Episode 49: Dr. Siri Chand Khalsa, MD on Ayurveda, Rhythmicity, and Art & Science of Healing

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SPEAKERS: Dr. Andrew Wong, Dr. Siri Chand Khalsa, MD

“Early morning sunlight is your best opportunities to set the stage for sleeping deep and well at night and now we understand that those retinal pathways in the early morning stimulated by the particular blue that’s there at when the sun is low in the sky sunset sunrise it goes through particular retinal pathways that then helps modulate hormonal surges through the day including early morning cortisol which has been linked with lower depression rates and early evening rise in melatonin which we know promotes deep and restful sleep it also that early morning sun has been shown to help regulate dopamine and sex hormone pathways. So wow! Just free early morning light 10-15 minutes you know and resetting that clock. Ayurveda talks a lot about the clock and the circadian clock there’s times of day where doshas are active you know I don’t want to be too technical but you know again there’s this quality of a profound understanding and when the pandemic first came out there was a position paper from Harvard’s sleep lab that read like an Ayurvedic textbook and they basically said, what we believe will give you the most best sleep because everyone’s schedules are disrupted whereas early morning light you know exercise every day and the other thing that’s very consistent which is actually spoken of pretty profoundly in Ayurveda is a routine that’s rhythmic. Lunch at the same time, this was in the Harvard paper, socialization at the same time exercise at the same time and think of how scattered all our lives are in this modern era. This rhythmicity. I always say, resilience is rhythmicity, rhythmicity is resilience these two are very intricately intertwined.”- Dr. Siri Chand Khalsa, MD

Today we are excited to bring you an insightful conversation with Dr. Siri Chand Khalsa. A medical doctor and Ayurvedic practitioner who believes that food is your best medicine or your primary source of disease. Dr. Siri Chand is an accomplished doctor and has studied ayurvedic medicine with master teacher Dr. Vasant Lad. She has also completed a yoga teacher training, reiki master training, and has a formal fellowship in integrative medicine through the University of Arizona under Dr. Andrew Weil.

I am Dr. Andrew Wong co-founder of Capital Integrative Health. This is a podcast dedicated to transforming the consciousness around what it means to be healthy and understanding the root causes of both disease and wellness. Please enjoy this conversation as we talked with Dr. Siri Chand today about how ayurvedic medicine and Ayurveda views both health and disease. What the doshas are, and how you can integrate an ayurvedic approach into your health care for your best life.

Dr. Wong

Well, thank you Dr. Siri Chand for coming on today. Known you for a while now through the Arizona fellowship and now you’ve had such a great path that you’ve just kind of, watched you grow as a, as a doctor, as a leader you know in the ayurvedic space especially, so welcome, thank you so much for being on today.

Dr. Khalsa

Oh! it’s a delight to be here and always grateful to connect with other open-minded clinicians.

Dr. Wong

Yes. I think that’s a big phrase you know, open-minded. Because really we don’t know what the possibilities are unless we have an open mind and open heart you know so…

Dr. Khalsa

Yeah, curiosity it did not kill the cat.

Dr. Wong

Do you have any cats actually? That’s a good place to start.

Dr. Khalsa

No.

Dr. Wong

Okay. I love, I love that actually we were just watching as a family, the, this is very random but I think it’s always good to kind of, kind of be real about these things. Tim Burton’s version of Alice in Wonderland and they have the Cheshire cat on there which is like the iconic right. So, it’s really the eyes you know. I think that’s the big thing right the eyes are the window of the soul and so we really have to keep our eyes open for what’s out there, what can help patients, what can help our communities right? Eyes are not open how can we how can, we really see you know?

Dr. Khalsa

Yeah, exactly!

Dr. Wong

So speaking of your own vision and your own path. In terms of seeing and you know seeing the light for you if you could just kind of walk us through listeners, your path to become you know medical doctor and all the things you went through and you know how did you become an ayurvedic practitioner and kind of that whole journey.

Dr. Khalsa

Well. I, so grateful for the question because it leaves a lot of it’s like a canvas I get to paint a story here but I think one of the most pivotal things to appreciate and understand and I imagine your listeners are from all over but I did, I grew up in the Washington DC area and I went to the Thomas Jefferson magnet school and you know this is now in the 90s long long time ago when the school was first starting but there was a tremendous prominence in that, in that four-year span on logic on reasoning it was the early evolution of computer programming right so you know we were the first class to have computers in the classrooms you know it was kind of a really interesting time but at the same time something inside me always felt a deep call and appreciation for the humanities and the arts going through the Smithsonian museums going to performances, my parents were ushers. So, we, you know, we found ways to be creative to get to shows. I remember so many fourth of July and we’re recording this around the time of the fourth of July going to the mall and just exploring so many different ways of celebrating life and so you know there always was a bit of a tension inside me between leaps of faith and intuition and creativity and just abject logic and sequence of thinking and I found that through the years that medicine seems to like to polarize itself between the two you’re either in the camp of evidence based on logic or you’re, you’re living in a camp of let’s just take it on faith we don’t have the information to fully understand all the pieces that would validate this from an evidence-based standpoint and so that actually started for me very very early. I didn’t have a big awakening well into my career. I kind of went into medicine knowing having studied botanical medicine having explored plant medicine in college you know there was a lot of openings that had already happened for me that you know almost encouraged me to walk away entirely from the allopathic journey but you know I, there were points at which I finally said I’m going to circle back in and try to find like I call it the corpus callosum like the middle path the one that fully integrates us as humans not the one that’s sort of like here or here because it can be yes and which I think is a very feminine projective consciousness and I know I’m taking some big jumps here but that was really, that was really what, that’s really how I was built at a young age there was always yes and existing for me and through my career it created a lot of tension because in many parts of the early portion of my career which was in the 90s there was a sense of now things are much more open and I, you know, I even had the thought today I don’t want to be a person who ages and the generations below me say I can’t wait till she dies, I can’t wait till there’s room for innovation, I can’t wait until they’re gone and there’s a part of me that feels that way about some of the way older medicine has been practiced and the paradigms that have been passed down that don’t look at empowering the person to make small micro changes from exposure to light, community, self love, sense of purpose, healthy whatever that looks like you know, non-standard american diet nourishment, how we use our five senses, how we connect with nature, all of that actually is powerful pieces of how health is created and on in all honesty there wasn’t a moment of awakening for me it really has been that way and all I’ve done really is engaged in my own self-healing and been pretty forthright about that and as I did that there were always new modalities to learn there was always new paths to discover and there still is, and that is what has led me to being really an excellent internist, very good, pass boards, you know I’m highly highly able to speak medical, but also to engage in deep healing and I think that’s been kind of a long-winded answer to your inquiry but to just give it a moment is probably not full justice.

Dr. Wong

Thank you, Siri Chand, it’s great to start off with that and opus you know, and we know about the corpus callosum and that connects the left analytic side of the brain and then the right creative side and actually my understanding because you mentioned the word feminine you know I believe on average anyone, on average not to generalize but on average there is a relatively higher percentage of brain volume as corpus callosum in females.

Dr. Khalsa

Oh! I didn’t know that!

Dr. Wong

Yes!

Dr. Khalsa

That’s really wild!

Dr. Wong

Something interesting why we might actually see you know more clinicians, that you know orient themselves toward the feminine you know I think a lot of times in Integrative Health that we see a lot of times, yeah.

Dr. Khalsa

Yeah. Oh, that’s so fascinating love that fact.

Dr. Wong

Yes.

Dr. Khalsa

That’s really cool.

Dr. Wong

Like for me. I think music is a big outlet you know. I like to play piano improv and things so that that allows me to balance that corpus callosum in between the analytics side which we know that medicine in general and even I would say you know our society kind of gears us toward like you said it’s not for a lot of people you can choose you know both you have to like choose one or the other you have to be an artist or you have to be a doctor or something like that and so we know that in integrative health it’s really like Dr. Low Dog says life is the best medicine right. It’s everything together incorporating both sides of the brain creative artistic heart you know mind body spirits and I believe that’s where Ayurveda comes in if you want to kind of talk with our listeners here about what is ayurvedic medicine is this something that you know you had basically said that you basically been you know enlightened for most of your life on the holistic side maybe, maybe from your upbringing too with like exposure to the arts and everything. I’m wondering how you got into Ayurveda and let’s just talk first real basic about, what is Ayurveda.

Dr. Khalsa

Yes. So Ayurveda is an ancient healing system that it’s very interesting over and I always say you know Ayurveda is the ultimate case study medicine in its own right because millions of lives were studied over thousands of years in India and probably ancient cultures that had weren’t under this the continental structures that we have now and there was an observation at that time, of course, we can’t make an assumption that everyone who came before us in terms of humanity didn’t possess our level of curiosity, didn’t possess our desire of healing, feeling whole so we have to say that perhaps these older systems when people were alive albeit without some of the modern conveniences they had a very dedicated study of health and healing that we maybe ignorantly say there’s no validity because I’ve only heard a little bit about it and I encounter a lot of cultural bias meaning people make statements about it that I think are actually quite xenophobic and say oh there’s no evidence or it’s all malarkey and I’m like, “do you actually know what Ayurveda is?”. I mean you know like I don’t think you do. I don’t think you’ve actually even done anything more than looked at some document that talks about Vatta-Pitta-Kapha and so Ayurveda evolved over the observation of humanity and man’s deep desire to be healed and whole and healthy and as that progressed the initial period in time there was a deep observation of nature, the external world and an inquiry as to how the external world is mirrored infinitely to our interior world, and they codified that into five elements. Those five elements have qualities and features that we then observe within ourself and so it’s then further those five elements become the three doshas so it’s further refinement in pattern recognition I always say most advanced clinicians late in their career mid to late in their career are actually excellent ayurvedic physicians because they have already started beyond what the books taught them beyond what you know maybe is on paper to notice patterns to notice features of things that are existing and Ayurveda technically was initially an oral tradition so it was regionally explored people knew about the seasons the botanicals that grew where they grew and it was shared as a spoken process between student to teacher and when the student had arrived to a certain destination the teacher then allowed them to practice independently and they then passed on the tradition and many of the Sanskrit sutras which are these rhythmic sort of like sonnets almost you know there’s we don’t have an easy translation for it in our training process but their soliloquies their observations their poems and Sanskrit are very descriptive language those then provide, were provided as an oral tradition and then over time that became written as there was some perhaps fear that the integrity and the beauty of what was being transmitted was being distilled or deluded and so it’s gone through many many generations of refinement exploration and Ayurveda technically the Sanskrit translates to the science of living. So people often say to me, “oh but that’s not ayurvedic” and I say, “oh well let’s back up for a second” because essentially from an ayurvedic standpoint, it’s really man’s observation of him or herself within the context of the natural world. So all the features and manners in which life interacts with us, externally perhaps even processes inc occurring internally are interpreted under the lens of a pattern and it gives us a very deep and rich way to understand how our lifestyle is actually a foundation for our future, our health walks us towards health walks us away from health and it’s an ever-present, effervescent series of decisions and Ayurveda really empowered me to understand that at a very critical time and as a small aside Dean Ornish who’s a very well-recognized lifestyle medicine proponent his primary teacher was Swami Satchidananda he talks about it. Fairly, modestly, I, Dean if you’re listening, I’d love if you’d speak up more about this but I know that when he was first doing his research there was more limitations on using terms like mindfulness and yoga and Sanskrit terms so things were sort of translated and he speaks about how he came home from medical school despondent, depressed, suicidal, and a swami his sister had invited this teacher was in his living room and said, “yeah why so glum chum come on life’s not meant to be lived this way”, not to trivialize depression in any way but like the swami basically said I think with some minor modifications and some internal exploration your mood will shift dramatically and when he once, he had that personal experience of self-care, mindfulness, movement, yoga, pranayama, which in and of themselves are not necessarily contained within Ayurveda they are sister sciences he had a revolutionary emergence of energy, effervescence, mood, happiness, vitality and he said I’ve got to figure out how to research this and share it. So many of the tenants of modern lifestyle medicine, the six pillars actually are foundationally connected to principles found in Ayurveda that seemingly are common sense but maybe we’ve lost our way a little bit.

Dr. Wong

Well, yes and I’d love to go through those pillars in a sec but you’ve said a lot of rich things here. First of all, I have to ask Swami Satchidananda. Was he the, he was the one that founded Yogaville is that?…

Dr. Khalsa

Yes, yeah, in Charlottesville, yeah.

Dr. Wong

Charlottesville, yeah. So it’s an interesting coincidence or maybe it’s not a coincidence. My sister is also an integrative family physician and she gave me as a medical school graduation gift a trip we took a trip to Yogaville.

Dr. Khalsa

Wild! yeah that would have been a while ago.

Dr. Wong

It was a while ago and it was funny because I remember the yoga teacher patting them back and say, “you’re, I know you’re not that flexible but you know there’s still hope for you” and…

Dr. Khalsa

That’s awesome!

Dr. Wong

It was a really great experience because you know having done yoga kind of you know a bit you know, generally but you know having like going there for a weekend and kind of emerge, immersing a bit it was definitely a deeper experience for sure and Dean Ornish, I know he’s done a lot of work with reversing heart disease with it sounds like a group support lifestyle nutrition but it does sound like he’s incorporating yoga in there and it sounds like ayurvedic principles so and what I also like about that definition of the science of life is that you know when you look at sort of allopathic medicine which we know there’s a role for a definite role for it is usually more of the study of disease right that’s what we were both taught in medical school yeah so it’s kind of nice to have this counterbalance of okay we, we can treat disease we can look at the pathophys and all that but then how do we study life and how do we study you know people and systems and communities that are thriving right so that we can uplevel life in order to prevent disease also.

Dr. Khalsa

And I love Dan Buettner’s work supports that so beautifully the blue zones where they looked at the five regions and found the nine features that really demonstrate health and vitality and I think you know what is often overlooked in medicine is the value of movement value of community, the value of sense of purpose. I mean these are plus the other things of wine down move you know mostly plants kind of picture so really interesting to consider that and I think from that from the ayurvedic standpoint, we can also understand now in our retrospectoscope as I like to say that there was actually a profound understanding of epigenetics of circadian rhythms of the microbiome of the autonomic nervous system and I could give you the ayurvedic terminology for those things but again you know just to appreciate that those things are actually remarkably well elucidated in ayurvedic textbooks. There was no disconnection from all these instances of our external world from our financial health from pandemics from exposure what we’re exposed to in our homes they have a whole science that’s like feng shui called Vastu. So there’s really it was really an open-ended discussion of how do we explore vitality and there was there’s a huge arm because not everyone’s going to be that good at that right we’re all imperfect in our habits our understanding our beliefs our trauma and so there’s actually a massive amount of information that looks at a disease model as well and so you had to really travel to India to get appropriate rich treatments but there are surgical techniques described in the ancient texts very advanced medical pathways and a small piece that I think is just relevant is that in the ayurvedic model there are six stages of disease stages five and six are the terminology that we know in the west nothing translates perfectly because it’s a different foundational model but one through four is often where we write people off, “Oh a somaticizer”. I don’t know about you but do you remember with disdain the teachers who would say, “it’s a somaticizer”.

Dr. Wong

Yeah, like it’s all in their head or something like that.

Dr. Khalsa

Right! But they’re actually experiencing physiologic changes which we now know are probably largely being driven by the autonomic instability that comes from probably the trauma of being alive but many people have very distinct trauma that’s impacted that those pathways of internal expression I always say, we, you know, we think about that “Oh wait I learned in medical school rest and digest”, but how actually important is it for the parasympathetic to be online for digestion way more than people realize.

Dr. Wong

Yeah. That’s definitely something that we kind of go back to over and over with you know working with people with gut health. It’s like, it really goes back to the autonomic nervous system a lot of times for people.

Dr. Khalsa

Yeah! That, that and that is Vata in a lot of ways managing Vata.

Dr. Wong

Kind of an overactive Vata.

Dr. Khalsa

Yes, Vata in excess due to, I’ll tell you something very interesting because I focus a lot on clinician health my focus at this stage of my career has really been devoted to supporting clinicians who are experiencing various stages of burnout or career redefinition or interest in Ayurveda and lifestyle medicine and in Ayurveda there’s a tenant that says suppression of natural urges will increase Vata unfavorably. So the natural urges are sneezing, coughing, peeing, pooping, eating, sleeping, ejaculation, your sexuality and I think about every physician I know has pretty much learned how to bypass the need to pee, the need to poop, their thirst, and their ability to eat for very extended periods of time. So just inherently when we look at burnout if we think about burnout from an epigenetic or an ayurvedic standpoint there’s actually you know I often hear people say, “oh well burn out get do your thought work”. I think it’s you know matter over mind in the sense not mind over matter. We have to understand that the matter has changed physiologic epigenetic changes have happened due to the long-term insult of being unaligned with our natural states as clinicians.

Dr. Wong

I saw that on your website which we’ll go over later it’s so brilliant you know because it is something I think we kind of jump to in society it’s like just willpower and let’s just kind of power through it but there’s a body effect that’s happened over probably years and decades of burnout for a lot of people.

Dr. Khalsa

Exactly! And that’s why it’s difficult to treat actually because you know what happens a lot of times is if people burn out so severely that they step away and then there’s a natural intelligence that emerges that is self-care. They believe it is, then the work or the psychiatry or perhaps as-needed medication that’s helping them, but in reality, it’s sleeping better, pooping peeing when they need to, nourishing themselves when they’re hungry, being in nature connecting with family and community, these all are epigenetic things and by epigenetics, for those that may not be as familiar these, are the mechanisms that are largely telling cells to do the things the machinery that inherently is there. Yes make these make this hormone yes make this neurotransmitter make this protein receptor to facilitate this, these connections is a really complicated thing. This still, this whole business here of our humanity is still pretty miraculous and the more I know absolutely, absolutely the less I know.

Dr. Wong

Yeah, yeah. It’s uh humbling right to kind of get, get the full picture of what’s going on. Let’s talk real broad about Ayurvedic principles. So what are your, what are your kind of general those six principles that you had mentioned there?

Dr. Khalsa

Yeah. So these are six principles that are also the foundations of lifestyle medicine. So number one is form and maintain relationships. So, and in Ayurveda, we actually look at that as first, relationship to self-right. This constant inner fine-tuning of how do we become more compassionate and the ayurvedic terminology that I particularly like is there’s a state of consciousness that sort of mundane gets us through the busyness of life and there’s also a state of consciousness that’s a little bit more focused on serving others that’s finding roots of connection and collaboration that’s community-oriented not dominion over others and I think that this quality of how to form and maintain relationships we’ve actually kind of dropped the ball on, on that in our modern culture but we also know from scientific literature that isolation for people as they age loneliness is an independent risk factor almost as potent as smoking. So for mortality and complications and even death. So this is actually this piece of forming and maintaining community is profoundly explored within the textbooks, improving sleep. So sleep and circadian rhythm are integrated very profoundly into Ayurveda and I’m a big fan I think you are as well of Andrew Huberman’s work, and he’s a neuroscientist with a focus on the retinal pathways, ophthalmology kind of angle, he talks a lot about and I used to say this to my patients at that point in time it was a little bit like what are you talking about but with his body of and things he’s talking about makes so much more sense from a physiologic standpoint but I used to say to patients early morning sunlight is your best opportunities to set the stage for sleeping deep and well at night and now we understand that those retinal pathways in the early mornings stimulated by the particular blue that’s there at when the sun is low in the sky sunset sunrise it goes through particular retinal pathways that then helps modulate hormonal surges through the day including early morning cortisol which has been linked with lower depression rates and early evening rise in melatonin which we know promotes deep and restful sleep it also that early morning sun has been shown to help regulate dopamine and sex hormone pathways. So wow! just free early morning light 10-15 minutes you know and resetting that clock. Ayurveda talks a lot about the clock in the circadian clock, there’s times of day where doshas are active you know I don’t want to be too technical but you know again there’s this quality of a profound understanding. And when the pandemic first came out there was a position paper from Harvard sleep lab that read like an Ayurvedic textbook and they basically said what we believe will give you the most best sleep because everyone’s schedules are disrupted whereas early morning light, you know exercise every day, and the other thing that’s very consistent which is actually spoken of pretty profoundly in Ayurveda is a routine that’s rhythmic. Lunch at the same time, this was in the Harvard paper socialization at the same time exercise at the same time and think of how scattered all our lives are in this modern era this rhythmicity I always say, “ resilience is rhythmicity, rhythmicity is resilience” these two are very intricately intertwined the third thing is avoid risky substances and I think this one is a little bit clearer but as integrated providers we also know endocrine disruptors right. All the things in our environment in our water in our food glyphosate you know that are inherently unknowingly to many and I get into online arguments with people about this because I feel so strongly that your budget and your awareness allows you to make informed choices about less volatile organic compounds in your body that is for the best, that is for the best. And, and this is my own particular soapbox but eliminating scents and colors from our laundry sheets and soap. I did a whole little deep dive because I was walking through this suburban neighborhood and every other house was perfuming the street with this sense from the laundry detergent and I was so nauseated after this walk that I looked it up and they said about three percent of air pollution in residential areas comes from dryer-related activity and etc. but that’s just you know of course, they’re also talking about smoking and we’re also appreciating more that things like alcohol may be a carcinogens of really looking at alcohol in moderation. So those are the three and then i’ll pause for a second see if you had a question and then i’ll do the second three if there’s…

Dr. Wong

I did want to take a little bit of a deep dive into the three doshas because you had mentioned the doshas for circadian rhythms so if you could just explain that a bit and maybe those areas where they’re more prevalent during the day.

Dr. Khalsa

Yeah! sure. So the way that we think about the circadian rhythm and again sort of sleep is we have the three doshas. So for those of you listening, we have Vata, Pitta and Kapha and this is not medical advice but if you went to ayurveda.com there’s a little sheet you can fill out to explore a little bit more because that’s the most common question I get. What are my doshas? And I always say it’s a little more complicated but I’ll go ahead and offer that as a resource because people may be curious which is my primary dosha but we have to appreciate that we have a way that we existed in sort of our genetic relationship to ourself. It’s sort of our genotype and then we have a way that our genes are being expressed, the epigenetic phenomena our phenotype and so in Ayurveda, we say there’s a Prakruti and Vikruti who we were at the beginning where our perfect health is, and where our states of imbalance are. Vikruti is our current state of imbalance. So when people do those forms there’s often a little confusion like well but I think I’m this but then if I this then that and so just to point out that sometimes when you do those forms it’s ideal to think back to answer the questions to a state when you were probably closest to your best health so small digression.

Dr. Wong

Got it.

Dr. Khalsa

So when we think about the doshas. The doshas are a way that we connect two patterns and interpret them, uh, interpret them. So when we think of the three doshas we have Vata, Pitta and Kapha. Vatas-the air and ether element, Pitta-fire and water, Kaphas-water and earth and we are all a combination of that. So think of Audrey Hepburn, this skinny mini Vata as my teacher said air and ether the bones are thin then we think of “The Rock” Dwayne johnson right? This is Kapha. He’s got a lot of earth element. He’s solid, he’s dense, he’s contained, he’s heavy. And so even we can appreciate that what they were doing was basically just observing differences in human constitutions. So, um…

Dr. Wong

Do you have a Pitta? Do you have a pitta?…

Dr. Khalsa

Yeah. So I think Ryan Reynolds is a great…

Dr. Wong

Ryan Reynolds!

Dr. Khalsa

You know I try to use movie stars because…

Dr. Wong

Yeah, yeah, yeah, that’s fine. It’s good.

Dr. Khalsa

But Ryan Reynolds. He’s kind of snarky, he’s got a little bit of fire in his…

Dr. Wong

Yeah! Little fiery.

Dr. Khalsa

Yeah, and typically his build is sort of middle-of-the-road build he’s not super bulky but he’s not super thin.

Dr. Wong

Okay.

Dr. Khalsa

There’s a bit of a hot head in there.

Dr. Wong

Yeah, yeah.

Dr. Khalsa

The fire element. Hot and sharp qualities. So, so the doshas actually exist in all of us. All three doshas and they have primary functions. So this is where it gets sometimes just a, a little bit like if you haven’t studied it but when we talk about different times of the day we’re saying those aspects that are the primary features of those doshas are more active and the best example I can give to this and I’ll just relay those times briefly but the Kapha time of day is 6 to 10 and this is am pm, the Vata time is two to six am pm and the Pitta time is 10 to 2 am pm. So when we think about, I’ll go through each of them. So Vata is the air and ether element and we think about ether as our create our creativity our connection to what’s vast to what’s beyond us and oftentimes we can be a little spacey in that two to six time per day right. So Vata balancing activities can sometimes be helpful in the, in the sense that there’s a dinacharya which is the daily routine recommended in Ayurveda it’s often recommended to be up with a meditation practice of some kind pranayama, yoga, meditation, mindfulness before 6 a.m. So this gives that two to six time where Vata is active in the early morning enhanced meditation, enhanced…

Dr. Wong

2 to 6 a.m. yes?

Dr. Khalsa

Yeah.

Dr. Wong

Okay so usually before the sun is up or something?

Dr. Khalsa

Before the sun is up. And then if we think about this again from say a Pitta standpoint, the Pitta is active from 10 to 2 am pm. So this is why and interestingly it’s in such and Panda’s work who does a lot on circadian rhythm it was in the, it’s not talked about in the lifestyle medicine curriculum but also the, believe the Harvard group looked at it, but largest meal when the sun or when pitta is high in the sky. So we are a little upside down we often eat our largest meal when the sun is set so that midday meal if it’s possible to be the larger one we have more of our in the ayurvedic terminology Agni or digestive capacity, digestive fire. The other way to kind of conceptualize this is that they also said the 10 pm to 2 a.m is a time when we digest the day but if we stay up past about 10 a.m 10 p.m charting, computer time, engaging, we get that second wind, so instead of diverting the energy to its appropriate physiologic, we are diverting it into an intellectual so there’s a lot of mental energy for pitta so you can see how it’s very nuanced in its own right and so particular people with more prominence of one dosha or another might be more prone to that so pitta predominant which is the preponderance of physicians because literally, Sadhaka Pitta is a sub dosha pitta, is responsible for the metabolism of information and the and the, how much information we consume as in our pre-med days in our med school residency is vast and you really just aren’t drawn to this field if you can’t metabolize information and you just don’t you don’t make it and that’s okay you’re, you’re not going to be happy in it either.

Dr. Wong

Right, right. It is a lot.

Dr. Khalsa

And so this is this quality a lot of physicians have a bright luminous sort of intellect but I always encourage them to recognize the heart it can be linked to that or alienated from that and that’s often a dilemma. So this concept of rhythmic qualities through the day there’s also times for all the organs I don’t have that memorized off the top of my head but we just begin to appreciate that certain times of day certain doshas will be more active which means that we can lean into that support the body or we can be separated from that almost in an ignorance to where health is and there’s some data that you know scientifically would support rhythmic movement through physiologic function in the day. I’d love to see a lot of refinement around that I think it would be really fascinating I think wearables are going to start to give us all kinds of information once they’re gathering more than just glucose and heart rate variability.

Dr. Wong

Yeah, yeah. Thank you. Well, they can, the rhythmicity like you said, creating resilience and vice versa, it does sound like when you look at those blue zones they not only have community and connection but they do have a rhythm to their day.

Dr. Khalsa

Yeah exactly!

Dr. Wong

And that’s, it’s almost like predictable so it’s like really reassuring to the body.

Dr. Khalsa

Yeah and I think it takes calories we always say calories and it’s like an abstract thing but like it takes um energy to like reorganize the day every day.

Dr. Wong

Yeah like if we had to redo our schedule you know just get this different every day, yeah it is definitely.

Dr. Khalsa

Yeah, it is exactly.

Dr. Wong

Well, let’s go to part two of lifestyle.

Dr. Khalsa

Sure!

Dr. Wong

The other three.

Dr. Khalsa

So number four is healthful eating. These again are the lifestyle medicine pillars so healthful eating whole food plant-based food and you know I think we’re starting to appreciate that vegetables don’t need to be vilified that they actually prolong vitality the way that I conceptualize this and this is actually a very broad conversation but probably the area of my career I’ve put the most focus is on I’m interested in all these pillars but food has been the one I’ve been, I wanted to be a chef and then I went into medicine so it’s been that’s…

Dr. Wong

You are a chef.

Dr. Khalsa

Well, that’s true. That’s been the push-pull for me. But I think that what I’ve really come to appreciate is that if we can have half the plates vegetables including leafy greens quarter of the plate protein oriented ethically sourced protein I don’t I’m not really interested in arguing with people about meat you know most people have their minds made up so my feeling is like okay if you want to reduce meat we can certainly show you how to do that in a healthy and thoughtful way if you need to eat meat it shouldn’t be the primary thing you eat now. I don’t want to argue with the carnivore movement I think there’s just no talking to that there’s no room for conversation with that mindset unfortunately from my perspective. But and then a quarter of the plate grains and a lot of the diets that have shown us especially like the blue zones work and longitudinal data shows us that the healthy fiber that’s found in legumes and grains and I do recommend soaking and rinsing cooking your own beans to reduce the phytates and lectins in them being you know carefully observing that people knew techniques of preparing legumes for millennia. I mean, I certainly hear people argue with me while pre-agricultural times there was many millennia of humanity living without what we do now but anyway I digress so really at the end of the day I like to think of the power plate half veggies a third of that leafy greens one-quarter grain one quarter protein source and if you want to do three-quarter plate veggie and no grain that’s fine you know just you know that’s fine too you just have to be careful in your, in your…

Dr. Wong

I think a lot of people just go more into nutrition because I am like you, I’m a foodie, and my dad owned a restaurant so I’m very into food but you know when you look at food it’s really as we know integratively, it’s, it’s, one of, if not the best medicines right. I mean and it’s really not been focused on traditional medicine at all um you know most of our medical schools don’t have a lot of courses on nutrition if at all and then I think if they do, it’s kind of like oh how do you, how do you prevent scurvy or something oh vitamins…

Dr. Khalsa

Right! Something ridiculous.

Dr. Wong

Something very very superficial. But I think really we, we definitely see that you know when

people eat more of a plant-based diet or more plants they’re going to get more energy because really if you think about sort of the science of life you know the photosynthesis and then the oxygen and the chlorophyll and all these things are needed to boost the mitochondria when you look at it from a from that you know level but I think it, there’s also something about I believe it’s the, you have to, you have to make sure this is correct, but I believe there’s some in Ayurveda, some energy that you get from eating plants, there’s a consciousness in a way…

Dr. Khalsa

The prana.

Dr. Wong

Yeah, the Prana, the energy. And it’s probably very life-giving when you do that.

Dr. Khalsa

And I think to your point you know one time and I’ll so I’ll digress into the intuitive realm here for a moment but…

Dr. Wong

Yeah, yeah, let’s go let’s go.

Dr. Khalsa

So when I was in India and I’ve been there several times. One of the times I was there studying, I went to like a very small ayurvedic botanical farm if you will and the keeper the botanical keeper it was like I remembered the episode of E.T. you remember E.T. was like this incredible botanical wizard like I just felt like I’d met this otherworldly being who had this incredible non-worldly knowledge of plants and the relationship was so synergistic you could feel this individual moving through the gardens and the botanicals with such fluidity, I was so enthralled by my time there to have such a profound respect for the botanical names the science and the metaphysics the principles that reside and in a very interesting manner. They actually had arranged the growth patterns in the garden akin to an astrologic phenomena like the, they’re called nakshatras which are the subdivisions in the ayurvedic Jyotish which is the equivalent of somewhat of western astrology. So they had these regions in the garden in a very particular pattern that were oriented to be grown because that plant was oriented to that planet to that, that energy.

Dr. Wong

Oh cool!

Dr. Khalsa

Yeah. Very very interesting and he said that he would go in the classic time of course we’re well, well past ever probably being able to deliver anything like this unless I get my secret fantasy to come true but he said basically what would happen is that the vaidya which is ayurvedic physician would go to the garden someone would come for healing they would go to the garden and tell the garden the plants “so and so is here this is what we need” and ask the plants to make what they needed to make to support the healing of this human and then they would harvest it within you know whatever period of time forward another moon cycle another astrological cycle another day you know whatever the time frame was and the mystical side of me was like “oh my goodness that is…” you know.

Dr. Wong

That’s incredible, that’s really amazing.

Dr. Khalsa

And so, I never really forgot that I never really forgot and I remember reading some research it’s been a while now where they talked about how different moon cycles affected alkaloids in certain botanicals and we can’t underestimate plants’ circadian rhythms either, right? If my circadian rhythm is optimal and you take a little piece of my blood and you test it right would not the plant have some relationship to circadian rhythm of seasons and any rate it didn’t seem so preposterous to me…

Dr. Wong

And then when we eat those plants you know the health of the plant obviously affects you know that plant genetic material. We know this from research even right it interacts with their own DNA and stuff and so so certainly the health of the plant and then of course even broad more broadly the planet you know is…

Dr. Khalsa

Exactly!

Dr. Wong

You know we’re all part of that too.

Dr. Khalsa

Right the Gaia theory.

Dr. Wong

The Gaia, yeah.

Dr. Khalsa

So yeah and Ayurveda has such an integral relationship to the interconnectedness of our nature to nature and I think this was a really, this was a really potent learning point for me. I’ll do the last two because I want to be mindful of our time together but the fifth one is increased physical activity and one of the things that we know fundamentally is what are we saying “sitting is the new smoking”, right? We are seeing so many independent risk factors that are telling us that our sedentary lifestyle, our computer screens, our lack of movement are very very detrimental on par with things like smoking. Again, you start hearing these things and you realize like well even if you have a progressive advanced disease like cancer, autoimmune, you can still do these six pillars to what end someone might ask me well perhaps less chance of reoccurrence, perhaps less progression, or if this is going to be a difficult and I have hospice you know I’m a hospice physician as well if this is the end of my life then perhaps one can have a deeper more profound spiritual opening by recognizing that these six pillars can give more ease in your being and so there’s no point in life where these wouldn’t have validity. So what’s interesting about Ayurveda though is that we also appreciate that nothing and extremes are not valued and so when people there’s actually discussion in the ayurvedic community about ultra-endurance sports and the inflammation that might be impacting the body or affecting consciousness. So it’s kind of interesting to just think about that there are conversations about what does excess look like in the textbooks and of course I always encourage people to get an early morning walk at all costs, take the dog, take the kids, rearrange your life to get that early morning life it’s like life-giving you know this quality is just so profound. And the sixth, a six pillar if you will is develop strategies to manage stress and they actually in their graphics show someone in Sukhasana like this very particular meditation pose and I have to pause just for a moment to say you know we want to acknowledge the South Asian communities that are bringing and holding these lineages of knowledge and not just appropriate thing fully to whatever version we want. There are experts who know what Ayurveda is who know what yoga is who know what mindfulness and meditation are founded in their roots in eastern traditions they are not inherently a part of western lineages and oftentimes we’re seeing the devolution of their essence by people that kind of use them for whatever purpose makes sense for them and I don’t necessarily think that’s appropriate or fair. I’m also not a cancer culture person either you know. I don’t believe in canceling people. I just offer that as a line of communication to reach out if you have any questions about whether you’re doing that not you personally but a listener you reach out to someone who might be able to provide some context or education and I think everyone is all in for reducing stress. We know that the impact of stress, inflammation, cancer, dementia, I mean the scope of what stress does to us physiologically is so profound that we all know we need to reduce stress but we can also at the same time open our hearts open our awareness to the fact that the, there are profound tools developed in the east that are ready for us to lean into but we want to do that in a thoughtful way we want to do that in a way that honors people and traditions and helps us work on our community mindset you know not just saying that person is other or foreign and opening up to what knowledge they might be bringing to this country to this nation from the traditions that were rich in their family history.

Dr. Wong

I mean ultimately you know there’s probably in some ways one of the pillars of health is also the realization that we’re all connected.

Dr. Khalsa

Yes!

Dr. Wong

As a globe, as a planet you know planetary communities. So, I think this whole idea we started this conversation of you know the eyes of the wind of the soul and keeping an open mind and I think this is where it kind of goes full circle back into “Okay, let’s look at these traditional you know used for millennia effectively and safely really” These traditions that you know there’s a lot of inherent wisdom in there that probably gets passed on like you said orally and then probably another I guess other ways too but you know this wisdom right? That’s really sitting out there in the universe for us to receive, yeah.

Dr. Khalsa

It’s right there!

Dr. Wong

It’s right there, yeah, exactly it’s right there.

Dr. Khalsa

And nature will teach you all of this. That’s the beautiful thing. Spend time in nature, observing nature, look at the patterns of nature, look at a the bark on a tree, the dew on a flower and see you know listen deeply and say how is that what is that mirroring for me in my own life today and in the world around me and there’s refuge there. I often think about it and I think this is a really interesting idea. It’s like you have two people in your practice same disease process both very difficult diagnosis and disease journey. One seems still sort of negotiated with a little bit of ease and the other it’s pure struggle. And neither is right and neither is wrong but I like to think about this idea over here that there can be ease even when dis-ease is present. So play on words there. But if we develop these relationships with nature it helps us manage our mind helps us manage our thoughts which drive our feelings, emotions and actions and nature in our evaded terminology is considered … it takes us to higher realms of awareness. I hate saying that because it sounds so cliche “higher consciousness” because that is so vague but by that I mean, I mean that’s the terminology that’s tossed around but by that. I mean the ability to redirect thoughts with ease responding not reacting when a thought emerges and saying I’m not that thought I don’t have to engage in that thought I don’t have to believe that thought. That thought might in fact be a lie nature provides that buffer that microsecond pause that gives the person who might take the path of “This is difficult, why is this happening for me? How do I get out of you know this situation? Why do I, why am I always in this situation you know to a state of this is what is? What can I…

Dr. Wong

Well, I want to say Siri Chand that you’re such a fountain of knowledge on Ayurveda here. I would love to have you back for like part two to talk about Ayurveda in some of the treatment of different conditions not that this is a podcast about like medical treatment or something.

Dr. Khalsa

Right, right.

Dr. Wong

You know they’ll be great to have you back for that now that the listener kind of has gotten some exposure to intro, you know, what these concepts are the pillars, the epigenetics, the lifestyle. But first I’d love for you to just, one closing thing on Ayurveda for this podcast. What is one thing you wish everyone knew about Ayurveda? If there’s like one thing and you know it’s like the take-home message for today for the listener.

Dr. Khalsa

Well, I’ve probably, I’ve actually already said it and that is that “Rhythmicity is resilience” and Ayurveda has a term called dinacharya which is your daily routine and if people could really hone in that daily routine, whatever it looks like, this planet would change, this planet would shift.

Dr. Wong

Absolutely and that is a great segway into our fun question that we always have for our guests segway which is, What is Siri Chand’s morning routine? You know, I think this is something that we just talked about rhythmicity. We’d love to hear your routine if that’s okay.

Dr. Khalsa

Sure. So I’m an early bird, have always been. I could be up late doesn’t matter. So I’m usually up by about five or five thirty and it depends a lot of times. I like to take time to journal a little bit of writing sometimes I’ll share that on social media if there’s not other things happening then I’ll, then I definitely get outside as the sun is rising like hands down I love that morning walk it’s so life-giving and then I’m usually before that morning walk I’ll do a few nuts or seeds just so there’s a little energy in the system. I don’t like to do it fasting just strut I think it’s a, just how I noticed for my physiology. I do a little bit of hydration before the walk then I come back and I do one of these guys which you can’t see too well but it’s a ball glass jar that’s I don’t know. It’s about 800 milliliters, it’s two quart, a quart I think.

Dr. Wong

Are we doing warm water, like that’s usually the warmth, yeah?

Dr. Khalsa

Yeah. So typically it’s room temperature warm with a little bit of mineral salt and lemon or lime. Lime is a little bit better for my constitution so I do morning water with ginger lime and a little bit of mineral salt and then it sort of depends from there you know sometimes there’s some meditation, pranayama, there’s usually a self-care routine that uses Ayurvedic body products that I do more in the evening but if I’ve missed that I’ll do a little bit in the morning too.

Dr. Wong

Great! We’ll have to hit that next time and then I think the other thing is you know we usually like to just make sure that listeners have the resources to kind of learn more about you and I know you’re focused on more clinician training but how can people like either work with you or engage with you a bit more?

Dr. Khalsa

Sure. So can find me on social media Dr Siri Chand “s-i-r-i-c-h-a-n-d” so “drsirichand” and there’ll be links to my websites through any of the social platforms. I’m probably most active on instagram. I do have a facebook group where I share lots of cooking lifestyle tips that anyone’s welcome to join.

Dr. Wong

Awesome!

Dr. Khalsa

So anybody interested in that, they can find that on my website which is drsirichand.com.

Dr. Wong

All right! Dr. Siri Chand, thank you so much for coming on today and I’d love to have you back for round two sometime.

Dr. Khalsa

Absolutely love that! Thank you, Andrew.

Dr. Wong

Thank you.

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