Chapter 04: Identifying a Purpose and a Graduate Focus in Health Psychology

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Chapter 04: Identifying a Purpose and a Graduate Focus in Health Psychology

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Dr. Cohen begins this chapter with an anecdote about an experience he had while traveling in India that convinced him he needed to find a purpose. This motivated him to think about graduate study, and he again gravitated toward the field of health psychology, selecting a program in Medical Psychology at the Uniformed Services University of the Health Sciences, Bethesda, Maryland (MS conferred, 1993; PHD, 1994). Dr. Cohen stresses that his aim was to go into research. He describes research he conducted during his fellowship years [1/1994-11/1995 National Cancer Institute of Canada and The Toronto Hospital, Toronto, Canada, Paul Ritvo; 1/1995-12/1997 Postdoctoral Research Fellowship, National Cancer Institute of Canada, Division of Behavioral Medicine and Oncology, University of Pittsburgh, Pittsburgh, PA, Andrew Baum]. He goes into detail about his work with mentor, Andrew Baum and the value of medical school courses he took in Bethesda. He then narrates how he came to focus his research on cancer. He observes that the field of health psychology was just forming and framing research questions to explore how psychological processes have an impact on health. He recalls his excitement when reading an influential study published in 1990 that showed that HIV patients who took part in stress management had improved immune markers. He was also influenced by John Kabat-Zinn's work applying eastern based philosophy to medical problems. He talks briefly about his dissertation research on the effects of surgical stress on the immune system. He recalls that the research pathways available when he left graduate school were "HIV or cancer." He discusses why cancer was a good choice for him. He mentions meeting his wife, Alison Jeffries, in graduate school. He explains how he ended up working with Andrew Baum at the University of Pittsburgh, noting that he learned to collaborate with a surgeon and run a small clinical trial.

Identifier

CohenL_01_20160504_C04

Publication Date

5-4-2016

Publisher

The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The Interview Subject's Story - Professional Path; The Researcher; Mentoring; On Mentoring; Inspirations to Practice Science/Medicine; Influences from People and Life Experiences; Understanding Cancer, the History of Science, Cancer Research; The History of Health Care, Patient Care; Personal Background; Professional Path

Transcript

Lorenzo Cohen, PhD:

Yeah. So that year was spent with her and getting to know her and doing a lot of yoga. I had friends who came in to the farm and were hanging out. And what's interesting is India was a very influential factor in certainly my grandmother's life and in her son's life, my uncle, who was very influential in my life, macrobiotic gardener and vegetarian and an unbelievable cook. He really took cooking to a whole other level.

T. A. Rosolowski, PhD:

I didn't ask you his name.

Lorenzo Cohen, PhD:

His name was Alberto like his grandfather. And he had always dreamed about going to India. He was an incredible traveler. He instilled in me the -- what's the right word? The mystique or the -- why am I not thinking of the word? Romance of travel. So he dropped out of Exeter because he was sent by his mother to Exeter because Exeter would be the best school, and to get your education. And he just wanted to be loved and hugged. His dad commits suicide when he's 10 and he's shipped off to Exeter. My mother is shipped off. This person did not want to be a mother. I feel sorry for my mother and her brother. But she was this free yogi there for the world. So anyway he rejected that and just traveled. He actually disappeared and hitchhiked and hitched a freighter, it's all this romantic stuff in my mind.

T. A. Rosolowski, PhD:

Like Arthur.

Lorenzo Cohen, PhD:

Like Arthur, exactly. And they would stay up for hours arguing. And so anyway my uncle was really smart and extremely well-read. Both he and Arthur, not formally educated, but because they were so innately smart and had the basics, they were voracious readers. So they knew history, they knew current events, they knew politics. But my uncle particularly loved Homer and the Iliad and the Odyssey. And they were his Bibles. He knew ancient Greek philosophy and these stories in particular. So as a young child in Italy every summer I always remembered he would recite the Odyssey in particular, not with the book in front of him, just telling it like bedtime stories of the adventures of Odysseus. And he tracked where Odysseus went. And he went and he traveled that route. So I always knew him as this great adventurer and traveler.

T. A. Rosolowski, PhD:

That is a romantic sensibility.

Lorenzo Cohen, PhD:

Yeah. And his great dream had always been to go to India because he was exposed to all this Eastern philosophy through his mother, through Iyengar, through Krishnamurti. Do you know who Krishnamurti is?

T. A. Rosolowski, PhD:

Yes.

Lorenzo Cohen, PhD:

So he was a huge influence in Vanda's life. He came every summer. She would host him in Switzerland. They were -- some were questioning how close, but that's not relevant. Very close. He literally wrote her every single day of his life on a pad of paper. He would have these entries. And then he would put the whole pad in the envelope and send it. So after Vanda died we found all these boxes of correspondence from Krishnamurti to her.

T. A. Rosolowski, PhD:

For the record, why don't you explain who Krishnamurti is?

Lorenzo Cohen, PhD:

Oh, sure. J. Krishnamurti is a very well-known Indian philosopher. He's no longer alive. Was originally part of the Theosophical Society, which was -- I don't have enough time to get into what the Theosophical Society is. But started by actually Europeans in India as originally I think a Russian -- Blavatsky and then Annie Besant, who became a very well-known women's rights activist in England. So in Madras, at that point in time it was called Madras, India, they formed this organization called the Theosophical Society, with aspects of -- I'm not that actually familiar with the tenets of the Theosophical Society. But they have an educational model and Eastern philosophy, etc. And so Krishnamurti claimed to be an enlightened individual who's found at a young age by the leaders of the Theosophical Society and brought into that organization, was educated in England, very -- an aristocratic upbringing, although he was born from a poor Indian society. And then at a young age separated from the Theosophical Society because his philosophy, which is a beautiful philosophy, is there are no leaders, there are no masters. We are our own masters. There's no such thing as gurus. This is all a bunch of BS. And everyone needs to ultimately find their own way. And so he split away. And he said, "Being part of the Theosophical Society is anathema to what I have discovered in my enlightenment. Of course in splitting away and being such a charismatic, physically beautiful human being, he had this whole organization form around him. And there's now the Krishnamurti Foundation, there's Krishnamurti schools all over the world. And stuff happens when you have very powerful people, even though they say there shouldn't be organizations. Organizations form. So that's who Krishnamurti was. And Vanda was extremely close with Krishnamurti and connected with him until his death. And what was interesting is that the relationship between Krishnamurti and my family actually predates Vanda's connection with Krishnamurti, which goes back to when I think Vanda was in her twenties, and her older sister Hilda had an incurable brain tumor. And her and her father, Alberto, had heard about this healer who was part of the Theosophical Society. So her mother, Clara, a Swiss Protestant, her father, Italian Jew, in Italy. So Jewish Protestant. She married a Catholic guy, but he was a Kantian philosopher. So obviously he wasn't religious. And you wonder why I do alternative medicine?

T. A. Rosolowski, PhD:

It's making sense.

Lorenzo Cohen, PhD:

So when she was in her early twenties of course she had this trauma that her older sister that she admired had this brain tumor. And her mother was part of the Theosophical Society, which was this weird Eastern thing, even though she was this very proper Swiss Protestant with the gloves and the keys and all of that as head of the household. So they went off to Belgium I think it was where this guy Krishnamurti was holding talks, and he was claimed to be a healer. So I think they met Krishnamurti after that and said, "Can you come and cure our daughter, my sister? And he's like, "No, I don't do that kind of thing. And then they were disappointed. But then Alberto loved what he heard and he said, "Well, I want to host you at my house. And then the relationship was formed. So it was through her father that Krishnamurti started coming regularly to Italy. And then after he died Vanda kept up the tradition of hosting him in Italy and then hosting him in Switzerland. So actually I've done energy medicine research at MD Anderson where we brought in a healer who claimed that he could shrink tumors with his energy. We actually published a negative trial that didn't work. And that's a whole other story. But I knew the story about Hilda and Krishnamurti and healer from as a young child.

T. A. Rosolowski, PhD:

What did you think about it as you grew up?

Lorenzo Cohen, PhD:

Well, it didn't really mean anything early on. Because I always knew about Krishnamurti because he was such a strong force in Vanda's life from the time I was born certainly. I knew he was a special man. Some people claimed he was a healer. I don't know of any evidence that he was a healer. He didn't claim himself to be a healer. He was just a philosopher who gave lectures and helped people lead more meaningful lives.

T. A. Rosolowski, PhD:

I guess what's really striking me as you're talking is that the people in your immediate circle who really have importance for you are people who they've made a real commitment to a way of shaping their lives very intentionally, and that those lives not only include work, but there's an overlap between work and a personal philosophy or some kind of official philosophy that's studied. It's a very integrated way of structuring your life. Unlike the ordinary American that oh, I'm organizing my life around going to the mall and what I buy and what fast food I stuff in my face. There are more intentional choices. A personal, emotional, perhaps at some times spiritual, commitment to the choices that are being made. It's just really interesting that you were steeped in that kind of environment from the word go basically.

Lorenzo Cohen, PhD:

I only met Krishnamurti a couple of times. And I was relatively young but of course knew of him and what he did. But Vanda, Alberto, Krishnamurti, Arthur, there was no separation between a work life and a home life, and it was life. It had a singular purpose. Alberto had to put food on the table, and Arthur had to be able to eat. But life was the journey. And wanting to intentionally be doing things that were meaningful. And of course meaning comes at all different levels for different people. I got to see that of course a lot more. When you're a high school kid particularly, I was a little misbehaving high school kid. A lot of the stuff of course wasn't resonating. But it was actually Arthur that turned that on in me. But then spending the year with Vanda. So the reason we had this long side road here about India and Krishnamurti is that Alberto, who had planted the seed of adventure and the romance of travel in me, had always had India as his ultimate place to go because he was exposed to Iyengar who was his yoga teacher and Desikachar who was the yoga teacher of Krishnamurti and my grandmother. And Iyengar was always around. India was this ultimate destination. And Vanda, people always assumed that she went to India every year. And her response was "No, India came to me. They came to her house. During this year I built up my time with her. Worked with Arthur to plan a trip to India in terms of what are some of the destinations. So I took off on my own and went and traveled in India for about three months. It was during that time -- and I actually cut my trip short. Because it was traveling around that I realized -- I focused my trip on going to ancient sites and again getting to the site was part of the adventure and the purpose. But I had this goal of going to these key historical sites. And I only went to southern India, I didn't go north of Mumbai. I actually had really interesting run-ins with Iyengar, who I didn't originally see. I went to Pune to deliver a gift from Vanda, and he happened to not be there, he was off somewhere. And then I'm in the middle of nowhere in this desert town having dinner by myself, and in walks Iyengar and his entourage. So it was very funny. And then I saw him in another -- two weeks later I'm at a temple and I feel somebody's watching me. And I turn around and there he is with his entourage again.

T. A. Rosolowski, PhD:

That's wacky. It's a huge country.

Lorenzo Cohen, PhD:

Kind of huge with a billion plus. So it was during that time actually I'd meet up with different people and travel. So you're never on your own when you're traveling on your own. And there was this one couple that I met up with at one point near the end, because this was the lightbulb that went off. They're just aimlessly traveling around with no purpose. And I thought at that point I need to now go back and do something with purpose. My time in India is starting to become purposeless. And what I also realized at that point -- because still even though I didn't do a full premed and I had not done organic chemistry I had in the back of my mind McMaster Medical School. McMaster Medical School is in Hamilton, Ontario just outside of Toronto. They're the ones who developed problem-based learning that then of course every medical school in the world adopted. They had a very I guess you could say alternative approach to educating doctors. That of course really appealed to me. And they accepted people who didn't have full premed backgrounds. My intention was to apply to McMaster, and whether I got in or not I didn't know. And to go into medicine. And I realized, just like I realized in my first year at Reed, that I was going to have to specialize, and that I would have to become a cardiologist and only focused on the heart and ignore the rest of the body, or I would have to focus in oncology and focus on one particular organ, etc., etc. Obviously there's family medicine and internal medicine if you're more of a generalist. But that was almost too general for me.

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Chapter 04: Identifying a Purpose and a Graduate Focus in Health Psychology

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