This episode explores the rich tapestry of traditional healing and integrative medicine through Linda Cohen Loigman’s novel “The Love Elixir of Augusta Stern.” Joined by Linda and integrative medicine expert Dr. Jodi Patel, the conversation delves into herbal remedies, generational wisdom, the healing power of listening and the enduring magic of chicken soup.
This episode explores the rich tapestry of traditional healing and integrative medicine through Linda Cohen Loigman’s novel “The Love Elixir of Augusta Stern.” Joined by Linda and integrative medicine expert Dr. Jodi Patel, the conversation delves into herbal remedies, generational wisdom, the healing power of listening and the enduring magic of chicken soup.
This episode was made possible by the generous support of Ken Stevens.
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Dr. Denise Millstine: Welcome to the “Read. Talk. Grow.” podcast, where we explore health topics through books. On this episode, we have another one of our integrative medicine topics, this time looking at traditional healing with what is often called herbal medicine. Our book is “The Love Elixir of Augusta Stern” by Lynda Cohen Loigman.
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.I am so excited about this book and my guests. Lynda Cohen Loigman graduated from Harvard College and Columbia Law School. She's written four bestselling novels, including the book we'll be discussing today, “The Love Elixir of Augusta Stern,” which was a September Book of the Month Club Pick. Lynda, welcome to the show.
Lynda Cohen Loigman: Thank you so much for having me. I cannot tell you how excited I am for this discussion.
Dr. Denise Millstine: Me too. Our expert guest today is Dr. Jyoti Patel. She's a trailblazing triple board-certified physician in internal medicine, pediatrics, and integrative medicine. Her personal journey through illness transformed her approach to healing, where she prioritizes root cause, prevention, and the power of lifestyle medicine. Dr. Patel is a consultant in the Division of General Internal Medicine in the Department of Medicine at Mayo Clinic in Arizona.
Jyoti, welcome to the show.
Dr. Jyoti Patel: Thank you for having me.
Dr. Denise Millstine: Well, Lynda, let me tell you about this book. My book bestie, Alicia, who works on “Read. Talk. Grow.,” read your book and I think moments after finishing, put it in my hands saying, you have to read this. I love the botanical medicine that's in this book. So I'll tell our listeners all about it.
“The Love Elixir of Augusta Stern” is really a love story. The main character, Augusta, is an elderly woman forced into retirement from her long career as a pharmacist, who then relocates to a senior living community, where she encounters a past love from her teen years in the 1920s. Growing up, Augusta lived above her father's pharmacy, and in those formative years, her Great Aunt Esther lived with them, mixing folk remedies that introduced Augusta to the overlap of her father's pharmaceuticals and these natural medicines.
Okay, you both know how “Read. Talk. Grow.” works. We discuss books that portray health topics in an effort to better understand health experiences and health journeys through story. In this case, we're going to discuss natural healing and herbal medicine.
Lynda, tell us your inspiration for the book and particularly for Aunt Esther.
Lynda Cohen Loigman: So this book was inspired from a couple different places. All of my books are really inspired by my family stories. This book is a little different because it's my husband's family, and my husband's great grandmother was a pharmacist. She graduated from Fordham's Pharmacy College in 1921. Her nickname was Goldie, but her given name was Augusta. And so this book is not about her, but it was really inspired by her. She was, by all accounts, an amazing diagnostician. She worked into her 80s. She lied about her age as the character in the book does, and eventually retired very reluctantly. There was no love story that I ever heard about in her past. The setting, the pharmacy setting was inspired by her, the 1920s. The idea of a female pharmacist definitely inspired by her.
The Aunt Esther character, who comes to stay with the family. There wasn't a specific person. She has a lot of my grandmother in her. And my grandmother definitely had very strong ideas about health, about what would make a person well. She was someone who actually, like, you know, how everyone talks about protein now, like you have to eat so much protein. All everyone is talking about….my grandmother was like that. She would always say, you have to eat protein for breakfast and protein fills you up. And she every day would have farmer's cheese and whole wheat toast for breakfast. And she just had a lot of thoughts about how we should eat and what it would be to make us well. She had little folk remedies, folk ideas, things that she would do, these little rituals when we were sick. And so there's a lot of my grandmother in Esther.
Dr. Denise Millstine: That's so beautiful, and there's just so much wisdom in tradition and traditional practices, particularly in supporting health.
Jyoti, Tell us about your reaction to the book and what it's like to practice integrative medicine.
Dr. Jyoti Patel: Yeah. First of all, thank you so much for that gift, Lynda. The book was beautiful. I enjoyed reading it from cover to cover. And, you know, it spoke to me because as you mentioned, your grandmother, I was raised by my grandmother and even though we come from different cultures, my grandmother infused a lot of the very same types of things. That food is medicine. And, you know, when I got sick, she would give me you know, food from our culture, whether it was herbs and spices like turmeric or cardamom, or you know, oils that help with healing.
So it is really brought back a lot of nostalgic memories for me, so I could really connect to the character in the book. Having a grandmotherly person teaching her these nuances. And funny thing, I can relate to your main character Augusta, because just as she was influenced by her father in a traditional science perspective, I too was raised by a physician father who, you know, believed in the sciences.
So it was this amazing sort of parallel in my own journey and my own nostalgia in the character's journey and how she was inspired via I think it was her grand Aunt, I'm going to call it that, to embrace holistic health.
And as Dr. Millstine mentioned, you know, in my own health journey, I also then was -- came full circle to learn more about ayurveda in integrative medicine. So thank you so much for that journey. I just really, really enjoyed the book and it really spoke to me in so many different ways from being a female physician who has to drive and strive and prove herself in her community, to bringing credibility to the integrative medicine field.
And Dr. Millstine knows that there is you know, there is dogma in medicine. There are traditionalists that believe in one way of practicing medicine. And then there's integrative doctors that might see a blend.
And it was so beautiful to see how Augusta and Esther brought that to life. In 1987, I was 14, I was in high school, right. So it's an interesting thing that she was in her 80s and having this flashback to when she was 14. And then the time she was having this flashback was when I was 14. I brought back a lot of things and I was very connected to the book. So thank you so much.
Lynda Cohen Loigman: Well, thank you so much for reading it, and it makes me so happy to hear you say that you connected with it. It just makes me … it's thrilling. So thank you.
Dr. Denise Millstine: I think you've just both painted a picture of this wisdom through the ages and your own experiences in your own families or your husband's family in some of it. But let's talk about Esther and her background, Lynda. So, you know, she comes to the family after Augusta's mother has passed away. So Augusta's mother has diabetes, and it's before a time. It's just before a time when insulin is discovered and can be used therapeutically. So she passes away quite tragically, just before the story is taking place.
And then really, Esther comes to the family to do the cooking, the cleaning, some of the domestic responsibilities, while Augusta's father is running the pharmacy and, you know, raising his daughters. But we learn that she has these skills.
And her father, Augusta's father references Esther as having been a self-proclaimed apothecary of her village, though she, quote, never had any training. Although her mother had done these therapies and her mother's mother had done these therapies. Can you just talk about how you pictured Esther creating this armamentarium of skills and techniques, and maybe some of the tools and tricks that she uses in the novel?
Lynda Cohen Loigman: Sure. So Esther, she's a little bit of like an old world Mary Poppins. You know, she's been in this country for a long time, but she comes from Russia, from the old country, we would say. And she was never allowed to have any formal schooling there because she was a woman. So there is a man in her village who becomes the apothecary because he's allowed to have education, and she isn't. But she has her own informal education from her mother, from her grandmother. This sort of female line of teachers and inspirations to her.
And when she comes to stay with the family, she and Sol, who is Augusta’s father, don't get along very well. They butt heads because of course he is working in his pharmacy. He's a pillar of the community. And it's not that he's not a good pharmacist. It's not that he doesn't care about his customers, he does. But if he comes to the end of a list in a book of all the things that could possibly help someone, he's come to the end, and that's the end, and there's nothing else that he can do.
Whereas Esther is thinking in this more holistic way. She is really seeing her patients. She is really listening to her patients. And of course, she comes into the pharmacy. And if someone isn't feeling well and isn't getting relief from Solomon Stern's medicines, she gives them a wink and a nod and she says, well, come upstairs with me. I may have something for you, but the way that she practices, she's just sort of this old woman that no one really suspects of having much to do with anything beautiful or anything otherworldly. She seems very plain. She seems very cold in a way, but she practices her art in the dead of night, by the moon, in the kitchen. And she. That's when she lets down her hair and she puts on this blue silk robe, and she has this special mortar and pestle that she's brought with her that has words carved inside it.
The folks on the podcast won't be able to see this, but I'm just going to show you this was my husband's great grandmother's mortar and pestle that my mother-in-law lent me. I've been keeping that on my desk as inspiration. But she just knows things because she has life experience and it's that that guides her.
She's not thinking only about mystical, magical things. She's very practical. Also, you know, there's someone who comes to her who can't get pregnant. And the very first thing she says is, you know, your husband travels for work, tell him to stay home for three months. You know, this is the absolute most practical advice you can give someone who's trying to get pregnant. There's nothing magic about that. So she combines sort of all these different things when she's giving advice to people. But she has a lot of faith also in her abilities. You know, she believes in herself. She believes in her own knowledge and her own wisdom. And I think that's a very important thing for Augusta to see.
Dr. Denise Millstine: That's really so beautifully said. And you spoke briefly there about the rub between Solomon Stern, who again, is the pharmacist, Augusta’s father in the novel, and Esther.
And so, Jyoti, I was wondering if you would comment on this quote from the book. So Solomon is very grateful to Esther for her contribution, contributions to their domestic life. But from the book it says, “…what he could not abide or condone was when she encouraged pharmacy patrons to bypass his treatments in favor of her own.”
And I think this speaks to the distinction between what we practice, which is integrative medicine, and what has often been called alternate medicine. And can you help our listeners understand that distinction?
Dr. Jyoti Patel: You know, Dr. Andrew Weil has a beautiful quote on that, and he says, “Integrative medicine is not alternative medicine. It's conventional medicine plus other evidence-based modalities that may show some benefit in us and no harm.”
So when we talk about integrative medicine, again, there's a misunderstanding that we're throwing the baby out with the bathwater. In fact, it's not so, we're adding more tools to our arsenal. So if we know that we need to listen to our patients, like Lynda mentioned. We make eye contact. We bring an energy of compassion into the room. We bring in kind words. And I really would like to come back to that kind words, because words have meaning. And Esther says that. And I just like I just that just touched me in the heart because I know it to be true.
When you tell a patient that they're going to be okay that you're there for them, it really plays a role in the healing process. When you make eye contact, when you touch their arm or their hand.
All of that has a role to be played. So integrative medicine is integrating both the human aspect and the cognitive aspect of medicine. Being present, being a silent witness to someone's suffering without expectation of the outcome, listening to their story is 90% of it. I feel like when you listen to somebody, you heal them just by being there and then using lifestyle.
Because again, in medicine, yes, you might have a diagnosis for the patient based on your observation and symptom, and you may have a therapeutic knowledge about what prescription you want to write for them. But there's so much more to their healing, who they are as a person. How hard does the person work? Do they sleep well at night? Do they have good relationships? What kind of food do they consume? Do they eat that protein in the morning? Right?
Those things matter. And unfortunately in medicine, we've siphoned and siloed health care into different organ systems. When we're really not a group of organs, we're an organism that's living in the microorganisms and macro-organisms and macro environment. So our macro environment plays a role in our health.
So I can go so far into that. And I love everything that Esther said. It has everything to do with whether her husband stays home, whether she wears the right shoes, how people perceive her like she was intuitive about how that affects your health. And that's what integrative medicine truly is, is to be intuitive, to be compassionate, to be a good listener, and to be a healer.
And you may or may not have the answers. And I love Esther’s comment about that as well. When she mentions her mother and, you know, could you have helped her? And she comes full circle and says, you know, sometimes you help and sometimes you don't. Sometimes you hurt. And that's not true just for homeopathy or integrative medicine. It's true for medicine as well, conventional medicine. So the humility of being a healer is knowing that we're not God.
We have some of the answers. We don't have all the answers, but the best that we can do is to be there for our patients. And I love that Sol was that person too. Like he had integrity in his work. He told his daughter, what happens in this room stays in this room. He has his respect for his clients, no matter who they are. He wants to help each one of them. He gives them privacy. He takes them back into the room and he talks to them in private. All those things are just, that's just a sign of a good person, an ethical person, a person that cares about their patient.
So you can be that person as a conventional doctor. You could be that person as an integrative doctor. There's no division. They're all one science, they’re one practice. And that's the practice of human medicine. Anyway, that's my rant.
Dr. Denise Millstine: That's so wise and I think one of the fears we have in integrative medicine is that alternative medicine truly can be dangerous. Where if you have a condition, we’ll take diabetes like Augusta's mother, that requires insulin, you don't not use insulin, that person will die. And so you have to understand that alternative medicine is sort of the danger to integrative medicine, but that when you integrate and you take this whole person approach, you actually can provide what I think you and I call really good medicine.
Okay. Lynda, I want you to share with our listeners the first remedy that Esther provides to one of the pharmacy customers. So it's a woman who comes in and is upset because after dinner, her two twin boys are always having a stomachache. What did she prescribe?
Lynda Cohen Loigman: It's so funny. When you said the first one, I was racking my brain. I was like, wait a minute. Yes. So this woman comes in and she has these two boys, and they're just always complaining about their stomachaches. And so she ends up feeding them just like toast and jam.
Because she's a good listener, Esther really understands that the woman's just a terrible cook, and she's feeding them like fish and greens, and these boys just hate it. And Esther is an amazing cook, and she makes this fantastic chicken soup, which is sort of the base for a lot of her cures. And she says to this woman, I'm going to give you this jar of chicken soup, and you're going to take it home and give them this, and they're not going to have any stomach problems tonight. And they don't.
Of course this was before people like knew about food allergies or anything like that. Like it. But she asks the woman what she's feeding them for dinner. She talks to Solomon Stern about it. Solomon Stern is up in arms because he doesn't want this woman thinking that there's quackery going on, and he says, you can't tell her that they can't have fish and greens. And she's like, it doesn't. You know, I'm just going to tell her those things are not easy to digest. They're not good for their stomachs and they should they should have something else.
And Esther, she's focused on the results. Right? She's not focused on how she gets there. She knows what's going on. And this woman, she knows that these boys are just kind of sneaky. And they're not going to say to their mother, you're a terrible cook or whatever. So it's the chicken soup that she starts off with, and she helps the woman sort of alter what she's making for them so that so that they eat.
But it really does come from what Dr. Patel and I have been talking about, listening. You know, really listening and having a sense of people. And I think we're all women here. I'm sure many of the women listening, we've been to doctors who maybe discount what we're saying because we're women.
But even if you're not a woman, doctors sometimes don't listen to you. You know, when you don't feel heard. When you don't feel like someone is paying attention or cares really about what you're saying. It can affect you. And so that's really Esther's, one of her greatest gifts as a healer.
Dr. Denise Millstine: Yeah, I think that's so important. And I'm going to go back to the soup.
But I wonder, Jyoti, before we talk about food as medicine, can we talk about what Lynda just said, which I think is so critically important that people need to feel heard and your perspective on the role for integrative medicine, because people often don't feel heard in more conventional medicine platforms.
Dr. Jyoti Patel:And so I've practiced, you know, in the Valley for over 20 years. And 15 of those years, I was a primary care physician insurance clinic. And I understand the nuance of clinic work. You have 15 minutes. You don't really have a lot of time to dive into the periphery. Right? You have very strict timelines and goals that you want to achieve when you're in the exam room. So it is unfortunate that patients don't always have the time to sit down with their doctors.
But I will say this as being a clinician, physicians do care. They're in it because they care about people. They care about medicine. They want to help. The structure, the way medicine is designed right now limits the amount of time that a doctor can spend with a patient.
So it is difficult and I I'll say that it happens. It's not fair on both sides. The doctor would love to have more time with you. I would love to be able to listen to you and hear you, but sometimes the noise that’s outside of you: the charts, the patients, the waiting, the phone calls, the triage, the, you know, the documentation, all that stuff can be really heavy on a physician.
So I really encourage my patients when they're in the room to really pick the one biggest thing that you want to talk to your doctor about and maybe the night before, have a really clear picture of what that looks like for you.
So you're really coming in zeroing saying, hey, doc, I know you only have 15 minutes, so I want to value your time. Here's what I really want to talk about today. I've had this chest pain and I don't know what to do with it. It happens at night. Happens, you know this and that.
So you talk about it, you get to the chase. You have time to really put your thoughts on the table. So communication is a two-way street. It's important for us doctors to put the hand on the door, leave everything outside the door before we walk in the room, and really give our patients 110%, even if it is only 15 minutes.
The luxury of integrative medicine is that we do have an hour for our consultations. So I see myself as an extension of my primary care colleagues because I've been in their shoes, I've been in the trenches and understand.
So my role now is so that if a patient comes in and they have been diagnosed with cancer and they have a lot that they need to unpack around it, I'm here now for you for an hour to dive into. How did your childhood impact your how does your family and your relationships affect your health? What questions do you have about nutrition? What concerns do you have? What fears do you have? The tools you have to deal with this new diagnosis and be that companion?
So I feel like in integrative medicine, we play this integral role in bringing time and that listening ear to our patient and hopefully giving them tools to bring everything together from the medical side, from the holistic side, from the mind body side, from the tools that the patient feels so that they feel like they're in control of some of the aspects of their health.
Because being a cancer survivor, I know the biggest fear patients have is not having control over the outcome, not having knowledge of what's going to happen. And so I feel like integrative medicine is a beautiful practice to bridge the gap between that conventional doctor and the patient and bring all the pieces, all the pieces together.
What do you think, Dr. Millstine, since you too play this role?
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:Yeah, no, I completely agree that it is a privilege to be able to have time with patients, and the way I start my integrative medicine consults is actually say to people, tell me your story, and I can't tell you the number of times that people are taken aback. Like, what do you mean? Well, you're here for a reason. You're getting care for a reason, so tell me the stories. Start wherever you think it's pertinent, whether that's birth or last week. But tell me, how did this all sort of come to pass?
Which is like the twin boys, as a mother of twin boys, I feel for this mother who's not a great cook. Which is the deal with the twin boys, right? The secret is not to give them like a gas medication or something to ease their stomachs. It's not going to come from a pharmaceutical shelf. It's going to come from really backing out and maybe telling her to get some cooking skills or providing her with some well-made soup.
Okay. I promised we'd come back to the soup. Lynda, the soup comes back again. So the other main character in “The Love Elixir of Augusta Stern” is Irving. And I should have said there are two timelines, and we see both Augusta and Irving in both timelines. But in the older timeline with young Augusta and young Irving, they're in the process of falling in love, and Irving actually falls quite ill, to the point that he has reached that end for Solomon's therapies. He's essentially said, I have nothing to offer you. The doctors have said, we've given you everything we can. He is at home with his mother, who has him in bed under blankets, you know, kind of closed off from the world just crossing her fingers, saying her prayers to see if he will recover. And Esther brings back the soup again. It's a special concoction of the soup. But then she throws open the windows, she opens the curtains, she gets the fresh air, and instead of saying, let's just let this run its course and see what's going to happen, she's very proactive.
So, Lynda, did you picture that Irving got better because of Esther and her interference, or did you think it just ran its course the way it was going to run, no matter what happened. Tell us what was in your head as you're writing these scenes.
Lynda Cohen Loigman: So the soup is a really important, was very important to me. I kind of thought about the soup for a long time before I wrote Esther's character, and I think that's because of the importance of chicken soup, sort of in my culture. In many cultures, soup is just a very healing food. But there is a phrase that people use for chicken soup, which is Jewish penicillin. And when I remembered that phrase, which was something that my maybe my mother used to say or my grandmother used to say, I thought, well, I must use this because Augusta's a pharmacist, her father's a pharmacist. It's penicillin. Of course, penicillin wasn't available in the 20s. It began to be mass produced for World War II. And for all the infections that the people, you know, the soldiers were having them, that's when they really mass produced it.
But the idea of soup as a vehicle for healing and being something almost magical, almost mystical, because so many times my grandmother would say, like she was making soup for me or my brother or my cousins when we were sick. So often there was just this faith in chicken soup that it really would make you feel better. And of course it does so often. I'm not saying that it that it could cure someone of a terrible disease, but it does tend to make people feel better.
And it was sort of. So in this book, when Esther goes to visit Irving and he's ill, and she forces the windows open and she forces him, you know, to eat the soup. And his mother says he hasn't kept anything down, but she's just absolutely determined. And you don't know exactly what's in her soup, right? She never makes it the same way twice. I leave it really to the reader. That was the fun of writing this book, is that it's sort of up to the reader. Is it magical? Is it just really good soup? Did the flu just run its course?
We saw this with Covid too, right? Like some people got better and some people didn't, and there wasn't necessarily an answer for why it was. Sometimes very, very healthy people that we saw, you know, famous healthy people who just died from this. Sometimes there were people with other, I guess I don't want to sound medical, but comorbidities or things that. Right. I'm going to use a medical word, come more these are or conditions preconditions that they had that maybe made them more susceptible.
And I guess that would be the case with something like the flu. And the Spanish flu was such a terrible disease, you know, of that time period. But I really think it's up to the reader to decide it's not even for me to decide and I wrote the scenes, but I like to leave it open ended.
Dr. Denise Millstine: I'm voting for Esther. What about you, Jyoti?
Dr. Jyoti Patel: I love the ingredients, and I don't know if that's a personal recipe of yours or somebody in your family. Since you said that you have had a tradition of chicken noodle soup. But I love all of it, to use the freshest chicken. Right?
So when I'm in integrative medicine, we really promote using whole ingredients, fresh ingredients. And you mentioned protein. So again, somebody who's maybe been sick for a while, that can definitely be supportive. The broth in itself. Right. So that's again very nourishing hydrating. It's a decongestant. He used, she used onions and we know those are loaded with quercetin. Quercetin, again a compound that we know supports immune system. She added garlic. Garlic has allicin. Again powerful antioxidant, has medicinal properties when it comes to healing as well as the immune system.
We know these things now, you know, in 2025. But back then, you know, it's just magic. But it really is magical because plant medicine is magical medicine. The parsley, the dill, the carrots, everything that was fresh in there was going to add electrolytes, vitamins, minerals and nourishment into the system. So it's supportive. I would never call it curative. I would say was definitely supportive of his healing.
Hydration because when a patient comes in with the flu, let's just take it since we're talking about a medical patient, you have a flu patient. What do we do? We take him to the emergency room. What's the first thing that the nurse does? Puts in an IV, right. What are we giving them? We're giving them hydration and electrolytes. What does a soup do? It's providing the same nourishment just through the GI tract. Right. And so we find that need supportive management. You want a decongestant that steam is a great decongestant. So anything that he or she used was supportive.
Also just being there maybe Augusta had healing powers. When you're with a loved one, right? When you see somebody that's like rooting for you, that wants to get better, that's taken care of you, that in itself has healing powers. So, I don't know, I think I like to think magic and medicine.
Dr. Denise Millstine: Fair enough. I like that argument as well. I'll cast my vote with you. I think you discussed that.
Jyoti, there’s a point where Solomon is furious with Esther when the customer attributes health benefits to Esther, instead of to the doctors that she had been seeing. Solomon accuses Esther of, quote, peddling nonsense. Can you react to that and tell us whether you've faced this type of reaction from your conventionally trained health care colleagues?
Dr. Jyoti Patel: Yeah. That's it. You know, that's a really good point you're making. And it's not uncommon. And it's also justified because as a physician, you know, when I was in traditional conventional medicine, patients would come in with a slew of supplements, a bag full of pills. They didn't want to take a prescription medication, but they were willing to take 20 different supplements from the drugstore and believe the label.
So I get that. I get that that there's a distrust when it comes to I'm not going to say integrative medicine. I'll say alternative medicine when it comes to alternative medicine practices, because, again, we believe in science. Like Solomon says, we look for evidence like he says. it needs to be tested and verified like he believes. And I believe in all of that.
So you right there is a room for us as physicians to be skeptical of everything alternative. But when you actually look at conventional science as an approach, you're also missing the window of opportunity when it comes to looking at botanical medicine, food is medicine, alternative practices, which might be just listening, meditation, movement practices like yoga, things that have been around for 5000 years, traditional Chinese medicine and acupuncture.
You can then become so dogmatic that you throw everything out the back door and say, the only thing that works is a prescription. So I feel like that there's room for both sides to come to the middle. There's room for people who practice alternative medicines to agree that chemotherapy is lifesaving, to agree that insulin is really necessary, you know, things like that. These are these are things we can all agree upon.
But conventional doctors also need to understand that sometimes the patient just needs to be listened to, or maybe lifestyle and changes in their behavior might be the first step before a hypertensive medication. So I feel like there's room for both sides to see the middle.
Dr. Denise Millstine: I really appreciate that answer. And it is true that when we practice medicine a bit differently, that sometimes it feels threatening, I think to people who are really ascribing to a different philosophy. Maybe what is currently the modern conventional medicine philosophy, which is often driven by algorithms and discreet interventions because that's evidence-based medicine. So that means there’s a lot of specific medications and procedures within those algorithms. And sometimes, like you and Lynda have both said, backing out and seeing this whole person and approaching their health holistically in the way that they operate in terms of how they eat, how they move, how they manage their stress, how connected they are. All of that is what comes into play with integrative medicine.
Lynda, I love, love that you included menopause. So as a women’s health physician, it’s so important and so there is no novel without conflict. Our listeners should know there's a big conflict in this novel that has very little to do with Aunt Esther. So please read it and learn about it. But there is a woman who's she's a bit intimidating, not a bit. She's very intimidating woman who comes because she's essentially having hot flashes and symptoms of menopause. She said that she couldn't sleep at night. She was achy. She was grumpy. I don't know if you want to comment about this patient and her menopause. And then Dr. Patel, if you want to comment about herbal medicine and symptomatic menopause as well.
Lynda Cohen Loigman: Yes. So this is Mitzi Diamond, who is sort of the villain of our story. She is terrible later on in the book, but when you first meet her, she's dealing with a lot. She's a gangster, essentially. Her husband is a gangster and he has dementia. And so she's dealing with a lot. Mitzi Diamond, she's dealing with her husband's sort of empire and how to keep that going without letting anybody know about him.
She's dealing with her daughter, who is sort of running around with the wrong crowd and getting into trouble. And then she's dealing with her own medical issues surrounding menopause and I really wanted to write this villain character, this female gangster. I also really wanted to humanize her and having her go through this, having her need Esther's help for all of her menopause symptoms, I think adds another layer to her in the story so that you understand that she's not just, I don't know, she's not just like a cartoon villain. You know, she's not just Cruella de Vil, who's just messing around for no good reason.
She’s really suffering when you when you first meet her and Esther helps her. And I think that's a point to be made in Esther's favor. Also, that Esther doesn't exactly know who this woman is when she first meets her. But she's not an easy woman and Esther has a sense of this. And even when she is told who this woman is, she still treats her. You know, she still chooses to help her because they have something in common, which is that they're both women who have suffered through this phase of their life. And she chooses to take the high road and to help her, which I think is really important and speaks volumes to who Esther is, you know, as a healer and as a person.
Dr. Denise Millstine: Yeah. That's so beautiful. And it's so true. You know, nobody goes through menopause in a vacuum. Not that you're necessarily also a gangster, but most women navigating menopause have careers and families and responsibilities and yet it can be so distressing.
So Dr. Patel, do you want to talk about botanical approaches to medicine. Are you getting out your mortar and pestle when these middle-aged women come in with hot flashes.
Dr. Jyoti Patel: I wish it was that mystic, but I love the idea of the fact that, Lynda, again bringing up the nuance that women don't feel heard in the exam room is a huge topic right now in social media and OB-GYNs and GYNs and, you know, celebrities and lots of people are now coming forward bringing up this important topic about menopause and women being heard.
So the first thing is now women are being heard, hopefully. And so we hope when we look at the topic in general, the Women's Health Initiative trial that occurred in the early 2000s basically put the kibosh on the use of hormone replacement therapy for women for the last 20 years, which unfortunately was a big disservice for women that were suffering. It didn't give them a lot of other alternatives.
So Dr. Millstine mentioned, you know, are there other, botanical options for women that are suffering from these hot flashes? And again, the science is still not certain. But antidotally, women may find benefit from some of the things that you mentioned in your book, such as red clover and black cohosh or primrose oil. Or the use of phytoestrogens in their diet like flaxseed, fenugreek, sesame seeds, soy.
There was a big trial called the WAVS trial. And what they found was they took women that had moderate to severe hot flashes, and they had half a cup of soybeans every day, which is a phytoestrogen plant phtyoestrogen, and they reduced their hot flashes by 80%. That's insane. Right? So food is medicine.
So what I loved about what Esther did is when she validated her, she related to her. She told her, yes, you are really going through something that's difficult. And that's what a lot of women don't hear. They get antidepressant, they get dismissed. They're told there's not much to do, that it's a way of life and they're just aging.
But in fact, Esther did the opposite. She validated her problems, her symptoms and gave her some solutions, and she followed up with her. That's another thing that I loved about Esther, because it wasn't a one and done. She had her come back, even though she didn't want her to come back, she kept coming back.
But that was because she trusted Esther. And she, you know, she trusted her, which is wonderful. That was a beautiful relationship between a healer and a patient. So thank you for sharing that story.
Dr. Denise Millstine: I can't help myself. I'm just going to take this moment to remind our listeners that. So soy is a phytoestrogen, which means that it acts on the estrogen receptor. And some people hear that and get scared of that, but it actually is very beneficial. So whole soy foods, edamame, tofu, tempeh, for example, are safe and probably beneficial for most, if not all women. So you heard it here. There's a little public alert. There you go.
All right, back to the book, Lynda. There's an incantation that Esther says when she is preparing her therapies, and I want to close on this and hear from both of you. I think it's a really beautiful summary of what integrative medicine is. So the words are, “To ease the pain of those who suffer, to repair the bodies of those who are ill, to restore the minds of those in need.” So beautiful. I wonder if you'll both just make some comments on that.
Lynda Cohen Loigman: So that incantation, it’s written in the bowl of Esther's mortar. It was inspired by a prayer that is said, sort of, I think every week or in different services. A prayer like this is common to a lot of different religions. The idea of praying for people who are sick, you know, of a community effort to say something about people who are sick and to name their names.
So in a Jewish service, a Jewish Sabbath service, it's called a Mi Sheberach prayer. It's not those words, but it's the idea of repairing the body and the spirit. And that's the part of it that I've always really loved. And the leader of the service will look around the congregation, sort of extend a hand and ask for people to say the name of the person who might be ill out loud.
I've seen this at churches. I've experienced this in many other kinds of religious settings. It's just a beautiful thing. And this idea of just it's again, a holistic approach, right? It's mind, it's body, it's spirit. It's the whole person. And that's what Esther is sort of trying to do. I wanted to put that into her mortar.
The idea of actually having words in the mortar came out of research that I did, finding out about incantation bowls that were found in ancient Iran and Iraq, and those had words written in them and were sort of buried underneath homes as a protection device, so that to protect homes from evil spirits. This whole idea of protection in a community of people coming together, it's just to me, that's a really beautiful thing.
And again, I don't I don't really think of it as a religious thing, you know, it's just it's the power of, I don't know, positive thinking. At the end of the book, Augusta says it's something along the lines of she believed in medicine and miracles. And so it's both, you know, it's what you both are talking about. It's this integrative approach where it's not just one or the other, it's both. And I think that's where Augusta comes to by the end of the story.
Dr. Denise Millstine: Yeah. That's so lovely. Thank you. Jyoti?
Dr. Jyoti Patel: So I was thinking about it in terms of the healer and how Augusta struggled in the beginning when she didn't really connect with the message. She was just rote memorizating. And I think a lot of doctors can relate to that. I think early on in your life you don't really have any life experiences. So when you go into the room, you might be judgmental, you might be more dictatorial in terms of telling the patient what to do. You might be more pragmatic, less from the heart.
And what I think Esther was teaching Augusta, at least this was my perspective. She was teaching her to be a true healer by connecting emotionally to her purpose and her mission. So when I read those words and I get goosebumps just thinking about it. I am not the healer. I'm a vessel, right? I am the vessel. I'm the vessel to allow this person to ease their pain, to heal their bodies, to soothe their mind.
And if then take that and say it over and over again to myself before I proceed to take care of my patient. Imagine that the energy that I bring into the room. Imagine the healing that I'm that I'm bringing to the room, and I'm in the presence that I'm bringing into the room, as opposed to being distracted by the diagnosis and the tools that I have.
And so in the same way, she didn't want her to think of the ingredients and the formula. She wanted to bring the purpose and the intention to her healing. I don't know if that was my take on it.
Lynda Cohen Loigman: I love that you said it so beautifully. It makes me want to cry. That was so beautiful.
Dr. Denise Millstine: It is really beautiful and this is a beautiful book. So thank you both for coming on “Read. Talk. Grow.” to discuss integrative medicine through “The Love Elixir of Augusta Stern.” I hope our listeners will check it out. Thank you.
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.
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