Please see: www.wetalksmart.com   and  click on "wellness".         www.wetalksmart.com   Since before 1983, I have promoted communication, cooperation, and participation between doctors and patients. Sometimes it's like interpreting between two languages and cultures.   I believe, as have taught some of the most influential thinkers in history, "As Within, so Without"; that our attitudes and faith and deepest committment bring about the evolution and direction of our lives.   I also believe that most medical "care" takes away the drive to find those attitudes, faith, and committments.     HISTORY MAKES ALL THE DIFFERENCE.     Profile:  Mark A. LaPorta, M.D., F.A.C.P. By Jeff Morris     When I started writing this profile, I knew nothing about Dr. Mark LaPorta. What I never expected was that I would wind up knowing so much about him. But I also didnt think finding out about him would be like solving a puzzlea very intriguing and challenging puzzle. I took more notes in speaking with Dr. LaPorta than Ive taken in speaking to any other profile subject. Since I dont use a tape recorder, I had to type as he spokeand I struggled to keep up. His mind works non-stop. Sentence fragments, incomplete thoughts, reflections, new and partial ideas shoot off in every direction, all of it delivered with an astonishing degree of self-deprecating honesty. When I looked over my notes, I felt inadequate, and despaired about being able to pull it all together into a cohesive profileuntil I got to the final line. The final line was, "My mother thinks Im crazy." I looked at that line, then scrolled back to the beginning. The very first line was, "My father was a doctor." It really wasnt so daunting after all. All those pages of notes, and we had traveled from his father to his mother. We were talking about Dr. LaPortas path as a physician, yet everything came back to his family. So what did I know about them? Lets see: he said his father was "My father was a doctor, who graduated from the University of Rome, Italy, in 1953. In Rome at the time, my people were landed gentry who lost everything during the two European wars. By landed gentry I dont mean they were rich or anything, but they maintained a fierce southeast Adriatic kind of independence. Despite generations of losses of males in my family, my father somehow went to medical school and literally lived on park benches to afford rooming in Romehe literally did whatever it took." Here Dr. LaPorta paused and reflected. "I never considered that, never used that term beforedid whatever it took" He thinks about this for a nanosecond, then quickly moves forward. "He came to the U.S. about 1955, and went to North Jersey. In looking back I see now how his being a doctor with an exquisite analytical engine, there was no question from the time I was a child that I would be a doctor too. My mother said I was raised to be a prince." (Im barely able to keep up; its not until afterward that I recognize the reference to Charles Babbage, the 19th century Englishman known to some as the "Father of Computing" for his contributions to the basic design of the computer through his Analytical machineeven though in 1878 a British government committee recommended not bothering to construct Babbage's Analytical Engine. What does any of this have to do with Dr. LaPorta, or his father? And why didnt I think of asking, does that mean your mother equated "prince" with "doctor"?) "When I was 4 or 5actually I was 5 and my brother was 4my father put us on a plane at JFK and said, Speak or dont eat. We went to stay with my uncle in Italy, and I came back fluent in Italian." (Now I recall he said he was fluent in Italian, Spanish, and a couple of other languagesone of which he was currently learning.) "I went through school a great big scholastic hot dog. I used daddys analytical engine, which had been passed down to me. Whatever came along I kind of learned by osmosis. I was a hot dog and had to show people how good I was." This much I knew: His full name is Mark Antony (what a name for a Roman prince!) LaPorta, and he had trained at Northwestern University and Rush-Presbyterian St. Lukes Medical Centers in Chicago, receiving his B.S. in Medicine from Northwesterns Honors Program In Medical Education in 1977 while simultaneously enrolled at Northwesterns Medical School from 1975 to 1979. After a brief Interim Internship at Monmouth Medical Center in Long Branch, New Jersey in 1979, he performed his Internship and Residency in Internal Medicine from 1979 to 1982 at Rush-Presbyterian Saint Lukes in Chicago, and continued there as Chief Resident in Internal Medicine from 1982 to 83. Dr. LaPorta confirms all thiswith a slight twist. "I went to Northwestern Medical School right at the beginning of my17th birthday. At 22, I had my M.D. I went to Rush-Presbyterian St. Lukes internal medicine program, and was chief resident. I used it as a chance to be a teacher and a leader. I knew at the time I had very little interest in the specialties, and I also had no interest in the Swan-Ganz catheterI was not a procedure guy. I remember dreadfully embarrassing myself in front of Grand Rounds, asking Does this help? Do we really need this test? Northwestern was really a place where you got a gentlemans education at the time. The school said you only do a test if you know what youre going to do with the result. But by the time I switched from the elegant gentlemens education at Northwestern to the more rough and tumble world of my residency, everybody had switched from that philosophy to, If you think of it, do the test. As a result, the sheer volume of data on any given patient is now too big; its simply impossible to use. During one of my practice years I saw a three-man specialty practice almost single-handedly put a hospital out of business by ordering all the tests they did." "I got married at 27 and moved down to Miami. I was invited by my uncleUncle Walter, who had put us up in Rome, had become a doctor and was already running a million-dollar nursing home practice. Beginning in 1983 I worked in nursing homes and lived on Miami Beach. I was one of the busiest internists on Miami Beach." Okay, this sounds good. I think. Doesnt it? "In the 80s, I came up with my rules. Rule #1: I dont give orders; I make recommendations. Rule #2: All pills are poison. I dont care what it is, even vitamins. Somewhere in there is something that will hurt someone. By giving someone a pill, you are undermining helping them find the internal causes of the problem. My life has switched from external causation to internal causation and external effect." "I wrote my first resumeit was pure self-aggrandizement. In that first resume I wrote in 1983, I put my top professional interest as private practice of internal medicine; #3 was wellness emphasis. But it turns out that all we were doing was spinning our gears. Ive come to believe that 85 percent of what we do is unnecessary or wrong. We have a horrible codependent relationship with our lawyers, our politicians, and each other. That includes the alternative community; theyre merely showing off and showing you how great they are: Look what we do and how well we do it!" Wait. What? I check out Dr. LaPortas bio: Dr. LaPorta is board-certified in Internal Medicine, with added qualifications in Geriatrics. He is a senior member of the Board of Directors of the Dade County Medical Association, and a Director of Florida Physicians Association. Dr. LaPorta has held multiple teaching positions and has been involved in editorials, medico-legal, and advisory consultations, and has practiced full-spectrum traditional and complementary Internal Medicine, in private, group, clinic, and solo venues since 1983. Dr. LaPorta has provided expert medico-legal and governmental consultations, researched and written, edited, founded, and run a multifaceted practice, participated in peer-review and hospital committees, developed staff, and practiced cost-effective care and evidence-based medicine. Now Im really confused. Is this the same guy? In the C.V. he sent me thats dated October 2002; it lists Professional Interests: Cost-Effective Private Practice of General Internal Medicine Public Health and Community Education Continuing Medical Education Organized Medicine And it ends with these quotes: Definition of a Doctor: On whom we set our hopes when ill, and our dogs when well. (Ambrose Bierce: Devils Dictionary, 1911) "We shall require a substantially new manner of thinking if mankind is to survive." Albert Einstein, 1937. The Hippocratic and Maimonides Oaths are a distillation of the most noble aspects of the human mind and spirit. "The weak are devoured, the strong are spit out.", Wu ButbutI know he said something to me about the Hippocratic oath. Yes, here it is: "A few years ago I went to an activity of local Catholic doctors. They recited the oath of Hippocrates. I wouldnt recite it; its become the hypocritical oath, not the Hippocratic oath. Were driven by money, prestige, and fear, fear, fear. Look at the Hippocratic oath and see what part of it doctors are actually doing today. The whole thing is a seduction. The whole context of what were doing is false. Thats why what Im doing is alternative medicine. This year Im going to come right out and say it: what people talk about in alternative medicine is really a substitution of unlicensed herbs and methods for mainstream medicine." I scroll back; hed said earlier, "The issue of traditional vs. mainstream is actually very subtle. Mainstream and traditional are not actually the opposites of alternative. Its all based on marketing. Most doctors believe theyre being compassionate but its really based on fear. We need to get rid of the fear, and get rid of the superstition. Fear is the killer." "When we dont like our pills or medicines and we switch to an alternative, we are simply switching from something licensed and regulated to something unlicensed and unregulated, but its still the material solution. By being traditional youre being alternative. I went from being a standard, thoughtful, reasonably cost-effective physician. The result I got was the same: the patients hate me; theyre continuing with their same unhealthy lifestyles and just want medicine to make it better. Why do people love going to chiropractors? Theres a laying on of hands, probably a release of endorphinsAll these wordsalternative, integrative, complementary, etc.all are still the same approach: A person comes to you with a problem, you give them something for it, they go away and come back to you with the next problem. If I get a choice between Motrin for back pain and a chiropractor, Ill take the chiropractor." Now Dr. LaPorta says something that he feels is especially important. He goes back to it and says it should be presented with great emphasis. So here it is: "Pitiful and incomprehensible demoralization: thats the state of healthcare in most of the world today. I know what people want the moment they walk in, but we go through this charade; they start saying they dont want a prescription, but they really do. Its we pretend to want you to treat us, you pretend to treat us. Were gentlemanly to each other. I saw the Dalai Lama a few years ago and realized all he was saying was, the highest form of wisdom is kindness. So I worked on my kindness. But what is it to be kind? Try to give people what they really need and see how they react to it." "I found myself in a quandary because all these years Ive been living a lie, doing it to the best of my ability, making plenty of money doing it. But suddenly there was a spark. If I cant convince a patient that hes contributing to his own demiseI can only be sincere, I cant force them to get it. I asked the boards of medicine here in Florida how the standards of care came around, and they basically said, Its what everybody does. Today, everybody comes in and says, I want Viagra. I want Allegra. Dont ask them what they are doing to contribute to this condition, just give them what they want. I dont believe in Satan, but these medications are like a Satanic conspiracy. You go to your doctor, have him write a prescription for a mood or mind altering substanceViagra includedand you dont have to find out who you are or build a relationship with anyone else or yourself. People were taking a lot fewer prescriptions five years ago than they are now. No, I dont have the figures to back that up, but its obvious from what I see. If you say to me, prove it, Ill say, disprove it! The pharmaceutical industry has doubled in size in five years. When I found out the Italians are taking just as many pills as we are, I was devastated. In the Old World, you didnt take pills unless you had to. My father would say: let it go. He was right. After a while I realized that not all of my aches and pains were important. Now people say to me, what do you think you are, a psychiatrist? But psychiatrists throw pills at people too." Hold on. Hold on. You were living a lie? "I walked away from one of the busiest primary care practices in Miami in 1999. Why did I leave the practice? I got demoralized. My morale fell in the midst of making more money than I ever had, and suddenly realizing that I was doing what I was raised to do, it hit me like a bolt of lightning, between the lawyers and the pharmaceutical agents and the managed care companies lying, telling people to go to whoever they want to but telling me to stop them at the doorbut I wouldnt. In 1999 I was 43, and I was done, gone, sick of it. I left for six months, just lived in flip-flops. The HMOs were always so late in paying me that when those payments finally came, they paid for the six months." "Doctor burnout is all about ego, yelling, look at me, I did it! I knew when I started yelling at the nurses, I was out of control. I was a rat caught on a treadmill. These patients are coming in pretending to want to get better and I was pretending to treat them. I was in denial for so long I didnt even recognize it. The punishment turned out to be a slap in the face; I cant keep doing this. How do you tell that to your colleagues? I just turned everything overthe whole practice. How do you find out what youre supposed to do without knowing who you really are? Id been hearing from movies since the hippie days, what if you found out that everything you thought you knew was a lie? It turned out to be true!" "Today, I consider myself wealthy because I have what I need. When people hold out a hand of need, I want to be there for them. You dont allow yourself to be hurt because if you do, you cant help the people you love. I do believe that out of chaos comes order. The healthcare system is due for a meltdown. The mentality of self-realization is you know who you are and you know what you must do. Theres an element of sincerity involved there that is absent on all hands of the equation in health care today. I am a very good (A+) diagnostician. Thats not self-aggrandizing, thats what I do. Im still doing that now, just less. I predicted the use of beta blockers after myocardial infarction, and people said dont tell anyone, youll get in trouble; now its standard procedure. In 1982 I thought patients should be able to self-medicate, they said dont let anybody hear you say that; now its standard operating procedure." "Ive been waiting for my consciousness to be strong enough to understand what I need to do. 20 years ago I was going to call the practice New Dawn. What Im proposing now is a kind of medicine that I want to call Step 12 Health Care. The last step is the result of the first 11. Theyre the same 12 steps that are used in other 12-step programs, like Alcoholics Anonymous. Theres a religious element, but theyre not religious in the organized religion sense. Part of this was because I discovered yoga. The elements are all there: Prayer, meditation, useful alignment, silence instead of noise, simplicity instead of multitasking. Andrew Weil just published a new book; hes now advocating that instead of thinking, What can I do to live longer? hes saying, Live the life you can; enjoy a more fruitful life." "My father knew who he was, he went to become what he knew he was; nobody was going to stop him. He did something most people do not do for themselves today: know who you are, even if you have to go someplace to find out who you are. The University of Rome was a stronghold of intellectual fortitude, which is lacking from our education today." "William Osler in 1901 said if you listen to the patient long enough, hell tell you the diagnosis. Thats now considered alternative, because were no longer doing it in the mainstreambut its the way things used to be done. A man can be led to find out who he is. I cant tell you who you are, but I can tell you how to find out. You go on the journey yourself. I am an advocate of the 12 steps. You dont have to be an alcoholic; they just used the model. Its been around since the Greeks, since Ignatius of Loyola." So this is what its all about. I think Im beginning to comprehend. Clearly, Dr. LaPorta has come to the realization that the most important things in his own life are the basics: his family, the way he treats others, his intellect, the lessons he learned from his father; and the most important things in medicine are the basics as well. And, equally important, these are the lessons we used to understand, the "traditions" we used to follow, but have somehow allowed ourselves to forget. And even the "alternative" medicine we practice today seems to be another manifestation of the wrong-headed belief that we can throw a substance at a problem, and that will somehow solve the problem. The only true "solutions" can be found by each of us, on our own spiritual journey of self-discovery. Of course, I only said I think I comprehend. I also see that Dr. LaPorta has slyly woven into his monologue cryptic information that explains a lot about him. Especially the reference to the Analytical Engine, that led me to Charles Babbage; as I read about Babbage, I found that he was the inventor of the first universal digital computer, and that use of Jacquard punch cards, of chains and subassemblies, and ultimately the logical structure of the modern computer, all come from Babbage. Among his other inventions were the cowcatcher, dynamometer, standard railroad gauge, uniform postal rates, occulting lights for lighthouses, Greenwich time signals, and heliograph opthalmoscope. I also find that Babbage was an aesthete, who found beauty in things as varied as stamped buttons, stomach pumps, railways and tunnels. He once choreographed a ballet utilizing experimental lights; he enjoyed fire, and once was baked in an oven at 265 degrees F for "five or six minutes without any great discomfort," and on another occasion was lowered into Mt. Vesuvius to view molten lava. And he considered spiritual questions; had considered becoming a cleric, and published a treatise to reconcile his scientific beliefs with Christian dogma. Yet by the 1880's Babbage was known primarily for his reform of mathematics at Cambridge. And in 1899 the magazine Temple Bar reported that "the present generation appears to have forgotten Babbage and his calculating machine." In 1908, after being preserved for 37 years in alcohol, Babbage's brain was dissected by Sir Victor Horsley of the Royal Society. Horsley had to remind the society that Babbage had been a "very profound thinker." I know what youre thinking: What does any of this have to do with Dr. Mark LaPorta? Well, for one thing, it shows that I can get into the spirit of things and jump off on tangents with the best of them. But more relevantly, I think that by bringing up the Analytical Engine, Dr. LaPorta showed that he identifies with Charles Babbage, as well as with the times in which he lived. Like Babbage, his interests and references are wide-ranging and varied. He can see the connections between seemingly dissimilar fields. He ties the scientific to the spiritual. He identifies with "Old World" valuesthe values of the Victorian era; the values of his father. Suddenly were talking aboutokay, hes talking aboutStephen Covey, and his 1990 bestseller, "The Seven Habits of Highly Effective People." "I was researching the immune system last year, and found Covey brought up the subject of the guy who first promoted the concept of stress as a biophysical phenomenonHans Selyeand as you look into alternatives, you find out that the way they did the testing depends on some assumption that cannot be validated. Its like being caught in a maelstrom." (Selye discovered and documented that stress differs from other physical responses in that stress is stressful whether the one receives good or bad news, whether the impulse is positive or negative. He called negative stress distress and positive stress eustress.) "People talk about stress as a cause of disease. Selye talked more about distress, and eustresssomething that, with your entire organism, you know youre doing something so good and valuable that the stress of focusing on it actually improves your health. Its like yoga; it hurts, but its the kind of pain thats a wonderful thing. You benefit from the stress. The teacher guides you but doesnt help you do it; you do it yourself. Ego, the sense of being alone, thats what kills us. We live in a state of codependence rather than interdependence." "Preventive medicine is the closest term to name what I do. And preventive medicine is really preventive medicine. When you know who you are and know where you are, you feel good, and you dont go running to the doctor. Some people get it, but most patients dont understand yet; the question we need to ask is, What are you willing to do to get better? Dont come to me and tell me youre trying to lower your cholesterol, when just because youre taking a pill you think you can eat a hot dog and ice cream." Dr. LaPorta says hes now doing (not surprisingly) "a lot of things. Im launching MyMedicalAdvocate.com to try to clear things up. If you go to a doctor and go through a series of treatments that are more and more confusing, call me. We're trying to figure out, how do you help the most people without scaring them away? So Im trying to set up easy access to simple and reliable, personal and compassionate information; its minimalist, its Zen health careI just thought of thatwhen you get to that point you realize less is better. I call my own work diagnostic and therapeutic minimalism. I only do what is right and good and necessary." "Self realization, self actualization, self spiritualization need to be done. Were not going to force anybody; our attitude is, You want to do the work? Youll get better. You dont want to do the work? Well help some things, and ultimately youll die of something else. I have four like-minded people working with me. Theres me, a psychiatrist, a nurse, and a psychology nurse coordinator, all involved in it. I want sort of a Jungian group consciousness to build this. Its not something I intend to pass down. Some things start with good intentions, but they go through generation after generation and pass to scoundrels." "I live a simple life now. I talk to people like humans. There are no secrets; you put a pill in your mouth, that pill's addictive. I want to write a book called How to Use Your Doctor. I cant go back and do the other thing; I would be lying. My mother thinks Im crazy." See, I told you that was the last thing he said. At the rescheduled  Integrative Medicine for Anti-Aging Conference, Dr. LaPorta  presented, "Putting Alternatives Into Practice." The description: "Our patients are looking for simpler and more understandable methods of diagnosis and treatments; they feel that the mainstream medical system has failed them and it scares themand us! How can we best help? What are the true alternatives? A survey of science, global art; the market, and the media: an eye-opening experience."