Tuesday, September 27, 2011

ND Student Unites Lab Research and Healing Work

This Ivy League graduate thought he had a career as a research biologist all mapped out. Then he learned to listen to his heart along with his science-loving mind.

Joshua Goldenberg
Joshua Goldenberg

When Joshua Goldenberg decided to study natural medicine, he located the rare pay phone in rural Guatemala that made international calls and dialed an old family friend back home in Philadelphia, a physician who had known him since he was a kid.

You're crazy, the doctor told him. You're an Ivy League graduate. You're smart enough for a conventional medical school. Why would you pass that up?

Goldenberg was taken aback. He liked the doctor and respected his opinion. He didn't have a ready answer for why natural medicine, which integrates Western medical science with centuries-old knowledge of natural treatments, excited him so much. He just knew that something inside him was tugging in that direction.

Now that he's a fourth-year student at Bastyr University, he's grown comfortable talking about his decision. It's always complicated to explain a field that draws on disciplines as diverse as acupuncture, botanical medicine, nutrition and counseling psychology. But Goldenberg appreciates the holistic approach — studying the health of body, mind and spirit all at once, with a focus on prevention and wellness rather than on treating isolated symptoms.

When he meets MDs at professional conferences, he says he's able to earn their respect.

"The challenge is that no one's heard of naturopathic medicine," he says. "That's fair — I had never heard of it either. But every time I've had a conversation with a conventional doctor, within a few minutes they see that I speak their language and know exactly what they're talking about."

It helps that Doctor of Naturopathic Medicine (ND) students at Bastyr take basic sciences courses as rigorous and extensive as those at conventional medical schools, and that NDs are recognized as licensed primary care physicians in 16 states (they practice all aspects of family care, from pediatrics to geriatrics).

It helps that Goldenberg is conducting professional-level research, with a forthcoming article undergoing Cochrane review, a widely respected medical review system.

And it helps that he had a career as a research biologist all mapped out, before he found a way to listen to his heart along with his science-loving mind.

Giving Up a "Dream" Job

Goldenberg, a 28-year-old with close-cropped dark hair and a quick, disarming laugh, grew up a block from the Philadelphia city line, the son of a professor of Jewish history and a clinical social worker. He was naturally drawn toward life sciences as a child, he says, especially once he learned about the molecular realm.

"I thought it was the most beautiful thing in the world," he says. "There was this entire world of things going on that you could never see, and it was really the crux of where things seemed to be happening, and it just blew my mind."

He studied molecular biology as an undergraduate at the University of Pennsylvania, looking forward to sharing "a sense of wonder about the human body" with his classmates. Instead, among the pre-med students, he found a relentless focus on grades. That was understandable, given the competition for medical school slots. But it wasn't for him.

Goldenberg focused on research instead. For his senior project he studied tree barks used medicinally by Native Americans, measuring the effect of extracts on cultured microbes. For a kid raised on "very conventional" health beliefs, with little exposure to other traditions, that was something new. "I thought it was cool," he says of ethnobotany. "But I didn't know if there were career options in it."

Starting a career in research, however, came easily. Immediately after graduation Goldenberg landed a job at a molecular ecology lab in an attractive forest location outside of Philadelphia. He spent his days studying genetic fragments from the Philadelphia water system, trying to figure out what organisms they originally came from. It was a grown-up job with a grown-up salary, directly in line with his research interests, and ideal prep work for a PhD program.

It should have been a perfect fit. It wasn't.

"By about six months in, I was miserable," says Goldenberg. "I wasn't happy being in a lab all day. I felt really trapped."

It was too repetitive. Too solitary. Too ... Goldenberg wasn't sure what.

He recounts the story in the Bastyr Dining Commons, finishing off a plate of curried vegetables in between morning lab work and afternoon classes. He puts on a slightly apologetic smile before telling the next chapter.

"I bought a rucksack at Goodwill," he says. He quit his job and booked a plane ticket for Central America. "I saved up some money and did this, you know, very trite 'finding yourself' trip that a lot of people do. And I said, 'I'm off!'"

On the Road

He started in Mexico and worked his way south, without a timeframe, volunteering on organic farms, learning Spanish, having a ball and wondering just a little where he was headed.

"I was thinking, 'Great, Josh,'" he says. "'This is a lot of fun. Now what the hell are you going to do when you get back? You don't know what you're doing with your life.'"

In Guatemala, he was persuaded to stay a while by the postcard-perfect Lago de Atitlán, a deep mountain lake ringed by volcanoes. He spent his days reading, writing in his journal and practicing Spanish. It was there that he met the woman he calls, with a touch of both irony and sincerity, his "oracle."

She was a midwife from Boulder, Colorado, volunteering at a village health clinic. When he told her about his career crisis — loving research but wanting to help people directly, wanting camaraderie more than competition — she told him about natural medicine. He could learn the philosophy of doctor as teacher, educating patients and encouraging self-responsibility. He could continue in research and also prepare for a career helping patients heal.

The idea felt intensely calming. Later, in his Fundamentals of Traditional Chinese Medicine class at Bastyr, Goldenberg would learn to call the source of this calm his hun (literally, "cloud soul"), a sort of inner spiritual guide located near the gut. When a person is on their proper life path, his hun lets him know. Same deal with the wrong path.

For the moment, Goldenberg wanted to know more, a lot more, about natural medicine and the schools teaching it. He learned what he could from Internet cafes, then started making calls home. That's when he got the cold dose of skepticism from the longtime family friend.

"I don't begrudge him what he said," says Goldenberg. "He was looking out for me."

Sharing the Love

Goldenberg brought that same skepticism with him when he visited naturopathic medical schools. He knew they would offer psychological and spiritual components that other schools wouldn't have. "I still needed to be convinced they were doing serious research and that I would get really stellar biomedical training," he says.

He was convinced on both counts by all four regionally accredited schools that he visited. Bastyr University rose to the top of his list because it had the largest research programs — both laboratory- and clinic-based. He liked that Bastyr's campus lies within a lush Pacific Northwest forest along Lake Washington. It felt like an appropriately peaceful site to study wellness and preventive care.

But he also appreciates that Bastyr's teaching clinic lies in the heart of Seattle, where he confronts the human need that compelled him to study medicine in the first place. He began clinical shifts this summer, seeing each patient alongside another ND student, then consulting with a faculty supervisor before making diagnoses and recommendations.

"It changes everything," he says of clinical work. "Instead of just looking at books, you have actual patients who need you. It reminds you why you're here."

Goldenberg says he's found plenty of research opportunities funded by the National Institutes of Health (NIH), which gave a multimillion-dollar grant to the Bastyr University Research Institute. One of his projects explored the immune-system benefits of the "turkey tail" mushroom, Trametes versicolor, long believed to have cancer-fighting properties. He also designed a meta-analysis (a study looking at other studies) on probiotics – live microorganisms thought to have health benefits, such as the "good" bacteria in some yogurts.

Goldenberg's passion for research is something he wants to share. He started three student clubs to encourage others to get into research: a research society, a journal club and a biomedical statistics group. He also organized an open house that made it less intimidating for inexperienced students to link up with research faculty, according to classmate Renee Choi.

"He's made it so much easier for students to get into research," says Choi. "Faculty support was already there, but a lot of students felt like they didn't know how to start."

"His enthusiasm is infectious," adds Mark R. Martzen, PhD, CIP, director of Bastyr's Center for Student Research and senior director of research development.

When Goldenberg graduates, he hopes to build a career that balances research and seeing patients. It's challenging to do both well, says Dr. Martzen, but multiple Bastyr faculty conduct original research and also maintain a patient practice.

"You have to be extremely well organized and committed to maintain high standards of patient care, run a research program and also reserve time for your personal work-life balance," says Dr. Martzen. "Joshua has the motivation, skills and compassionate heart of a healer necessary to succeed as a clinician researcher."

Goldenberg still finds it challenging to explain the concept of natural medicine to skeptical family members. (Imagine trying to summarize Western medicine to someone who's never encountered it.) When he made his final choice to pursue an ND instead of an MD degree, he remembers the decision gnawing at him.

He was lying on his childhood bed at his parents' home, back from Central America. "I was literally writhing in bed," he says, laughing in retrospect. "It was horrible."

He discovered, he says, that the voice in him that wanted an MD was chiefly concerned with acceptance from others. When he listened to a deeper part of himself — his hun — he knew what he wanted to do.

"You've only got one life, right?" he says. "Why spend it doing something you're not really happy about? You only get to do this once."

This story originally appeared in the September/October 2011 issue of PreMed Life magazine.

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