cleared up. And, in her dreams, the snakes parted ways when she approached them!Knowledge of the Chinese medical paradigm, or a similar system, is crucial if one is to move beyond thinking just in terms of pathology, biochemistry, and physiology, and include

Knowledge of the Chinese medical paradigm, or a similar system, is crucial if one is to move beyond thinking just in terms of pathology, biochemistry, and physiology, and include connection to mind-body energetics and all that is implied by the word environment. Chinese medicine allows you take something as abstract as Qi and look at how it can be disturbed, which can lead to a range of symptoms. At a time when many doctors were prescribing benzodiazepines like valium for their stressed clients, I was able to recognize the pattern of their stress and use acupuncture and Chinese herbs to address it. For instance, the kind of stress brought on by deadlines where a client experiences increased muscle tension is different from the stress in someone who is prone to anxiety, insomnia, and panic attacks. Also, the person who gives into emotional eating is different from the person who does not have the vitality to handle situations that should not be so exhaustive. These nuances, and there are many more, allow for a more patient-specific treatment.Knowledge of the cranial sacral system, a diagnostic and therapeutic system that looks at the integrity of the movement of cerebral spinal fluid around the brain and spine, along with the movement of the cranial bones and any other

Knowledge of the cranial sacral system, a diagnostic and therapeutic system that looks at the integrity of the movement of cerebral spinal fluid around the brain and spine, along with the movement of the cranial bones and any other tissues that are impacting this movement, is also helpful. I have seen cases of anxiety and migraines that have responded well to this therapy and if you explore this discipline you will find that there are many chronic ailments that may respond to biomechanical manipulation. But it can’t be learned from “Grey’s Anatomy.” It has to be experienced in a living system because our cranial bones actually move and have their own rhythm independent of the respiratory and cardiovascular system. Cranial sacral therapists are touch masters.Structural alignment issues may be at the heart of biochemical ailments. I once spoke at a “millionaire’s” conference, and I was asked to consult with the wife of one of the organizer’s. She had, I believe, ulcerative colitis. She did not want to go back to the drugs she had been taking—she had had diarrhea for 18 days and was not getting better. When I checked the alignment of her spine, I found multiple subluxations that created a denervation in nervous impulses from her spinal chord. I asked one of the chiropractors at the conference to adjust her. Once this was done her diarrhea completely stopped. Indeed, I have had similar cases of organ dysfunction normalizing after realignment of the spine. I doubt if this statement would surprise anyone familiar with chiropractic.

Structural alignment issues may be at the heart of biochemical ailments. I once spoke at a “millionaire’s” conference, and I was asked to consult with the wife of one of the organizer’s. She had, I believe, ulcerative colitis. She did not want to go back to the drugs she had been taking—she had had diarrhea for 18 days and was not getting better. When I checked the alignment of her spine, I found multiple subluxations that created a denervation in nervous impulses from her spinal chord. I asked one of the chiropractors at the conference to adjust her. Once this was done her diarrhea completely stopped. Indeed, I have had similar cases of organ dysfunction normalizing after realignment of the spine. I doubt if this statement would surprise anyone familiar with chiropractic.When establishing an integrative practice, a good allopathic physical exam and laboratory work should not be neglected. Indeed, high blood pressure and cancer may only be detected through allopathic diagnostics. Still, this safety net should be employed without becoming enmeshed in it. Unnecessary testing and procedures have been well documented as doctors try to adhere to rigid guidelines and legally protect themselves. At the other

When establishing an integrative practice, a good allopathic physical exam and laboratory work should not be neglected. Indeed, high blood pressure and cancer may only be detected through allopathic diagnostics. Still, this safety net should be employed without becoming enmeshed in it. Unnecessary testing and procedures have been well documented as doctors try to adhere to rigid guidelines and legally protect themselves. At the other extreme we must remind ourselves to not be so caught up in the mind and energy of a client that we neglect something that can be best corrected using an allopathic model. Who said medical practice is easy?

Setting up my own shop

In the late eighties, I left my Bedstuy practice to work in a holistic medical office on Park Avenue South. This was the practice of Dr Warren Levin, who had really extended the practice of allopathic medicine to include novel allergy testing, intravenous and chelation treatments, and the use of nontraditional laboratory measurements. After six years in an environment where I used his services in addition to my work in homeopathy and Chinese medicine I decided to really set up my own shop closer to home in Brooklyn. It was in Park Slope that I established my first holistic medical center: Kamau Kokayi MD and Associates.

At Kamau Kokayi MD and Associates I employed an acupuncturist, a homeopath, a chiropractor, a cranial sacral therapist, a physician’s assistant who was also a nutritionist, and a gifted nurse who conducted age and past life regressions. One of the things that tickled me about this office is that I had three other African American male professionals working alongside me, as well as a homeopath who was native to India. Everything about this office was different. As this endeavor progressed my work became mostly about developing treatment plans and using the skills of the people working with me. As a Yale-educated physician I was the main draw, and I saw everyday people, as well as Hollywood celebrities like Russell Simmons and Wesley Snipes.

Chinese medicine gave me a paradigm inclusive of physiology and energy. Homeopathy gave me a paradigm through which to consider our dynamic relationship with vegetables, minerals, and animals and how these can affect the mind and body. It was not until I added kinesiology that I found a bridge between different disciplines, including modern medicine and theoretical physics.

A kinesiology examination allows you to access the more subtle flow of energy that underlies mind, body, and spirit. Kinesiology allows you to tap into the mind-body software, where emotions and memories are stored. Here the practitioner can access the indwelling intelligence of the body. Most significantly, kinesiology taps into a web of omniscience and omnipresence that permeates reality. Space and time fade away as the practitioner accesses experiences that the patient has long forgotten, or checks a client miles away using another person as a surrogate.

The mind-body field that we are tapping into using kinesiology is subject to modification according to how we want to measure it. The kinesiology playing field is omnipresent, reflecting the holographic nature of our reality. The whole body can be reproduced in single body parts, i.e. iridology, hand acupuncture, foot reflexology, ear acupuncture, abdominal diagnosis, and Japanese acupuncture. The kinesiology inquiry can access the functionality of different levels of energy and is very helpful for the practitioner to get in touch directly with what the indwelling intelligence of the client’s mind-body has to say.

The technique in kinesiology called muscle testing simply allows one to gauge the level that a challenged muscle can resist a very light pressure. With practice you can elicit a binary response of yes or no to a variety of stimuli. Because the testing parameters are limitless, they need to be standardized by the practitioner and different systems of kinesiology employ different calibration methods.

For the everyday practitioner kinesiology is very accessible. Kinesiology allows practitioners to escape the confines of their five senses and space-time reality. Through muscle testing I have been able to see what the mind-body has to say about the onset of a problem (checking muscle strength as we count years in a person’s life), which may initially be a mystery to a client but with further reflection a memory comes to the surface which helps to shed more light on the nature of the problem. The greatest limiting factor in using kinesiology is our own mindset—our belief that only what registers to our five senses is real and our ignorance of the body’s energetic anatomy and its relationship to the cosmos.
With a tool that can explore the interface between mind, body, emotion, and spirit, a primary care practitioner can arrive at comprehensive assessments. In addition to achieving a diagnosis, therapeutic ideas or substances can be tested to determine their suitability for a client. The assessments made with kinesiology can be further validated through whatever means are available to the health practitioner, depending on his or her discipline.

One of the clinical components I added to my skillset has been in the area of structural medicine. In working with chiropractors, I am amazed at what they can do with certain problems. The hands-on work is also gratifying, and the clinical applications are endless. This discipline has become a foundational element in my practice. Just the other day I saw a client who had been in urgent care twice in the last week for neck pain. The usual pharmaceuticals for pain and muscle relaxation were prescribed but another client referred her to me. Just by palpating along the facets of her spinal column I could feel what was out of alignment. By having her breathe slow and deep while I applied the right amount of directional torque to her spine she came off the table explaining how much better she felt and then with an acupuncture treatment to lock in the adjustment she left my office happy, returning two days later saying that she was 70 percent better. All primary care practitioners should be able to offer these simple therapeutic techniques.

By 2002 I grew weary of the administrative slog of having my own office. I moved to a med spa in Manhattan along with four of the practitioners working with me. I became the medical director of the Olive Leaf Wholeness Center. We were able to work together as a functional unit as a result of a grant we received from the Red Cross to work with victims of ground zero.

The Red Cross thought they were sending policemen and fireman to a spa. The treatment we provided employed our integrative model, and was more than what the Red Cross expected. We documented that their illnesses were the result of exposure to toxic chemicals at ground zero. But more importantly, we were able to successfully treat their symptoms within a detoxification framework. We published our clinical results in Explore the Journal of Science and Healing. We were not refunded.

When the Olive Leaf closed in early 2007, I established Kokayi Holistic Medical Center in midtown Manhattan. At this center we offered intravenous vitamin therapy, chelation therapy, chiropractic, colonics, acupuncture, emotional release therapy, homeopathy, Chinese medicine, energetic healing, and nutritional therapies. I also worked with a medical intuitive to help me with difficult cases and assist in individual protocols. I recall one case in which past life regression was employed. The client had had chronic headaches that were resistant to just about every kind of therapy. In the technique employed she went back to a previous lifetime in which she was in an abusive relationship. When she became pregnant her husband became convinced that this had happened as a result of her infidelity. He shot her in the head. This knowledge came out of her own consciousness and allowed her to loosen the past’s hold on her, which stopped her headaches.

After June of 2009 I continued this same work but as part of a large integrative medical center, Patients Medical, on Second Avenue in midtown Manhattan. It is here that I began to explore the applications of stem cell therapy for a variety of conditions, and in 2012 I became the medical director of a multidisciplinary team of doctors and nurses for stem cell or stromal vascular fraction adipose tissue harvesting and deployment. We were part of a national clinical research team and were very excited about the possibilities of this work. Unfortunately FDA regulations, which do not allow stem cells to be cultured or administered on a day other than the day they are harvested, severely limited the effectiveness of this therapy. I believe the best options for this therapy are currently being offered outside of the United States.

In addition to my stem cell work at Patients Medical, I reestablished an integrative health practice in the Park Slope/Prospect Heights neighborhood, where I continue to practice my craft, working with individuals and families, some of whom I have seen since my early days in the eighties. It’s been an incredible journey and I look forward to adding new chapters.

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