Notes from the Field #37

Jared Zeff, ND, FNMI, LAc

The following is not an article prepared for a medical journal. Not every statement of fact is cited or referenced. This is a commentary on medicine—a running set of observations about practice in the field. It’s not meant to be a peer-reviewed presentation; rather, these are notes and thoughts from a practicing naturopathic physician, a primary care doctor in general practice.

How I Learned the Medicine

I am a naturopathic physician, and I have practiced as such since the autumn of 1979, some 45 years. What follows is a wide lens view of a career that has not been shaped by school, for medicine cannot be learned in a classroom. School is largely an unfortunate step on a path of something much more profound. The mentorship I have been fortunate enough to find has been the true journey of becoming a physician. Apprenticeship is how one learns medicine: through watching and working with someone who has ascertained mastery over a skill in such a way it has become an art form. This is the way one learns medicine. In this regard, I have been fortunate. 

When I graduated from medical school, I very much wanted obstetrics to be a part of my family practice. I wanted to attend home births. In the early 1980s, a naturopathic physician’s license in Oregon included obstetrics, though there was limited access to additional training beyond graduation requirements. In those days, we had to deliver a certain number of babies to graduate. I did not think this was sufficient training. I wanted to know all I could about delivering babies and ensuring I could handle any problem that might arise. This was difficult because we had no access to advanced obstetrical residencies.

There was an MD in Southern California, Dr. Abdul, who did home births, and I contacted him to see if he would let me learn from him. He had never heard of naturopathic medicine and was quite skeptical of me. After I showed him my license and documents and statutes allowing me to attend births and deliver babies legally in Oregon, he invited me to California for a visit.

I flew to Los Angeles, rented a car, and drove to Azusa where his birthing center was located. After a formal interview, he agreed to have me stay for a couple of weeks. I found a room to rent, though I only spent one night in it: After the first day, I hardly left the birthing center, except for a few home and hospital births. The initial 2 week invitation became a 600-hour marathon, as my interest, and his perception of the value I brought to his practice, extended my stay. Together we dealt with all manner of emergencies, including at least 1 ambulance ride. We delivered a baby approximately every 10 hours.

After our time together, Dr. Abdul offered me a job in his clinic. He was impressed by my training and my use of homeopathy to solve certain problems. I wanted to take the job, but previous commitments made it necessary for me to return to Oregon. I ran a small clinic in McMinnville, and a contract with my partner, the late Dr. Bruce Dickson, who wanted me back.  I regretfully turned down the job offer in California and went home. I had been successful in opening Dr. Abdul’s mind to naturopathy, and several colleagues ended up apprenticed under him over the years, including Dr. John Dye of Arizona, and Dr. Michael Ancharski of Hawaii, who still practices obstetrics. 

What I learned from Dr. Abdul I put into practice in rural Oregon, delivering babies at home births. I had developed a confidence in obstetrics I did not have when I graduated. As I continued to gain experience, I became very comfortable with home birth situations. Through such experience, I wrote the first guidelines for out-of-hospital births for naturopathic physicians in Oregon. 

Obstetrics had not been the only area where I had a concern about my level of knowledge. Nor was that the only time I actively searched out a remedy for this predicament.

Several years after graduating from the National College of Naturopathic Medicine (NCNM), I had a general sense that I simply did not know enough. I had a growing family practice in rural Oregon: I was a kind of old-fashioned country doctor, often making house calls, and often called out in the middle of the night by a mom with a feverish child or some other medical urgency. Acute cases quickly resolved with my homeopathic knowledge, hydrotherapy, and herbal medicines, but I did not see the same type of success with severe chronic illness. I just did not know enough to handle these conditions. 

I contemplated enrolling in the Oregon Health & Science University School of Medicine and met with the dean of admissions. Would my application be accepted, or would I be thought a heretic. To my surprise the dean welcomed me enthusiastically. Apparently, a naturopathic colleague was in the 3rd year class and doing quite well—after all, he’d already gone through medical school once.

I had already taken the Medical College Admission Test (MCAT), and the application process would have been straightforward. But for one thing. I loved the principles of naturopathic medicine and the philosophical orientation to healing that I knew to be true. I wanted to be a better naturopath, not a naturopath and a medical doctor.

I decided to fast and pray for a few days, and guidance was not long to follow. Two weeks after my fast, I met Dr. Harold Dick. He was an old-timey naturopathic doctor. He maintained that difficult cases are the easy ones, the impossible cases are challenging, and there are no incurable diseases. When I first met him, I remember thinking, “He is either full of it, or he knows what I need to know.” 

Immediately after meeting Dr. Dick, a man called me from Southern California seeking care. He had a terminal kidney disease. He was being treated at USC hospital, but had been told there was no treatment for his illness. He asked if there was any hope for him from naturopathic medicine. I told him I did not think I could help him, but that there was an old doctor in Spokane who likely could. If he was willing, I would make an appointment and accompany him. 

The day of the appointment, I arranged to spend the entire day shadowing Dr. Dick. I was quite surprised by the patients he was treating, many with serious chronic illnesses. Not only was he managing severe arthritis cases and COPD, he was reversing the arthritis and improving the COPD. These were conditions I had no idea how to help.   

This was the mentorship I was looking for. But Dr. Dick was reluctant to agree to have me return. Only after consulting his wife, Ruby, did he only allow me to come back to the clinic. He extended the invitation for me to return one more time.

Each time I shadowed Dr. Dick, I would request to return. Each time, his response would be the same: one more time. So, for months I would drive up to Spokane from my home in McMinnville, rent a cheap hotel room by the airport, and learn everything I could from the old country doc. 

My sincerity must have impressed Dr. Dick, because he finally invited me to stay in their guest house on my monthly trips. What I learned from Dr. Dick was the old way of naturopathy. Dr. Dick had learned from Dr. Otis Carroll, and Dr. Carroll was a student of Henry Lindlahr. My apprenticeship was a fourth generation of a lineage of traditional naturopathic doctors who produced miraculous results for their communities.

Dr. Dick didn’t start out as a doctor. He had been an auto mechanic at a repair shop in Idaho that he and his brother owned. Harold met Dr. Carroll when his brother had a severe case of bleeding stomach ulcers, which Dr. Carroll cured. Dr. Carroll also cured Ruby of a severe case of crippling arthritis. Harold was concerned by his mentor’s age, and who would people turn to for care after the old doc died.

This concern led Harold to inquire how he could become a doctor like Carroll. Dr. Carroll told him that first he had to go to medical school, and then he could study with him.

Harold enrolled in the Oregon Health & Science University School of Medicine, but wasn’t learning the sorts of things Carroll was practicing. Dr. Carroll laughed and told him that he was going to the wrong kind of medical school. Harold transferred to the Western States College of Chiropractic and Naturopathic Medicine, where he graduated in 1956. He then worked with Dr. Carroll for 3 years until he opened his own clinic in 1960. This naturopathic lineage extends directly from Dr. Carroll’s mentors, Dr. Alex LeDoux of Louisiana and Dr. Lindlahr of Chicago. 

I learned how to heal the sick from Dr. Harold Dick. He was reluctant to teach me at first, having become somewhat discontent with the curriculum of the naturopathic schools. They were not teaching the medicine as he knew it and practiced it. This was true, and when I began to study with Dr. Dick I was confronted with concepts that were contrary to what I had learned in school, such as vitamins and other supplements being suppressive. It took me a long time to understand, but seeing such miraculous results motivated me to continue seeking and trusting his knowledge. He slowly grew to trust my sincerity and became open to my inquiry and genuine interest in carrying on this knowledge.

Why do I write all this? 

Because the most significant deficiency in naturopathic medical education is the absence of comprehensive “apprenticeship” opportunities. In conventional medicine, internship and residency is a built-in apprenticeship, and a sine qua non of conventional medical education. The process of taking the didactic education of medical school and experiencing its application alongside seasoned veterans is what transforms a student into a doctor. This is how medicine is learned. This is how I became the doctor I am today, through my apprenticeship with Dr. Abdul, and later with Dr. Dick. I was able to see and experience how one actually participates with the medicine, how one applies the knowledge in actual practice. 

Without this, one has to invent a practice for themselves. Many naturopathic physicians have done this over the years. It is possible, but far from ideal. It produces spotty and inefficient learning, as well as inconsistent results.

With more and more practicing naturopathic physicians, there should be more opportunities for new graduates to find someone to teach them how to practice. There are a few formal residencies, but some of these, it appears to me, are more an opportunity to get a young doctor to work for a minimal salary than a structured and advanced learning opportunity. 

My advice to the young doctor, or new graduate, who feels the need for more training, is to seek out someone who does what you want to do and encourage them to take you on as a student.  One way is to actually join the practice in some capacity, but the way I did it is another option.  Find a mentor and spend as much time with them as you can and as they allow. 

I taught at NCNM, which became the National University of Natural Medicine in Portland, from 1979 until 2020. I had many students. Once, a first-year student wanted to shadow me in my clinic. I told him that I reserved that for 3rd and 4th year students. He was so persistent and persuasive that I eventually allowed him to spend every Friday in my clinic for 4 years! 

Something that students need to understand is that most older doctors will respond favorably to an interested young doc who wants to learn what we do. There becomes a time in a doctor’s career when they simply feel the pull to teach another, so their wisdom can live on.

There are several organized mentorship programs: through the AANP, and through the vitalist Naturopathic Medicine Institute (NMI). There are other opportunities, programs that one could join or even create. Again, find someone who is doing the medicine you want to practice, and talk with them.

Last year I was approached by a student at the NUNM in Portland. He asked if I would be willing to do a regular tele-seminar with a group of students. I suggested we try one and see how it went. We did, and I ended up meeting with these students throughout the year via Zoom calls on Saturdays for about 90 minutes. We discussed clinical situations, they brought cases to get my insights, and I brought cases to illustrate various points. One Saturday, a student brought her father, a medical doctor, onto the call to listen. I also have a few young doctors who contact me by email or phone for clinical advice or support, and I am happy to help. 

There are many ways to access the expertise of those with experience. These are just a few examples. It was vital to my own progress in this work, and I am so happy to extend that opportunity to those who come after me.

Respectfully,

Jared L Zeff, ND, FNMI

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