Susan Fekety's "Community Character" Interview (Originally published in The Community Leader, February 2007)
- Name: Susan Fekety MSN CNM
- Age: I'll be 50 this summer!
- Town of Residence: Portland, Maine.
- Occupation, title and name of organization: I'm a master's prepared nurse (originally educated as a nurse-midwife) currently providing holistic women's health care and lifestyle counseling for men and women at the holistic practice True North Health Center in Falmouth. Letters after my name mean Master's of Science in Nursing and Certified Nurse Midwife.
- How/why did you choose your profession? I grew up in a medical family (dad doctor, mom nurse) and got an undergraduate degree in political science at Yale because I wanted to be involved in health care reform. (As a doctor's kid I learned early on that the medical care system in this country is not serving patients or practitioners as well as it could be.) As I pursued my studies I came to believe that health regulators were pretty clueless about the realities
of providing patient care (which I found, and still find, vexing in the extreme) and therefore came up with solutions that didn't work like HMOs, and the Medicare Part D drug thing. Our system is really good at what I call 'rescue medicine' and funding boat payments for insurance executives but what we're really needing, I think, is a health care approach that consciously puts energy into keeping precious human beings from needing to be rescued in the first place.
Where the context of illness, what else is going on in a person's life, is taken into consideration. This could take a lot of pressure off the system, and it would be more humane.
Boatloads of authorities have said that health education and disease prevention are the way out of the health care mess this in paper after paper it made me nuts that nobody was DOING it! Even though it's really a no-brainer, preventive health care is not a big moneymaker in the short term, and it requires philosophical and procedural changes that threaten some deeply entrenched financial interests (see boat payments, above.) I eventually lost confidence that the
political process could ever offer a fix that was sensible and decided that I would have the most impact in clinical practice, working with people one-on-one.
So after college I was very interested in health consumerism and women's health issues, and when I learned that the Yale School of Nursing offered an innovative program educating non-nurses to become nurse-midwives I jumped to apply. Midwives know that the body knows exactly what to do, and that the job of the care provider is to maintain an intelligent, supportive, watchful expectancy over a normal physiologic process. Of course there are circumstances that call for
rescue in obstetrics, but most of the time things go exactly the way they're supposed to if you resist the impulse to tamper with them. When you pay attention you can usually see small signs that predict big problems later so you make your interventions early and usually they are simpler and safer. It fit perfectly with my sense about how a logical health care system ought to work and it was a ton of fun helping babies be born.
I practiced nurse-midwifery in a big academic inner-city practice in Houston, Texas and later in Maine at Women to Women and Mercy Hospital for over 20 years before I moved my practice to my current setting. I delivered more babies than I was able to keep track of. Right around the time I was realizing that it was time for me to experience sleep on a more consistent basis, I got connected with the people at Mercy Hospital who were visioning what ultimately became True
North and I felt like I'd come home yet again, to find folks with a similar philosophy of health care, but who were not midwives.
It was hard to give up delivering babies a few years ago, but I have found that working with families accomplishing physical miracles (pregnancy, labor and birth) translated beautifully into the work I do now: supporting people to take the best daily care of themselves so their bodies can function well. In addition to doing routine annual exams and addressing women's health problems I help people implement the programs their doctor has recommended to them. I also run the
First Line Therapy program, which is a 12-week clinically-tested functional medicine "tune up your lifestyle" program for people who want to get or stay healthy, or who want to minimize their use of medicines for things like pre-diabetes and high cholesterol. I have seen people reverse diabetes and completely change how they feel with this program it's done a whole lot for me personally, too, and it is not difficult to implement.
Many people would be really surprised to know how much good science there is to support the idea that when you feed and care for your body correctly you can safely fix a lot of health problems for good. The term "functional medicine" in the True North practice name refers in part to our primary focus on supporting normal function in our bodies by knowing what's needed all the way down to the cellular biochemical level. Most of the interventions we use in functional
medicine are based on supplying specific foods and nutrients or changing behaviors like activity and stress reduction because those things affect biochemistry. Our bodies are very wise and responsive. Starvation and strenuous exercise are NOT required elements on the pathway to health: what you need is nutrient density, pleasurable movement, and compassionate support. In practice, this means learning ways you can normalize metabolism, reduce inflammation, and respond
better to stress. It is possible to do this without moving to Canyon Ranch or quitting your day job.
For instance, I think of premenstrual syndrome (PMS) as symptom of nutrient imbalances that show up in distorted hormone metabolism, so the approach I take to it does not look at which antidepressant or birth control pill to give to make the symptoms go away, but how to help a woman naturally balance her hormones by changing what she eats, adding supplements of what's missing if needed, and looking at how she manages stress. I often use the analogy that one approach is
to "snip the wire to the red light on the dashboard," and another approach (the functional medicine approach) is to "pop the hood and see what's going on." Similarly, the years around menopause are tumultuous for many women, and lots of them turn to hormone replacement to help them get through it. We now know that hormone replacement carries more risks than some used to think (but many of us suspected), so the question arises, what can a midlife woman do to navigate that
transition more comfortably and minimize her use of hormones? In my experience, again, how you experience menopause reflects how you're caring for your body overall so women who eat well (and the functional medicine definition of good nutrition is a little different than what you'll find in other places), are active, and take steps to address life stress are far less dependent on drugs and hormones and they are also reducing their risk of later-life health problems,
too. Take care of the big stuff and a lot of the little stuff takes care of itself.
It's actually a fairly old-fashioned philosophy, and a lot of the time I feel like grandma: "Eat your vegetables. Honor your need for rest and sleep. Go for a walk. Have a heart to heart talk with someone you care for." I feel extremely fortunate to be in a practice where we emphasize helping people develop healthy lifestyles and to use natural healing methods where they work and are desired, and where we are learning how to make a health care system that accommodates
I also wrote a book of affirmations for pregnant women called "The Pocket Midwife" which I sell online and am in the middle of reprinting, and I co-authored a program for prenatal bonding and relaxation called "Nurturing Baby and Me During Pregnancy." I am a big believer in the power of the mind and spirit to influence the body and support a healing journey. I've always been a bookworm, and I love to write.
- Favorite quote or words to live by and who said them: I have gotten two pieces of essential career advice over the years: "Define success as getting paid to do something you'd do for free," and "Figure out what you're good at and do more of that." I am fortunate that I can check both of those off in my practice at True North.
- What would people be surprised to know about you? That I was a two-pack-a-day smoker for 15 years.
- Who is your favorite musician, singer or artist? Hmmm…This changes daily. Right now I am on a Bossa Nova kick, so I would say Astrud Gilberto, the original singer of "Girl from Ipanema." I also like Tom Lehrer probably nobody besides me remembers him. If I'm feeling overwhelmed, give me some Vivaldi or Mozart. I would love to sing like Eva Cassidy.
- What is on your refrigerator at home? What interesting items are inside? On: recipes to try, list of foods inside that need a plan before they rot, an awesome collection of Virgin Mary magnets (mostly gifts), my favorite photo of my sister and brother in law, and spare batteries for my pedometer. In: 3 flavors of hummus (great substitute for mayonnaise, especially in things like chicken or tuna salad), 2% fat Greek yogurt (yummy like sour cream but a lot
better for you), shell bean stew made with beans a patient gave me last summer, a roasted chicken, and a bunch of veggies that I need to make a plan for before they rot.
- What is your favorite restaurant and what do you order there? Anyplace where I can eat fresh local fish and look at the water.
- What is your most important possession? Any modern convenience: furnace, hot water heater, indoor plumbing, automobile. I would have made a lousy pioneer woman. My idea of roughing it is no room service.
- Do you have pets? What are their names? Two cats, Buddy and Magic, adopted as adults from the Brunswick shelter. My home is awash with moonbeams and cat hair.
- What talent (or super power) would you most like to have? I would like to be able to bestow more hours in any given day whenever I want.
- When did you last take a vacation? Where did you go and with whom? Twice a year I take a long weekend solo retreat up to Corea, Maine, where I rest and write and read and hike in Acadia and on the Schoodic peninsula. I was there last September; it rained quite a bit but I didn't care. It always seems to rain when I'm up there.
- What is your favorite place/special spot in Maine? The prizewinning vegetable display barn at the Common Ground fair.
- What's your biggest pet peeve? You know, it should probably be something important but it drives me nuts when signs are absent, hard to read, incorrect, misspelled, or mispunctuated.
- If you could have dinner with one person (friend, family, celebrity, etc.), who would you choose? I would like to meet Peace Pilgrim, the woman who dropped her ordinary life to walk all over the United States alone, sharing a message of love and peace with people she met, and with no possessions except what she could tie up in a hankie. I think of her often when I feel overwhelmed with obligations and deadlines and "stuff."
- What quality about yourself would you most like to change? I'd like to be better at math, especially long division.