Health and Heart Time / Nicole Suppiger, Med.Pract. Specialist FMH, General Medicine, Partner in Hausärzte Reiden AG

Especially in this day and age, (almost) everything revolves around health, maintaining it and dealing with situations in which health is endangered or lost.

I particularly appreciate my general practitioner and friend Nicole Suppiger for her holistic and comprehensive view of health and humanity combined with logic and modern science. For Nicole, the human being counts as a whole. She deepened her passion for medicine during her medical studies in Munich, where she earned the highest grade, although very rarely given, for her explanation of the human heart in her physics examination. Her previous posts have taken her to the Asklepios Nordseeklinik Westerland on the island of Sylt as an intern in internal surgery and rehabilitation, to the Obwalden Cantonal Hospital in the area of interdisciplinary emergencies, as well as to the paediatric clinic of the Inselspital Bern, Department of Paediatric Surgery, and to GP practices in the cantons of Bern, Solothurn and Lucerne.

Nicole and I share many similarities and conversations regarding the holistic view of health and wellbeing as well as on the connection between anatomy and architecture. I thank her for sharing her views with the Colour Talks readers.

What does health mean to you as a general practitioner and family doctor?

Health is the greatest asset a person can possess. Unfortunately, in this day and age we have forgotten to appreciate what it means to be healthy. I experience many people, professionally or privately, who feel healthy because they have no visible or tangible symptoms. Therefore, nowadays most people define health as the absence of symptoms, even if they are still taking medication. However, for me personally and as a doctor, health means a state that includes all areas of life. For me, a healthy person is someone who is physically, mentally and spiritually at peace with themselves and who is also happy and satisfied at all times in their social and professional environment.

Is there a difference between health and wellbeing for you, and if so, what is it?

This was a difficult question for me at first. I came to the conclusion that one’s own wellbeing depends on external and internal conditions. It describes a state of mind, i.e. how do I find my situation and how do I evaluate it. I think wellbeing is more a subjective state and describes whether I am moving in my comfort zone.
Real health, on the other hand, I think can only be achieved from within and it can be objectively measured to some extent.

Your special field of expertise is the human heart. What makes the heart so special and how do you see it from a medical and scientific point of view?

A very exciting, almost philosophical question. I have already asked myself this question many times before and tried to look at it from different perspectives. From the point of view of conventional medicine, we regard the heart as a simple pumping organ, i.e. purely mechanical. It is, so to speak, the motor of the body. Put simply, it pumps oxygen-rich blood from the lung into the body and oxygen-poor blood from the body into the lungs.

For me, however, this view was and is clearly too one-sided. As you already mentioned in the introduction, I was already interested in the functioning of the heart during my studies, where it became obvious that there is much more to it.

The heart is a very sophisticated system consisting of muscles and its own conduction system, which can be visualised as an ECG, for example. For a long time, my understanding of the heart was shaped by this very mechanistic, electrophysiological picture. However, deep down I knew that there must be more to it. For example, everyone knows the feelings when one has just fallen in love, feels great joy or has a warm feeling inside the heart.

When I first asked myself the question about the cause of such feelings, it allowed me to look at the heart from a completely different perspective. In this context, I asked myself whether it is right to look at the heart only as a pumping organ. For me, it is much more a pacemaker of life. In this context, I always remember the sentence from the “Little Prince” by Antonie de Saint-Exupéry: “One sees only with the heart, and the essential is invisible to the eyes.” This perspective led me to the assumption of exploring the heart as a sensory organ and as the seat of feelings and of essential being. In my research I discovered that this has been taught for hundreds of years, especially in the Eastern cultures. There, the heart is regarded as the centre of intuition, wisdom, passion and love. According to the books, this is also reflected in our Christian culture.

Scientifically, it is mainly the Heart Math Institute that deals with the other characteristics. For example, its researchers have been able to prove that a structure is created in the heart that is similar to our brain and that our heart and brain influence each other. This is, by the way, similar to the intestine and the brain.

In addition, the researchers found out that the heart generates a magnetic field that is many times stronger than that which emanates from the brain. If these research results were aligned with the ancient Far Eastern teachings and and combined with conventional medicine, then completely new possibilities would emerge and open up towards a new and truly holistic understanding of diseases and their treatment.

A very exciting example for me in this context is the Broken Heart Syndrome (= Takutsubo Cardiomyopathy).
Takotsubo cardiomyopathy, also known as “broken heart syndrome”, was first described by Japanese scientists in 1990. They named the disease “Takotsubo” (translated as squid trap) because the left ventricle of the heart during the disease phase resembles these special clay jars used to catch squid (narrow neck and bulbous body).

Psychiatric and neurological diseases often involved in the syndrome

Takotsubo cardiomyopathy is an acute pumping disorder of the heart that affects mostly women and occurs mainly after emotional or physical stress events, such as the loss of a loved one, bullying at work, family disputes, but also in the context of severe infections or during or after surgery.

‘In the acute phase, the disease resembles a heart attack, so that a distinction can only be made by means of a heart catheter examination, whereby – in contrast to a heart attack – open coronary vessels can be detected. One of the suspected causes is a temporary cramping of the smallest vessels in the heart muscle, which leads to reduced blood flow and even life-threatening pump failure.’ 1

Unfortunately, there are only few research results on this disease so far, and these only with a purely western, conventional medical view. It would be very exciting to take a closer look at other influences.

Along with time, health is one of the highest values of life. Lifetime and time-life are mutually dependent. How do you experience openness for prevention a) in relation to your patients and b) among your colleagues?

Patients have a great need for preventive medicine. Patients often ask for “check-ups”. However, the conventional medical options available to me are very limited. In our way of thinking, the detection of diseases is based on the detection of a disease in its early stages, i.e. when there are already visible or measurable data. For me, however, this means that the disease has already occurred.

From my point of view, however, prevention would make much more sense in order to prevent the development of the diseases altogether, but for that a change in thinking would have to take place.
I think the patients’ wish would rather correspond to a real prevention instead of an early detection, i.e. a prevention in the sense that the doctor already recognises pathogenic behaviour and thought patterns, which he then points them out to the patient in order to prevent the development of a disease already at the root.

My colleagues in the field understand prevention as the avoidance of illness by recognising it at an early stage. I think there is a lack of awareness of the development of disease here. In conventional medicine, unfortunately, the mistake often lies in the very one-sided approach.

The concept of healing does not enjoy a particularly good reputation in Western medicine and is therefore not used in connection with scientifically based medicine. How do you see this and how would you describe the relationship between healing and medicine?

Currently, the term “cure” in conventional medicine is equated with not showing any symptoms. In oncology, a patient is considered cured when no tumour can be detected in the image or laboratory chemistry.

For me, however, healing means something completely different. I regard healing as when a person is physically, mentally and spiritually at peace with oneself, i.e. has regained his wholeness. For me, a healed person is a person who is conscious on all levels, and who is free from fears, worries, physical and mental impairments. Such person perceives himself in his wholeness.

Today’s conventional medicine has little of this holistic understanding. I notice more and more that the technical development is put in the foreground and that as a doctor you no longer learn to look at the human being as a whole. The technical development of medical devices, but also of genetically based medicine, is progressing in great steps, but unfortunately the human being or humanity has been lost from sight.

Today, conventional medicine views the human being only as a “2-dimensional” system consisting of body and psyche. To put it provocatively, one could almost say that the human being has been degraded to a functioning machine with a brain. Since only 2 out of 3 parts are considered, no healing is possible in conventional medicine from my point of view.

 

I think that in order to be able to really help people again in the future and to give them the possibility to heal, we need more humanity again and a more holistic view of the human being. A first step would certainly be if we, as doctors, would take more time for our patients again, to examine them with all our senses instead of reducing consultations or treatments to purely technical or laboratory-analytical examinations.

You have seen and experienced many ups and downs of health – professionally and privately. What would you say to people who are at risk of burnout or in the process of finding their strength again?

In my practice I see a lot of people with burnout and the numbers are increasing. In a data collection by the Swiss Federal Statistical Office, it was found that in 2017, 21% of people at work suffered from stress at their workplace , compared to 18% in 2012.

I could not find more recent data, but from my personal point of view, this figure is certainly significantly higher at present. The workload in all professions is constantly increasing. Whereas in the past it was mainly employees in top positions who were under a lot of pressure and at risk of burnout, today I see this in almost every occupational group and people are getting younger and younger, especially in the social professions there is an ever-increasing stress load.

In our society, only the principle of “higher, faster, cheaper, more effective” applies, it’s all about functioning. For me, this has little to do with humanity. Many employers no longer see the human being in their employees, but only “productivity”, the person becomes a machine… In the last few decades, our world and also the world of work have become more and more mechanised, which should be a support for people. Unfortunately, what has happened is that people have started to measure people only by their performance like that of a machine. A sense of humanity has been completely lost; it is no longer a question of how people are feeling at their workplace, what worries they might have, how their working environment could be better designed, but instead, it is all and only about how much they are able to achieve in which time they complete the job.

I myself experienced my second burnout in October 2020. Although initially a shock for me, I now see it as a great gift. I have been able to recognise what life is really about and how easily it can happen to run into a burnout. I have also learned to see this diagnosis as a strength rather than a weakness. Now, I am more sensitive to the “taboo topic” of burnout and can even recognise it in my patients before they can feel, see or name it themselves.

From this experience, I can only advise everyone to observe themselves better again. To see if you still enjoy what you do or if your life consists of a constant obligation. If you feel pressure to do something every day, then you are already very far into the burnout process or have already lost a good amount of your original strength. Then, you might only function and have completely lost self-awareness and access to yourself.

I would like to explain it with my personal example as it is easier for me. As a general practitioner in a larger group practice, I treated 40-50 patients a day. The consultations were very much the same: “Good afternoon, Mrs Müller, how are you? Good? Fine. Your laboratory data is fine. See you next time….” I never had time to really care about the needs of my patients or to listen to them. I was always driven by the pressure of deadlines. My own needs became irrelevant, too. I always convinced myself: “It has to be like this, you have to be there for all patients, the others do it like this too.” I always measured myself against the expectations of others and forgot about myself and my needs in the process. When I was at the end of my tether, I couldn’t sleep at night and was afraid of making mistakes during treatment and I thought that a break of 6 weeks would be enough. I just needed to recover a little…

At the beginning, it was very difficult for me to accept that I could no longer simply function, as our society sets the pace for us. Looking back, I am very happy that I didn’t continue to function, but reached a point in my life instead, where I had to take a closer look. I realised that I had not enjoyed my profession for a long time because what I did in order to please and meet treatment conventions, did not match my innermost convictions. I wanted to have time for my patients, I wanted them to feel heard and seen and that I could pay attention to their needs and exchange my observations with them.

The coaching with you, dear Ines, helped me a lot and I am always happy to recommend it to others.

The most important thing for me is to teach people that burnout is not an expression of weakness, but the strength to admit that you can and should take more responsibility for yourself again. This can only be done by dealing with yourself and your environment more consciously. The following clearly applies here: “There is strength in calmness”. Admit to yourself that you are not a robot, but a human being with thoughts and feelings and that you should take good care of yourself.

The voice and voice training are something very important for you, professionally and privately. If the heart had a voice, what would it sound like and what would it want tell us?

The voice of the heart includes all tones and rhythms, similar to the heartbeat. It can sound harmonious or disharmonious, high or low. Our heart has a lot to tell us, but we have forgotten how to listen. I think what our heart is constantly trying to tell us is that our most important mission in life is to take good care of ourselves.

I am convinced that our heart has a voice. Sometimes it is very quiet, so that we hardly hear it, but sometimes it is very loud and tries to let us know something in all kinds of ways. For me, for example, our heartbeat is the voice of the heart. We can all try this out by paying attention consciously to what happens to our heart in certain situations: our heart warms up, our heart leaps with joy when we meet someone we love, or it gets tight in our chest when we are afraid or very sad.

For me, for example, music or singing represents the voice of the heart on the outside. During the first concert, in which I sang, I strongly sensed how much a person’s voice can touch the hearts of other people in the room. For me, this was a very special, beautiful and meaningful experience.

 

You love animals in general and horses in particular. In your family and free time you work intensively with your own horses. What can we humans learn from these intelligent creatures or what would horses most like to teach us?

I have been around horses since my earliest childhood days and I have always had a very special connection with them. They are very intuitive animals and they always live in the here and now. If you are lucky enough to be able to experience them freely in nature, then you see how very content they are with themselves and the world. They take life as it comes instead of thinking of life in if-then conditions.

From horses, we can learn to enjoy the moment and to connect with nature. They tell us a lot, because they always reflect us and our behaviour without filter. If we look, listen and feel carefully, the horses show us very precisely where we are and whether we are already or not yet completely at peace with ourselves.

It was while spending time with my horses that I first perceived that something was wrong. As my horses were different, I realised that my own life needed change. Today, however, I see how well my horses are doing again. To see this progress makes me truly happy inside my heart, above all, because it also tells me a lot about myself and the progress I have made.

If we go back again to our own inner leadership, the horses will follow, too.

You were born and raised in Stolberg and have lived with your family in the energy town of Altbüron (Canton Lucerne) since 2011. What do you love most about and in your adopted home of Altbüron? (Favourite places, favourite food, favourite activity)

I have lived in Altbüron with my husband since 2011. This beautiful, small village in the Lucerne hinterland offers a lot of recreational opportunities. The hilly landscape with many forests and fields and the view of the Jura and the Lucerne mountains have a very special charm. I particularly enjoy walking in our beautiful forest or along the Wässermatten. My favourite activities are of course horse riding, walking and singing, which I discovered for myself only five months ago. You might find me warbling on the back of my horse in the forest.
I don’t have an explicit favourite food, but I do enjoy the special ‘stomach bread’ produced in the village or the cheese fondue from our neighbouring village Melchnau.”

 

1 Source: https://www.usz.ch/gebrochene_herzen-neue_erkenntnisse/