Dear reader, as you may already know, I did not match into family medicine residency this past Spring. It was devastating news, though now I understand it's because I'm different. I'm a maverick, a creator, a dreamer, and a do-er - and a lot of programs don't want that kind of free thinking and creativity. The feedback I got from my top choice program was that I wasn't enough of a "yes sir" type of girl. This is not surprising to me, as most applicants probably didn't sign themselves up for a full slate of summer camps at eight years old without telling their parents, or drop out of high school to start college early where I was encouraged to cultivate even wilder ways of thinking about the world. Most western medicine residency programs want a blank slate candidate they can mold into whatever they want you to be. But I already know the kind of healer I want to be, and I can't hide it - though I am ever more aware of the fact that there are so many places I need to soften. Specifically, I am always reminding myself to remain open-minded about the ways that traditional Western medicine training will help me better serve my future patients.
This aside is relevant, I swear: when I SOAPed (non-medical readers: this means scrambling to find a place to train who had unfilled slots), I blessedly landed in Boone, North Carolina. Shortly after, I received an email newsletter from the Western North Carolina Medical Society. At the end of the email, there were resources for healers (funded by WCMS!!), and one stood out to me: a meal plan for anti-inflammatory eating and strategies to cook for the entire week in a single hour. I clicked the link and found Asheville Mountain Kitchen, and Ofri. I remember getting goosebumps realizing she was doing the very things I dreamed of doing with patients: healing through self-determination and autonomy of food - learning to cook. I cold emailed her after reading her beautiful story of healing herself from Lupus with food. This was how she got her start. (Dear reader, this is another reminder to me that people who follow their truest paths are vulnerable and courageous in sharing their stories and journeys, wind up in careers that highlight the lessons they've learned, and attract others in need of that exact kind of help. This is why I won't be silent about my own story. It doesn't make me unprofessional, or selfish. It's how I tell the world, and my future patients, who I am and what I have to offer. We each have these gifts, divinely ours, and worth celebrating.)
Ofri and I chatted on the phone a week later, and as soon as I moved I went to Asheville to take one of her classes and meet her in person. She is doing the longitudinal, difficult work with regular people who want to take ownership over their health and also recognize they have no idea where to start - but they know that food is crucial. Ofri knows how to have compassion for folks who are dependent on processed foods that are making them sick and want to change, but are afraid. Ofri knows that autonomy over food, and learning how to nourish and heal with each meal, starts with acquiring skills, then knowledge, and then you can start cooking. Ofri knows firsthand that the journey to wellness isn't linear, and that each person forges that path on their own. Ofri knows that two ingredients are indispensable for this transformation to occur: support and love along the way. She holds space for that softness while also holding strong feelings about what we call "food" in America:
"If you don’t learn how to cook, you eventually get sick. The food is toxic."
Her journey echoes mine in so many ways. As I reviewed and edited this interview, I see it as a cautionary tale for myself and other go-getters – as you'll hear, she used to be more "Harvard" and now she's more "go with the flow". Her disease taught her that, and she now thanks her disease for these lessons. Lupus has softened her and taught her to listen, to accept love, and to welcome rest and self-compassion.
If you'd like to learn more about Ofri or even take one of her classes (some of which are online!) you can find her website below; and read her story in her own words, here.
"If you don’t learn how to cook, you eventually get sick. The food is toxic."
the origin story: Ofri and Lupus
Ofri has lived all over the world - Israel, Australia, and the United States. She was born in Israel and came to the US for graduate school at Harvard when she was 29.
Initially, she was diagnosed with antiphospholipid syndrome due to a series of symptoms that aligned with autoimmunity, but later she was officially diagnosed with Lupus. Her symptoms evolved from peripheral to central - initially just joint pains and skin rashes, and later such severe inflammation she was at risk of needing open heart surgery.
I had multiple diagnoses. It started with the antiphospholipid syndrome, then the Lupus diagnosis when I was 29, and then I had other diagnoses later on. I actually diagnosed myself initially. It started with a blood clot when I was 25. I developed joint pain and Raynaud’s, and I complained to my doctor about it. They dismissed it and said it was ok for me to be cold. I went to an arthritis website; they had a questionnaire that was interactive, and I went through the prompts it gave, and one of the things that came up after I finished the survey was Lupus. I hadn’t heard of that before, because I’m not a medical person, but under that label were all the symptoms I had since I was a child. I’d never put it all together.
My official diagnosis came right before I was leaving for Harvard (when I was 29). I wasn’t sure what to do. I had a full scholarship lined up, and I didn’t want to lose all of that. My dad told me “Take the drugs; you’ll be fine.” My parents had no idea. I had no idea. So I went.
How was your diagnosis delivered to you?
A rheumatologist diagnosed me formally, and said a lot of stuff to scare me. I told the rheumatologist the truth about my symptoms: that some days were fine and some days were not. I did not want to start with drugs and medication, but the doctor went on to really scare me into taking drugs. But I didn’t think medicine was really what I needed just yet. They told me if I didn’t take the medicine, I’d end up in the hospital in critical condition. It felt like they were threatening me.
I did take the prescription drug he gave me, Plaquenil, an anti-malarial drug. I was also trying to eat healthy, but I didn’t really know what that meant. I was so overwhelmed with illness – so sick – that these efforts didn’t really help me. This was all right before I went on to Harvard.
No one explained to me the mental and physical implications of this medicine, or how to use the drug.
No one explained to me lifestyle, or how important it is to get sleep and rest. These are probably the most important things you can do to start, and I know that now.
What was it like at your sickest?
My peak sickness was at 30 years old when I was at Harvard. Looking back, I have no idea how I got through it. It was my first semester in grad school, and I worked way too hard. I was sick everywhere – head to toe. I would get to school and just not move all day if I could. I’d sit down, since I was at design school, and try not to have to walk the rest of the day. I couldn’t breathe well, I couldn’t hold a glass of water, I was hearing voices, I lost all my hair. I was extremely depressed. Clinically, I had brain and heart inflammation.
I remember traveling to Turkey, and limping everywhere the whole time. All I was fed in Turkey was meat and bread – two things I thought were not good for me. The sun was so intense, and I was very anxious. Looking back, I felt unsafe that whole trip.
Back home, a doctor at Harvard gave me prednisone. She told me to use it like ibuprofen, to take it whenever I felt like I was having a bad day. Now that I understand steroids, I do not understand this recommendation. It just made everything worse – this medication made me really nasty (emotionally); I’d have to apologize to people after our interactions.
I was detached from my body. Before I was always mindful of my body and connected to it, through yoga and other practices; and yoga is how I initially recognized I was losing some of my physical ability. Things I could formerly do I couldn’t do anymore because I was in too much pain. I’d disconnect from my body. I remember trying to hang on in the beginning, to meditate and stay connected, but it was very hard.
All this time, I pretended to my parents (who were abroad, in Australia) that I was okay. Because I’ve always been a person who people didn’t have to worry about – I was always checked off as being fine. So I kept up that image. I felt they had enough to deal with from others.
I became so sick that my friend from Israel came to Harvard and took me home with her because she was so worried about me. I had to take a semester off. I remember people saying, "Where did Ofri find such amazing friends?" They took care of me like a baby; I was so sick and declining really rapidly. I was reluctant to take drugs, but what I didn't realize was that I was so sick I needed to stabilize myself.
Where do you think your dis-ease came from?
There are a lot of factors. One was that I was in a relationship that wasn’t right for me; it was not abusive or traumatic, but it wasn’t right for me. Also, I think always being a leader, carrying that weight, being someone others always leaned on - that took a toll. When I was sixteen, my parents left to travel, and I watched my three younger siblings for a month. That was my first Lupus flare up: I had Herpes Zoster (shingles) and my arm was paralyzed from it. I had no idea I had Lupus at the time. It was excruciatingly painful.
Ultimately, I always had way too much responsibility on me. I never said no, and I never said things were too hard. My sickness allowed me to start saying no and saying that things are too hard. I started saying no to meeting people far away, or big engagements. I still have trouble saying no to things, but I’m a lot better. It [Lupus] allowed me to really prioritize myself. It gave me an excuse to say “I can’t do that, it’s hard.” I never said that before I got sick, about anything.
For a long time I thought “Why me, why me” but now I see my disease as an opportunity. It’s here to show you something. It’s your body talking to you, that’s what it is. Lupus at first is very peripheral – just joints and skin, nothing too bad – but then it goes in if you’re not listening to the messages. The signs are there and you have to acknowledge them.
Something else I've realized I need a lot of love. Just saying that out loud is okay for me now. My husband would be too much for most people, too loving and caring. He’s just right for me. I need all of that. I never accepted that from others before.
What helped you heal? What did you utilize - conventional and otherwise?
I tried all different crazy things: homeopathy, you name it. I tried cold compresses from a woman in Israel’s recommendation who’d written a book about how to heal cancer – that was nonsense. I took a semester off at Harvard and I learned a lot; I saw some different healers who made me much more aware of my lifestyle. I made sure to rest, take breaks; I changed my curriculum completely. In design school, we do design studio which is like residency for medicine. People work all nighters constantly. The school gave me more money to come back, because I had done so well the first semester. I told them I’d come back only if they let me change my degree from a professional degree to a master’s program so that I could take any courses I wanted. I took sculpting, I took courses at the college – and I didn’t do the design studio. During this time, I really improved my writing – they even gave me a writing coach. This made more sense for my health and wellness because it was less labor intensive, and I acquired some important skills.
After I graduated, I had more time to dive deeper. I eliminated things that weren’t important to me. I stopped going out all the time, and yes, this left me feeling a little lonely sometimes but it was okay. I eliminated stuff so that I could do what I needed to do for my health and wellness. I did yoga, I considered going to a sweat lodge. I stopped drinking coffee because it was too draining. All that energy doesn’t come from outer space! It comes from your body. Now, I can drink coffee. Anything that seemed exhausting to me I didn’t do. I didn’t go to graduation or the parties, because it was too much. I didn’t care about it. I committed to healing, and being selfish in a good way. You just have to put yourself first and your needs first. Nothing else matters really. You can’t participate meaningfully in anything if you’re not okay.
What is one thing you think doctors in America need to know?
It starts with compassion and empathy for your patients, which a lot of doctors lack. The healing journey is complicated - it’s not a straightforward thing. You have to walk it. No one can do it for you, not even a doctor. But doctors need to let patients have the support that they need, and be patient. Like the doctor I had in Israel when I was at my sickest and my friends were caring for me – she didn’t try to scare me or impose anything on me. She said "I’m here if you decide you want to take drugs; that’s what I do." She was honest with me about her assessment and what might happen if I didn’t choose drugs. She told me if I didn’t take medicine I might need open heart surgery, and that I had two weeks probably before that was necessary. But she wasn’t doing it in a threatening way like my first rheumatologist who diagnosed me.
Even the functional medicine doctors I connect with now - they also lack empathy and understanding. Healing is a journey. It’s not linear. Patients don’t need to be judged. Someone was telling me recently: “I don’t understand why they don’t just follow the diet I give them.” It is hard to make these changes!
How has your life changed to support your healing? It's amazing to me to know how sick you were - unable to even lift your arms - and see you thriving now, and free of inflammation. What is your day-to-day like?
Now, I'm less of Harvard (driven, go getter, get what you want), and more of my mom: more caring and loving and understanding. An iridology practitioner told me to be more like my mom - that it would be good for me. It has been.
Other things I did: I changed partners. I changed my work to have less stress, because managing projects is really up there with the most stressful jobs you can have. I work part time most of the time, and I get breaks between events, down days where I can relax.
I always weave in rest and relaxation throughout the day. I lay down in the middle of the day. Break things up! Don’t cram your calendar. All the blue zone people take a nap. Your body has to rest. You can’t live in this constant state of stress. It’s not good. (A note from Olivia: Ofri told me in conversation when we first met that when the body wants sugar, it actually needs rest.)
I also practice breathing a lot – it’s the best way to connect with your body. You don’t have to be in a yoga class or at a meditation center to breathe. Just breathe! I like to inhale, fill my lungs up as much as I can, and then a little more once I think they’re full, take one more whiff, and then slowly exhale. I find that extremely relaxing. There’s a scientific explanation for all that, but I know it from experience. Alternate nostril breathing I do a lot, too.
Anyone can do this, even if you have a full time job. I think you could find a way to do it.
Break things up! Don’t cram your calendar. All the blue zone people take a nap. Your body has to rest. You can’t live in this constant state of stress. It’s not good.
Ofri, can you describe what your work is like now? How do you heal others through food?
I run a part time recreational cooking school, public classes and corporate team building classes. I have an online course and coaching program for people who would like to improve their health. I teach all kinds of cooking. I don’t promise any healing. People take it as far as they would like. My online course is self-paced, and it teaches basic cooking and what comprises an anti-inflammatory diet. You learn a system, which I call 1 hour a week, to put together healthy meals for the entire week in one hour. It teaches people a system rather than a collection of recipes.
What I find is: most people don’t know how to cook. The ones who do are usually men who care about fitness, which gets them in the kitchen – they realize the importance of nutrition. A lot of people look down on it [cooking], which is silly, because it’s a way of taking care of yourself. It affects your finances and your wellness.
The clients I get are a lot of older women who hit a wall. If you don’t learn how to cook, you eventually get sick. The food is toxic. It’s a big moneymaking system. A recent example is a woman called me this week who grew up in the south and has type 2 diabetes, and all she knows how to make is biscuits and gravy. I tell her, "it’s a process." First you have to acquire the skills, then we can refine your diet, then we can learn other things to support you like breathing, and other practices that will help you heal. But to me, the cooking skills are the basis of all of that.
