Heart to Heart With Mimi Guarneri, MD

When Mimi Guarneri was eight years old, her mother died of a heart attack — she was just 40 at the time. "That my mother — so young and alive — could simply cease to be was a defining event for me," she would later write in The Heart Speaks, "the shock of my young life." A decade later, her father also died of heart problems. But it wasn’t until Guarneri was in medical school that healing hearts became her life’s mission.

A cardiology fellowship brought her to Scripps Clinic, known for its pioneering work with coronary stents, the metal sleeves that prop open blocked arteries. Guarneri’s resume might have ended there — that of a successful interventional cardiologist who mended broken hearts for a living, a plumber who cleaned out clogged arteries. But the more Guarneri treated patients — and listened to them — the more she realized that medicine isn’t just about fixing people after they get sick, it should be about preventing illness in the first place. Health, she believes, is about treating the whole person, not just their parts. For Guarneri, that philosophy, truly, is the heart of the matter. "When we think about the heart, we have to think about it at all levels — physical, emotional, mental, spiritual," she said in a recent interview. "Treating one piece and not getting to the underlying cause of illness — is really missing the point.

Guarneri got the chance to make that point with the January 1999 opening of the Scripps Center for Integrative Medicine in La Jolla, co-founded with Rauni King, a registered nurse and certified healing touch practitioner. In a serene environment designed to promote harmony and health, patients receive conventional care along with alternative therapies — acupuncture, yoga, nutrition counseling, cooking classes, meditation, music therapy, stress management, and healing touch. The center also includes a gymnasium, fitness center, running track, swimming pool, and an herbal and nutritional pharmacy. A women’s health center is in the works, as part of a $12.2 million remodel that would expand the center by 23,000 square feet.

While integrative medicine isn’t universally accepted by physicians, it’s hardly health care hocus pocus. After all, Guarneri points out, acupuncture and meditation have been around for thousands and thousands of years. And it was Hippocrates who advised: "let your food be your medicine." Not bad advice given the epidemic of diabetes and obesity in this "super size me" nation. "If we think for one minute that we can’t save lives by just changing peoples’ diets," says Guarneri, "then we are fooling ourselves." In short, modern medicine doesn’t alone hold the answers to what ails us. The center also believes in borrowing from ancient healing practices.

"The whole concept of being able to bring evidence-based alternative approaches is to really complete the circle of care where Western medicine is failing," Guarneri says. By and large Western medicine is a disease model system. "We don’t have health care in the United States, we have disease care. We pay for people, when they already have a diagnosis, to see a nutritionist. We take care of people after they get sick. And my focus, from an integrative medicine, holistic perspective, is how do we get to people sooner? Why do people have to fall off a cliff, why do they have to break down, why can’t we recognize a problem earlier, why can’t we intervene sooner?"

When it comes to intervention, Guarneri’s center has powerful new diagnostic tools: x-ray machines so sophisticated they can scan you from stem to stern in a matter of seconds. The 64-slice CT scanner, one of only two in the country, can detect a clog in a coronary artery in exquisitely detailed 3-D images. While the technology is especially helpful in detecting heart problems, it can also find tumors in their early stages.

Guarneri tells the story of a 50-year-old patient who "looked like a Barbie doll" and was seemingly in perfect health. She was physically fit, her blood tests were normal, and she had no symptoms of disease. And yet the scanner picked up a tumor in her pancreas. It was caught early and treated successfully. While concerns have been raised about the possible overuse of scanners, the amount of radiation involved, and the cost — which isn’t always covered by insurance — Guarneri is a proponent of these high-tech tools for early detection. "I think we have to put these things in perspective here. If you wait for symptoms, it’s too late. And the whole purpose of early detection is to get to things before you have symptoms, before the cat is out of the bag. And, again, if you use the technology every couple of years, not every couple of weeks, then you are exposed to radiation, but the risk is minimal as far as I’m concerned."

But perhaps one of the most potent tools for healing, according to Guarneri, is really listening to her patients. "They most always have the answer," she says. "Patients are very intuitive. They very frequently know what’s wrong with them." Guarneri has not only listened to her patients over the years, she has learned from them. "I was trained to see the heart as a simple mechanical pump," she writes in The Heart Speaks, "and was led by my patients to appreciate it as a center of great complexity and power." In the end, it’s her patients who’ve taught this cardiologist to have an open heart. (858/554-3300, www.scrippsintegrativemedicine.org)
— Andrea Naversen, photo by Vincent Knakal

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Craig Kielburger: Me To We
Like lots of people, Craig Kielburger dreamed of changing the world, a world where children don’t go to bed hungry, a world where parents don’t have to sell them into slavery to survive. So Kielburger started Free the Children with his friends, a group dedicated to breaking the cycle of child poverty through education. Kielburger was just 12 years old.

He is now 23, and like him, the organization he founded has grown up. Free the Children is now the largest network of kids helping kids, an international organization that sponsors programs in 45 countries. It has built more than 400 schools, shipped $9 million in medical supplies, and provided health care services to more than a half million people.

Kielburger, in town recently at the behest of philanthropist Walter Green, shared his story with the Rancho Santa Fe Foundation, along with local students, and launched his fourth book, Me to We, Finding Meaning in a Material World. Its message is simple but powerful: change your life by helping others. Celebrities such as Oprah and Desmond Tutu share inspirational stories. But at its core, Me to We is a self-help manual, a guide to doing good in the world, beginning with yourself, in your own backyard.

For Kielburger, the journey from his home in a Toronto suburb to slums half way around the world began with an article in the Sunday paper. He was looking for the comics. Instead, he found the story of a Pakistani boy, shackled to a carpet loom for six years to repay his family’s small debt. The boy broke free of child labor only to be killed when he spoke out publicly against it. Kielburger was so angered by the story that he ripped it out of the newspaper and shoved it into his backpack. On the bus ride to school, he kept unfolding the newspaper, looking at the picture of the boy who, like him, was just 12 years old. "I need your help," he told his classmates when he got to school. " We have to do something. I don’t know what. But we have to do something."

Eleven boys raised their hands. They came to be known as the "Twelve 12-year-olds," ordinary kids who held car washes and garage sales, mounted petition drives, and volunteered at food banks to meet their first goal — building a school in India. Kielburger eventually persuaded his parents to let him see, first hand, the faces of child poverty and slavery. A boy who wasn’t allowed to go downtown by himself, instead, traveled with a chaperone to India, Bangladesh, and Sri Lanka.

A decade later, Kielburger is still traveling the world. He’s appeared on Oprah and 60 Minutes, been profiled in Time and The Economist, been honored with the Nelson Mandela Human Rights Award, and been nominated three times for the Nobel Peace Prize.

The organization he founded has grown to 100,000 young people in 750 chapters worldwide. But fundamentally, Kielburger says, Free the Children hasn’t changed: "It’s still ’kids helping kids’." As for all his accolades, he’d be the first to say, it’s not about me — but we. — Andrea Naversen