Origins #2: Peter D'Adamo, ND on the Musical Inspiration for "Integrative Medicine" in 1979
Written by John Weeks
Origins #2: Peter D'Adamo, ND on the Musical Inspiration for "Integrative Medicine" in 1979
Summary: Internationally-known Eat Right 4 Your Type author Peter D'Adamo, ND recalls using the term "integrative medicine" in 1979. D'Adamo was part of a team which was charged with developing the clinical education strategy at John Bastyr College of Naturopathic Medicine, founded the year before. D'Adamo, a musician and composer, recalls how the concept, which became embedded in the naturopathic curriculum as "integrative therapeutics," was shaped by some musical concepts with which he was working. The story recalls to mind conversations two decades later with Tracy Gaudet, MD, when she and her team who founded the Program in Integrative Medicine at the University of Arizona sought to get their academic minds around what "integrative medicine" was, and then how to teach it.
I recently reconnected with well-known author, clinician and musician Peter D'Adamo, ND. He read a bit of the Integrator and saw the note from David Riley, MD on the coining of the term "integrative medicine." (See Your Comments: Riley on origins of "integrative medicine, August 6, 2008.)D'Adamo responded with an off-the-cuff comment that he'd used the term in 1979. I asked him for more information, which grew into the account which follows.
D'Adamo has since become internationally known for his controversial writing on blood type diets. He was, in 1978, a member of the first class of entering students at John Bastyr College of Naturopathic Medicine (JBCNM - now Bastyr University). Among D'Adamo's present passions is the Institute for Human Individuality, which he co-founded at Southwest College of Naturopathic Medicine and for which he serves as board chair. His own blog is available here. Here is D'Adamo's emailed comment to me on reading Riley's account of a use of "integrative medicine" in 1994.
D'Adamo: Guess what? I coined the term "integrative medicine" in 1979 to
describe a class that I had designed while on the Curriculum Review Committee,
which was tasked to develop the first clinical curriculum for then John Bastyr College of Naturopathic
Medicine. The idea was that practitioners of different systems would present on
their treatment/analysis for a particular syndrome or special topic. I believe
that the course (as "Integrative
Therapeutics") continued on for quite a while.
I wrote to D'Adamo that this was interesting and that I would like details for the Integrator. What he wrote, below, needs a little stage-setting. The JBCNM D'Adamo attended was founded on a $200 gift from a patient and a deal arranged with Seattle Central Community College to rent space for basic sciences classrooms and laboratories. (Gross anatomy lab was later created adjacent to a second floor rental above a bank at the "45th and University" location D'Adamo references.) At the time about which D'Adamo was writing, the school had roughly 60-70 total students, split between the first two years of the 4-year residential program. D'Adamo was part of a team that was busy inventing the next two-years of the program's didactic and clinical training.
________________________
The 1979 John Bastyr College Curriculum and 'Integrative Medicine'
Peter D'Adamo, ND Greenwich, Connecticut
At the time there was quite a bit of tension about
the upcoming clinical years, since so many of our prior bases during the first
two basic science years were covered with the deal that [John Bastyr College (JBC)] had with Seattle
Central Community College [which provided the original basic science lab space].
It seemed that we got almost to the end of the
second year before anyone thought about how we were going to do the clinical
years. Luckily Joe [Pizzorno, ND] , Sheila [Quinn] and Lester [Griffith, ND] were able to find the space for the clinic at University
and 45th soon enough, which only left the design of the curriculum.
Joe's first attempt was uniformly rejected. In
frustration, he threw it open to the floor and asked for a Review Committee to
be formed, to include himself, Sheila and several students. Although not much of
a joiner at the time, for some reason I threw my hat into the ring --and even
more surprisingly was selected, probably because I could appeal to the
brainiacs without also scaring off the touchy-feely folks.
For a musical score I was working
on at the time, I was using Venn Diagrams
and set theory to depict the spacial relationships between certain musical textures
(sonorities).
One evening I just migrated the thinking over to the
curriculum design, as it seemed logical to me that since we were supposed to be
the 'know-it-all' healing art, we would have
to synthesize some sort of a know-it-all
environment for ourselves.
- Peter D'Adamo, ND
At the time I was also doing music scores for several of
the modern dance choreographers at Cornish Institute [now the Cornish College of the Arts]. For a score I was working
on at the time, I was using Venn Diagrams
and set theory to depict the spacial relationships between certain musical textures
(sonorities).
One evening I just migrated the thinking over to the
curriculum design, as it seemed logical to me that since we were supposed to be
the 'know-it-all' healing art, short of the one or two people who did 'know
it all' (like John Bastyr [ND, after whom the school was named]) we would have
to synthesize some sort of a know-it-all
environment for ourselves.
The curriculum actually had other overlaps as well
between concepts and specialties, but I can't remember specifics. The final
version which I delivered to the committee actually looked like a scroll and
read sort of like a piano roll or polygraph printout. I remember as I explained
it to Sheila she said that it was the "interface" that would do the
teaching, which was the first time I had ever heard that word.
Anyway, almost nothing of the original plan was used,
except for the "Integrative Therapeutics" class, but even that veered away from
what I had originally suggested, to wind up as a therapy free for all more or
less moderated by an ND.
That's pretty much it...
________________________
I then asked D'Adamo for a little more specificity on how and in what ways "integrative medicine" was used as a term, as distinct from "integrative therapeutics." He responded thoughtfully.
D'Adamo: I've kinda rolled my eyes over the years when I hear 'who
says who' coined the phrase 'integrative medicine', since I've
never really liked the phrase anyway and at the time I just sort of stuck it in
as a sort of placeholder, thinking I'd eventually come up with something
better. Funny, but in my mind it derived from the notion of
integration as in an almost 'civil rights' sort of way. I suppose that was
real 'minority' naturopathic-type thinking! At the time I wasn't sure that 'integrative' was even a real word. My point was
that naturopathic medicine at its best was an 'integrated medicine,' in the
sense that 1) it had no overarching philosophy and no gurus 2) it used whatever
worked and 3) the clinical interpretation of the situation -- the what, why and how of things to be used in that particular patient--was best
left in the hands of the practitioner --or the 'integrator.' I wish I could remember more, but it was thirty years
ago!
Comment: D'Adamo's story recalls to mind a series of conversations I had with Tracy Gaudet, MD, between 1997-1999 when she and Susan Fleischman, MA and Andrew Weil, MD and others were developing the curriculum to teach the University of Arizona's initial fellows in their emerging Program in
Tracy Gaudet, MD - key role in shaping an integrative medicine curriculum
Integrative Medicine (now Center for Integrative Medicine). Gaudet shared that her team had come to realize that what was to distinguish their work was not principally teaching medical doctors alternative therapies. Yes, they would learn about herbs and guided imagery and acupuncture and massage and etc. But shaping the program would be an orientation and an approach toward assisting the healing power of nature and supporting the patient's ability to heal. These would provide, to use D'Adamo's musical metaphor, a key part of the score.
Interestingly, this moment for Gaudet's team took place at about the same point in the program's maturation as the moment which D'Adamo describes in Bastyr's effort to put academic form to an emerging idea. In both cases, the faculty and administrators needed to create an integrated
curriculum and develop clinical teaching strategies which respected Western medical sciences together with diverse healing
traditions.
The formation of both programs also had in common something which is clear in D'Adamo's account. Both academic strategies were significantly shaped by the students who were the guinea pigs in these emerging and re-emerging healthcare education programs. Happily for all of us, both sets of students were mature groups. Bastyr's average student was in a second career and an average ewas over 30-years-old while the Arizona stduents were all medical doctors returning for additional education. As you might imagine, both sets were excited and inspired by their roles in shaping new/old ways of practicing medicine.
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