Are you eager to try the latest serum or supplement — or are you suspicious of every wellness influencer who crosses your social media feed? Either way, there’s much to learn and consider in Kelsey Rae Dimberg’s novel “Snake Oil” about the wellness industry. Kelsey and Mayo Clinic integrative medicine expert Dr. Brent Bauer give us a nuanced view of integrative medicine and the business of wellness.
Are you eager to try the latest serum or supplement — or are you suspicious of every wellness influencer who crosses your social media feed? Either way, there’s much to learn and consider in Kelsey Rae Dimberg’s novel “Snake Oil” about the wellness industry. Kelsey and Mayo Clinic integrative medicine expert Dr. Brent Bauer give us a nuanced view of integrative medicine and the business of wellness.
This episode was made possible by the generous support of Ken Stevens.
We talked with:
Purchase “Snake Oil”
Got feedback?
If you've got ideas or book suggestions, email us at readtalkgrow@mayo.edu.
We invite you to complete the following survey as part of a research study at Mayo Clinic. Your responses are anonymous. Your participation in this survey as well as its completion are voluntary.
Connect with others talking about the podcast in the Read. Talk. Grow. group on Mayo Clinic Connect, an online community moderated by Mayo Clinic. Mayo Clinic Connect is free, trusted, moderated, welcoming, safe and easy-to-use.
Dr. Denise Millstine:Welcome to the “Read. Talk. Grow.” podcast, where we explore health topics through books. Today we're going to take a hard look at the wellness industry. Our book is “Snake Oil” by Kelsey Rae Dimberg. I'm your host, Dr. Denise Millstine. I'm an assistant professor of medicine at Mayo Clinic, where I practice women's health, internal medicine and integrative medicine.
My guests today are Kelsey Rae Dimberg, who's the author of “Snake Oil” and “Girl in the Rearview Mirror.” She received an MFA from the University of San Francisco and is a recipient of the Swarthout Award in Writing. She was the editor-in-chief at Arizona State University literary magazine “Lux.” Before writing novels, she worked for startups like Google and Groupon. Born in Seattle, she's moved all over the West and Midwest and currently lives in Chicago. Kelsey, welcome to the show.
Kelsey Rae Dimberg: Hi. Thanks so much for having me.
Dr. Denise Millstine: It's our pleasure. Our expert guest is Dr. Brent Bauer, who's a professor of medicine at the Mayo Clinic College of Medicine and Science and the research chair for Mayo Clinic Integrative Medicine and Health. Dr. Bauer focuses on the scientific evaluation of integrative medicine therapies. He has served as medical director of Rejuvenate, the first spa at Mayo Clinic, and of the Well Living Lab that's exploring the impact of the indoor environment on wellness. Brent, welcome to the show.
Dr. Brent Bauer: Denise, wonderful to be here. Thanks for having me.
Dr. Denise Millstine: “Snake Oil” is a literary thriller about the larger-than-life Rhoda West, who has built a company called Radical, which sells cult-status products. She's on a rocketing trajectory of success, including seeking whether Radical is worth $1 billion, while she confronts haters and economic pressures that start to threaten the core values of the empire she has built.
Okay, you both know how “Read. Talk. Grow.” works; we discuss books that portray health topics in an effort to better understand health experiences through story. In this case, we'll discuss an integrative medicine topic, which is the wellness industry and the things that we are sold, through the lens of this pretty dark satire.
Kelsey, it is really nice to connect with someone who's spent some time in Arizona, which you've said was a major inspiration for your first book. Tell us what sparked your interest in exploring the wellness industry in “Snake Oil?”
Kelsey Rae Dimberg: Ooh, that's a great question. I would say the first seed of this book came more about exploring startups. I went to graduate school in San Francisco, you know about 2010, and it was a time when kind of phone apps were really taking off. So these startup companies were really in the news, and it was a time of huge, accelerated, dramatic kind of growth and promises for these kind of small, scrappy companies and it felt like kind of a mini gold rush in the city of people trying to come up with these different ideas and turn them into a billion dollar idea. And I was very interested in the personality of somebody who was devoted enough to kind of pour their life into this. And I think especially with kind of female leaders, they often really put their whole personality into the brand. And you see their personal life on Instagram and they're very confessional and open.
So that is kind of what I really wanted to explore. But I needed the startup to be in an industry. And at the same time that I started writing the book, I was struggling with an autoimmune disorder and had kind of fallen into or found the world of wellness through that door. So it just was something I knew a lot about. And I felt that wellness and startups had a lot in common in terms of this way, that they use kind of language and marketing and make really big promises. And it just seemed like a really good, interesting pairing for the book, where there was a lot of tension built right into those two worlds, the startup world and the wellness world.
Dr. Denise Millstine: That's so fascinating that you started with the startup, and then moved into wellness, and you can tell from reading the book how it's informed by some deep research. And now you've shared with us personal experience with navigating healthcare.
So, Brent, you, I think, have not started a Silicon Valley startup, but you have had personal experience of building unique and interesting wellness offerings inside a major medical center. Tell us about that and also your reaction to the book.
Dr. Brent Bauer: Well, I'll start with the reaction to the book. My initial reaction when you asked me to talk about “Snake Oil,” I assumed the book was going to be about patent medicines and the real snake oil of the 1850s, early 1900s. I'm a big collector, and half my basement's full of old patent medicines. So I came in under false assumptions and then I turned out to love the book. I would not have read it without you and obviously without Kelsey writing it. So thank you both.
I think there's a lot of parallels between starting something novel, different, new. So a startup within an academic medical center, I think had many of the same things that Rhoda faces in the book. And again, I think you have to have a strong personality to stand up against the conventional, the “this is the way we do it” mentality. It takes a while for people to see that what we're trying to do is create something new and novel, but it's still aligned with the rest of the institution. So I felt a kinship with Rhoda.
Dr. Denise Millstine: And probably felt like the other two main characters, Cecilia and Dani, were somewhat familiar as well. So Kelsey, we talked about Rhoda as the developer, the founder, the CEO of Radical, the company. But these other two main characters are in sharp contrast to each other. So what we see is Dani, who is all in, dedicating her life, trusting, buying into the brand. Really thrilled to be working at Radical, and then her friend and counterpart Cecilia, who's cynical. And we do find out pretty early in the book we're not spoiling anything that she's actively trying to undermine the products and the movement that is Radical. Can you comment whether this is your perspective on how people are engaging with the wellness industry and these two types of approaches?
Kelsey Rae Dimberg: Definitely. As a writer, I don't usually want to write a type character, but it felt like overwhelmingly people either have a very positive reaction to wellness and they really buy into it. Or they have a very, very hostile reaction to it and some of that might be some of the personalities involved in the industry. I think Gwenyth Paltrow’s the most famous, that if you don't like her, if you don't buy into her messaging, then I think maybe you're a little more skeptical.
But in general, I do think that people fall fairly, are pretty divided. Like they're either really curious and I'm not going to say gullible, but they're really open to these different opportunities that wellness is offering or selling, as the cynics would be more likely to say. And then I think the cynics find plenty of things to criticize. And as a writer, I think, and somebody who has experienced the wellness industry on a personal level, I felt like I could really sympathize with both sides. I could really see this promise of wellness. But certainly you know, you've experienced the pitfalls as well. And I just wanted to explore that conflict in the story. And also dig deep into what's going on in these characters lives that wellness is sort of standing for or offering them.
And some of it is really just as this framework of belief, especially for Dani, I think wellness for her is almost spiritual. She has this kind of relationship with wellness that it's like a guide for how to live and how to keep yourself safe and healthy. And I was very interested in exploring just those polar opposite reactions.
And I found that readers tend to really strongly side with one of the three characters. I've had some readers reach out and say, oh, this story is really, really dark, and it has such a grim ending. And I've had people say, oh, I just love that ending, you know, it's like a triumph. So I think it's been interesting to see that people have taken sides or really identified with one character or another. And that's been really fun for me as a writer to hear.
Dr. Denise Millstine: That's really fascinating. I have a hard time imagining somebody not seeing the ending as being very dark, even though I could see it also being described as triumphant. But once again, listeners will have to read the book to find out what we're talking about.
Brent, has this been a theme in your career as you have really moved forward, the field of integrative medicine that you've found people who are those that completely buy in, jump in with both feet, and others who tend to be the cynics and the haters?
Dr. Brent Bauer: Yeah, obviously, I mean, I think this is how we kind of approach things, especially nowadays in our culture. We were pretty quick to say; this is my camp, that's your camp. But it's interesting both, you know, Dani is somebody who we see all the time in integrative medicine, right? A person struggling with an illness that's ill defined, not well understood and conventional medicine doesn't have all the answers. It's not that there's not some answers, but it's not going to be the full answer for how do you live your life?
So she comes into an approach that gives her connection, which we know is valuable, gives her something of meaning, which we know is valuable. And then, of course, there are some supplements and so forth, which we don't really know. Are they really helping? Are they snake oil in the old-fashioned sense? In fact, much of the snake oil that we had in the past wasn't all that bad. So some of it did better than the medicines we conventional doctors gave, when we gave mercury and so forth. So there's a very interesting web around Dani and what she's choosing to do and what she's believing, and how it gives her a spot or an anchor that says, yep, now I can move forward. And then she starts to blossom into somebody who's got good health.
And on the other end, you know, I think Cecilia is somebody we see a lot of too. Right. Angry, angry at medicine. Angry at the world. Angry that things aren't going well. And you can see that kind of self-destructive emotions are not going to allow her to heal. She's not going to get better. She's her own worst enemy. And not that it's her fault, but that in a bad situation, taking that tack, she does not get the healing and she doesn't get to rise above it. And she misses the community. She misses the deeper meaning. She misses all those things that I think are really kind of cool. Whatever you think of Radical, whether it's, you know, all snake oil or whether it's the best thing in the world, she's missing what she could have taken out of that and made herself a healthier person.
Dr. Denise Millstine: I love that comment because I think, Kelsey, you weren't trying to come down and say the wellness industry is all bad. You were really trying to pull from where some of its inspiration, where it comes from, the journeys people have been on. It really is meeting a need, but then everybody's experience of it is going to be their own. Is that fair?
Kelsey Rae Dimberg: Definitely. That was very much my intention. Yep. And I love that sense of the connection and community that there are things to be taken from wellness beyond just like, is the serum literally going to do everything it says? And I think that it's kind of that lifestyle and there's lots of different facets to wellness, which I think Cecilia in particular or doesn't like to acknowledge.
You know, I also think she has good reason to be angry. She is kind of literally suffering. I think when you are somebody who maybe doesn't have as much money, and I think the implication for me is that her health care is not great. You know, I think she feels very trapped. And if you're somebody who has spent $100 on some supplement, that then doesn't work. I think there is a lot of wellness seems to reach like or the most visible customer of wellness is somebody who has like a lot of money, a lot of time, a lot of support that they're able to pursue all these different self-improvements. And I think Cecilia doesn't have that luxury.
I was never nearly as dark as Cecilia, but when I was sick and I had this autoimmune disorder and it took a really long time to even get diagnosed. And then once I was, there wasn't a lot of answers about what to do, how to treat it. And it does wear on you. You know, this feeling that you don't have control over this. And I think that it really affected my mental health too. And that can be kind of surprising because I think our culture is very like, get out and fight and battle. And, you know, even if you have something dramatic and awful like cancer, we have this narrative of never being sad or never being frustrated, and we have this like, it's on you to fight narrative. And for me, it was very surprising to have such a psychological side of my illness. And I really wanted to give that to Cecilia, too, that she probably could really benefit from therapy and having mental health support as well, because I think it's really kind of dragged her down into this bitter place. I like to think at the end of Cecilia, at the end of Cecilia's story, there are signs of hope. But that's up to the reader to decide.
Dr. Denise Millstine: Decide and experience for themselves. I think that's a really important comment to make, though, because many people who have medically unexplained symptoms will receive advice to speak to a mental health professional. And that can, depending on how it's delivered, be viewed as being told it's all in your head. But the flip side of that is that whether it's started with a mind component or not, when you live with something, particularly something that's chronic, ongoing, unexplained, there often is a mind component as a result of that, in terms of not feeling well for a long time and also being frustrated with the system that you were hoping was going to be able to give you this straightforward diagnosis with this straightforward treatment plan. And unfortunately, that's just not how, certainly many diseases in integrative medicine are really seeing diagnosed, treated, cured, fixed. It's just not the reality. Brent, do you agree?
Dr. Brent Bauer: Yeah. And I think that's why integrative medicine has such a great role to play. Obviously in integrative medicine, we always talk about nutrition. We always talk about exercise. That's not terribly unique, but we always talk about the mind body connection and whether that centers on meditation, yoga, tai chi, all these different facets. We know whether you have a chronic illness or not, pPeople who practice a daily mind-body practice do so much better on so many outcomes.
And then another thing we spend a lot of time on is spirituality, right? This is part of what integrative medicine, nutrition, exercise, mind body, spirituality, sleep, social connectedness. So in many regards what Radical is creating is a lot of that integrative medicine framework. Where the supplement may be a lot like a lot of our drugs. We know there's a huge placebo effect with our drugs, and we probably have a huge placebo effect over here. And to some degree, we don't care if it's enmeshed in a healing process so that Dani is trying to eat better. She is exercising. They know sleep. They're monitoring all these things. There is sort of an integrative medicine weave underneath it all.
I would love to know if the serum really worked or not. But again, I suspect that's up to the readers to decide. But Dani became endearing because of that. You can see her on that journey of suffering, but trying and she is benefiting from the community, the connectedness, all that.
Dr. Denise Millstine: We really haven't talked much about Rhoda's inspiration for starting the company and her own wellness journey. Which is a story that she tells in the retreat, in some of her promotional in some of her promotional posts, and the way that she's pulling people into this community. But Kelsey, you describe her being in college. It's a highly competitive college. She becomes sick. She thinks that she is just going to bounce back from whatever this is because she always has and she just can't do it. And she reaches to the health care system, which is what she's been instructed to do. And they start telling her things that really don't align. They tell her to party less. She says she lives like a monk. They tell her to sleep more. Meanwhile, she's sleeping 12 to 14 hours a night and it's just nonrestorative. And they tell her to manage her stress, which actually is a true component of what's probably affecting her immune system and her ability to recover. Can you talk a little bit about that as the impetus for doing good things in the world, for bringing this wellness movement forward.
Kelsey Rae Dimberg: Definitely. So I think that Rhoda's kind of definitely based on, well, she's her own character, but her journey to wellness is inspired by some different wellness company leaders, and a lot of them get very personal and have similar origin stories of whether they had a specific illness or just weren't feeling well. Something was off for a long time and they and there's this narrative of traditional medicine failing them I think a lot of the times, like not being curious about what's going on and kind of being more dismissive and then kind of deciding that they can enter this, that become a messenger for other people and become somebody who is not dismissive and who is going to be the voice and an ear for all these different people.
For Rhoda, I think she is somebody she's a little bit inspired by Elizabeth Holmes in that Elizabeth Holmes as a child, and growing up really specifically wanted to start a company and change the world. And she is just biding her time till she's sort of found something that she could run with. And I think there's a little bit of that in Rhoda. That there is this authentic seed to it. But then she also sort of is able to see it as a lucrative potential business that she can really kind of go with and build. And so I think that's the double start of Radical for her. So, yeah, I think it was both genuine and calculating at the same time.
Dr. Denise Millstine: Hey listeners, we hope you're enjoying this episode of “Read. Talk. Grow.” If you find our discussions helpful and insightful, please take a moment to subscribe to and rate “Read. Talk. Grow.” on your preferred podcast platform and don't forget to tell your friends to listen. Your support will help us reach more readers and those eager to learn about health through books. As always, feel free to drop us a line at readtalkgrow@mayo.edu with suggestions for books, topics or any comments. Thanks for listening.
Dr. Denise Millstine: All right, we're going to get to that calculating part. But I like what you just said about the appeal that if you've tried to access care and you've been dismissed or you haven't been listened to, here is this platform that we see you. We understand you. We have empathy for what you're negotiating. So, Brent, I thought there was a really important message and component to Rhoda’s story and her message. We talk a lot about whole health and the body's wisdom, the body's ability to intuit what it needs. And there's a quote where she says, “Our culture teaches us to ignore the simple ways the body communicates its needs to power through hunger, tiredness, fear, pain.” Will you just talk a little bit about how important it is to listen to what the body knows it needs, and try to meet those needs.
Dr. Brent Bauer: Yeah, there's two pieces of that. One is the individual themselves. Do I listen to my body? And if my phone's in my hand 24/7, I'm probably not listening to my body. So there's a lot of interesting things that way. But I think this is also a little bit of what Kelsey is saying. In our culture now, medicine has become commoditized, where the physician often has to see 20, 30, 40 patients a day, and in that, there's no time for the patient to tell the story. If you give a person a time to tell their story, this is when these things change. This is what happened. A, the patient understands more about their journey. We start to understand more. But as soon as you commoditized that into a transaction. Now guess what? The patients aren't happy. And guess what? Doctors aren't happy because nobody went to medical school with the vision of, I really hope I can see 40 patients today and then do it tomorrow and every day.
So somehow we have created in our culture, or we have accepted the creation of a health system that really does a great job when things are bad and broken. But we're not a culture that has allowed our health system to help us stay healthy. And I think we're starting to see that. And I think as we recognize that, we as individuals are starting to get that idea. I do need to listen to myself. I do need to understand how is my sleep? What is stress? Is my stress really contributing? And if so, how do I deal with it? What can I do? And that's where I think it's kind of fun now, because integrative medicine gives us a place as doctors to breathe, hear the story and then bring some wisdom to share and help find a way forward. And it's also a place where people get to tell their story.
Kelsey Rae Dimberg: I love what you say about telling the story, because some of Rhoda's kind of anecdotes about meeting doctors, were just straight from what happened to me. You know, when I started feeling sick and I remember one doctor I went in to see and, you know, I'm in there for ten minutes, so how much can they know? And he was like, you know, I really recommend eating more vegetables and no fast food. Well, and he didn't know that I was a vegetarian. Like, I don't eat fast food. It was just very all purpose, not based on the individual's experience. And that wasn't totally their fault. I mean, when you just have this window of five or ten minutes to talk to somebody, you just aren't able to even understand what their routine is or what. Let alone their background and where they're coming from.
Dr. Brent Bauer: And how challenging that is for somebody. Well, I'm going to characterize as intelligent, resourceful. You know. Now imagine you don't have a college degree. Maybe you don't have a strong education. Now you have to take that person and go into this system, which is not geared to hear their story, to understand, and certainly not put it into a cultural context, a family context, and all of a sudden now we said, no wonder we don't have the health care system we want.
Very hard from where we are to get to where we could be. And I hope that things like Radical or things like integrative medicine are kind of like showing us the way. They're not the answer. But like if we all would talk about, how is our nutrition, how is our sleep, how is there, how are we doing spiritually? What are we doing to honor those spiritual things in our lives? What about your social connections? Who is my tribe?
And as we start to normalize that, that's one of the beautiful things about a lot of the more esoteric parts of integrative medicine. When they used to call it alternative medicine, a lot of that stuff has now become mainstreamed because we understand the value of human touch. And massage now is like one of the most requested services we offer here at the spa in Rochester. So I think we're learning. It's a very slow process, but I'm kind of encouraged that things like Radical kind of make sense. Now we understand where Rhoda’s taking it or what she's trying to do, and she's made it normal.
She's made it cool to have a tribe, to have connection, to think about your nutrition and have your app tell you how much sleep you got and so forth. So I still haven't warmed up to Cecilia totally, but Dani and Rhoda, I'm kind of like yeah, you go.
Dr. Denise Millstine: So each of the chapters is told from a different perspective, from one of the three perspectives. And in one of Rhoda's early chapters, she's just finished giving this talk about her story at the end of a Radical retreat. And we get to get inside her mind where she says, total revenue is the only number that matters. That she makes it a point to set nearly impossible goals and these are monetary goals that when they're met, she sets them even higher.
So she's been driven to bring this wellness initiative to influence wellness for others. But she at the time we meet her, has already flipped to being driven by these objective standards. And I would think Kelsey, now knowing how important the startup industry was, what the outer culture and pressures are telling her is the important part of her work. Is that fair?
Kelsey Rae Dimberg: Yeah, definitely. You know, she's in business and she also has a mission. And I think at some point, in a lot of companies timelines, you can see the point where the mission is in the past tense, and then the business takes over and kind of undermines the mission almost. And there's a little tease that that might be happening at Radical, not just because Rhoda cares about revenue, but because one of the early rumors, Cecilia, is kind of running this Twitter account that is spilling little secrets from inside Radical. And there's this kind of rumor that one of the products has been reformulated and not in a positive way, but just in a pure cost slashing way. And this feeling of almost like Radical watering down its own potions, and its own serums and its own cures. And I think that that is just definitely coming right out of the startup question.
And I think with businesses being so large and so influential in our society today, that is, I think, something that's fairly problematic. This way that everything becomes viewed through a business lens. And I think going back to what Brent was saying about health care and doctors having to see 40 patients a day. I think that's a similar theme, right, that the insurance companies or whoever hospitals or whatever corporate interests are really trying to lean into this sort of business view of profits a they're moving away. It often comes at the expense of the mission. And I think that's a really big conflict in the story. And that's just, I think a big conflict of our society as well.
Dr. Brent Bauer: And it's a great microcosm of what's happened to medicine. Right. I'm much older than both of you combined, probably, but I remember as a young person in a little town in Pennsylvania, our family doctor probably had maybe five drugs, you know, he had at his disposal. But he knew my parents. He knew my sister. He knew where I went to school. He knew what I. And you could never leave that office. No matter what you went in for not feeling better. And you always came out of there with an idea like this will get better, I will. And from there we started to grow.
We said, hey, this is really important, and we're doing more. And we got to be more scientific and more and more. And then somewhere we pivoted and said, now we have. It's so complicated. We better have somebody run the business so I can take care of my patients. And all of a sudden we became to a large extent, business. And now in many places, the outcome isn't how did the patient do? It's like, well, that's important. But what's really important is did we make the spreadsheet?
So that parallel of kind of going from mission to money. And one of the sisters who helped found the Mayo Clinic has been quoted as saying, no money, no mission. Right. So we're not agnostic to the fact that we need money to help people. But the second part of that quote is usually stated as no mission, no money, right? If you don't have the soul, if you don't have the heart, if you haven't held on to those values, then you won't get the rewards.
You won't have the benefactors and supporters and so forth. So there's a nice tension as a startup. There's a big tension in medicine. How do you get money to serve people and help, but also how do you keep the mission without being overrun by bureaucracy and third party payers and all the other challenges out there?
Dr. Denise Millstine: I think you referenced another important aspect that we deal with and integrative medicine, Kelsey, which is the purity of products. So practicing integrative medicine, I just this morning saw a patient who very clearly did not want to take, quote, chemicals that come from the pharmaceutical industry in preference for taking what he views as natural products or supplements. And there are times that we can do that.
But also, even as professionals, we navigate the purity of the product. And is the product the same product that it was when it was tested in a lab to get its certification and its regulation being really essentially ineffective. So it's not that supplements are regulated, they just aren't regulated effectively. And so it can be hard to know, very much in the same way that when you're following a brand of food. How many of us have loved a certain product that we eat and then give it a couple years, we try it again and we think something's changed here. Something is not quite as delicious as it used to be, or something of that sort.
So I really like that you've drawn this tension carefully. Again, not really. Landing on one side is better, one side is worse, but really showing how there's just that tension, like you said, between business and mission and intention and where people land, sometimes I think unintentionally. Like Rhoda did set out to be a successful businesswoman. But she also initially started out really wanting to help people and wanting to use her journey to help people.
Brent, I want to talk to you about some of the therapies that Rhoda puts out to the world. So there's a note that she says. As she's posting, she realizes the more personal and stranger the better. Branching out to oil pulling, cryotherapy, sensory deprivation, every detox known to man.
Do you think there is a draw for people seeking this type of healing toward the unfamiliar? For example, if we say, well, you should do some breathing exercises which every human breathes, so that's not unfamiliar versus you should start swishing oil and do some oil pulling. That's going to be more novel and more appealing to people.
Dr. Brent Bauer: Yeah, I think so. Americans are certainly always seeking novelty, right? We always want bigger, better, faster. And so I think there is an element of that, right? As soon as something hits the airwaves, wow. There's this new thing that's going to cure cancer. A lot of people, without thought, without talking to their care team, go out and buy that substance or take that treatment. And in some cases, they may actually get a great benefit. In many cases, it's something they should never have touched because of their own underlying health issues and so forth.
So I think there is a segment of the population. It's got to be new novel. And if some celebrity is saying this is really good or this is what I use, there are people who make their decisions based on that. So that is a challenge. Now, having said that, a lot of the things that were kind of funky when I started doing this 30 or 35 years ago and now are routinely offered here at Mayo Clinic. You know, we teach yoga, we teach tai chi, we offer massage, acupuncture, tons of mind body stuff. But 25, 30 years ago, it was a battle to get our conventional colleagues to even acknowledge that these things might have some benefit.
Dr. Denise Millstine: We often say in integrative medicine, Kelsey, that integrative medicine is good medicine. And when we discover something that's really effective, then the goal is to put ourselves out of business and have it just be pulled into the medicine that everybody has access to when they come in for care.
There's a comment that Rhoda makes while she's being interviewed that she's citing ancient traditions resurfacing and astonishing us with their wisdom. So not just the wisdom of the body, but the wisdom of these types of therapies that have existed for centuries and in some cases, even thousands of years. I do think that and ascribe to their being wisdom in these lasting practices. What do you think about them?
Kelsey Rae Dimberg: Well, I think she's right. Some of the kind of medicines and supplements are things that people have taken for thousands of years, or just are more prominent in other cultures. And they're often like mushrooms and herbs and these different kinds of substances that might be more common in like Eastern medicine. So they're not novel, they're just these ancient things.
So I think that the way that people sometimes very casually dismiss things can sort of ignore that. You know, the Western world is just small and that other people, other places have different theories. It actually reminds me of the term snake oil, which did kind of refer to this oil that Chinese laborers working on the railroads out West would buy to rub on their joints. At the end of a workday and if you use a particular snake's oil, it can be very effective. But then kind of mostly Western opportunists decided to bottle just any oil and sell it as a cure for the same ailment and so then it got a reputation for being kind of quackery or something very fake. It originally started as something authentic, and it gradually became known as something totally fake. And I think that some wellness things were discovering that we kind of maybe scoff at, like acupuncture, are now things that you can actually test and that seem to be very effective.
Dr. Brent Bauer: Well, you make a good case for humility because, you know, it wasn't that long ago, over a third of the United States pharmacopeia, so when you looked and said, what are the drugs that doctors use? More than half, or at least more than a third, were all herbals, right. So it wasn't that long ago that we were using herbals on a regular basis as part of what we would have considered conventional medicine. If we are too quick to dismiss the wisdom that actually gave us our medicine here in the United States for many, many decades, we probably need to rethink our strategy.
Dr. Denise Millstine: Yeah, thank you for that. I want to make sure that before we wrap up, we talk about Dani and the fact that she's pregnant. So once again, Dani is the employee who is all in. She discovers that she's pregnant. She's still taking a number of supplements and participating in a Radical company clinical trial. She goes to see her obstetrician, and she tells her the list of what she's taking. The obstetrician comments that she really only needs to take a prenatal multivitamin with folic acid, and Dani responds, there are natural. And it's a really smart exchange, Kelsey, because that's a common justification. It's natural, so it can't be toxic. And I think it's a really important reminder of how we have to be careful about safety when taking natural products, and particularly in a woman who is potentially going to become pregnant, is pregnant, or is breastfeeding. Will you comment on that?
Kelsey Rae Dimberg: Definitely. When you're in the wellness world and immersed in these discussion threads or videos from influencers, there's a tendency to use some terms really loosely. Like chemicals being automatically meaning something bad when like chemicals are in everything. They're just part of our world and natural. What does that even mean? And that term on, especially on packaging, has literally no meaning. It's not kind of regulated at all. So I really wanted to capture that aspect of this kind of culture. Of this reflexive distrust of kind of conventional medicine and this kind of reflexive trust of things that are like pure or natural.
And then as a writer, on a more practical level, I really wanted there to be like something actually at stake in terms of whether Radical is kind of dangerous or not dangerous, real or not real. So having Dani, this very vulnerable person who's pregnant, you know, she just gives it this real stake of there's a real sense of this could go very badly if Rhoda's hiding something dark. Or if Radical isn't what it says it is. So just as a writer, you're always looking for ways to up the stakes and to make that more suspenseful. So that was definitely something I wanted to do.
And I also really wanted her to be pregnant, because I think that the way that people talk to pregnant women can be so kind of controlling and policing. And I think that was just an interesting aspect that I wanted her to negotiate as well.
Dr. Brent Bauer: Kelsey, I think it was brilliant to do that because it is a critically important discussion point. We have two large dietary supplement or herbal products that we're doing studies on right now. And one of the first criteria is you have to do a pregnancy test because we don't know that much about these chemicals, natural or otherwise. We don't know how they may impact brain, liver, kidney function in adults. So we study them in adults because that's probably where we're going to have the least harm.
But we really don't understand them in children. Right? Children are not little adults, are totally different creatures. And then what does a developing baby do if we give it. So there is that critical kind of who's going to protect the ones who need to be protected when we don't have all the answers?
And so I think that was a nice thing to bring in, because you do kind of see the tension. You know, she wants to be healthy and part of how she's being healthy is using the serum. But we don't know. Is that serum going to be one of these things that turns out to cause birth defects or things like that? And this is where you really want to kind of bring the two worlds together. Natural, I can take it, I don't have to talk to my doctor. Let's get rid of that thought. Natural, you can't take it. We don't know enough about it. Just take my pharmaceutical drug. The truth is in the middle. And it really should be a dialog.
It really should be a dialog between the patient and their physician. And possibly with the third party. Who's recommending this? Is it a traditional Chinese medicine doctor who knows a lot about. So that discussion would be the place to have that rich understanding of like, well, here are what we know. Here's what we don't know. And sometimes the answer would definitely be do not take it. We don't have enough information and there is some risk we see.
In other cases it may be where the personal decision is. I understand the risks and benefits I wish to move in a direction A or B. That's a very critical point, where how do we get to that discussion point, and a place in time where everybody's so busy?
Dr. Denise Millstine: I think that is an excellent way to end this episode, talking about the beauty of integrative medicine, which is something we both practice. And Kelsey really shining a light on it as it comes from an industry standpoint. So I want to thank you both for participating in this conversation with me and Kelsey for writing this very thought provoking book. I hope our listeners will go out and read “Snake Oil.” Thank you both.
Dr. Brent Bauer: Thank you, Denise.
Kelsey Rae Dimberg: Thank you, Denise.
Dr. Denise Millstine: “Read. Talk. Grow.” is a product of the Women's Health Center at Mayo Clinic. This episode was made possible by the generous support of Ken Stevens. Our producer is Lisa Speckhard-Pasque and our recording engineer is Rick Andresen.
Visit our show notes to see the books discussed today and for links to other health education materials. Follow us on social media like Instagram and Facebook, or reach out directly to our email readtalkgrow@mayo.edu with suggestions for books or topic ideas. We'd love to hear from you.
This podcast is for informational purposes only and is not designed to replace a physician's medical assessment and judgment. Information presented should not be relied on as medical advice. Please contact a health care professional for medical assistance if needed for questions pertaining to your own health. Keep reading everyone!