Macrobiotics Today, March/April 1992, Vol. 32, No. 2

Introduction: Dr. Martha Cottrell is a respected physician who travels extensively lecturing on health promotion and disease prevention. She was Director of Student Health at the Fashion Institute of Technology in New York for sixteen years and served as the clinical administrator and medical consultant for an AIDS research project in conjunction with the Boston University School of Medicine and the Kushi Foundation. That research project studied the effects of macrobiotics as an alternative and adjunctive therapy for AIDS. She is co-author, with Michio Kushi, of AIDS, Macrobiotics, and Natural Immunity (Japan Publications, 1990) and contributed to Doctors Look at Macrobiotics (Japan Publications, 1988). Dr. Cottrell, much in demand as a lecturer and teacher, shared some of her thoughts with MBT on women’s health, her style of medical practice, social attitudes on nurturing children, along with a few comments on the writings of George Ohsawa during the 1991 Fall Health Classic in Palm Springs, California. Dr. Cottrell has recently retired from her medical practice in New York City and now makes her home in North Carolina.

BL: I thought that we might explore several areas. One is women’s issues in health. Another is your background and evolution from a medical doctor to a preventive medicine/macrobiotic practitioner. And another is your method and style of treatment as a health care practitioner, plus anything else you would like to share.

MC: That covers a lot of ground. Well, my focus at this time in my life is really coming together with women’s issues. Nature, in its infinite wisdom, requires that higher-order species have a long period of nurturing from infancy to maturity. The female does most of this nurturing. The whole structure in both the animal kingdom and particularly in our human species acknowledges the fact that the female needs to be protected as well as the young so that nurturing can take place until the next generation can get along on its own. The male is the expendable part. The male goes out and fights the wars, hunts, does whatever. But it’s the female that has the long gestational period and also has the long period for the nurturing and development of the human species.

What I see happening in our society which concerns me so much is that women are so ill. We are seeing epidemic forms of disease among our women that have not been so prevalent before. Now we see the young women getting a lot of the diseases of men – heart disease, strokes, and lung cancer. The cancers are just eating our young women up. We’re seeing younger and younger women having hysterectomies from cancers.

BL: Do you have a feeling about what the cause might be?

MC: Well, whatever the cause, I think that what I’m concerned about, first of all, is that there is not an awareness of the importance of this message. We’re always talking about diseases and what is the cause of the disease and what is the cure. But we’re not looking at the graver and larger picture, which is the deterioration of our health and destruction of our society.

What I’m seeing, from a wholistic perspective, is that we, as women, have left a place in society that was not working really, and now with the women’s movement, we’ve come to a place where we have many more options for self-realization. In the process, we have been literally denying, rejecting, and destroying our reproductive systems. Which is almost self-hatred of ourselves as women, in an attempt to be male-like. In so doing, we are destroying the opportunity for continuation of the species.

Traditionally, the female has been the one that has received the fertilization, given birth, and nurtured the next generation. And now we see that we are allowing this to happen in the test tube. We are giving over this power that is female to technology. I see more and more infertility, more and more spontaneous abortions, and more early abortions. It seems that we are losing our identity as women. What are we? What is this female energy? What is the power that we have been endowed with? We are losing that power. I’m concerned with that.

BL: How do you see that expressed in the patients that you see? When they have physical conditions, do they also have emotional and psychological concerns?

MC: There is always an emotional overlay with illness. We tend to think we can separate mind, body, spirit, and emotions. But we can’t. Anytime there is an illness, I think we have to be very sensitive. As health practitioners, we have to help patients to understand the metaphor of their illness, the language of the illness, in order for them to heal. Just addressing the nutritional or stress factors is not enough. We must also come to an understanding of how our emotions have helped to create a particular disease. What does this message [disease] mean? Why does one person develop breast cancer, another cervical cancer, or ovarian cancer, or colon cancer?

To facilitate healing in other people, first of all, we as healers have to be aware of what it is to be healthy ourselves. If we are not attaining that awareness, it’s pretty hard to be aware of what’s going on in somebody else.

What I see is that the form of the illness can tell us, and the individual, a lot about the areas that need to be worked upon. Breast cancer is an example. I can’t think of any woman that has come to see me with breast cancer who, after working with me, has not been able to acknowledge that they’ve never known how to nurture themselves.

BL: Why do people come to see you in particular?

MC: Well, you have to realize that by virtue of who I am, I’m going to attract certain kinds of patients. Just the fact that I have a medical degree behind my name, provides people entrée to me. Many, many people come to me with physical problems because it’s their entrée. But also, at some level of their consciousness, they have chosen to come to me because they know that I’m operating on a level other than the physical. So whether they are conscious of it or not, they’ve chosen to come to me because they are available to look at the emotional and spiritual side, the wholistic. They have an awareness that many patients, who just get into the medical model and never get out, don’t have.

My practice is very exciting and very stimulating. Most of the time it’s extremely rewarding because I can work with patients on many levels – on the physical, the spiritual, the nutritional, the environmental. Even if it’s not right at the surface, I just have to dig a little bit and soon I’m hitting paydirt. If they’re really available, we can do some incredible things together.

BL: Could you describe your method of treatment? What is it that you do in your practice?

MC: I mostly facilitate. I don’t treat anybody. I help them to get in touch with their own questions and answers. Then I share my opinions and make some recommendations. It’s a partnership; we work it out together. So it’s a real facilitating, sharing, exploration. I used to treat people before – write prescriptions and things like that.

BL: You no longer write prescriptions?

MC: I don’t do that kind of medicine any more. In the past few years I’ve moved further and further from crisis intervention. Most of what I do in my practice is to facilitate the person in their search for the modality that’s most appropriate for their healing. What I’m available to do is to help them find their own answers. I ask patients to bring as much information as they can: their blood work, any kinds of reports, and I ask them to write out their health history. I tell them to bring any concerns or questions and we’ll look at all this together. Then I will help them to find their own answers. So it’s a type of counseling. And it can vary from doing macrobiotic counseling, to helping them to decide whether they want to do chemotherapy or radiation therapy – or, if they are going to have surgery, what they are willing to accept or not accept. It’s a real exciting process, exploring options and encouraging them to use their own intuition to determine what the best choice would be for them at that particular time.

BL: What led to your transition? I assume that previously you were considered a mainstream physician who prescribed drugs and surgery.

MC: Yes, I was in a sense, but I’ve never really been mainstream anything. Even as a little child I questioned. My home was such that my parents encouraged me to question, encouraged me to never be mainstream. I was always brought up to be very suspicious of the way the majority was going. And to always ask myself, “Is this the right direction to go?”

I had a lot of experience before I even went to college. I had two children before I went to college. I had been married for quite a while. I had worked. I had been in life, I had lived life. I didn’t go from high school to college to medical school. I went from high school to marriage to being a mother. I experienced my parents’ illnesses, my children’s illnesses, and my own illnesses. So, in medical school, I was much more mature in many ways than the other students. So just to sit there as a student and swallow anything hook, line, and sinker – that was not where it was at. And that made it difficult for me at times. The whole medical model is to have things poured down your mouth and then you regurgitate it. I wanted to know why. And I was taught that in science you don’t ask why, you ask how. And if you ask how, you can manipulate it. I wanted to know why. I wanted to know the cause. So, in spite of the fact that that I was always told that I couldn’t ask why, I continued to ask why.

BL: What was your practice of medicine like when you first started?

MC: I was a family physician. I delivered babies. I was first assistant at all my major surgeries whether it was brain surgery or orthopedics. I did my own minor surgery. And it was a wonderful experience. I kept up with all the postgraduate stuff. I went to conferences. I prided myself on keeping up on what was going on in medicine, always in the first wave. But even at that, I began to observe that no matter what I did, people kept coming back; they didn’t seem to get better. They would get one set of symptoms out of the way and they’d come back with another one. Or I would put them on medication that would work and then they would have side effects and I would have to put them on something for the side effects. And I thought, “This is not what I thought it was going to be like in medicine. I thought we were actually going to heal people. And they don’t seem to be healing. As a matter of fact, they seem to be getting worse. Now why is that?”

And, even way back in the sixties, for example, I began to notice that women who would come in with vaginal problems would say to me as they were leaving, “I’m not supposed to have sex with my husband, am I, as long as I’m on this medicine?” And I thought, “That’s interesting.” And I would say, “Well, yes, you’re right.” I picked up that that was a way of saying, “I don’t want to have sex with my husband. Could you give me permission not to?” So I put it in the back of my mind that the next trip around I would have to talk about this with them. I began to ask myself, “What’s going on here?”

The next time that patient would come in, I would say, “How are things at home? What’s going on? Is something going on between you and Frank?” And the answer would be, “He’s having an affair.”

I began to see that there’s some connection. So I began to integrate more and more. Teenagers, unmanageable at home, would be brought in and I would say, “What’s going on at home and what’s going on at school?” And a lot of times, after talking a while, the mother would say, “Well, you know my mother’s living with us and I love my mother but she’s such a cantankerous old woman and she just butts into the kid’s business. And I can’t seem to get her to realize that they’re not children anymore. She can’t tell them you can’t do this or that.” And I begin to see, mmm, the problem there is related.

And patients would come in and say, “You know, Dr. Cottrell, I read this article in Prevention or I read this article in Ms., or somebody told me about this, and I’d like to know what you think about it.” So I’d say, “Well, let me read it and I’ll get back to you.” So I would read it. And I became aware that there was a whole body of knowledge out there that I didn’t know anything about. And I would say things like, “Well, I can’t see how this could hurt you and if it seems to be helping you, why not?” So I never made them feel like they were idiots or anything like that. I tried to give them my honest opinion. Sometimes I would say to them, “I really think this is a racket. I think you’re being exploited. It’s up to you, but for myself this doesn’t seem legitimate to me.” We’d have that kind of exchange.

So then in my own evolution, when my own illness came about because of my lifestyle – and that’s a whole other story that I’m going to write one of these days – but when the time came for me to reflect on my own illness and what I was going to do about it, I realized that I didn’t want what I had to offer. My patients had made me aware that there were other ways of doing things. So I began to search for alternatives. And it just so happened (you know it’s never an accident – when the student is ready, the teacher appears) that I met a very bright young family doctor right out of residency up in Seattle, Washington who was very wholistically oriented. He invited me to go to a conference out in Wisconsin of the American Wholistic Health Association. I had never heard of it. I was scheduled to go to Washington to a regular medical A.M.A.-promoted thing. I said, “Oh, John, I would love to go but I am already supposed to go down here.” And he said, “I really think it would be very beneficial if you would go.” I had so much respect for him, there was just some energy there that I said OK. I canceled the other one and I went with him. And that really turned my life around. I became aware of a lot of options and it was really fascinating for me.

That was when I began to explore other options. Other people came into my life “accidentally” that told me about this one or that one. And through meeting a female sailor who had a lot of problems with arthritis, a very angry woman, I learned about a lady, Ilana Rubenfeld, who had been doing some work with Feldenkreis, Fitzpearl, and Alexander. I put that in the back of my mind, but I didn’t do anything about it. Then when I had my episode of acute inflammatory arthritis and became very ill, Ilana’s name came back to me. So I decided I would go find this woman.

My level of consciousness was not very high at that time. When I went to see Ilana, I said, “I’ve heard about your work and I’d really like to study with you. I’d like to learn your techniques so that I could help my patients.” That was my access point. I could not walk in and say, “Ilana, I need help.” It’s so interesting how we find our way. So I said, “May I study with you? I want to learn your technique. I want to be a better doctor.” She said, “I don’t know if I can teach you how to be a better doctor or how to take better care of your patients, but I can teach you how to take better care of yourself.” That went right over my head. I said, “Well, then are you saying that I can study with you?” I never got off my focus, see. And she smiled and said, “Of course.” And I began to study with her. It took me about two years before I got the message that I was there to help myself.

She facilitated the raising of my consciousness and I realized that I needed to get out of New York City. I wanted to get to a more natural environment. I was down at the college [Fashion Institute of Technology] compulsively going through the mail and I threw out this little professional journal. Then I quickly grabbed it out of the trash can for fear I might miss something. I went through it and saw an advertisement for a position in a rural health initiative. So I took it home and I looked at where it was on the map and it looked like a fascinating area.

I went down to Hyde County which is in North Carolina right on the coast, a very rural area. I was there for a year, but in the process, my arthritis flared up and I went to see an orthopedist because I was having so much bursitis in my left shoulder. I’ll never forget it, it was excruciatingly painful. I had gone in actually to get an injection because I had had injections of cortisone before. I didn’t want to, but it was so painful that I just forced myself to go. I felt I had no alternative, I had to get some help.

While I was sitting in the waiting room, I picked up the Saturday Evening Post and read Satillaro’s article. So my shoulder got me to the orthopedist waiting room where I read about him, and I thought, “This is fascinating.” And from that began my search for information on macrobiotics.

I finally got hold of some information. At that time I didn’t know how to do anything but boil rice and steam vegetables, which was very boring, but I started getting better. So then I went back to New York. I realized that everything I was doing in North Carolina was acute crisis intervention. I would try to teach people and they didn’t want to hear what I had to say. “OK, Doc, that sounds real good, but what can you do for me now? Can you give me something for this pain. That sounds real interesting, Doc, but you know I’ve really got to have something for this.” And I realized those patients weren’t ready for what I had to offer.

So I went back to the college in New York and continued in the administration. I applied and got a year’s fellowship in preventive medicine at Mt. Sinai School of Medicine. I continued to study with Ilana Rubenfeld. I searched out and got into the macrobiotic community in New York, through which Michio Kushi heard about me and approached me in 1983 about working with him with the AIDS group. At that point, I began to go to Boston on a regular basis and study with Michio. And I would sit in with the senior counselors when they came to New York. That’s how I learned. That’s how I taught myself. It’s just been an ongoing study since then.

BL: What convinced you that macrobiotic principles might be effective?

MC: What convinced me, like a lot of people, was that here was a fellow medical doctor, Anthony Satillaro, who had some positive experience with macrobiotics and felt it contributed to his healing process. If this doctor says there must be something to it, I want to look into it. Pure and simple. Satillaro. Simply because of the little M.D. behind his name, macrobiotics has touched many Western minds.

After that, when I began to read more about macrobiotics, I found it fascinating. Much of what I read, with my Western medical background, made sense to me. The first thing that clicked for me was when I read about the connection of the ears to the kidney. I was taught the same thing in medical school. When you see a deformity of the ear or the ear sitting in a certain place on the skull, you better be highly suspicious that there’s a deformity of the kidney because they form at the same time. So I said to myself, “If this is true, if they knew this 6000 years ago, I want to know what else they knew 6000 years ago that we don’t know now.” So that’s what intrigued me.

As I studied macrobiotics, I would research what was available in Western medicine that might support or disprove macrobiotic ideas. As I went on in my own research in the medical literature and studying macrobiotics, I was excited and amazed at how well they dovetailed, how supportive they were of each other. They’re not contradictory, counter to what many people in medicine think.

BL: Then there is a lot of existing documentation in the medical literature to support macrobiotic claims?

MC: Oh, most of what I use in my lectures comes from Western medical research. I just integrated it with macrobiotic thought. That’s what’s so exciting for me. I felt confused the first few years when I was in transition. I stopped practicing medicine altogether because I could no longer do what I knew how to do. It was like, “I don’t want to do what I know how to do, and I don’t know how to do what I want to do.” So I quit. For three years I didn’t practice medicine.

I was very fortunate. Again, things don’t just happen, they’re always meant to be, in my opinion. At that time at the college we were experiencing tremendous growth. We had to expand rapidly to keep up with the growth of the college. At that time, I was the only doctor. I had one nurse. So I sat down and presented to the administration my needs in order to keep up with the growth of the college. I needed to do more administrative work so I took on more responsibility as the director. I hired a doctor and nurse practitioners and I put them in to do what they were comfortable doing. I did the administration, took my fellowship and learned more about preventive medicine, and then came back to the college and developed a program in prevention and health promotion for the students, staff, and faculty. You see, I was able to manipulate my workplace so that it was balanced for me. I was giving the students the Western medicine they needed, but I couldn’t deal with it so I provided somebody that could. And on the other hand, being the director, I had the opportunity to develop a program in health promotion. So that satisfied me. That was the beginning of my learning how to balance and to integrate and to take care of other people’s needs as well as my own. So that’s been the journey.

BL: You’ve talked a lot about prevention and educating children in your lectures. Could you describe your ideas about these areas?

MC: Well, as far as my interest at this time of my life, it’s really in women’s issues and children’s issues. As I said, I feel that if we women can’t heal and be healthy, we can’t nurture our children and our society, which is the future. And so I’m very committed to supporting women in finding that healthy place. And in some instances this means not having children. In other instances it means trying to be both the chairman of the board and a mother. How can we facilitate that so that a woman can take care of both her needs and the child’s needs and the family needs. How can we support our young people in that way? It’s just, as I see it, another direction of the extended family. The extended family has to be the workplace and school and society. In a way, it’s very exciting in that the extended family is going to have to be really extended if we’re going to have a healthy society. It’s not just going to be blood kin. We have to become universally each other’s family.

This is a challenge. What we need to do is to look at the old patterns and update them. The same needs are there and the same solutions are there. They’re decked out in a different form, but the principles are there.

And then there are other women who want to stay home and be housewives and mothers and care for their children. We should provide them the opportunity to do that as long as they want to. Politically, I think we have to redirect our economic resources toward providing either tax benefits or economic incentives to help replace a care giver’s earning ability, because that person is earning money. That person is putting a great deal into the society. Therefore society should pay their social security and pay their retirement and pay them a salary for staying home to care for the next generation. The care they give means that we will not have moneys going for crime, dropouts from school, or emotionally ill people that become homeless and a care on the society. So we have to really value those women who want to stay home and give them the economic rewards they are due.

The way that women were treated in the past and even since the Second World War is that if you didn’t work in the workplace, you didn’t have any income, then you weren’t known to the government. You had no social security. If your husband died, you had no skills, and you were lost. That’s not going to work anymore. That will not work.

On the other hand, if our women go to work and our children are being bounced around the way they’re bounced around, the children develop different kinds of problems – emotional problems. They’re socially handicapped. They lack communication skills and the ability to commit. They fear and distrust one another and they are filled with paranoia, frustration, and anger which manifests itself in destructive behavior and violence. It shows up as self-destructive behavior as well as drug abuse.

So we really do have to realize that providing nurturing environments is part of what we call prevention just as much as providing a health care clinic. Part of a national health program is to see that healthy homes produce healthy citizens who are productive and contribute to the economic health.

It’s a real long-term vision of investing in women and children. Otherwise we’re going to end up with an increasingly heavy social debt that we can’t possibly keep up with. A premature baby costs something like $8000 or $10,000 a day to keep in a neonatal clinic. Even after that, 70 percent are severely handicapped and severely deformed. We’re going to have to provide custodial care for these people. With the medicine and technology we have to keep people alive, they may live 40 or 50 years. We can’t afford that. We have to go back to the beginning and provide supportive and nurturing environments, beginning in school – we have to start there because there is no home.

We hear very conservative people talking about nurturing being the responsibility of the home – what home? Our society basically is a conglomerate of dysfunctional families. High divorce rate, child abuse, latchkey kids. What home? The parents come home, they’re so tired they can’t even cook a meal, much less sit down and listen and know what’s going on with their children.

We have to reevaluate the role of the school. The school has to be part of the extended family so that we can teach communication skills beginning from kindergarten or preschool. We can teach children to negotiate instead of fight. We can teach them to share. We can teach noncompetitive games so that everybody wins. Win-win situations. That has to begin very early because we know from recent studies that children who experience disruptive episodes before the age of three are at great risk of psychosis. Children who experience marked disruptive experiences before the age of six are at very great risk for neurosis. So we have to work with children during the first six years before they even get to school. Daycare has to be more than a babysitting thing; it has to be a positive and stimulating experience.

And women, if they work, need to have flexible hours so that they can breast feed and interrelate with their child, keep that connection. We need to give the opportunity to women, if they choose, to breast feed at least eighteen months to two years minimum. But once children are weaned, then the father needs to have some flexibility to play more and more of a role. We have to adjust our workplace so that fathers can have time off because as children get older – as they detach – they need more time with their fathers. Both boys and girls need their fathers.

We are in a most exciting time. We have a lot of examples of what doesn’t work and we also have some examples of what can work. We have the incredible opportunity of taking all of this knowledge and doing something really great with it. But, I think things will get worse before they get better. The bigger the front the bigger the back. If we learn from all of this, I think we have a tremendous opportunity and we can come into a real golden age of humankind.

BL: What are your current projects?

MC: I’m in transition myself right now. I have a lot of dreams. I would like very much to be involved with trying to create the opportunities I described for families and children. I’m very dedicated to that. I’m trying to find the vehicle for that. I am also trying to create a lifestyle that will allow me to spend more time in the library studying and then from that reflecting, meditating, writing, and teaching. So my dream is that my so-called practice of medicine will be less and less and less. And that my writing and teaching will be more and more and more.

BL: You spoke of studying with Michio Kushi. Are you familiar with Herman Aihara’s book, Acid and Alkaline?

MC: Oh, yes. I have it and I go back and read it and reread it. It takes time for all that to soak in, but I think it’s a great book.

I’m very happy that Herman is publishing Ohsawa’s works. I get every one that I see. I get a great deal from going back and studying Ohsawa. I really enjoy that.

BL: Some people, particularly women in American/European culture, have a little difficulty with some of Ohsawa’s views.

MC: You know, you have to understand the historical aspects of anything before you can understand why we are where we are. So for me to read and study Ohsawa helps me to understand better where we are now and gives me the perspective that will help me to know where we’re going to go in the future.

I just take it in. It’s history. It’s just like we’re trying to do with Columbus. I don’t care how we want to write him up. Columbus did what he did. That’s history. And I think it’s sad that we try to change history. We need to understand it and see what we can learn from it. If we appreciate the fact that change is the name of the game, it’s imperative that we know where we come from in order to know where we’re going.

I had some dynamic history teachers when I was in school. When we studied history, we didn’t just memorize dates. We talked about the social climate, the political climate, and the economic climate of this country. Why did this happen? What generated it? What was the fertile ground for generating this disruption or this progress or whatever? If we could present history that way to our children, I think they would be far better citizens. Because, as I said, we must know where we came from before we know where we’re going. And that’s what Ohsawa does for me, studying him really helps me understand a lot about what’s happening now in macrobiotics.

BL: Thanks very much for your time.

MC: You’re welcome.