Alternative and Complementary Therapies
Volume 6, Number 3
June 2000
By Russ Mason, MS

Healing the Whole Person on the Journey Through Cancer: An Interview with Jeremy R. Geffen, MD, FACP

Editor's Note:
Jeremy R. Geffen, MD, FACP, is the founder and director of the Geffen Cancer Center and Research Institute, Vero Beach, Florida. Russ Mason, MS, interviewed him for Alternative & Complementary Therapies. First Mr. Mason provides us with some background on Dr. Geffen and how he came to be where he is today.

Background

In Vero Beach, Florida, something remarkable is happening to people who are diagnosed with cancer. It is the result of the vision of Jeremy R. Geffen, MD. According to Dean Ornish, MD, president, Preventive Medicine Research Institute, Sausalito, California: "Dr. Geffen is an oncologist of the future, one who integrates the best of traditional and nontraditional approaches. He addresses the physical as well as the psychosocial, emotional, and spiritual dimensions of health and healing. It is unfortunate that all people with cancer can't have Dr. Geffen as their doctor."

How Jeremy Geffen, MD, a board-certified medical oncologist, came to establish the Geffen Cancer Center and Research Institute appears to be straight out of The Hero's Journey by Joseph Campbell.

In his senior year of medical school at New York University School of Medicine, Dr. Geffen personally witnessed the clinical, matter-of-fact approach of conventional medicine when his father was diagnosed with metastatic gastric cancer, which was a virtual death sentence. He saw how his father was transformed from a human being into a "cancer patient," with all medical attention being focused on the tumor instead of on the person and no attention whatsoever on what his father might do to help himself battle the disease. Nor was any attention paid to the profound mental, emotional, and spiritual challenges his father was experiencing.

Deeply anguished, the young doctor-to-be began to search outside of conventional allopathic medicine for anything that would help his father-diet, acupuncture, Ayurveda, or homeopathic medicine. He consulted numerous health care practitioners and found a dizzying maze of contradictory theories that provided no useful answers. His father was dying and Jeremy Geffen could not help him; worse, apparently no one could. And the Geffen family suffered along with the dying man with no place to turn to for help.

Although at the time he had no idea how, Jeremy Geffen resolved to create a cancer center that would not only provide impeccable oncologic care, but would also support the whole person with mental, emotional, and spiritual care. People with cancer are often staring into the abyss of the unknown, and they need love, support, wisdom, and incredible kindnessóalong with outstanding medical care, he says.

After the death of his father, the young Geffen received his MD with honors. He then completed residency training in internal medicine at the University of California at San Diego Medical Center, followed by fellowship training in hematology and oncology at the University of California at San Francisco Medical Center. Thereafter, he moved to Vero Beach, Florida to begin his clinical practice and, two years later, opened the cancer center in 1994. In January 1995, he was elected a Fellow of the American College of Physicians (FACP).

More recently, Dr. Geffen has brought his journey to a new level with the publication of his first book, The Journey Through Cancer: An Oncologist's Seven-Level Program for Healing and Transforming the Whole Person (New York: Crown Publishers, 2000), which presents a unique program he has developed to help people with cancer and those who love them.

The Interview

Russ Mason: What led you to become a doctor?

Jeremy R. Geffen: When I was very young, I recognized that I had a spiritual hunger, a longing to understand who I was spiritually. It may sound a bit corny, but it really began when I was preparing for my Bar Mitzvah, at the age of 13. I began to experience deep feelings and memories that were gnawing at me. The journey continued significantly in a conscious way when I was 16. I went to Israel and spent time studying with orthodox rabbis in an orthodox community. This was an exploration into my own religious heritage. I dived deeply into that tradition and had some remarkable experiences. Yet, I felt somehow that it was not my path. I returned to America.

After graduating from high school I went to Hampshire College, in Amherst, Massachusetts, for 1 year. There I had a wonderful physics professor who dared to teach quantum mechanics to freshmen. At the time this was a very avant-garde thing to do. The course opened my mind to another amazing domain of reality. I was mesmerized and inspired by the genius of people such as Albert Einstein, Niels Bohr, Max Planck, Werner Heisenberg, and other giants in the world of physics. I also studied biology and discovered the extraordinary treasures that could be found in that domain of science as well.

At the end of that year, however, my spiritual longing was tugging irresistibly at my heart. After a great deal of reflection, I decided to leave school and go on a formal spiritual quest. This was a scary thing to do, but I knew I would never find answers to the questions in my heart if I stayed in a university, as much as I loved being there. So, I went off on my spiritual quest, and went traveling around Europe and America, visiting various communities. Then, when I was 19, I met a famous Zen master who became my first formal spiritual teacher. He introduced me to the teachings of the Buddha, and taught me meditation for the first time. I spent months doing zazen (a formal, sitting meditation) and immersed myself into the Zen tradition. It was beautiful and profound, but once again, ultimately, not my path.

Then, just before I turned 20, I met a Hindu spiritual teacher and went to live in an ashram, a Hindu spiritual community. It was there that I felt reconnected with my spiritual roots, very deeply. I took to yoga and meditation like a fish to the water. It was joyful and effortless. More importantly, I began to find answers to the questions that had been calling me my whole life. I went very deeply into yoga, and Eastern philosophies, and became a vegetarian. It was at that time that also I began to first explore Tibetan Buddhism. I fell completely in love with these traditions. They are filled with such great wisdom, knowledge, and truth and are very practical as well. For a long while, I genuinely contemplated spending the rest of my life as a monk. But after 4 years I began to hear the inner voice of my heart calling to me again. This time, it was saying: Jeremy, you have to leave the ashram and go to medical school.

At first my reaction was, what? But this was the same voice I had heard as a child and at many other times in my life. In fact, when I was 4 or 5 years old, I had a very distinct feeling that I was going to become a doctor, and this same intuition was now reappearing. When I was a teenager, that intuition was pushed aside when I began my spiritual quest. But now, here I was, 23, about to turn 24, and this voice was back: It's time to become a doctor. And I just couldn't get it out of my head.

So I left the ashram, went to New York City, and attended Columbia University. I received a BS degree and, from there, I went to New York University School of Medicine. Very early in my first year, I realized that oncology was the field I was going to work in. I was captivated by the fact that oncology utilizes the very latest and most sophisticated medical technologies available, but also deals with the deepest issues of life and death that confront human beings. Patients and their family members are often right on the edge of these two worlds. Right away, I just knew this was the field for me.

As my studies progressed, however, my interest in spirituality and the traditions of the East never left me. After my second year in medical school, I had the opportunity to go on a medical expedition to Nepal. Nepal is a small Hindu kingdom in the Himalayas, with a large population of Tibetans as well. Going there was another life-defining moment for me: I was part of a small group that trekked on foot for ten days from Kathmandu to the Langtang Valley, way up near the Tibetan border. We did a public health survey of four villages in this valley. Along the way, I did a research project on the indigenous forms of medicine in the region. These included Ayurvedic medicine, the ancient form of healing from India; Tibetan medicine, from Tibet and Tibetan Buddhism; and a form of healing unique to Nepal called Dhami Jankri medicine. These are the three major forms of healing in that part of the world, and they were largely unknown in the West at that time.

In Nepal, I met and interviewed several Ayurvedic and Tibetan healers, and was astonished by their knowledge, insight, and diagnostic skills. It was all breathtaking to me. Here I was, high in the Himalayas, and I realized that the Eastern traditions not only have profound spiritual knowledge, but they have profound medical knowledge as well. And it became clear to me that they had an enormous amount to offer humankind, that was very real and practical, that could definitely help people who were suffering. This was an epiphany for me. When I realized this, light bulbs went off in my head like the fourth of July. After the expedition in Nepal was completed, I continued traveling and went to visit an ashram in northern India. This was another incredibly powerful experience for me.

Early in my senior year of medical school my father was diagnosed with gastric cancer and he died less than four months later. This was a heartbreaking experience for me and everyone in my family, but it confirmed the specific direction that I was going to work in. I looked and looked, but there was no place in the world where I could bring him where he could receive top-notch medical care for his cancer, along with other modalities and paradigms of healing that I knew -- from direct experience -- could help him significantly along the way. So I realized that I would have to build that place, because it didn't exist. And I resolved to do it.

RM: Was it difficult to establish the center?

JRG: Oh my God, you have no idea! First I had to become an internist and then an oncologist, and this took 6 years after finishing medical school. If I hadn't done that, we wouldn't be having this discussion. I was very fortunate to be able to go to top university medical centers for my training. During that time, I continued to devour Western medicine. Even though it was a very challenging road, I really enjoyed those years because medicine is a wonderful field. The technologies are fascinating and incredibly powerful and they're getting better and more sophisticated all the time.

Along the way, however, a deep fire kept burning quietly in my heart and I kept looking for ways to go back to the East. I wanted to continue to study and research more about what I had discovered on that first trip. During my residency, I finally was able to go to Lhasa, the capital of Tibet, as a visiting physician at The Hospital of Traditional Tibetan medicine. Going to Tibet was the fulfillment of a dream of many years. That's when I started diving more deeply into the tradition of Tibetan medicine, which I think is a truly extraordinary approach to physical, mental, emotional, and spiritual healing. After leaving Lhasa, I journeyed overland in a jeep for 4 days, from Lhasa to Kathmandu, on my way to Dharamsala, India, to spend time at the Tibetan Medical Institute. While in Dharamsala, I had the opportunity, the great, great privilege, to have a personal interview with His Holiness, the Dalai Lama. This was as you can imagine an extremely moving, and deeply meaningful, experience for me. He is an incredible being and we are so blessed to have him alive right now.

This is the heart center of my story, the rationale, the reasons why I was compelled to do all of this. And it became increasingly clear to me that this was a major part of what my life's work would be.

After completing my residency and fellowship training I moved to Vero Beach, Florida, and opened the Cancer Center in 1994.

RM: How does one just start a center? You had finished medical school, finished your residency, and finished your fellowship in oncology. What happened next?

JRG: I worked in private practice for 2 years in Vero Beach and then I told a local bank about my dream. I said: This is the dream of my life: I want to build a magnificent, state-of-the-art cancer center that will provide the very best medical technologies from every approach and paradigm on earth. Will you help me? I convinced the bank to lend me the money to do it. So, I rented a 6000 square-foot empty building and carefully designed the layout with an architect. Then I set about hiring and training the staff and building the infrastructure: everything from examination and chemotherapy rooms to computer systems to a full-fledged CLIA-certified laboratory. [CLIA stands for Clinical Laboratory Improvement Act and comprises stringent Federal standards for medical laboratories.] It was a tremendous amount of work and everything was created from scratch.

Now, 6 years later, we have a wonderful staff that includes three fulltime oncologists, nurses and medical assistants, phlebotomists, lab technicians, an administrator, billing and insurance personnel, and a licensed clinical social worker who leads the cancer support groups. We also have a fulltime massage therapist, as well as a yoga/meditation instructor and a licensed acupuncturist, all of whom provide care or offer classes here. Additionally, we have a network of alternative and complementary health practitioners in the area that we work closely with, from a variety of specialties. The Center also has a massage therapy/acupuncture room, a yoga and meditation room, and an educational/spiritual bookstore. We also have a database, a serum bank, and a Web site: www.geffencenter.com .

One of my major goals in this work is to encourage patients to think about disease in a new way. This is also true for doctors and other health care practitioners.

Again and again, I say to patients: Make sure to address all the dimensions of who you are as a human being. The biggest mistake you can make is to focus only on your body. Yes, we must deal with the body, but let's also explore your mind, your heart, and your spirit. Let's see how these are influencing how you feel, what you are experiencing along the way, and where you're going in your life. Let's explore your emotions and heal any traumas or unresolved conflicts that might still be there. Let's also see how your thoughts and beliefs are impacting your perception of reality in every moment. And, above all, let's explore your spiritual nature -- the timeless and dimensionless aspect of life that we all share.

RM: What have been the most rewarding aspects of this new approach to health care?

JRG: It is to see fear and despair transformed into love and joy in the hearts and minds of patients and their families -- regardless of what may or may not happen to their tumors during the course of treatment. This love and joy arises -- not necessarily because the cancers went away -- but because of what these people have discovered deep within themselves. As far as I am concerned, this is one of the greatest miracles that can occur in medicine. In fact, I believe it is something we should aspire to openly and consciously.

RM: How do you and your colleagues accomplish this?

JRG: First of all, by recognizing that it is possible. All human beings have tremendously powerful resources within themselves that can play an important role in the process of dealing with cancer -- or any other illness -- and we look for ways to activate and strengthen those resources in our patients and their loved ones. At our Cancer Center, we rely primarily on impeccable, high-tech, conventional medicine to treat the specific cancer -- especially chemotherapy, radiation, and surgery. But, as we have discussed, we also explore a wide variety of other modalities to augment and promote the other dimensions of healing. To facilitate this, I have developed a Seven Level Program that guides patients and their family members through a careful exploration of who they are -- physically, mentally, emotionally, and spiritually -- so that no part of themselves is left out and no opportunity for healing is missed. By honoring and caring for the mind, heart, and spirit in this way, as well as providing outstanding care for the physical body, we have found that patients and their families have the best chance of achieving the results they desire. However, in the end, it all begins with our own consciousness and our own intentions. As a medical team we have spent a lot of time, over years, talking about these ideas and everyone on our team understands and is inspired by them.

RM: How was the Seven Level Program created?

JRG: The Seven Level Program is not something that I conceived from a theoretical standpoint and then tried to impose on my patients. Instead, it came about in a completely organic way.

Over many years, caring for hundreds and hundreds of patients and their families, I spent countless hours talking with them and listening, carefully, to their needs, questions, and concerns. After a while, I began to see a very clear pattern in the kinds of questions that patients and their family members were asking me and the kinds of concerns they were trying to deal with. Over time, I realized that all of their questions and concerns consistently fell into one of seven distinct areas. After I recognized what these seven areas were, the program instantly became crystal clear. It was like putting pieces of a puzzle together and then suddenly recognizing what the picture was all about. One night, in a flash of insight, I literally saw the structure and content of the program in its complete form. I then started sharing it with patients and was astonished at how effective it was. In minutes, it gave them an understanding of so much of what they were going through and where they needed to put their focus in order to truly heal at the deepest levels. It also helped them make sense out of the avalanche of information and recommendations they were receiving from so many sources. So the program emerged in this completely organic way, out of years of caring for people who were facing and dealing with cancer from every conceivable angle.

RM: What are the components of the Seven Level Program?

JRG: Level One is called Education and Information. It is no accident that this comes first. The reason it is so important to address this issue right up front is because, when a person receives a diagnosis of cancer, the first thing that usually happens is he or she becomes terrified. Right on the heels of this fear comes a big wave in which the mind is flooded with an avalanche of questions: What kind of cancer do I have? How did I get it? What treatments are available? What are the side-effects? Can I be cured? Am I going to die? The importance of finding accurate, comprehensible, and reliable answers to these questions -- particularly in the early phase of the illness -- cannot be overstated. This is what Level One, Education and Information, is all about, and why it comes first. Without it, patients may derive less than the maximum possible benefit from their treatment. They will also not be able to relax enough to explore the deeper dimension of healing.

Level Two is called Psychosocial Support. This level of the program is where we focus on the need for, and benefits of, having a strong support network on the journey through cancer. Connection with others lies at the heart of healing. This is not only intuitively true, but it is now abundantly clear from countless scientific studies in the medical literature. The expression that no man is an island is rarely more true than when dealing with cancer. The need for connection with others is as basic and important as the need for surgery or chemotherapy or any other medical treatment. Thus, in this level of the program, we focus intently on making sure that all of our patients have the support they need during this critical and often very challenging time. It is clear that this support can come from a variety of sources, including cancer support groups, family members, clubs, religious organizations, friends, or our medical staff. What is most important is that patients -- and their family members -- know where to find support when it is needed, and that they do so.

Level Three is called The Body as Garden. This level of the program invites patients to think of their bodies in an entirely new way than they may ever have before. I first encountered this metaphor, The Body as Garden , in my travels to the East, years ago. I immediately fell in love with the image and it inspires me still today.

In the West, as we know, the body is thought of basically as a machine, as something purely mechanical. As a result, to a very large extent, doctors have been relegated to the role of mechanics. In the East, however, the body is seen as a garden, as something sacred and precious. Here, doctors are seen as gardeners and their role is to help patients nurture and cultivate the garden of their being so that the fruits and flowers of health and wellness can truly blossom and grow. From this viewpoint, restoring health and inner balance is not something a doctor does to you. Rather, it is a vital, active, and ongoing process in which you, yourself, can and must play an essential part.

In this context, Level Three of the program is where we guide and assist our patients in exploring the entire spectrum of alternative and complementary approaches to healing. These include things like diet; nutrition; exercise; massage; yoga; herbal therapies; Ayurvedic, Tibetan, and Chinese medicine; acupuncture; homeopathy; chiropractic; visualization; and many others.

It is important to reiterate here that we do not offer or promote these approaches as treatment for the cancer. Nor do we believe that they should be viewed in this manner, because, at least at the present time, they are unproven for this purpose. In fact, in my opinion, they are quite unreliable as treatments for cancer. However, there is no question that many alternative and complementary therapies can supplement conventional care in important and significant ways, most notably by helping to cleanse, relax, and tone the body. This integrative approach really seems to provide the greatest chance for health and well-being to emerge. For many patients and their families, this level of the program also provides an opportunity to explore the pleasures of the physical world in new and surprisingly powerful ways. Massage, deep relaxation, and healthy foods alone are not cures for cancer, but as demonstrations of love and care for the garden of the self they can be extraordinarily helpful.

Level Four of the program is called Emotional Healing. This is a critically important part of the healing process that is often overlooked in the urgent, compelling desire to, get rid of the cancer. As anyone who has ever dealt with this disease knows, the diagnosis of cancer can be profoundly unsettling and disruptive for everyone involved. For many patients and their families, cancer shakes the very bedrock of their existences. Long-held beliefs and cherished self-identities are often called into question, and nothing is -- or ever will be -- the same. Along the way, an avalanche of troubling emotions is often unleashed in the patient and caregivers. These emotions, which can range from simple fear, pain, and sadness, all the way up to intense anger, guilt, rage, bitterness, and despair, must be addressed in a sensitive, yet intentional, way. Until all of these emotions are brought out and healed in the light of love, it is impossible for patients and their family members to have the kind of healing experience that they truly desire.

In fact, I can honestly say that, in my many years of experience, not one single patient who has been seriously challenged by cancer has ever truly healed without undergoing a deep healing of his or her emotional self.

Level Five is called the Nature of Mind. This level of the program is where we help patients begin to understand -- in a conscious way -- how their minds really work. Furthermore, as I mentioned earlier, we help patients discover how their conscious and unconscious beliefs, their continuous streams of thoughts, and the meaning they give to events, are influencing -- in the most profound way imaginable -- their experience of life in every moment. Of course, this also applies directly to how they are experiencing the diagnosis of cancer and how they experience every single aspect of their cancer treatment.

It is also remarkable to understand how our thoughts, beliefs, and values influence every single decision that we make in life, especially since the process of how we tend to actually make decisions is, for most people, unconscious. Once again, these same forces are operating in cancer patients and their family members and are influencing all of their decisions as well.

This is a critical point, because the decisions that people make about their cancer treatment can have profound and long-lasting consequences. This applies to very large decisions, such as whether or not they will undergo surgery, chemotherapy, or radiation -- to apparently smaller decisions, such as whether or not they will attend support groups; whether or not they will consider massage, acupuncture, or dietary changes as part of their treatment program; or even when they will call their doctors if they are not feeling well. On an individual basis, these smaller decisions may not seem that significant. But when taken together -- particularly over many months of a cancer treatment program -- they can make a huge difference in what people experience along the way. These decisions can also influence, in a very significant way, their ultimate outcome as well.

Level Six is called Life Assessment. Here we help patients begin to explore the deeper meaning and purpose of their lives. It is crucial, we feel, for cancer patients to clarify their lifes' intentions. At this level, our program asks: Do you want to live? Why? What exactly do you want to live for? What do you want to do with the time remaining in your life, whether that is 10 days, 10 months, or 10 years? And how can you develop a realistic plan that allows you to accomplish these goals?

On the journey through cancer, these questions achieve great significance because it suddenly becomes clear that we don't have all the time in the world, even if we have a cancer that can be readily cured. For most people, cancer shatters the illusion of immortality in an irrevocable way. This is actually one of the great potential blessings of cancer, if patients are open to receive it. Their illness gives them an opportunity to look at their lives in an entirely new way and reconsider their priorities in ways that they might not have otherwise ever done.

To facilitate this process, we ask our patients to write down answers to a number of important, specific questions, including: What is the meaning and purpose of my life? and What are my most important twenty goals for the coming year? Recognizing that we are all going to die some day, even if we are successfully treated for cancer, we also ask our patients to consider another sensitive but profoundly important question: How do you want to be remembered after you are gone?

RM: Those are very challenging questions.

JRG: Yes, they are challenging -- maybe the some of the most challenging questions people will ever face. But I can't tell you how valuable it is when they find deep and meaningful answers that make sense, and that really speak of their heart.

RM : Tell me about Level Seven.

JRG: Level Seven is called The Nature of Spirit. This is, in many ways, the most precious and important level of our entire program. There are several reasons for this. First of all, as I mentioned earlier, a diagnosis of cancer evokes in many people a deep sense of fear. Usually, this fear involves a sense of physical risk, loss of control, and fear of the unknown. Almost universally, it is followed by a powerful urge to protect and defend a physical body that is now perceived to be under siege, and perhaps even threatened with extinction.

So what happens in this situation, as we have discussed, is that that people tend to focus more strongly than ever before on their physical bodies as the most significant aspect of their existence and of who they are. While it is certainly important to love and care for the body in an absolutely serious and impeccable fashion, the physical body is not the only -- let alone the deepest -- aspect of who we are. Thus, along with caring for the physical body, as well as providing care and attention for the mind and heart, I believe it is vitally important that we take time and attention to focus on our spiritual dimension as well.

When patients and their loved ones take some time each day to focus on the timeless and dimensionless aspect of their being, this ocean of pure being, or consciousness, that we can call our spiritual nature, several important things can occur.

At the very least, it can help patients and their family members remember that there is more to who they are than can be seen with the eyes, touched with the hands, or measured on a CAT scan, X-ray, or blood test. As a result, the emotional turbulence encountered on the journey can be quieted and softened, often in a profound way. I also believe that tuning in to the spiritual dimension of who we all truly are as human beings actually provides patients with the very best chance of getting well on the physical level as well. This is because the realm of spirit is where all true healing ultimately comes from, so focusing some attention there helps make its manifestation more likely.

Tuning into our spiritual nature is of course not a guarantee that healing will occur on a physical level, no matter how sincere, focused, or well-intentioned we may be. But it can almost always facilitate healing on the mental and emotional levels. And it is impossible to overestimate the importance of this in everyone's life -- especially for people with cancer.

Tuning into the spiritual dimension of ourselves in a conscious way, at every step along the journey through cancer, can, thus, be one of the most important and profound ways of helping patients experience the love and joy that they truly seek. Most significantly, it helps them discover the experience of love and joy that they seek, here and now, regardless of their circumstances. The realm of spirit is, after all, the ultimate source not only of physical healing but of the love and joy that we all seek. Helping patients to discover this source -- deep within themselves -- is the true essence of what this level, and in fact the entire program, is all about.

About the Geffen Cancer Center

Geffen Cancer Center and Research Institute
981 - 37th Place
Vero Beach, FL 32960
Telephone: (561) 770-5800 ; Fax: (561) 770-5805
Web site: www.geffencenter.com

The Geffen Cancer Center and Research Institute offers comprehensive medical evaluation and treatment for cancer and hematologic disorders in adults, along with a growing array of alternative and complementary therapies for healing and transforming body, mind, heart and spirit.

Dr. Jeremy Geffen's Paradigm

"There's a wonderful story about Mother Theresa that beautifully illustrates what I'm talking about. One day, Mother Theresa was visiting a prison and a group of prisoners was brought before her. She had a large pad of paper and a magic marker, and she drew a big, big circle. Then she said to the prisoners: 'This big circle represents who each and every one of you really are.'Then she put a small dot in the middle of the circle, and said: 'The dot is your offense. The problem is, you are focusing all of your attention on this small dot -- instead of appreciating the huge circle and vastness of who you really are as a human being.'

I am saying the same thing exactly. My message is we have to pay attention to the dot, to the tumor, and to the physical body as a whole, but that's not the whole picture. We must certainly pay attention to the physical body -- with tremendous skill, love, and integrity. In fact, I believe we should actively explore every technology for healing the body known to humankind. But, along the way, we must also remember that while we have bodies, we also have minds, hearts, and spirits. And these other dimensions of who we are need and deserve our attention as well. Because, if healing is to be complete, every dimension of who we are as human beings must be cared for with equal skill and integrity." Jeremy R. Geffen, MD