Conversations on Healing

Esther Sternberg

Integrative Medicine in the Workplace and Beyond

Featuring
Dr. Esther Sternberg
Professor of Medicine in the University of Arizona College of Medicine Tucson, Research Director of the Andrew Weil Center for Integrative Medicine and Director of the UArizona Institute on Place, Wellbeing & Performance

Dr. Esther Sternberg is renowned for her significant influence in integrative medicine and is known for her research bridging mind-body science and built environments. She is the Research Director at the Andrew Weil Center for Integrative Medicine and the Founding Director of the University of Arizona Institute on Place, Wellbeing & Performance. Before her tenure at the University of Arizona, she was a Senior Scientist at the National Institutes of Health. Sternberg has advised various high-profile organizations, including the U.S. Congress and the Vatican. She has authored over 240 scholarly works and two influential books, with her latest title, “Well At Work”, receiving notable accolades. Sternberg also played a crucial role in the design of the new Andrew Weil Center for Integrative Medicine building in Tucson, Arizona.

In today’s episode of the Conversations on Healing Podcast, host Shay Beider speaks with Dr. Sternberg about her work in integrative medicine and how she has incorporated design elements for wellbeing into the workspace. She shares the 7 domains of integrative health and how you can incorporate these into your everyday life. Dr. Sternberg also discusses how some of these domains influenced her personal health and the design for the Andrew Weil Center. She talks about her most recent book, “Well at Work” and shares some of her research to transform workspaces into wellbeing spaces. Additionally, Dr. Sternberg discusses her time advising the US Congress and General Services Administration on a post COVID entry plan back into this work place. Several tips to stay well at work are included in this thoughtful conversation.

Show Notes:

Introduction Welcome to the Conversations on Healing podcast, where host Shay Beider speaks with renowned healthcare leaders, practitioners, and thought leaders to explore the world of wellness, the incredible powers of self-care, and what it truly means to heal today. Join us on this journey to become more whole healed and connected.

Shay Beider Hello, lovely listeners and welcome to The Conversations on Healing podcast. I’m host Shay Beider, and today I’m joined by Dr. Esther Sternberg. Dr. Sternberg is internationally recognized in the world of integrative medicine and is a health pioneer whose research takes mind-body science from molecules all the way to built environments. Currently, Dr. Sternberg serves as the research director for the Andrew Weill Center for Integrative Medicine, and she is the founding director of the University of Arizona Institute on place Wellbeing and Performance. She’s the inaugural Andrew Weill chair for Research in Integrative Medicine. And prior to working with the university, Dr. Sternberg was a senior scientist and section chief at the National Institutes of Health. She’s been recognized by the National Library of Medicine as one of the women who changed the face of medicine. In today’s episode, we talk about her book Well at Work, creating wellbeing in any workspace and the importance of creating built environments that we can not only function in but actually thrive in. We also talk about the seven domains of integrative health and how these can be incorporated into our daily life to both maximize health and increase longevity. No matter where you are in your healing journey, I think you’ll enjoy this wonderful and dynamic conversation on healing about how to get well in the workplace.

Well, Esther, I want to welcome you to the Conversations on Healing podcast. It’s absolutely a delight to have you on the show.

Dr. Esther Sternberg Well, I’m thrilled to be here. Thank you so much.

Shay Good. Well your background in integrative medicine and just the sheer quantity of research that you’ve done over the years is truly impressive. And I thought for our listeners, because a lot of what we’re going to focus on today is sort of wellness in the workplace and how that’s created, but I also wanted to give a little bit of a framework around the conversation, and I know that you and others at the Andrew Weill Center for Integrative Medicine, where you’re currently the research director have distilled these seven core areas of integrative health. And so I thought it might be nice to start with what are those seven core areas of integrative health and how they can benefit each one of us in our day-to-day lives?

Esther Sure. Well, as you said, the team at the Andrew Weill Center for Integrative Medicine distilled the seven core areas of integrative health. We also call them domains and they are sleep, resilience, environment, movement, relationships, spirituality and nutrition. And we can dive into what each of these encompass. They’re small world words, but they I almost said small worlds, but in fact,

Shay They are that too, aren’t they?

Esther They’re small worlds and you know it can be daunting to say, oh, in order to stay well, I have to engage in all seven of these. How am I going to do it? But that’s really what my book is about. Well at work, creating wellbeing in any workspace, it is designing the spaces where you work, but also where you live or play or learn to help you engage in those seven domains without even realizing you’re doing it.

Shay Exactly. And so yeah, let’s talk a little bit about your book. Well, at work, creating wellbeing in any workspace, there’s a number of wonderful areas that you dive into and you’ve divided it by the domain. So that’s kind of a really cool way that you share the story. And I was actually thinking about maybe we could start with the impacts of the built environment on our physical health and emotional wellbeing, just so our listeners kind of get a deeper understanding of how much that is influencing us.

Esther Well, it’s huge influence that most of us don’t even realize. And I myself didn’t even realize it until I started doing research with the US General Services Administration, and that’s the agency of the federal government that builds and operates and maintains all non-military federal buildings in the United States and around the world. So all your embassies, all your courthouses, your federal office buildings, your libraries, and so on, over 374 million square feet of office space for over a million civilian office workers. And prior to coming to the Andrew Weill Center for Integrative Medicine, I was a senior scientist and section chief at the National Institutes of Health, where I had been studying the impacts of the Brain Stress Center on inflammatory diseases like arthritis. I had discovered that the Brain Stress Center is important in susceptibility to arthritis. And back in 2000, so over two decades ago, the then research director of the US General Services Administration, Kevin Cher, came to me at the NIH as a sister agency and asked me would I help him to measure the impact of those millions of square feet of office space that he had on health, wellbeing and performance of the office workers in the space if the work product was not a widget that you could weigh and measure, but if it was a creative product.

And so we started on a journey, and I tell this at the beginning of the book. The first part of the book tells about the story of how I, a rheumatologist got into studying the built environment, and we started using wearable devices and we continued using state-of-the-art wearable devices, when I came to the Andrew Weil Center for Integrative Medicine to measure the stress and relaxation response movement, posture, sleep quality and so on, and connect those health outcomes to various aspects of the built environment that we could also measure continuously in real time. And we came up with what effectively is a prescription for a healthy wellbeing building. And when I talk about healthy, I mean physical health and emotional wellbeing. So really what the book tells you is how to design your own spaces to enhance both physical health and emotional wellbeing.

Shay And we’ll actually get into some of the recommendations. You have sort of a nice summary towards the end of the book that I really enjoyed that just sort of pulls together what you’ve been laying out throughout the entire book into a succinct summary that might be useful for people that are listening. You also have a really interesting personal story of healing where you had developed an inflammatory arthritis and you had some neighbors who had a place in Crete, and they always wanted a writer to come and stay at that property. And you’re like, I’m a writer. You were working on your first book and you ended up going there and noticed that you felt so much better. And what you’ve then since identified is that at that time you were actually practicing the seven domains of health kind of unknowingly, and that had a huge impact on your personal healing. So I thought it might be wonderful to share a little of that story as well.

Esther Yeah, so you just summarized the story. So yeah, at the same time as I was doing this research, getting the actual data of how dark dingy six foot high wall cubicle office spaces with loud mechanical noise and poor airflow and no light and no views caused people to be more stressed than people in beautiful open office design with lots of sunlight and beautiful views to the outside and good airflow and low mechanical noise. When we got that data, at first I was surprised, and I do not know why I was surprised, but I think it’s because we all get used to the horrible spaces where we work or live or wherever we are, and that’s just habituation. So I was doing that research and prior to that, as you said, about eight or nine years after I had discovered the Brain’s Stress Center, the role of the Brain Stress Center in susceptibility to inflammatory arthritis, I developed, I went through a period of extreme stress in my own life and I developed inflammatory arthritis, which was kind of ironic. I’m a rheumatologist and here I get arthritis, and you’re right, my neighbors, I had just moved into a new house. That’s a big stressor. My mother had died. I mean, I was experiencing the major stressors in life, and my neighbors saw me writing on the computer and they asked me, are you an author? And I said, I don’t know. Why do you ask? I hadn’t yet published my first book. What I was writing was to become my first book, the Balance Within the Science, connecting Health and Emotions. And I asked them, why did you ask? And they said, we’ve always wanted a writer to stay at our cottage and Crete. So I said, yes, I’m a writer. And I went with them and I was supposed to go into hospital. I had knee biopsies. I was scheduled to go into the National Institutes of Health Research program into the hospital to get more knee biopsies, a liver biopsy, experimental drugs for epilepsy.

And instead I went with them to Crete and I healed. And it wasn’t a miracle cure. I was there only about two weeks, but I had this aha moment while I was there that I felt so much better and I asked myself, what was I doing? I was swimming in the ocean every day. I was eating a healthy Mediterranean diet. We of course know that that is an anti-inflammatory diet. I was surrounded by my friends and all the villagers and the grandmothers of the village who fed me all this wonderful food, shared their stories of arthritis with me. I was walking every day. I was climbed to the top of the hill, above the temple, above the village where there was a temple to the Greek God of healing, Asclepius. And on top of that was a tiny little Greek chapel. And I would sit there for hours and just look at the beautiful blue Mediterranean and the fuchsia bia against the white stucco buildings and listen to the birds and the sheep and the goats and the wind and hours would pass.

And I didn’t realize it, and I did not know then that I was meditating and I had healthy sleep. As a result, my stress levels were lower. I was eating healthy, I was exercising, I was moving a lot, so my sleep was much better and I had a calm, refreshing sleep. So I was engaging in all of those seven domains of integrative health without even realizing it. And that made me realize when I came back to Washington dc which is where I lived at the time, that if I continued on the path that I had been before I left eating french fries and cheeseburgers every day for lunch and having a sedentary life and you know being stressed and not doing the kinds of things that we do in integrative medicine like meditation, I realized I would continue to get sicker, and if I continued doing the things I was doing in Greece, I would continue to get better.

And that turned out to be the case. And when I saw my doctor a month or so later, he said, well, you don’t need to go into hospital. You’re so much better. So that really, more than the data that we were getting, I mean intellectually the data that we were getting from our studies showing that people were less stressed in these kinds of positive environments than in the negative environments, that convinced me intellectually that it’s important to design place and space around you for health and wellbeing, but more important at a deep emotional level. That experience in Crete really brought it home. I really understood how stress can make you sick, how believing can make you well, and how the built environment and the physical nature natural environment can actually help you heal.

Shay Absolutely. And I do want to touch Esther a little bit on that first book that you were writing in Crete, The Balance Within because it’s about the science connecting health and emotions. And I think our listeners would be interested to hear what you understood and then conveyed in that book around the science that connects our health and emotions just as a primer.

Esther Well, so I wrote that book, I started writing it shortly after my mother died. So that was in 1997. It was published in 2000, so that was now a quarter of century ago. At that time, it was really hard to convince the serious scientists, especially at the National Institutes of Health, but anywhere that stress can make you sick, that believing can make you well. And the book asks the question, why is it that those of us who were doing research in this area, in the brain immune connection? How does the brain talk to the immune system? How does the immune system talk to the brain? Is that connection, is that two-way conversation important in maintaining health? And if it’s broken, does it cause disease? And yet we were very serious scientists and we were rejected by our parent disciplines. We were considered flaky, we were considered out there. One of my or supervisors early in my career that was in the 1980s and patted me on the head and said, Esther, you’re going to fail.

This is not an area that you should be working on. Another of my supervisors said, he showed me the palm of his hand and he said, you’ll do this research when grass grows here. It was really, we were not ignored. We were actually, and I was not the only one who experienced this kind of marginalization from the mainstream of science. We were actually actively discouraged from pursuing these questions. And yet there was a mounting amount of data that showed indeed that there are many ways in which the brain and the immune system communicate, talk to each other, and if those connections are strong, you have health. And if they’re broken, you have disease. And so that’s really what motivated me to write the book, is to try to trace the history of the science, of the mind, body connection or the belief that emotions have something to do with disease, which goes back thousands and thousands of years millennia since the dawn of humankind, and yet we didn’t have the tools in science to prove these connections.

And that’s the conclusion in that book is that in western science, unless you can see it, it’s not real. So until we had Molecular Biology, Biochemistry, Cell Biology, Immunology, Brain Imaging and so on, we could not not see an emotion. We could not even conceive of how an emotion could affect something as solid as the immune system. But we now know that that’s true and that there are many, many ways at the genetic, at the molecular level that the neuronal level, the hormonal level, that these two systems communicate continuously and every moment of the day and night. And that’s what keeps you healthy. If these two systems were not communicating and we’re not responding to the external environment, every single moment you would begin to get sick and eventually die. That’s what living is, that’s healing is it’s continuously responding to those external cues. And so that’s how that connects to what I’m doing now, which is how do those external cues in the work environment influence all of those systems that are there to keep you healthy? And how can we make sure that those external cues, that those features of the work environment are optimal to keep you healthy and both physically and emotionally.

Shay And I just have to ask Esther, how did you have the courage to persist through all of this? Because like you said, you went to McGill, you were at the NIH for more than two decades. You had all of the credentials, right? And MD, you went to medical school, you did so many things that obviously you have total legitimacy, and then you get the grass growing out of your palm kind of moment, which is no fun. But you persisted because there had to be something in you that saw a bigger picture that you were willing to persist in the face of that kind of criticism. So I’m just curious, why have you persisted through that kind of criticism?

Esther Well, it’s all started with a single patient whom I saw as in a consult when I was finishing my last year of training in Rheumatology at McGill at the Royal Victoria Hospital. And it was Christmas Eve and I was called to see this patient. It was an emergency consult. I have to say not happy that it was an emergency consult on Christmas Eve, mainly because the patient had been in hospital for three weeks. And I thought that the doctor should have called me before, but they wanted to know if they could send the patient home the next day for Christmas. And the question was, so he was in hospital for a very rare and fatal form of epilepsy, and he was getting an experimental drug back at that time, it was before SSRIs. And the question was, did this drug that changed brain serotonin caused this horrible scarring, inflammatory autoimmune disease that involved all his joints?

He looked like he had been in third degree burns. He couldn’t bear for the sheets to touch his legs. So the sheets were tented up above his legs. He couldn’t extend his arms. He was in huge pain. And the question was, did this experimental drug, which actually helped his epilepsy, prevented him from dying from his epilepsy, but it had this effect and they said, does it have anything to do with causing this disease? So my belief at that moment, to me, it was such a graphic example, such a concrete example of how you can do something to the brain and cause an immune disease that I spent the rest of my career trying to figure out how that happened. Now for people who SSRIs don’t do this, don’t worry about it. Current medication obviously is designed to not have these kinds of effects. But for me that was a very tangible proof that changing something in the brain could cause an autoimmune inflammatory disease.

And that’s what caused me to change the course of my career. And also to say when my supervisors and I was a postdoc at the time when I was told these things, what I did to protect myself is to the supervisor who told me, you can’t do this research until grass grows on the palm of his hand. I just did it surreptitiously. I continued to do the project. He wanted me to do you know a very mainstream immunology project, and I’d come in on weekends or in between experiments, I’d do my own experiments, I put neurotransmitters, I put serotonin and dopamine on immune cells, macrophages in culture. And lo and behold, I could see under the microscope that by adding these neurotransmitters to these little cells that they gobble up tiny little beads of if you put beads in the Petri dish with the cells, they just gobble them up.

They’re like garbage collectors. And I felt like I was farming. I loved my little macrophages. And when you put these neurotransmitters on the cells, they would just get even more excited and gobble up more beads. So I knew, knew that I was right, but I didn’t tell my supervisor until I had all the data. And when I had all the data, I put it together and I went to him and I said, can I present this at a meeting in an immunology meeting and publish a paper? And he saw that there was something there, and he said, yes, okay. But that’s really what I did my whole career. I made sure that if you’re going to do something that’s out there, I’m going to use a religious analogy, you need to be more Catholic than the Pope. You need to really be more rigorous than anybody, more rigorous than any of your colleagues. Make sure that your experiments are absolutely watertight and at the same time on the side, do stuff that is really considered mainstream, otherwise you won’t survive. So for example, during the anthrax attacks in Washington, I studied anthrax lethal toxin. Well, nobody could say, you’re not credible. I’m studying anthrax lethal toxin. I discovered something about that. So I managed throughout my career to balance mainstream solid, rigorous research with rigorous research in the science of the brain immune connection. And that’s how I did it.

Shay Well, it’s wonderful. You’ve done a number of things in your career, including you’ve advised the US Congress and the Surgeon General. You mentioned about the general services administration or the GSA, and you did some work with them on that post-Covid entry back into the workplace. And I thought it would be interesting to talk a little bit about that. I know that you shared with me that how an individual responds to a virus like Covid is dependent upon three primary things, the dose, the duration, and their resilience. And I thought in particular, you can explain those three things, but our listeners might want to hear about that resilience side of it and where they have room to make a positive impact on their own health.

Esther That’s an excellent point, and that’s another point that I make in the book. So the third part of the book is the post covid world and especially the workplace, which was hugely affected as we all know. And as you said, whether you get sick and how sick you get from exposure to any infection, any virus, any bacteria depends upon the dose of exposure. So how much you’re exposed to the duration of exposure, so how long you’re exposed to it and your own resilience. And in terms of the work environment or the physical environment, you can reduce or mitigate the dose and duration of exposure with frequent fresh air turnover in the ventilation, very strong ventilation systems. Excellent filtration. So during Covid, we all became experts in Merv 13 filters, right? You had to have really strong filtration to get rid of that virus. Masking, distancing, all of that can reduce the dose and the duration of exposure, but you are going to get exposed to bacteria or viruses.

There’s no question you can’t avoid that. So to maintain your own health, to the extent possible, you’ll get sick. But to reduce how sick you get or how long you’re sick for, you really need to be resilient. So what is resilience? Well, first of all, how do you stay resilient through engaging in those seven domains of integrative health and what is resilience? So in the book, I give the example of a fresh rubber band. If you pull a fresh rubber band, a new rubber band apart and then let it go, it zings back together very quickly. If you have an old played rubber band and you pull it, it just doesn’t zing back. It just hangs there limp. And that’s what resilience is, getting back to your healthiest baseline self as quickly as possible. Once you have experienced any kind of insult, whether it’s a virus, a bacteria, a trauma of any sort, emotional trauma, it’s being able to bounce back.

And it doesn’t mean that you have to be a hundred percent healthy. None of us as we age are a hundred percent healthy, but it’s to get back to your healthiest self. And it is by having healthy sleep, reducing stress to the extent possible, or at least coping with it, healthy relationships, movement throughout the day, healthy nutrition and spiritual practices, that all, and being in the environment not only having clean air and frequent fresh air turnover, but being in nature, in the green environment, we all love to look at nature, we all that is everybody in the world, no matter what your age, your gender, your culture, your background of any sort, there are many studies that show that humans prefer to look at views of nature than compared to, for example, a belching chimney stack. So we are programmed to love to be in nature and to feel calm in nature. And I have a whole section in the book about biophilia, which is love of nature and how does nature help you maintain health and resilience and wellbeing? So really it’s by engaging all in all of these activities that you maintain your resilience.

Shay That’s great. I want to read a little excerpt from your book. Well at work, this is from page 257, and this is kind of that summary that I was referencing a bit where you say, as we’ve seen, there are many things we as individuals can do to turn our own workspaces into wellbeing spaces. The easiest way to start is to think about your five senses, what you see and hear and touch and smell and taste, and how to enhance what they perceive. Diffuse light instead of glaring light, bright light in the morning and a redder light towards sunset nature sounds such as a fountain or birds chirping or wind in the trees, fragrant plants, as long as you’re not allergic, a kitchen garden for healthy, fresh vegetables and herbs, even if it’s just a couple of basil or oregano plants in a pot views to nature and access to places where you can be in nature, even if your workspace is in a tiny corner of your home, maybe placing your desk by a window can help with many of these enriched moments on top of it all.

Make room for exercise, whether indoors are out. If you’re sharing a cramped space with others, there are many under the desk exercise machines that can help you move even while sitting at your desk. And then you go on to talk about if you are worried about viral spread in a space, you can purchase a CO2 meter and use the CO2 level in the room as a surrogate for viral concentration and adequate ventilation. And it’s really cool. You talk about this simple things like a little fan can disperse. You’ve seen in some of the studies that you’ve done a buildup of CO2, from what I read, it sounds like that can make you start to feel groggy and tired over time. So you talk about ways to mitigate that even in large spaces that might get stuffy, which you’ve indicated that’s probably because too much CO2 has built up that you can still make changes by reducing the number of people in the room as an example. And so I just thought this was kind of a fun, and there’s so many tips in the book. We obviously can’t cover everything, but I liked giving our listeners just a little bit of an overview. So if there’s other things you want to add to the list or you want to spotlight in what I just shared, feel free.

Esther That’s great. And thank you so much. Thank you for reading it. You did a great job. Yeah, so you know I like to say start with a window, because a window really does give you so much of that. It gives you the circadian light. Why do you need circadian light bright morning in the sunlight? It helps you sleep at night. It’s counterintuitive. In fact, in the chapter on sleep, I start with saying what you do during the day affects how you sleep at night. So that bright morning sunlight helps you fall asleep faster. It helps you have a better quality sleep. You wake up in a better mood, you’re less fatigued the next day. Same thing with movement. The more you move during the day, the less stress you are at night. And this is from quantitative data from wearable devices that we put on people. And there’s no question that when you move during the day, certain office designs can encourage you to move up to a thousand steps more a day, so your office can be your new gym.

And then if you move more during the day, you’re less stressed at night, and then you sleep better at night and the next morning you wake up less fatigued and you’re in a better mood. So it’s all this kind of cycle. And the other thing that I realized as I was writing the book, I did divide the chapters. The middle part of the book is each chapter for each of the seven domains of integrative health. But I realized as I was writing it that the borders between these domains are very fuzzy. As I just said. I have a chapter on sleep, but the chapter on movement feeds into how well you sleep. I have a chapter on stress, but how much you’re stressed or how little your stress affects your sleep, and so on. So there’s all these interacting pieces for these seven domains. But the thing I want to really underscore, and I said this at the beginning, is that if somebody looks at these seven domains and looks at the seven chapters and says, oh, no way am I going to be able to do all this, that’s just overwhelming. It’s stressful just to think about it, but that’s the whole point. You can design your spaces in simple ways as you described, those simple tips that I give and I give many more throughout the book to help you engage in those activities without even realizing it.

Shay Yeah, I had the pleasure of touring the Andrew Weill Center for Integrative Medicine, and it is absolutely beautiful. You’ve done an incredible job in working with the architects to design it so that it is a place where you can feel well at work. And it has a room that I thought would be fun to talk about. It’s a little bit futuristic, I think, in where we might be headed next. And you have a chapter in the book that talks about the future and where we might be headed next. It’s called the Recharge Room. So I thought it’d be fun for you to share a little bit about the Recharge Room, where that came from, and how you plan to use it at the center.

Esther Well, it is really exciting, and it’s a serendipitous moment of how that came about. So I’ll tell the story, and I tell the story in the book. There’s a young woman whose name is Morell Phillips, who was in the video game industry, and she was in a serious accident and was in and out of hospital. She had neurotrauma. She was desperate to be in nature, couldn’t be in nature, and actually read my last book, my second book, Healing Spaces, the Science of Place and Wellbeing, while she was in that period of really despair in her life. And she told me, she shared with me that that book inspired her to when she got better, get out of the video game industry and apply her skillset to creating these recharge rooms. So what the Recharge Room is, is an immersive video nature, immersive reality experience with light, sound, and visuals that make you feel like you’re really in a nature space.

So it was 2019 when she started her studio called Studio Elsewhere in New York City, and she had just got it up and running, and then 2020 happened, and she realized being in New York City where it was ground zero for burnout, suicidality, depression amongst healthcare workers, that these recharge rooms could help. And so she very quickly during Covid, ramped up to create recharge rooms. Now she has 70 across the country in 70 different hospitals across the country. And what she found in her research during COVID, was only 15 minutes a day of sitting in this recharge room, which it’s like a guided meditation in nature that people who experienced that had significant reduction in anxiety, significant reduction in burnout, significant reduction in depression, and much improved sleep quality. And she’s gone on to, she has a million, I think, over a million users who she’s studying, and she keeps finding these effects.

We’re now collaborating with her and Morale Phillips and Studio elsewhere donated that research dedicated recharge room to the Andrew Weill center for Integrative Medicine. So we’re very excited about it. And I can tell you that all of our staff, when they saw this, they said, oh, wow, when can we use this? And any visitors that come through say, how can we get one of these in our workspace? When you think about it, it’s only 15 minutes a day. It’s not much to have that tremendous effect on health and wellbeing. And just another little side story, I met Morell just when the galley proofs for well at work, were closing, I think the Friday, and they had just closed, and I couldn’t add anything to the book, but it was such a great story that I convinced my editor that if I could find a space where I didn’t have to change the number of pages, the pagination I could put this story in.

So I found a place where at the end of one of the chapters that had a whole three quarters of a page available, and I put the story in, and I was so excited that it got into the final book. It’s not in the galleys. I found out about this too late for that. And then as you saw when you did the tour, we were able, that was I think February or March of 2023. So it was remarkable speed at which we were able to get that recharge room up and running in the new building as Morell began to work with the architects and the staff to do what’s needed to get that functional. And it’s just amazing. So anybody who wants to come to visit, I’m happy to show them.

Shay Haha. It’s quite a treat, I have to say. It also made me wonder, in addition to having these in the workspace, if eventually there’d be a home version, I could also, it would probably have to be less expensive and done a little differently, but it made me wonder about that as a future idea.

Esther And I do talk about a lot of futuristic ideas that will probably come to pass. And we talk about whether we really need to travel from one place to another for a conference, and that there’s actually companies that are creating holograms that allow you to hologram yourself across the world and be there as if you’re a real person. So I think a lot of these technologies will come online in some form or another, and it’s just a very exciting time to be living where we can envision these kinds of things happening to help keep us well. Yeah.

Shay Yeah. We’re at a fascinating juxtaposition of science and medicine and technology, whereas I feel like there’s this whole new interface that’s happening that has tremendous positive potential, and the wearables are a simple example of that, but there’s tons of examples. But how we’re getting such cool biometric information coming back to us that can then improve our day-to-day life and how we feel so, and there’s tremendous futuristic possibilities on the horizon, which are exciting.

Esther Well, and that’s why you mentioned that I’m working with GSA and post COVID Reentry. So we got our data, we published our first paper in 2018, and then a whole slew of papers the last couple in 2023. So we were positioned right before COVID to deliver a prescription for a healthy Wellbeing building to Kevin Kasher who started off doing this research. We did it together for over 20 years, and he’s now chief White House Sustainability Officer for the GSA Chief and Director of High Performance Federal Green Buildings for the GSA. So he’s in a position where he can implement that prescription during what is now an essential period of post COVID reentry into the workplace because there’s a tremendous questioning in all. It’s sort of an existential moment in workplace design because the question is, why do we need those towers where everybody used to go lockstep nine to five and fight the traffic to get downtown?

Do we need that anymore? We’ve demonstrated that people can be just as productive working at home, and why do we even need to go into a common workplace at a common time? And it turns out that we do need it. We need it, but for different reason than those mid-century towers were designed. We needed for that social interaction, for that social support. I also write a blog for Psychology Today, and my blog this month was on Friendships at Work, which is the blog is essentially excerpts and condensations of well at work, different chapters. And there is evidence that having friends at work is beneficial. You get sustenance from the relationships, the interactions that you have at work, as opposed to back to back video conference calls, which are draining. There’s burnout from that kind of thing. So we do need to be with other people, and it can be nourishing, and that’s really the reason to go into a common workplace.

But for that reason, it’s important to have a prescription for a wellbeing workplace because the last thing that I want to do that I’m sure most people I know most people don’t want to do is go back into those six foot high wall dark cubicle spaces with poor airflow and no light and no views to the outside, and no access to nature, no ability to be in nature. You are not going to attract people to go back to work to those settings. You need to design those workspaces to attract people to go back to them, to want to be in those spaces so they can enhance their wellbeing. I wrote an opinion piece for the Arizona Daily Star saying that I live about 10 or 20 minutes drive from five world-class spas. Nobody is forcing anybody to go to those spas. Those spas were designed to attract people to come to them for wellbeing. And I think that the office industry, the office design industry, the workplace decision makers can learn a lot from the spa and entertainment industry to design those places to attract people back to work. Not to say you have to go back to work in your six foot high wall dark cubicle. It’s just obvious to me.

Shay Yeah! You’ve certainly put it into action in the design of the center. And so it is a great example for people to see, well, what does it actually look like in real life? And so for our listeners that are international, you can also look on the website and get some images. And I would imagine as the center continues to grow and evolve, there’ll be tons of videos of things that are happening there and people will be able to see it in real time because I know we were talking about events that we might partner on, so I know things are coming.

Esther No things are coming because you’re going to do it. That’s great.

Shay It’s going to be part of some of them.

Esther It’s true. And we did, when we were very early in the design phase, Dr. Andrew Weill asked me to convene a committee of architects building experts to advise and work with the architects to make sure that we embed all seven domains of integrative health into those buildings. And so it really is a flagship example of that. We have the mind building the bodybuilding, which is the Cantor building, Iris Cantor donated for that building and the spirit building. So we have three buildings, each of which embody all seven domains of integrative health. And I talk about that in the book actually, how we did that and how we designed from the get-go, because it’s much better if you do that from the beginning than you try to tack it onto something that you’ve already designed. And I have to say, the architects that line in space, wonderful in working with us, I’d like to say if I was a doctor in the emergency room seeing a patient and an architect came and told me how to take care of that patient, I’d be pretty unhappy. But these architects were very, very open and we worked together and it’s just great. It was a very exciting process. And we’re opening just next week, actually.

Shay Exciting. It’s fascinating to me in your story, and you cover a lot of this in the book while at work, how much of your career you’ve spent working with architects, because so much of your work has been how do we bring health into these spaces where people work? And you have to design for that. And so it was very logical that you were partnering in many cases with architects, but it’s a fascinating part of your story.

Esther Thank you. Thank you.

Shay You also did a PBS TV special called The Science of Healing, and we’ve talked a lot about wellness and wellness in the workplace, but I’m also curious, since this is a Conversation on Healing podcast, how you would define or describe what healing is?

Esther Well, and this is interesting because I describe that in this book and also in healing spaces, which is what that TV special was fundamentally based on my experience in Greece and how I healed. And really, I talk about, I say that health sounds like a noun, but it’s not a noun, it’s a verb. Health is continuously healing. It is. Every single cell in your body is continuously responding to those external insults of whatever sort, physical, physiological, emotional. And if it didn’t respond, if those cells did not respond to correct to course correct, then you would get sick or you would start dying. So health is really a very active process, and it’s kind of like walking up a down escalator. You have to keep moving in order to stay in the same place. And really, that’s to me what health is, and it’s continuous healing.

Shay Yeah, I think about that a lot. That idea of health is dynamic, right, which is fundamental to what you’re describing. And actually, I think about that in my own life because for those who are familiar with the ACEs score or the adverse childhood experiences score, it’s on a 10 point scale, 10 being the worst, and my ACEs score is a nine and would be a 10 except on a technicality. And I think about that in my own life because the data, pretty large scale data done from Kaiser Permanente and others, and I met Dr. Feleti who was very instrumental in that and heard him speak and got a chance to talk to him at a certain latter stage in his career. And the data is compelling that when you have a high score like that, that it’s very likely that you’re going to have a whole number of things happen to you physiologically as you age, increased risk of heart disease, cancers, etcetera.

And a few years ago, I was at my doctor and she said to me, you’re the healthiest patient I have. And I thought about, I really thought about how is that possible haha with the life I had some of those adverse childhood experiences and where I am. And I think a lot of it goes to what you describe in your definition of what health and healing is, Esther, which is its dynamic. We’re not stuck. It’s not like you had something bad happen, and that’s it. You do have a potential to use that dynamic interplay to make changes very much in the way when you went to Crete, you made some really substantial changes and your health started to transform as a result. And probably because I’ve dedicated so much of my life and my work to learning about studying now, interviewing some of the top experts in the world on what you can do to improve your quality of life, your health, your wellbeing, etcetera.

I’ve had a lot of practice. And so that dynamic interplay over time seems to be working somewhat in my favor, which is good. And I share that because what I do want people to understand is no matter what has happened, and we all have stories, every single one of us at times, we’re going to face illness, we’re going to face trauma, we’re going to deal with losses and grief and tragedy. It’s important to remember that there’s a potentiality in each one of us to continue to grow and to heal even through really hard things. And that help is dynamic. Just as you’re describing.

Esther I couldn’t agree more. I agree a hundred percent. And there’s a famous research paper by Dean Ornish, who I’m sure you know. This paper measured the length of telomeres. Those are the ends of chromosomes that shorten as you age, but if you’re chronically stressed, they shorten. They can make you look 10 to 17 years older than your biological age. And he did a study with patients who were recovering from prostate cancer, and he had them meditate, I think mindfulness, meditating three times a week, 30 minutes of walking a day, and a healthy Mediterranean diet. And the people who maintain that regimen for five years, their chromosomes actually not only stopped shortening, they actually started lengthening. And the people who didn’t maintain that regimen, they continued to shorten the chromosomes, continued to shorten. So what I like to tell people is that it doesn’t matter how long you’ve been a couch potato, and I certainly experienced this in my own life, it doesn’t matter how long you’ve been eating an unhealthy diet, you can always stop and change and don’t try to change all seven at the same time. Again, it’s daunting. Pick one of these domains that you feel you can handle or you can manage and you can change, and you can help yourself improve and get back to your healthiest self. And then the other thing that’s really important to remember is I think one of the things about integrative health is that people feel if they can’t get healthy, then there’s something wrong with them, you know that they’re a bad person, that they’ve failed, that they’re just not doing it right. Well, that’s not true.

You know when Olympic athletes train, they have a trainer. When you go to the gym, you have a trainer to help you stay on track and engage in these kinds of activities. Well, you can’t do it on your own. Find an integrative health practitioner who can help guide you and be your trainer throughout your life and pick one of these domains, whatever it is that’s easier for you to work on. And start with that. And as soon as you do, and I can say this from my own experience, as soon as you do, you notice that you feel better, and that gives you the energy to continue on that path.

Shay That’s great. Yeah, I think that’s wonderfully said. Many, many moons ago, I spoke at a conference and I was a speaker and Dean Ornish, I don’t know how I ended up speaking, and he also was speaking, but so this was I think the second annual integrated medicine conference at UCLA. And so we were sitting next to each other and I got a chance to talk to him about some of his research. And I think he’s also someone that for many years faced a lot of pushback from the medical community because his research was unique and innovative and different, but over time has made a very significant impact on the way that we see and understand our health. And so another person who I think had a lot of courage to put his work forward and to study it with some rigor, even when there was resistance haha.

Esther Well, I mean certainly Dr. Weill, Andrew Weill is he’s a pioneer in this. I mean, he coined the term integrative health, and he experienced tremendous resistance way back when he was starting to do this. But he persisted. He has the credibility, the chops to have survived and persisted. And he started True Food Kitchen at a time when people felt that nobody’s going to want to eat healthy food. Well, it turns out that this is huge. People want to eat healthy food. And so that took off like a rocket ship. And the good thing about the era in which we’re living is that finally, finally, there is enough hard data to show that integrative health is beneficial for your health and wellbeing. And it’s a good thing that pioneers like Dr. Weil and Dean Ornish and others have stuck to it. And we have enough data now that everybody can benefit.

Shay Absolutely. Well, I think you are also one of those pioneers, Esther, and I want to acknowledge and appreciate your body of work and the contribution that you’ve made and the courage that it takes to hang in there, even when there is some resistance, but to persist, because as you said, once you saw in that one patient, that connection between the brain change and the immune response, you didn’t want to let that go. You saw there’s something of value and importance here that deserves understanding, which I think is really what science is all about. The whole model is about experimentation to try to understand what we don’t know so that we can figure it out and get more insight.

Esther You’re right, a hundred percent right.

Shay I think it’s just good science in my view.

Esther Yes, you’re right. Thank you.

Shay But I want to give you an opportunity in closing for our conversation today, if there’s anything else that we didn’t touch on in terms of your book while at work or your career that you feel like would be valuable for our listeners.

Esther Wow. I mean, you’ve touched on so much, and thank you very much for your kind words about being a pioneer. I do appreciate that. In the book, I just want to emphasize, I tell stories, I tell a lot of stories. My reason for writing books for the lay public, and as you said, this is my third book, is because if we as scientists keep this all to ourselves, there’s no point. I want to spread the word. If you want, somebody asked me how I’m evangelizing, but I am evangelizing the notion that there is evidence for all of this, and I did not want to write a textbook and I didn’t write a textbook. It really is filled with stories of all the different researchers who came together across many different disciplines to create this body of work. You can’t do it on your own. And these are people, these are human beings who have lives and are interesting and have passions, and how did they get to have those passions?

So I do tell all of these stories. And then in the middle of the book, there’s the seven domains of integrative health, each chapter. So you can pick a chapter in whatever order you want and you can read it the way you want. And then there’s the future. And the future is just very exciting because we have so many technologies and tools that are coming online and at our fingertips. And I guess the one last thing is no one size fits all for your workplace. And that’s one of the big things that we learned from these studies. And that means that workplace design has to have many different kinds of spaces to accommodate different kinds of work that you’re doing throughout the day, whether it’s heads down or you need to be with colleagues to accommodate neurodiversity. There are so many different ways that people work, and some people are better off in a quiet space. Some people are better off in an open space with lots of stuff going on around. So we also have the technologies to be able to create these many different sizes, shapes, and kinds of workspaces so that people can choose to work where they work best. So I think those are the messages I want to leave you with, but it’s been great talking to you. Thank you so much.

Shay Oh, absolutely. My pleasure. And I hope that many of our listeners will grab a copy of your book. And I’m grateful that you highlighted that idea because when I got to the end of the book, and you mentioned that how important it is to personalize and individualize this and the kinds of things that we each individually need in the workspace, that they’re not identical, that that’s one of the big takeaways from all your research over all these years is that there still is, even though there are coherent themes across individuals, there also is individuation that needs to be acknowledged and sort of tweaked, is how I would say it in your own workspace. You could ideally make personal adjustments. And so I think that’s a great takeaway for our listeners. So I really appreciate that.

Esther Thank you so much. It’s been great talking to you.

Shay Great to talk to you as well. Thank you.

Conclusion We hope you enjoyed this episode of The Conversations on Healing Podcast. If you haven’t yet, please go to Apple Podcast, Spotify or your preferred podcast platform and subscribe, rate, and review. This podcast, it helps so you won’t miss an episode. See you next time.