Today I have the honor of connecting with the renowned speaker and bestselling author Dr. Gabor Maté! Dr. Maté is highly sought-after for his expertise on various topics, including addiction, trauma, stress, and childhood development. He recently wrote a New York Times bestselling book, The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture.
For many of us, the concept of trauma is controversial and largely misunderstood. In today’s discussion with Dr. Maté, I am transparent, honest, and open about how I grew up and how my childhood experiences have influenced me throughout my lifetime. We get into the definition of trauma, why trauma is so widespread and misunderstood, the differences between habit and addiction, the impact of a toxic culture and materialism, and the epidemic of loneliness. We discuss the impact of the pandemic, a loss of control, why women are at greater risk of developing autoimmune disorders, and the impact of adverse childhood events. We also speak about what negatively impacts healthy childhood development, multigenerational trauma, and healing through compassionate inquiry.
I hope you will find great value in listening to today’s thought-provoking and insightful podcast!
IN THIS EPISODE YOU WILL LEARN:
Dr. Maté discusses and defines trauma.
The difference between a habit and an addiction.
How do various addictions ( drugs, work, shopping, attention, etc.) differ?
How the loneliness and isolation from childhood trauma get carried into adult life and could lead to illness.
How the social isolation of the pandemic brought some families closer together and drove others further apart.
How materialism ties into trauma, addiction, and the current epidemic of loneliness.
How many of the problems clinicians deal with today result from trauma and disconnection
What studies show about women and autoimmune diseases.
Why do we need to acknowledge the impact of the disparity within our modern-day materialist culture?
What can we do to ensure that our young children develop in a healthy way?
Healing from multigenerational trauma.
"Materialism is a reduction of human beings to a very narrow range of their
activities and their interests."
-Dr. Gabor Mate
Connect with Cynthia Thurlow
Check out Cynthia’s website
Connect with Dr. Gabor Maté
Transcript:
Cynthia Thurlow: Welcome to Everyday Wellness Podcast. I'm your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent are to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.
Today, I had the honor of connecting with a renowned speaker, bestselling author Dr. Gabor Maté. He's highly sought after for his expertise on a range of topics including addiction, trauma, stress, and childhood development. He has written a recent New York Times bestselling book called The Myth of Normal, and today I had the opportunity to connect with him. We talked about the definition of trauma, why it's so widespread and misunderstood, differences between habit and addiction, the impact of a toxic culture and materialism as well as an epidemic of loneliness, the impact of the pandemic, a loss of control, why women are at greater risk for developing autoimmune disorders and the impact of adverse childhood events.
What negatively impacts a healthy childhood and development, multigenerational trauma and how we can heal through compassion, inquiry, and healing? Today is a particularly transparent, honest, and open discussion about how I grew up as an individual, how that has influenced me throughout my lifetime. This is a particularly insightful podcast that I hope you will find great value in. Dr. Maté, it is such a pleasure to connect with you. Your book and the work that you do is so transformational. I'm very grateful for this opportunity to connect with you and share this with my audience.
Gabor Maté: Thank you. It's such a pleasure to be with you and thanks for giving me the invitation.
Cynthia Thurlow: Absolutely. Can we start the conversation talking about what exactly trauma is? Because I know myself as a trained medical professional, my perception of trauma is very different than the way that you explain it. And it makes much sense. I think for so many people that are listening, trauma and the concept of trauma is so controversial and largely misunderstood.
Gabor Maté: The problem with the word trauma is that it's one of these words that everybody has got their own interpretation, so all I can do is give you mine. In this culture, trauma is both overemphasized and where it matters it's not emphasized at all. Often people talk about being traumatized by having a difficult experience. "I went on a picnic and it rained and I was traumatized." No, you weren't. You were just disappointed. You know, you weren't traumatized. "I went on a date and it was terrible and I was traumatized." No, you weren't. You just were upset. Not every upset, not every stressful, not every painful experience is traumatic. Every traumatic experience is stressful, but not every stressful experience is traumatic. Trauma comes from a word, but on the other hand in the medical world, in the legal world, in the educational world, where a deep understanding of trauma is essential it's absolutely missing.
The average medical student never gets a single lecture on the relationship of trauma and illness, which is scientifically not even controversial. So, what is trauma? Trauma is a wound. It comes from a weak word for wounding. A wound is where you hurt and the effects of that hurt persist. Psychological trauma is what happens is when we are hurt and trauma is not what happens to us. People think of trauma as a war, a tsunami, or sexual or physical abuse. Those are traumatic, but they're not the trauma. Trauma is the wound that we sustain as a result. Two people can go through a war. One will be traumatized, wounded, the other one not. Physically, but that's also through psychologically as well. Trauma is not the experience externally of what happened to you, but what happened inside you as a result. The biggest impact of trauma, both on the psychological and the physical level, is the disconnection from the self.
When children, for whatever reason are being hurt, the only way they can survive or endure it is to disconnect from their sense of physical and often emotional pain and then we lose ourselves. Trauma really is a loss of self, is what happens. That has all kinds of consequences, physically and emotionally. In a simple nutshell summary of it, trauma is a wound that happens to you as a result of what happened to you. The impacts of that wound persist and show up throughout your life until you resolve it. The impacts can show up physically in the form of illness or mentally in the form of mental illness or through behaviors like difficult relationships, addictions, and so on and so forth. So, it has many manifestations. The source of it is this wound that you sustained. I hope that was clear enough.
Cynthia Thurlow: It was a beautiful explanation and it allows me to kind of lead into something that you touched on, that our personality develops out of these experiences and that our personality is a reflection of the traits we take to survive our childhood. When I heard you say that, as someone who did have a great deal of physical and emotional trauma growing up, it really made a lot of sense, because on the exterior, I looked like I got the good grades and all these things fell into place. It was all a built-up coping mechanism to survive what I was growing up in within my household. When you describe personality in that manner, it's really a direct reflection of our experiences as our younger selves.
Gabor Maté: Yeah. I could relate to that experience of yours because in my 40s if you looked at me from the outside, I was a successful physician, quite respected in my community, vocational newspaper contributor, married with children of success and internally I was depressed and alienated and workaholic and difficulties in my marriage and challenges in my parenting and the traumas that I had experienced as an infant actually drove me into that successful path. The world would say, this is a man who's functioning beautifully. That's not who I was at all. And having to explore that and then seeing the same patterns in my patients, is what got me to start looking at health and illness in a completely different way.
Cynthia Thurlow: It's interesting when you touch on the fact that trauma can be at the root of a lot of our choices, our addictions, our habits. Where do we go from something being a habit to something being defined as an addiction? Because that distinction, I think, is really important for people to understand.
Gabor Maté: Well, a habit is something that we do habitually. I go swimming every day when I can do that. That's a habit. Now, a habit can become addictive depending on how you relate to it. I define addiction and maybe I'll ask you a question about it afterwards if I can. I'll define addiction as I do in this book, The Myth of Normal as manifested in any behavior in which a person finds temporary relief or pleasure and therefore craves but then suffers negative consequence as a result of and cannot give up despite negative consequences. So, pleasure, relief, craving in the short term, harm in the long term, inability to resist despite the harm. Notice I didn't say anything about drugs. I said any behavior could be drugs, but of course, could also be eating, shopping, gambling, smoking of course, obsessive drug, pornography, the Internet, gaming, extreme sports, relationships, anything.
If you're craving, it gives you temporary pleasure, causes you harm, not giving it up, you got an addiction. Just in order to throw a light, Cynthia, on this question, can I ask you, according to that definition, and I'm not asking you for any specifics, but was there ever any addictive pattern in your life ever?
Cynthia Thurlow: Oh, absolutely. I think that because of my relationship with my father, who was very disconnected. My parents were divorced at a young age, very disconnected. He himself had trouble connecting and emotionally and otherwise. He is an alcoholic and was emotionally and physically abusive. My relationship with my dad created the desire to have attention for men as almost if I was trying to replace the attention I really wanted from my father. That played itself out as a teen and an early adult until I started doing therapy. For me, yes, I think that I got intoxicated with attention that I received from the validation.
Gabor Maté: Right. You've already answered the next question, which I was going to put is "Not what's wrong with the addiction, but what was right about it? What did it give you?" They gave you something we all need. As children, we all need attention. Now, we need attention not for what we do or how we look or what people can get from us, but just because we exist. That's an essential need of the child. If we don't get it in an unconditional manner, then we'll seek it, whatever we can get it. So that the addiction comes along not as a problem primarily, but as an attempt to solve the problem. In this case, for you, it was the attempt to solve the problem of not feeling valid unless you had attention from others. In my case, my workaholism was an attempt to solve the problem of not believing fundamentally that it was important enough just for existing.
Because the message I got as an infant through my particular history is whether I wasn't wanted. If I'm not wanted, one way to deal with that is to become a doctor and meet other people's needs. Then they'll want me all the time. It's very addictive because it doesn't matter how many men give you attention or how many people want my help, fundamentally there's emptiness inside us that says what if I wasn't pretty or if I wasn't attractive or what if I wasn't smart? What if I wasn't helpful? Would they still want me, would they still give me attention? And so, it's addictive. Yet, you keep everything, add more and more to feel that emptiness, so addictions are not a choice. They're actually an attempt to solve the problem, the problem of emotional pain. That emotional pain always originates in children.
Cynthia Thurlow: Certainly for me, reading your work and listening to your work and reading your book as the parent of teenagers now, it makes me really reflect a great deal on how differently my children have grown up without me even realizing how substantially different their experiences are from where I originated from. My parents did the best that they could. A lot of your work talks about intergenerational trauma and so I think that can be propagated in a lot of different behaviors whether they're healthy or unhealthy. In your work with patients over the course of the years, is there any differentiators between whether it's shopping addiction or drug addiction or sexual addiction? Is it all the same when we get down to it in terms of trying to heal this wound, trying to numb our feelings, trying to address uncomfortable feelings? Do you find that one addiction is better than another? Meaning more curable? Is that even possible?
Gabor Maté: Well, so for twelve years I worked in what is North America's most concentrated area of drug use, which is the Downtown Eastside of Vancouver. If anybody ever visits here, they're shocked by what they see in the street here. People are living intense. People injecting, inhaling, trading drugs, poverty, they're ill, they don't look well, many of them have HIV, hepatitis C and that's where I worked for 12 years. Now, you can't compare that. You can compare it but you can't equate it to my shopping addiction or to my work addiction. I didn't have HIV, I didn't have hepatitis C. I had a well-paid profession. In that sense and the drug addiction because of the nature of drugs and also because of the way society relates to them, is far more punishing for them. In that sense, there's no equal, there's no fair comparison. So, the differences are obvious.
Also, it's physiologically difficult to get off drugs and opiates. You go through terrible withdrawal symptoms. That's true. If I look at the similarities, that's what they're striking. I could recognize myself in every patient I had, despite the obvious differences in our life conditions, they just suffered more than I had. They had suffered more deeper and more persistent trauma than I had. Their physiology was their brains were more prone to need drugs in order to temporarily feel better about themselves. The emptiness that they had, I had it. The desperation to escape from my emotional distress, I had it. They had it. The behaviors that followed, which were compulsive and self-destructive, that was similar. The lying that I engaged in, the dishonesty in my marriage as a result of my addictive habits that reflected the manipulations and dishonesties of my clients. What I'm saying is that the differences are obvious, but it's the similarities that are interesting. In that sense, most of us are very much like those very abject, drug-addicted people that we like to admit. Because we don't like to admit it, we look down upon them, ostracize them, and punish them. Really, they're just more extreme versions of ourselves because their suffering had been more extreme.
Cynthia Thurlow: It's interesting, I trained in inner city Baltimore and this is in the 1990s at the height of the heroin crisis, IV drug abuse. Every socioeconomic issue you can think of. Number one city for teen pregnancy, for syphilis, for HIV and AIDS and coming from the suburbs, it was a baptism by fire, if you will. I have never been more humbled. The issues that my patients were dealing with, I thought to myself, it was the greatest opportunity to grow as a human being because it made me so profoundly empathetic. I worked in the ER and you see everything there. When we touch on that loneliness, when I reflect back on my childhood, my parents got divorced when I was seven and my grandmother actually shared it with me years later, it was like you went from being a happy child to being very quiet and very introspective and that sensation of loneliness and not feeling that at seven years old it was very hard to talk to my parents about.
Certainly, seven-year-old children don't have the ability to talk to their friends about it, not like adults do. The recognition as I was reading your book, of, "Oh, my gosh, that's exactly that feeling that I had as a small child, and that's exactly the feeling I had when I was getting older," and I would get attention from someone and then that attention would shift. It was the same feeling of rejection that my father gave me. It was a really profound realization for me, especially because I think so many of us on social media, we want everyone to think everything's perfect. This artifice of perfection, which is an example of this toxic culture that we're all growing up in.
Gabor Maté: There's a new book that talks about some of the themes I cover in my book, but it's all about the way that the tech companies deliberately target the circuits in the child's brain that are more prone to get addicted. Now, just a new book, what you talked about not being able to talk to somebody, I would suggest it didn't start at age seven because you mentioned that your father emotionally abused you. I think you said?
Cynthia Thurlow: Yes.
Gabor Maté: That didn't start at age seven, did it?
Cynthia Thurlow: No.
Gabor Maté: Okay. When you suffered, who did you speak to about it?
Cynthia Thurlow: No one.
Gabor Maté: Okay. Now, this is a question I often ask people. You have children, if they suffered just one episode of emotional distress, never mind abuse, who would you want them to talk to?
Cynthia Thurlow: I would want them to come to my husband or I'm.
Gabor Maté: Yeah. Now, if you found out that one of your children had had such a negative experience, just even once, even a fleeting, not an ongoing one, and they hadn't talked to you, how would you explain that?
Cynthia Thurlow: I think I would struggle to find a way to explain I'd be devastated.
Gabor Maté: Of course, you'd be emotionally devastated. I'm asking how would you ultimately explain it. Because the day that your child was born, they expressed everything. How would you explain the fact that now at age four or five, they're not talking to me with what hurts them?
Cynthia Thurlow: I haven't created the environment to allow them to feel comfortable to express themselves.
Gabor Maté: Which leaves them how?
Cynthia Thurlow: It leaves them feeling invalidated, lonely. Their needs aren't being met.
Gabor Maté: So, I'm saying that that sense of being alone of yours didn't start with your parents' divorce. It long predated it, you know.
Cynthia Thurlow: I would agree with that.
Gabor Maté: So that the sense of isolation and then the problem is we then carry that into adult life and the imprint of that isolation until we really learn to deal with it, until we get some therapy or some other transformational experience falls our way, we carry that sense of isolation. In the midst of an earth with 8 billion people on it, we all experience as isolated ourselves. In today's world, there is actually an epidemic of loneliness and isolation, which because the mind and the body can't be separated, that loneliness translates into illness. It's been shown and according to studies that extreme loneliness and isolation is as bad for your physiological health as smoking 15 cigarettes a day. But it's an epidemic in today's world. That's the world that we're living in now.
Cynthia Thurlow: I feel like with the pandemic, it has probably magnified that with so many people that were separated from their loved ones, not able to connect physically in person. Have you seen that to be the case in your work as well?
Gabor Maté: What I've seen with the pandemic is largely what you described because we talk about social isolation. Well, social isolation has been happening in our culture for the last several decades. The sense of isolation statistically has been increasing to the point where in Britain they appointed some years ago a minister for loneliness. That's how bad it has become. That's a product of modern culture especially since certain economic and political changes happened about 40, 50 years ago. Under COVID, some families who had not been carrying a lot of trauma when they found themselves socially isolated, they actually got better because the parents all of a sudden couldn't go to work and they stayed at home and, "Oh, my God, I'm seeing how my kids play. I'm seeing my kids' milestones. I'm recognizing how my kids' study." And they reconnected with their kids. In other families, child abuse went up and alcoholism went up, and the number of visits and emergency wars for her children went up during COVID. So those that had been fortunate enough to have connected childhoods, COVID actually brought families closer together. Of course, with the help of the internet, they could talk to grandparents and all that. Those that were already isolated or traumatized, it made it a lot worse. The result has been an increase in mental health issues, addictions, and so on.
Cynthia Thurlow: It's really interesting because we lived in a very big city on the East Coast, and during the pandemic, my husband and I decided we didn't love where we lived, and we picked up and moved. In the middle of the pandemic, we moved to another part of our state. The mental health benefits of being where we are now slower pace, less people, and people are friendlier because now we're technically in the south of the United States and it's been such a gift and a blessing. Maybe for some families, the recognition that the pandemic brought some of us together creating more boundaries for maybe unhealthy relationships where you physically couldn't see them in person and more boundaries were created in response to that.
Gabor Maté: That's right.
Cynthia Thurlow: When we think about the changes that have happened in our culture over the last 40 or 50 years that you've kind of alluded to. Where in your methodology does the degree of materialism that we see nowadays, this conspicuous consumption? The best example I can give, United States, Black Friday, Cyber Monday. People are shopping like crazy from Thanksgiving through today. Where does materialism fit in amongst all of this trauma and addiction and this epidemic of loneliness?
Gabor Maté: Well, materialism is a reduction of human beings to a very narrow range of their activities and their interests. Materialism basically says that what matters is matter. The more matter I can manufacture, sell, own, control, the more I'm a valid human being. The people that we idolize and certainly who to a significant degree run our society are people that control a lot of material. Through their control of materials, they control a lot of people's lives as well. A guy like Elon Musk was in a certain way a genius but in other ways, it's completely disconnected from reality and with the stroke of a pen, fired 7500 people from a job overnight. Now, that's his right to do that given our current economic and political setup.
My question though is what is the impact on the 7500 who all of a sudden are out of a job or to the employees that he kept to whom he said, "You can stay in the job but you are going to have to work longer hours and more intensively." This materialism and our worship of the two P's, profit and power actually make people sick because that loss of control, that loss of meaning and belonging that losing a job means, the sense of invalidation, that uncertainty those have physical impacts on people's health. Now, when you look at more traditional cultures, it was all about restitution and connection and coherence and harmony and belonging, totally different set of values where material possessions weren't the be all and the end all, as a matter of fact, here in British Columbia and northeastern, northwestern United States as well it used to be this tradition of the potlatch. In the potlatch, what would happen is that all their relatives and friends invite a lot of people and give everything away to them.
Your wealth was measured not by what you kept but by what you gave away. That we have this belief that what we're doing is normal and this is the way it needs to be. Human nature is grasping and selfish and greedy and aggressive and competitive. When somebody does something along those lines, what do we say? We say, well, that's just human nature. What about when somebody gives, when somebody's generous, when somebody's kind, when somebody's open hearted? Do we ever say, "Oh, that's just human nature?" We don't, so we make a certain assumption about what human nature is. Traditionally and from the point of evolution being coherent, living in harmony, contributing, being in community, being connected, being collected is far more of human nature than its opposite. So, this materialistic culture narrows us down. Matter does matter, but it's not everything. If this culture narrows us down to our most lowest basic denominator that's what it does. And as such, it hurts us. It hurts us physically, it hurts us emotionally, and it certainly limits us spiritually as well.
Cynthia Thurlow: It's interesting that the area of the United States that we just moved from, it was very much the concept of Keeping up with the Joneses. Is that how people felt. We made a conscientious decision to leave that environment because I kept saying to my children, this isn't normal and this isn't healthy. It's amazing to be in environment where there's a lot more income disparity and people living in different-- And I just kept saying to my children, when you go off to college, this is normal. It is not normal to be very homogeneous in terms of income and the way people live. It also kind of distracts from what's most important. I think sometimes people get disconnected by the things and it doesn't build or yield more connection. It just yields more time away from the people that they love and care about, whether it's a bigger house, a more expensive car, expensive vacations, et cetera.
It's something that I certainly have kind of watched from the inside out. Being an introvert and a big observer of trends and things that I witnessed, and certainly being a clinician, seeing a lot of that as well, how that showed up for patients, especially in the 2008 timeframe when there was this stock market crash and resultant real estate crash. A lot of my patients would tell me they would literally just leave the keys to their home and just leave. They would just stop paying. It was just such a burden to have so much financial responsibility that they didn't fully appreciate or understand. It was almost like a noose around their neck if you will.
Gabor Maté: This society creates a lot of uncertainty, loss of control, conflict, and those are documentively the biggest triggers for physiological stress. I suppose what I would ask you is that in your own medical training, did anybody talk to you about stress and illness?
Cynthia Thurlow: No.
Gabor Maté: Did anybody talks to you about the fact that the more trauma you have, the more likely to have an autoimmune disease? That women with severe PTSD, while this is a new study, have doubled the risk of ovarian cancer, that women sexually abused have vastly increased risk of endometriosis, that people who suffer childhood adversity have far more heart disease, far more migraines? They don't tell us these things. It's almost like when you first start seeing it, you think you're seeing things while you are seeing things, but that's because nobody ever told you that a lot of other people have seen the same thing, studied them, and researched them, documented them, but that someone never enters into our education. As medical people, we're left blind to what's in front of us, which is that most of the problems that we deal with of chronic illness, mental illness, addiction are actually outcomes of trauma and disconnection. Living in a culture where trauma, disconnection is considered to be so normal that we don't even see them.
Cynthia Thurlow: Yeah, it's interesting that the issues with autoimmunity and for listeners, if they're less familiarized with that terminology, in your clinical experience, what types of autoimmune disorders are you seeing in more females versus men? Are you seeing more rheumatoid arthritis or celiac? What are the typical manifestations you're seeing of autoimmune diseases?
Gabor Maté: Well, so there are about 60 to 80 conditions that are identified as autoimmune in which the immune system turns against the self. It's as if the American Army invaded the United States with hostile intent. The immune system that's meant to protect us turns against us and attacks our nervous system, in which case we may get multiple sclerosis, Parkinson's, it attacks our joints, our connective tissue. They may have systemic lupus or rheumatoid arthritis or gouts, in which case there's inflammation. Then we have Crohn's disease or colitis. Now, here's the thing. It's not what I see personally, it's what the studies show. Statistically, 70% to 80% of autoimmune disease happens to women. The medical professionals throw up their hands and says, well, what's causing this? They're not looking at people's lives because the people who get autoimmune disease in my experience, and also in more than one study, are people who are self-effacing, who are compulsively meeting the emotional needs of others ahead of their own, ignoring their own, who repressed their healthy anger, are very very nice, they're peacemakers.
People who believe that they're responsible for other people feelings and almost disappoint anybody and who are therefore absorbing the stresses not only of their own, but of their families and of their spouses. Now, which gender is actually programmed to do that in this culture? It's females. That's why women have 70% to 80% of immune disease. It's no mystery. It's only a mystery if you don't understand the unity of mind and body, that emotions are inseparable from our physiology, which scientifically is not even controversial, but which nobody talks about in medical school. There's this astonishing gap between what science has shown and what we are taught as medical people in our education. Which means that when you go to a neurologist or gastroenterologist, rheumatologist, cardiologist, there's a Danish study this week that one more time shows the relationship between childhood adversity and adult cardiovascular disease.
If you go to any one of these allergists, they're going to deal with the organ that the pathology is showing up in. They're not going to deal with you as a human being. They're not going to ask you about stresses in your life, trauma in your childhood, how you relate to your spouse or your partner, how you feel about yourself as a human being, or what your work is like for you. Most of the time, they're not going to ask those questions. Yet in those questions is the answer to why you got ill and also why you can heal. Because if you can recognize the stresses that you're generating unwittingly for yourself, you can stop creating those stresses that can make a huge difference to the course of your illness. There's only one point I want to make which pertains to you and I, I think we have to recognize. You mentioned that you and your husband during the pandemic realized that you were not living in a very healthy place and you moved to somewhere much more congenial, much more connected, communal, interesting, peaceful.
I have all kinds of choices available to me but we're privileged. Not everybody in this culture has those kinds of privileges. Not everybody can just move on and start doing something different or follow their passions the way you and I can because of materialism. This is a culture based on strata. Health itself is a social gradient that the lower down the pole you go, the more likely you are to get any kind of illness. That's connected to social class, and to race, not to race, but racialism. Not that you and I can do anything about that in the short term, but I think we have to acknowledge that it's not just an individual choice. It's also a set of social circumstances.
For example, in the US 25% of women have to go back to work within two weeks of giving birth, which amounts to a massive abandonment of infants, but they can't help it because they have to and the impacts are terrible. But these are social issues and again, nobody in medical school teaches you to look at the larger social picture. It's all about the individual organ, the biology of the individual organ. Everything is reduced to the material facts but not to the context in which those material facts evolve and exist. I think we have to keep that in mind.
Cynthia Thurlow: No, I totally agree with you. We are very fortunate, very privileged and that kind of reductionistic methodology that is aligned with traditional allopathic medicine where you're reduced to your kidney doctor, your cardiologist, you deal with GYN, whatever it is that you deal with and you don't think about other systems and yet they're also interrelated. I think on a lot of levels the understanding that certainly for me, training in the inner city, I always felt that whatever work I did with my patients they really appreciated and valued and they were so unaccustomed to people being kind, just simple kindness. When I finished my training and moved to the area I just left, I remember feeling very differently about my patients. There was an expectation that I was serving them and there wasn't merely the amount of appreciation and not that I needed that validation. It was just observational that these people who had every economic, materialistic advantage over the patients I had initially trained around oftentimes are not particularly appreciative of anything.
To me, I feel very grateful that I had the opportunity to train with a group of individuals who taught me a lot and taught me a lot on a very substantive level. In fact, the greatest patient experiences I've had as a clinician were the ones that I had when I trained in Baltimore because those patients made such an indelible impression on me. Yet in some ways, they had the most disadvantageous environment. They had no access to fresh fruits and vegetables. They were oftentimes dealing with significant violence, day to day, multigenerational, drug use. I would have 15-year-old patients delivering their second child. It was just a degree of experiences that really taught me a lot. I think if you really go into medicine because you want to serve others, those kinds of impressions really leave quite a bit of an imprint on your psyche.
Gabor Maté: Well, in my case, so I was in family