Medicine With Meaning – An Interview With Internist Paulette Saddler

I visit her in her Pasadena office Thursday morning. Video




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Luke: "Dr. Saddler, why did you decide to become a doctor?"

Dr. Saddler: "I became a doctor because I love medicine, I love biology, and I love being with people."

"I decided I wanted to be a doctor at about five or six. At that time, all you could get for Christmas was a little nurse’s bag. So they gave me a little nurse’s bag and I pretended it was a doctor’s bag."

Luke: "And did you play doctor as a kid?"

Dr. Saddler: "Not in that way, no."

Luke: "I started asking that question before I knew where I was going."

Dr. Saddler: "I sometimes pretended my dolls had little problems and I’d diagnose them and put a bandage on them."

Luke: "Were you a candystriper?"

Dr. Saddler: "I was in high school. We wore the little outfit with the little stripes, very cute. I worked in the pediatric ward at Columbia Presbyterian Hospital. It was my first inside look at medicine. I remember the interns trying to draw blood from the little infants and they would cry. They would give us the job of trying to feed the babies. The nurses were great. I’ve always had a great respect for nurses. That’s helped me in my career because I feel like we are all part of the same team."

"I went to college at Wesleyan in Connecticutt and then I went to medical school at Howard in Washington D.C. I met my husband there. We gave great parties at the end of exam time."

Luke: "How did you develop your specialty?"

Dr. Saddler: "My mentors were endocrinologists and internists. I followed in their footsteps. Right before I became ill with breast cancer in 1995, I started getting acupuncture and was very excited by that as a treatment modality. When I got better, I studied acunpuncture and wanted to have a practice where I did best. I branched out into other aesthetic services because I felt like my patients had needs and I felt that if I could meet those needs, it’d be good for them."

Luke: "What convinced you about acupuncture?"

Dr. Saddler: "I had arthritis in my hip. It reduced the pain. Second, when I was getting chemo, I had considerable nausea and vomiting. My therapist came to my house and helped me. It also helps with energy. It uses needles to unblock the energy of the meridians and open things up."

"Nobody really knows how it works but we have ideas. It does work. It doesn’t work for everybody, but nothing works for everybody. We use acupuncture as a total treatment plan for that patient."

"I’m a board-certified Internist and a fellow of the American College of Physicians. An internist helps diagnose and treat diseases such as high blood pressure, diabetes, intestinal problems, you’re likely to go to an internist first and he’ll refer you to a cardiologist, etc."

Luke: "This doctor Sally Satel wrote in the New York Times Sunday magazine that if she didn’t take into account her patient’s race, she wouldn’t be doing her job. Is it true that people of different races and backgrounds have different predispositions to different diseases?"

Dr. Saddler: "Yes, there are different risk factors for different ethnic groups. In terms of medication, some groups respond better to certain medication than others. There are genetic predispositions. Some groups will get a particular disease that other groups won’t."

Luke: "It’s a scary fascinating world."

Dr. Saddler: "It is. When we have better use of the DNA breakdown, we’ll be able to get a fingerprint of a person’s particular disease. They’re doing this for cancer research. For instance, if you need chemotherapy, they’ll be able to use the profile of your tumor cells to figure out which agent would be best for you."

Luke: "I imagine that some of the people who come to you with things such as cancer just want to give up."

Dr. Saddler: "That is one of the hidden beauties of acupuncture. We do a lot of psychological work for the pain patients and the cancer patients. Many of them are irritable and grumpy. They’re in a lot of pain. They’ve been to a lot of doctors and they haven’t had relief. As the acupuncture starts to work, we can see their true personality start to work. After three or four visits, they start to laugh and joke with us. People will frequently tell someone who’s doing acupuncture things that they might not have shared with another practicioner."

Luke: "You actually deliver the needles?"

Dr. Saddler: "Yes, I put the needles in."

"If you had told me 15 years ago, ‘You will be doing acupuncture,’ I would’ve looked at you and said, ‘What are you talking about?’ It wasn’t part of anything that I had thought of."

Luke: "What do you do at USC?"

Dr. Saddler: "I am part of the faculty that teaches medical students how to become physicians. It’s called ‘Introduction to Clinical Medicine.’ I also have a clinic at the downtown facility of USC where we do acupuncture one morning a week."

Luke: "What are the principal complaints people see you for?"

Dr. Saddler: "Neck pain, back pain, hip pain, carpal tunnel, headaches, migraine or tension, fatigue, chemo patients with nausea, asthma. The acupuncture is useful in relaxing them. Colitis, chrones disease, irritable bowel, fibromyalgia."

Luke: "Chronic Fatigue Syndrome?"

Dr. Saddler: "Some of them are on a continuum with fibromyalgia. We try to improve their energy levels. We do neurotransmitter testing to see if they are low in dopamine, or ephinephrine, seratonim… A sleep disorder is underlying both the chronic fatigue and the fibromyalgia. They don’t sleep well. When they wake up, they’re tired. They go through the whole day tired and when they go to bed, they’re more tired. We tried to break that loop and get them some rest. When you do not have deep enough sleep, REM sleep, there are factors that the body releases that damage you."

Luke: "What can you do to help someone sleep?"

Dr. Saddler: "Through a combination of points. We try to figure out the best acupuncture points to help them. Are they in pain? Do they have a neck spasm that prevents them from falling asleep?"

Luke: "What are the principal ways your patients frustrate their own health?"

Dr. Saddler: "Not having a realistic idea of what they can and can not do. Not following a proper diet. Smoking. Not protecting their skin from the sun. Sometimes people just don’t want to do something. They don’t want to exercise. Exercise is so important in preventing many of the side effects of aging — pain in the joints, difficulty moving, cardiac deconditioning…"

Luke: "How long ago were you diagnosed with breast cancer?"

Dr. Saddler: "1995."

Luke: "Did you get a clean bill of health?"

Dr. Saddler: "After a certain amount of time, they feel you are cured or in remission. Every year is a blessing."

Luke: "How did the experience being a [breast cancer] patient affect the way you practice medicine?"

Dr. Saddler: "It let me see what it is like to receive distressing news that could affect your own mortality. It let me see what it is like to live with pain, to live with a disability… Even though I’m a physician, when you’re sick, you’re sick. I had a lot of complications from the chemo-therapy that gave me more insight into that level of suffering. Many breast cancer patients have told me that talking to me has been useful. You feel like you’re alone. You need to have someone to share that with you."

Luke: "Do many patients treat you like god?"

Dr. Saddler: "Not in America. Patients today are better read. They’re better informed than 20 years ago. Many physicians today try to have a relationship with their patient. ‘Here are the options and let’s try to pick the best ones for you.’ That’s the way I work with my physicians. It’s less authoritative, less didactic, and more friendly with the patients.

"There is a bottom line. If the patient needed a medication for their heart, the physician would say, ‘You really need to take this. I understand why you don’t want to take it, but you really need this.’

"For example, a patient fell the other week and had a horrible abrasion on her leg. I said, ‘You really need to get an x-ray. You’re elderly, a white female, and at high risk for osteoperosis.’ She didn’t want to get an x-ray.

"The x-ray was negative. Great. I told her, ‘Physicians are in a lose-lose situation. If we don’t get a test, that physician is negligent. If we push for a test and it is negative, oh, they just want to push for a lot of tests.’

"We don’t get any benefit from tests. Our only benefit is to help the patient."

Luke: "I notice a lot of stuff about dermatology on your website."

Dr. Saddler: "We offer many skin care services. We have an aesthetician who comes here to do facials. We also provide microderm abrasion, oxygen facials, laser hair removal, pulsed light laser to help who’ve had sun damage to their skin, vibraderm, and botox. It’s more ways to help people, which we love."

Luke: "How long have you been in California?"

Dr. Saddler: "Tweny two years."

Luke: "Are the health concerns of people similar around America?"

Dr. Saddler: "Yes. People want to feel good and reduce health risks. I do think that people in California exercise more consistently."

Luke: "Do you notice a difference in the way men and women relate to medicine and to doctors?"

Dr. Saddler: "Yes. Men are generally more resistant. They don’t want to do anything unless they’re bleeding to death. They don’t want to follow advice. You have to work harder to convince them that they need a medication or they should do testing, until they’ve been test. If they’ve been ill and they’ve been through the system, they’re better. Women go to the doctor all the time. We get our pap smears. We have our babies. We take our kids to the doctors but men generally don’t go unless they have a real problem, usually pain or blood. ‘I threw up blood.’ ‘I saw blood.’ ‘I can’t move a joint.’ Then they go to a doctor."

Luke: "Are there certain common ways people relate to their mortality?"

Dr. Saddler: "When people realize the end is near, they’ve usually reached a certain level of acceptance. They’re usually very sweet, very easy to work with. They don’t let the little stuff bother them."

"Our body always knows if something is not right and too often we don’t listen to our body."

About Luke Ford

I've written five books (see My work has been noted in the New York Times, the Los Angeles Times, and 60 Minutes. I teach Alexander Technique in Beverly Hills (
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