Andréa: Welcome to The Changemakers Podcast, where we talk with amazing women who are changing the world through their work and through their life. I am Andréa Rene. I’m a leadership coach, and I’m here with Dr. Neha Sangwan, who is an internal medicine physician, a coach and speaker. She’s also the author of Talk Rx, and I’m super-super excited to talk to her today. How are you, Neha?
Doctor Neha: I’m great, Andréa. Thanks for inviting me.
Andréa: I saw you speak on the live stream of Emerging Women in 2015. I was inspired about your work, and I’d love it if you would share about the work that you talk about within your book.
Doctor Neha: Well, I’m an internal medicine physician, so my premise is that our inability to communicate makes us physically ill. I don’t think a lot of doctors are talking about that. When people come in to see their doctor, they have a physical ailment: “I have a headache,” “I can’t sleep at night,” “I’m anxious.” And they expect physicians to give them a prescription or solve their problem. What I realized, after working with thousands and thousands of patients, was that it wasn’t that their physical ailment just needed a physical answer. Research shows 90−95 percent of all illness is caused or exacerbated by stress. So the question is, what’s at the root of all that stress?
What I found when I talked to patients was that some sort of communication issue—passive-aggressiveness at work, being in a relationship too long after its expiration date, not speaking to their sibling, feeling trapped by a coworker or boss—often is what stressed them out. Some inability to communicate with someone else or with themselves was at the root of their stress. So Talk Rx gives the tips and secrets that I gave to my patients to help them get well.
Andréa: I love it because you put relationships in the context of health and how we need to be in relationship with ourselves and in relationship with other people in a healthy way in order to be healthy. This is obviously a different approach from a lot of doctors. Have you found any kind of resistance or naysayers from your colleagues or your peers in the medical world?
Doctor Neha: They’re the only ones who resist me. The patients completely get it. They know exactly why they’re sick, and they get the connection between it all. With doctors, they’ve spent so much time training to get questions on tests right, that it’s easy to think, If I was in school for 30 years and nobody told me about this, it must not be true—except sometimes we miss some of the basics. We miss some of the basics on nutrition. We miss some of the basics on stress. When people say things like, “Go to your yoga class” and “Get your stress out of you,” they’re right on the plan—stress management skills.
I thought I better write a book that actually addresses how do you handle tears, anxiety, and anger, and what is forgiveness. When someone tells you to forgive someone else, like, “Oh, you just need to forgive your brother.” How does one actually do that? Maybe very few people know how to do this. Maybe we haven’t showed them how, and maybe they don’t understand the link to their body’s physical sensations. And when their doctor tells them they’re okay when they don’t feel okay, something may be happening on another level. For example, if someone’s heart is not doing well, but the doctor says, “Oh, there’s nothing wrong with your heart, you’re fine,” maybe the patient is having anxiety. It could be something else on a mental, emotional, social or spiritual level that’s unresolved, that’s showing up physically in their bodies.
As a medical community, we acknowledge the mechanics of the body. We can give you drugs. We can do surgery. We have all things medical to take care of your physical world. But we’re not as skilled or trained in managing what happens when something on another level, mental, emotional, social, spiritual level isn’t addressed and then shows up on the physical level. We basically tell you that you’re fine when you’re not fine.
Andréa: Wow, everything is interconnected! And so much of the medical industry is focused on, “Okay, you have this one ailment in this one part of your body, let’s focus on that, let’s fix that,” and then not focus on the rest of you, your whole being.
Doctor Neha: You’re absolutely right. My doctor is a functional medicine doctor, and what functional medicine means is, even on the physical realm, they look at the body in systems. So there’s the immune system, the hormonal systems, etc. You don’t look at your lung as separate from your heart or your stomach—they’re all connected. Even on a physical level, you need providers who look at an integrative approach.
Andréa: So how do you know if your doctor has this approach?
Doctor Neha: You ask questions, and you know what you value. For example, Andréa, I’ve only known you a few minutes but it’s really clear to me that connectedness is important to you. Relationships are important to you. [With a doctor] you know what you value and then choose a provider who you feel connected to—that’s how you get the healing experience. It’s even more important than the prescription a doctor writes—that we feel connected, that there’s healing in our exchange. [As a doctor] if somebody’s having a heart attack, I need to give her the right medications to help her, absolutely. That’s not hard once you learn how the protocols. Really, that’s the science of medicine. The difference between a doctor and a healer is whether one uses the art of medicine, that human connection, and the place of shamans and of medicine men, and the way that communities used to do it. Do you help connect to somebody else in a way that stimulates their own healing and confidence?
So first you have to know what you value. Then ask good questions. Prepare before you go with the questions you want to ask someone. When they give you an option, you say, “Are there any other ideas? Do you have any other options besides putting me on an antidepressant?” I have nothing against medications at all. If you use the right medication at the right dose for the right length of time with the right person for the right ailment, it’s amazing. But I think that now we’ve decided that medicine is the only answer and sometimes that takes us off track.
Andréa: So what are some of the values that you hold in your practice and in your life? What are some of the things that you really find close to your heart?
Doctor Neha: My highest values are love, integrity, service, beauty and play. It took me a long time to add beauty and play to that.
Andréa: Tell me about that.
Doctor Neha: Under love are all people and connections. So it’s me with my patients, me with my colleagues, me with my family, me with my friends and community. There’s a big umbrella there for love. It’s also all things that create connection for me, including human and nature. Integrity for me is that I’m doing my best, that I’m aligning my actions with what I value, and I’m giving something my best shot. It doesn’t mean that I always get it right. It just means that I’m open to learning from every experience, and I’m doing my best to keep re-correcting so that my actions align with what I value.
Service is when I recognize my own health is important and I’m in service to others. So the “and” is important—where I don’t forget myself. As a healthcare provider, it’s pretty easy to help everybody else, serve everybody else, take care of everybody else, and then not take care of me. So how do I take care of myself so that I can serve others. I say that it’s not selfish to take care of me, it’s actually self-full, so that when my container is full I can give to others.
So that’s love, integrity and service. And then, in my book I talk about how hard it was for me that beauty and play are important to me. I actually realized that I had so much resistance to those values. So I got really curious. My thoughts were like this: “Oh no, beauty’s not important, play’s not important—that’s ridiculous.” So for one week, I just kept notes on my phone about anything I noticed that I thought was beautiful, anything that brought me joy that I thought was playful. And when I reflected back on it at the end of the week, I had a list of items like the beauty of a child’s honesty, the beauty of nature. Turns out that yes, I like aesthetics and I like the beauty of a new pair of shoes. But it was so much deeper than that. I also see the beauty of the courage it takes for someone to speak the truth. I saw beauty in patients, in their bravery as they waited for results, such as from a mammogram. I started realizing that the reason I loved beauty so much was that it was inside and out, and it meant so many things. So I got over my judgment of it.
Then play—it was something I stopped doing way too young. I have taken myself way too seriously for a long time. Now I have a little niece who’s six years old. While I was writing the book, she would periodically knock on my door and then she’d say, “Mausi [Hindi term for ‘mother sister’], are you done with that book yet?”
I’d say, “Oh no, I got another chapter done but I’m not done with the book yet.”
“Well, I don’t know why it takes you so long to write that book, because I just wrote another one and I wanted to give it to you.” So she’ll give me what she drew into a book. Then she’d say, “I was really wondering if it was time for a hide-and-seek break.” I always said yes, and looking back, I think [that playfulness] got me through it all. So I think that as important as love, integrity and service are, I must have joy through the process. It’s equally important.
Without play, I can’t put out the quality of work and the quality of material that I hope to put out in the world. I want people to be joyful. I think it’s why we work hard. I think it’s why we try to create great relationships.
Andréa: I definitely resonate with so many of those—definitely the resistance to the play and the beauty, because I also started to grow up way too early and take myself too seriously. That’s beautiful that you implemented play while you were writing your book, because I think book writing is intimidating to many, and it is easy to get serious about it, especially if it’s something that’s important to you.
Doctor Neha: Even though I talk about heavy subjects such as how to handle anger and anxiety and tears, I do it in a pretty fun way because I thought, If I write this from a really heavy place, it’s not going to be fun to read. I want this to be a joy to read. I want it to be unexpected. I want people to learn things that they think are heavy, messy and uncomfortable and laugh their way through it. Could it be possible to make self-awareness hip, cool and sexy? That’s what I tried to do.
Andréa: Your values of love and integrity and service—where do you think you got those from?
Doctor Neha: Well, I come from an immigrant Indian family, so everything’s about education and creating grandchildren for my parents. So the community itself was pretty tight. Family and togetherness was a big part of forming my values. Also I was raised for two years by my grandparents. Indians have this extended-family thing that they do, where everybody helps take care of the kids, but I think it had a big impact on me. Being with my grandparents for two years and then coming back into my primary family made belonging and love important for me.
For integrity, that one is rooted in fairness. I think it’s important that people are who they say they are. Who you are in the world matters more than what you say. And while I’m certainly not perfect and have a lot to learn, every day I make mistakes, I hope to be what I teach. To me that’s the importance of integrity, and the mentors who have influenced me didn’t need to say as much because they showed up with integrity in the world.
The service piece also kind of ties into the other two for me. I think the endgame is that everything’s connected all the way from the cells in our body making up organ systems and every function within us to all of us being connected to each other, to the world, to nature and to the planet. So anything I do has an impact on someone else. Remembering to be in service to others feeds back into love, integrity, and beauty. And play just reminds me that we can do all of those things joyfully.
Andréa: You mentioned mentors. Who are some of the relationships that have been healing for you throughout your life?
Doctor Neha: That’s a great question. First of all, writing this book was a very healing experience. That wasn’t a person, but that might be why writing a book is so hard. I didn’t write a book; this book rewrote me.
Andréa: Oh, I love that.
Doctor Neha: I had to go deep. I had to heal a lot of experiences within myself and with my family. My family’s woven through a lot of the book. I always had a close relationship to my grandparents. They had raised me initially. I’d also say my uncle. The people who have been the most healing were those who saw me; I felt seen by them. They didn’t just hear what I said, but they heard the emotion underneath what I was saying and they really understood what was important to me, what I valued. My uncle used to play with me. He used to ask me questions, rather than tell me what to do. So I felt such a strong connection with him, and I loved his playful nature. Then he actually passed away when I was 10 years old, and I think that was the time I became quite serious and I started just being introverted and studying.
In school, I admired people who really excelled. I had a math teacher in 10th to 12th grade when I started to become interested in brilliance and intelligence. I admired those who were smart and kind and could simplify information in ways people could understand. So I started to really admire teachers. Then as I grew older, I started to admire physicians who were a little bit different, the ones who didn’t just excel, but also cared. It was almost like the atypical or the unusual people. The ones who were good at what they did, because I expected them to be good at what they did, but they also showed a lot of compassion and connection. I admired the people who were willing to slow down to speed up—they were willing to slow down and connect because they also cared about who was in front of them, which actually helped them get things done that we needed to get done. Those were some of the most healing mentors and relationships.
I also have a great friend Cathy, who is a nurse, and she’s amazing. She’s another one who just gets me. She is kind and compassionate. She’s curious. When she doesn’t understand what happens, she’ll ask me. She doesn’t assume anything. She just assumes that, “Wow, this didn’t really make sense. Maybe I should ask Neha what she meant by that or what happened.” Compassionate, curious, gentle, caring—all of that falls under love for me. And by the way, I dedicated the book to Cathy, too.
Andréa: I’m curious, what is your vision for the medical world, the medicine industry, the healthcare state of our country? What is your vision for what you want to help create?
Doctor Neha: I think we need to transform healthcare on every level. We need to start thinking about healthcare not as a place where you go to the hospital or clinics, but we need to move healthcare from hospitals and clinics into communities and families. It needs to be happening much earlier than it’s happening. The good news is the government has made some changes in healthcare that no longer allows insurance companies to drop people with pre-existing conditions, that makes all preventative health, like screening for mammograms and pap smears and all these things free—this is amazing, because no insurance company was going to put handcuffs on their own hands where they can’t cherry-pick who they allow to have insurance.
So the good news is, you can’t cherry-pick anymore, which means it changes the incentives. The incentives now have to be for wellness, because if you include the whole population, the way that you save money is by giving incentives to people to be well. So I think we’re on the right track even though there’s a long way to go, but let’s just talk about a couple of them.
It’s up to insurance companies and doctors and the medical team and patients. On an insurance company level, the insurers that are going to do well are the ones that start to focus on wellness, care about incentives and caring for their own staff. So instead of burning out doctors and nurses by having standards like doctors need to see people every seven minutes, the wise insurers are going to start investing in their providers having connection with their patients and using that relationship to inspire and engage patients in taking accountability of their own health. Technology also plays a role. Insurers need to start expanding their thinking. They need to start investing in doctors and nurses and allowing them to actually give time to creating healing relationships.
Another vision I have for healthcare is that I would educate the doctors and nurses. Often, we don’t actually address what’s underneath a physical issue. Somebody comes in to the hospital with a heart issue, and we clear them if the EKG comes back fine. We have to educate doctors to tell a patient, “The good news is your heart’s fine. The bad news is that you still don’t feel okay. This may be something else so let me direct you where to go next.” Instead, we often leave patients feeling like, “The doctor said I’m fine, but I don’t feel fine.” We do them a disservice—and cost the medical system a lot of money there.
Then I would empower and inspire patients with great information. I actually think the insurance companies have a chance to become a trusted extension of the healthcare team, rather than being someone who pays for my visit when I see a doctor. What about when I don’t get what I need? What if I walk away and I’m not satisfied? An insurance company in this part of the game has a chance to actually say, “Well, when you don’t get the answer you need, here’s some other resources.”
We all have to get innovative. Start thinking outside the box and start getting to the root of problems, like what’s underneath all that stress, rather than try to numb people’s stress. Part of my contribution to this idea is Talk Rx. I wrote it directly for patients. I hope that they now get information that maybe they wouldn’t get otherwise. Now I also have free videos every Thursday morning. There’s so much good information. You have to pay attention. Do you resonate with what this person’s saying? Does it seem like it’s true? Does it resonate with your values?
Andréa: What is one tip you would have for someone who is wanting to make a difference in the world? And I think health has a lot to do with making a difference and making it sustainable through your life.
Doctor Neha: If somebody wants to make a difference in the world, the first thing I’d say is it’s easy to look at other people and what they’re doing and let it stop you from doing what you want to do. Change worldwide starts from inside. So get really clear on a couple of things. Get clear about who you are and what you value. Understand how your body is communicating with you, so that you can make clear decisions in real time. When you get frustrated with other people, I’d say get curious not furious. And trust yourself—when something doesn’t seem right or you don’t feel like you resonate with something someone’s saying, even if it’s your doctor, listen to yourself. Don’t give up your power. You can only reach your true potential if you can hear the sound of your own heart and what it’s saying slightly louder than the voices of others.
Andréa: I remember that.
Doctor Neha: It’s really what guides me. Some people think it’s selfish, and I say absolutely not. The world is confusing when you’re taking in everybody else’s judgments and opinions but you don’t have a place to ground all of that. You have to get clear about your own house. You’ve got to get clear about what’s going on in you. Know who you are, what you stand for, what’s important to you. And then listen to other people. You do want to let other voices and opinions and perspectives in, absolutely, but you don’t want to let them overpower who you are. That’s when you get resentful, upset, feel taken advantage of, or you did something you really didn’t want to or you went down a path that wasn’t yours. So let the sound of your own heart be slightly louder than the voices of others. We’d have a very different world.
Andréa: And what is one tool or resource that you have used that has revolutionized your world, your life, your work?
Doctor Neha: The one tool or resource that has changed my entire game is the ability to communicate. Communicating with myself, paying attention to my body’s signals—my throat constricts and my stomach turns whenever I say yes when I really meant no. I used to try to make those go away. I tried to subdue those, push those down. I’d drink caffeine and sugar and go to sleep, anything I could to get those signals to go away.
What revolutionized my world was starting to listen to the signals coming from my body and being able to interpret and decipher them. Instead of numbing them or getting rid of them, they have become my biggest ally. They let me know what I want and what I need. When I’m getting out of my comfort zone, when I’m starting to feel panic, when something isn’t okay. So using the signals from my body is one of my most trusted tools. I actually do teach people how I learned to do that. Once I understood how my body was working with me and for me, it was a lot easier to navigate the world and then decisions were much easier to make.
Communication with myself then allowed me to communicate with others more easily. Think about how many times a day you communicate with other people and how successful you are. That determines whether you can influence them and how much of an impact you can make in the world. Future leaders in any industry are going to be the ones who understand how to communicate with themselves and communicate with others.
Andréa: Boom! So basically, go read the book Talk Rx. So how do we do that? How do we go deeper into your world?
Doctor Neha: You can get Talk Rx on Amazon or Barnes & Noble. Also you can download a free intro chapter at my website: doctorneha.com. If you go there and put your name and email in right away, you can download the intro chapter. It will also give you those free videos that I offer every Thursday. In those videos, I allow people to come talk with me in person to ask their questions so other people can learn. They sit down, they ask a question, and in under 10 minutes we turn around some sort of a real-life communication or health dilemma, and then I give you tools and tips so you can learn from their bravery. I’ve gotten lots of great feedback from it. You get this sneak peek in what it would be like in a coaching session.
- Recall an important event or experience in your life
- Name the physical signals in your body tell you that it was important to you (e.g., heart racing, muscles relaxing, smiling—refer to the Body Map on page 24 in TalkRx for ideas).
- Identify your top three values related to this experience by asking: What was most important about this? (See pages 216-217 in TalkRx for a list of common values.)
- Bring to mind a situation that you would like to change.
- Then ask yourself, what would these values do now? For example, what would love, integrity and service do now? Trust the answer!
Send me your questions — drop me a tweet at #AskDoctorNeha or write your question and comments down below.
Be the change you wish to see,