Mike Berkley 03/12/2018 Spence: Hello, everybody, and welcome to another Golden Podcast. I have the honor of being here today with Dr. Mike Berkley. He's here because this is where we do interviews with world-class TCM community leaders to discover the stories, habits, psychology secrets and everything else that led to their success. Thank you for being here today, Mike. Mike: Oh, it's my pleasure. I'm honored to be on your show, thank you for inviting me. Spence: Awesome. You and I have known each other for quite a while now, and I think that's through ABORM. For those of you who don't know Mike, that's too bad, you should, and you will today. And that's primarily what I want to dig into today, because people like Mike have done so much for the movement of Chinese medicine period in the West, and for sure for integration. If I get anything wrong, you’ll correct later, Mike. You graduated from the Pacific College of Oriental Reproductive Medicine in ’96, you've seen a lot change since then. You've practiced for 21 years, and you're the first acupuncturist in the U.S. to completely devote and specialize in the care and treatment of infertility. Mike: That's correct, perfectly stated. Spence: That is quite a badge. Because of the inroads and the research that's been done, etc, there's so many people that are able to just hang up ‘I treat fertility’ flag in our industry now. But it's really great to, and that's what we're going to do today, dig through your story of how you pioneered that, because you did it with like canoes. Mike: Exactly. Spence: The Berkeley Center For Reproductive Wellness has been around since about a year after you graduated in ’97. Mike: That’s correct. Spence: He’s in Manhattan, he’s got the grit to kick ass out there, and he’s been doing that ever since then. I visited your clinic, I've had the pleasure long time ago with Lauren, and that is quite the operation or it was then. I assume that's ten years probably. Some things have changed, but you work hand in hand with a good handful or many of New York's most prominent fertility and IVF clinics or centers. You believe, as these are your words, “I believe it takes a village in the new gold-standard, for Reproductive Medicine is the integration of Chinese and Western medical protocols.” I couldn't agree more. Backpedaling, do you mind starting like way back and kind of giving -- I don't know if everyone loves this but I love hearing the story, because acupuncturists come from all walks of life, and it’s not something you fall into it like after you graduate high school. Go for it. Mike: I guess back in the day, I think I started school when I was about 31 or 32. Before that, for many years, I had been involved in the electronics business. And I owned a couple of different types of businesses. I won't explain it as it will take up too much time in the show, but I was a semiconductor broker. I was selling electronic components. Then I got out of that, like, I went into manufacturing computers. And when I say manufacturing, don't misunderstand, I wasn't Dell or IBM, I would just buy motherboards and 10Mb hard drives. And I had a guy that could put them together and we'd sell them, and we did very well. And then I went out of business, and I went to work for companies selling computers. Throughout this whole period of time, I was studying martial arts with a guy whose name is Tom Bisio. And Tom Bisio is a very renowned acupuncturist and body worker. When I say body worker, I mean, like tweener. Tom can turn your head 365 degrees and fix it. He's a bone setter and an acupuncturist. I had been studying Filipino martial arts with him for about ten years, and at some point, he said to me, you know, I've spent about ten years teaching you how to kill people, and he said, you should consider learning how to help people. And I'm like, yeah, it's all good, I don't know. I sell my computers and make my money, and that's what I was about. But at this point, I was going out of business, then out of another business, very convoluted. I took my business in San Francisco, I failed there, I came back here. It was at the tail end of this market that I was in. And so, I had this conversation with Tom, and then, one day this odd thing happened, which was that a newspaper found its way onto my desk. And the reason I said that's odd is because I never read this newspaper before. I wouldn't go and get it, and I haven't read it since. But the newspaper was called The Village Voice, which is a very popular newspaper in New York City, kind of an alternative newspaper, shows a lot about music and restaurants and all this stuff. I opened it up because I hadn't much to do, I was going out of business, I just threw my feet up on the desk and opened Village Voice. And I see this, I guess it was a quarter-page ad, and it said something like, Pacific College of Oriental Medicine. We've been in San Diego for 21 years, and we're pleased to announce that we're going to be opening in New York City. We invite all of you to an open house. And I basically thought acupuncture was a bunch of quackery, I still do. No, I'm just kidding, that's just a joke. I thought it was a bunch of quackery, but I just had this conversation with Tom Bisio, he’s an acupuncturist, and I said, you know, let me go to this thing and like see these idiots who don't know anything and they think that they do. Now, like, I'll just go because it'll be like a fun evening and it'll give me a good laugh. So, I went. And what I discovered was highly articulate, extremely intelligent, accomplished, knowledgeable people giving this presentation. And I, at that very minute, got really excited and got chills down my spine, and I said, holy moly, this is pretty different than what I thought, and I'm going to take a shot at this. At this time, I was working for a company called Horizon Technologies. It's a funny story, I was a computer salesman because I had gone out of business and now I'm working for these guys now. I realized my timeline sounds off, but that's just because I was involved and in and out of so many things I can't really keep track, but I was working for Horizon Technologies when I started to go to Pacific. When I went to Pacific, I was just taking one class. It was like intro to Chinese medicine. You know, I wasn't going to sign up big time, I didn't know if I was going to like it. Then the next trimester comes along and I take two classes. My boss’ name was Phil, I said, Phil, can I meet with you after work, and he's just, fine. I am terribly sorry to say this, I can't come to the sales meetings anymore. Because I'm going to school, but you know, I've been selling for twenty years, I don't need to come to this stuff. He said, it's fine, no problem. Then the following trimester, I took a couple more classes, and I said, Phil, can I meet with you after work, and he's just, sure, sure. I said, Phil, listen, I can't work Wednesday evenings anymore, I can't work Wednesdays anymore, because I'm in school now and I have this thing, but I’ll work every other day, and don't worry, I'll close deals, it's all good. And he's like, let's fine, it's no problem, no problem, it's all good. Then the next trimester comes, I take like four classes, and I said, Phil, can I have a meeting with you after work. And he says, sure. I’m like, Phil, I can only work one day a week. He goes like this, he puts out his hands like this and says, Mike, I had high hopes for you, you're a great guy, it's been a pleasure to work with you and I wish you the very best. So, he very gently fired me, and I understood, of course. Then I went to acupuncture school full-time. I had been out of school for quite a while so it took me a minute to get readjusted to school, but I loved it. I enjoyed studying, I was very determined because I had been in and out of several businesses, and now, I was like 30 or 31. I was like, if you fail at this, what are you going to do next. I was like kind of an MMA fighter, it's my debut and I can't lose. No matter what, I can't lose. So, I studied really, really hard, like fanatically. I was in Barnes and Nobles, and Barnes and Nobles in Manhattan, they would have tables and chairs and you could literally hang out there all day. They had a café, so you could get coffee and a sandwich. I was studying all day. I mean, when I wasn't in school, I was just studying, everybody in Barnes and Nobles knew me. I did that, and I completed the course. I just did acupuncture, I didn't do herbs. And then when I graduated, I went to work as an acupuncturist, then I went back to school and I did the herbal program. I didn't want to do them together because I felt that each discipline required complete focus, and to do both at once is kind of like studying piano and studying tap dancing at the same time. I don't think you can get really good – please, forgive me, with respect to the audience, I just don't think you can get really good at studying both at the same time. It's like martial arts, just like anything. A martial arts teacher once said to me, you can't chase two rabbits. Anyway, I went hard and I studied and I became pretty good as a student. And then I remember getting out of school, and I guess it was a clinical depression, I'm not really sure, but when I went to Pacific College, it was extraordinarily competitive. I went to school with really smart people and really aggressive people, aggressive in the sense that everybody wanted to get an A, there was no cheap twinkies. You know what I mean, everybody was hardcore, and you had to take tests all the time. And we had these things called the first-year comprehensive exam, and the second-year conference, and the third-year conference, tremendous pressure, study, study, study all the time. And you know, working in a clinic and all of this. So, one day what happens is I graduate, and I go home and guess what I have to do the next day? Nothing, nothing. I don't have to study. I don't have to pass any tests, I don't have to write any papers, I don’t have to do any presentations, and what happened to me was, because I was functioning up here for so long, and now, I was like purposeless. And I got to tell you, I've never had this before, and God willing, I'll never have it again. I literally couldn't get out of bed, like if I had to pee, I would have to take like 40 minutes and talk myself into getting out of bed to pee. I was severely depressed, severely. And I don't mean suicidal, I didn't have any suicidal ideations, but I just felt like I weighed 600 pounds. This is just coming out of school. I just had crashed from all that pressure to no pressure. Eventually it just lasted for about a week and a half, and it was very frightening because I didn't know if it was going to last forever. I didn't know what it was. I knew I was depressed but I didn't really totally get it. I was like, this is how I'm going to be from now? I'm going to be in a hospital. I came out of it in a week and a half. I took a deep breath, and it was all so frightening, it’s very frightening when you get out of school. Because when you're in school, you have nothing but support. Your classmates, your teachers, dean, everybody is there to help you. Even though it's competitive, it’s people who help you. So, now I’m completely on my own. I don't have anybody to tell me what to do and that's quite frightening. Freedom is very frightening, when you don't know what to do. In any event, I moved forward emotionally, I was very good friends with a guy in school, we opened a practice together in the beginning of ’97. I wanted to do fertility work, but it was a very different time then. Like, I would go and set up appointments with reproductive endocrinologists and I was very aggressive about getting those appointments. I wasn't going to take no. I would make these appointments and all of these guys were the nicest guys, but they all do this: I don’t know if you can see it through my glasses, but they go [mimicking them]. Spence: Eye-roll. Mike: Eye-roll. They just thought I was like a quack, which I probably was, and I probably am. I mean, they just couldn't fathom! And I'll never forget, I'll tell you another cool story. There's a clinic in New York that I'm very friendly with. I know all the doctors and they send me patients and we go out to dinner all the time, but just to show you where I was at, I got a meeting with the medical director of this clinic. That's a big thing, and he's a big guy in a big clinic. And I go there with my office manager, and we sit in his conference room and I said, listen, I'm doing this, here's some empirical evidence, it is not a lot of data yet but acupuncture exists for almost 3,000 years, and it's been treating infertility for 2,000 years, they didn't have IVF in China hundred years ago, blah, blah, blah, blah, blah. I tried to present my case, and he says to me -- and remember, I'm a new practitioner -- and he says to me, well, we'd love to send you patients for stress relief. And I said to him, no -- my manager is like kicking me under the table -- I'm like, no, no, Dr. Jones -- that's a fictitious name-- I'm not here to treat your patients to stress relief, I'm here to create an improved hemodynamic milieu in your patients’ ovaries and uterus so we can help drive more FSH/LH nutrients, oxygen, electrolytes to the follicles and help expedite the -- what's the word -- getting rid of debris, dead cells. And he kind of looked at me like I was crazy and I said, so, can we move forward based on that, and he said, well, I can't recommend that to my patients because I don't have any data, I don't have anything. Literally, I stood up, I extended my hand and I said, well, look, I'd like us to remain friends but we're not going to do business together. but thanks for the meeting. And I left. Spence: Wow, really? If you know Mike, you know this is likely true. Mike: Because I had spent two years on acupuncture and almost two years on herbs, and, listen, dude, I'm not a massage therapist, and I mean no insult to massage therapists. Please, the audience, don't misunderstand. I'm not here to like rub your back and like relieve your stress. I became an acupuncturist so I can do internal medicine. By the way, just many years forward, we're all good together in that clinic, I'm on their website, they send me patients and I send them patients. And it's not the stress relief. I just got a call today from a patient from another clinic, she's got lining issues, she's got like a six millimeter lining so she wants me to help her with that. And this doctor, he's a very well-known reproductive endocrinologist, sends me the patient out of nowhere. He just said, go see Mike Berkeley. So, times have changed. Doc was actually referring patients to me, it's a whole different world. And interestingly, when I was graduating, it's a very funny thing, my teachers would say, oh, this is a great time tipping in acupuncture. When I got licensed, nobody was doing acupuncture. I got licensed in 1970 or whatever. I was like, you're in a great time right now. It wasn't exactly true, but now it's a great time. People that are graduating now, I mean, an acupuncturist is very much accepted in every avenue. This is a whole new thing about using acupuncture to reduce the need for opioids, it's all over social media. So, acupuncturists come a long way, but in any event, back to us, back to me. When I first wanted to practice, I was treating everything, like every acupuncturist. I was treating a neck pain, a back pain and elbow pain and headaches and all this stuff, and I'll tell you a great story, it's my first fertility case. You have to realize that I knew nothing about infertility, I just had the desire to engage in that practice, and I studied a little bit. I didn't study much. I mean, eventually I studied like an animal. Once I got out of school, I read every darn Western reproductive medicine book and every Chinese medicine book on fertility, well, there was not a lot of fertility book. I mean, there are now. I did study very diligently, but at this point, I just gotten out of school, so, I was worried about opening a practice. Anyway, my patient comes in, she's 40 years old. This is a great story. And I didn't know herbs yet, so I didn't do any herbs, and man, I didn't know anything. I didn't know what FSH meant. I was doing a strict TCM diagnosis and treatment protocol, and this woman was 40 years old, and she had done multiple IUIs and several IVFs. Multiple IUIs, meaning four or five, and then maybe three IVFs or something – failed, failed, failed, failed. And in those days, my office had a doorbell on it. I'm treating this woman, not a long time, three months, four months, and my doorbell rings. And I opened the door, and it's her, she's coming at her appointment, and the oddest thing happens. She's standing in front of me and her eyes start to get a little red, and she aggressively comes towards me, like quickly. I had done a lot of martial arts for a lot of years. I'm 61, and I've been training more or less, seventeen. And so, I almost just went whoop, and just elbowed her right in the face, not meaning to. It’s just a reaction because this person is kind of coming right at me right. And she grabs a hold of me, and I'm like, what the hell is going on. And remember, I'm a new practitioner, I don't know how to deal with people. I mean, I've always been empathetic, but this is a new thing. And she bursts out crying. I'm like, holly goodness, what’s going on. And I'm thinking, let me tell you what I'm thinking. I'm thinking, I must have done some damage to her. Like, she's going to tell me she's got this huge hematoma over here, or she can't feel anything at her left leg. I'm like, I'm going to be sued, I'm out of business, I'm done. And I'm like, what's the matter, are you okay. I don't even know what to say. And she separates herself and she says, I'm pregnant. Now, I was ecstatic as well, but you know, I didn't have any experience. I know that so many pregnancies end in miscarriage. We get excited when a patient gets pregnant but that's something to get excited about. It's exciting when they're like 13, 14 weeks. But in any event, she got pregnant and had the baby, and it was a healthy, normal baby. And that really solidified my desire and helped even more as an impetus to drive me into that direction. And why did I choose fertility? Well, two reasons. Number one, I wanted to do internal medicine, and number two, I wanted to get really good at one thing. And again, this is not meant with any criticism at all, but to the listeners, to the audience, to the women listeners, if any of you needed to do an IVF or an IUI, would you go to a podiatrist and spend four hours with that IVF or a chiropractor who learned to do insemination, you wouldn't do that. You’d feel this person has no credibility whatsoever. How can a reproductive endocrinologist practice podiatry? It doesn't make any sense. Well, wait, maybe he's a dentist also. I didn't want to be one of these guys that treat everything. Because I always felt like this is my own opinion, I mean no disrespect to anybody, but I just felt like there was a lack of credibility. I just see these ads that say, I'm an acupuncturist, I treat the following. And it literally starts with the letter A and ends with the letter Z. I mean, like every single thing, and even things that are not on that list. Like, you know, if you want to be rich, come to me, we have secret points. I wanted to get one thing, and I wanted to specialize. And so when I had this case that really pushed me over the edge, and I said, that's it. I was a great reader of literature, I was an avid reader, I was constantly reading. Well, for the next ten years, I never read a book. I mean, to say I never read literature. For the next ten years, I strictly and only read reproductive medicine, both from the Western medical point of view, Western medical paradigm and the Chinese medicine paradigm. The other thing was, I had developed some friendships with reproductive endocrinologists, and I was the biggest pain in the butt that they ever known. Because I'd be constantly like texting them, calling them, emailing them. Listen, this patient has da, da, da, da, da, and she has da, da, da, her husband has da, da, da -what does this mean. And they'd be like, well, it could mean this and it could mean that, I don’t understand why could it mean that. And I would annoy these guys and women to death, constantly peppering them with questions. And then I’d go, listen, can I sit in and watch you guys do what you do, a retrieval and a transfer. I got close with a lot of good people, and I learned a lot. And one of the interesting things about Western reproductive medicine is there's really no consensus about how to perform IVFs. Different doctors use different protocols, medically, they trigger it at different times, talk about endometriosis. I went to an endometriosis seminar on Manhattan several years ago, with a reproductive endocrinologist, my friend, we went together. And the people who attended and who spoke were the world's top people on endometriosis. People came literally from Egypt, from all over the world, and this is an amazing story I'm going to tell you. There was literally no consensus. No consensus on how to treat it, or what the best-case scenario is to treat it. Do you do it surgically, do you do it medically, what do you do when the patient wants to get pregnant. And then, when I left the seminar with my friend who was this reproductive doctor, I said, Joel, I don't understand. These are the most brilliant minds on earth and none of them agree with each other. And he gave me a very interesting answer. He said, listen, we all know what we know, and we’ll all use what we're used to do the best that we can. And I was like, wow, that's wisdom. That pertains to acupuncturists as well. You and I see the same exact patient, and I say, Spence, you know, this is what I think, and you say, no, Mike, I don't agree with you at all, this is what I think. And what's interesting is that we could both be right because there's nuance. Anyway, I’m probably digressing for which I apologize. Spence: I love that though. That's just practicing medicine. That's why it's not called the mastery of, it's what we're practicing medicine. It’s just the fact. Mike: Thanks, man. As the years went on, as time went on, I developed more and more relationships with more and more doctors, and I think that we've done things for each other. I think the doctors have helped me by referring patients to me and by helping to educate me. And I think what I've done for them is I've helped to educate them to the potential benefits of including acupuncture as part of the reproductive protocol. To tell you a quick thing, there is a guy whose name is David Kreiner, he's a reproductive endocrinologist in Long Island, which is a suburb near Manhattan, and Dr. Kreiner is an amazing guy, he's been the reproductive endocrinologists for 30 years. He's one of the first guys out there. And I had some office space with him in Long Island. I don't want to bore you with this, but I left it after a while. But he and I had done some lectures. He would have these Friday night lectures, he would invite all his patients and I would lecture with him. And he really didn't know me. I'd be lecturing, he'd be like, who is this guy. Not that I'm such a brilliant guy, but, I didn’t mean to say that, he didn't expect an acupuncturist to know what I know. Anyway, what happened, a couple of years ago, is David Kreiner, this is the first in history, in the world that I know of, went to acupuncture school for four years, not the three-weekend or three-month nonsense, he went to four-year acupuncture school while practicing reproductive medicine. And David Kreiner is a licensed and board certified acupuncturist, a real acupuncture, and he's a reproductive endocrinologist, and he said to me that it was because of me that he did this. Like, I inspired him to do this, which is obviously very gratifying for me, but I'm also extremely proud of him. And I think that what David Kreiner has done, it’s both, a great thing and a bad thing. It's a great thing because he actually broke the mold. I mean, this is nobody that's just out of school two years ago. This guy's a well-known serious player. So, if he's doing it, you know who he's having dinner with every night, he's going to the ASR. All he knows he is a reproductive doctor, he's talking to them. That's good, and why is it bad? It's bad because if every reproductive endocrinologist becomes an acupuncturist, we're screwed. But I don't think that's going to happen. Spence: Can I ask you a question, do you know much about his experience? Because when I first started going to school, one of my favorite teachers, this really fiery Chinese guy, he's like, it's easy for you guys after studying Chinese medicine to go to Western medicine because it's reductionist. But to go there to do the opposite, to study a reductionist medicine and then come to Chinese medicine is a huge feed. Like, what was this guy's experience? I don't know any reproductive endocrinologists that would do that, that's for sure. Mike: Nor do I. I mean, I don't know what his experience was in school, but I suspect it is pretty easy for him and I'll tell you why. I've never been to medical school but we all know that it's brutal. We all know that medical school is like, you can have no girlfriend, no boyfriend, and if you do, you'll end up separated. It's just brutal. So, when you have that kind of work ethic, acupuncture is hard. I think he's studied hard and did it. I don't think it was a big deal for him, he was relaxed. It wasn't like, oh, if I fail, what am I going to do. The guy’s doing very well without acupuncture. I think it was more like fun for him. When I went, it was like, holy man, this is what I'm going to do. It's like serious, I can't mess around, I can't mess up. When you're really relaxed, that's when you can accomplish huge things. I think he was fine with it. I don't speak to him that much now, but I should call him and find out like really how many patients he's treating with acupuncture. For anybody listening to this in here, if you want to check him out, David Kreiner. He's a terrific guy, he should be in the ABO around. Spence: Good call. Maybe I should interview him on here too. Mike: Yeah, he's a great guy to interview. Spence: He must have just been a unique fellow too. I mean it's unique physicians that even take the weekend courses because most are so… I don’t know, so far down the rabbit hole. I mean, they were specialists that have been in school for a quarter of their life, so, for them to delve into something that is now more so, but when he went even less so rooted in evidence-based. But one thing I’d love to digress too because you’d be able to shed some good light on this, you started working with IVF docs late ‘90s. Between then and now, holy shit, their industry has changed a lot as well, and the recognition just like acupuncture by the public and the acceptance, and once you get down the rabbit hole, you and I both know that they're not always practicing evidence-based medicine either. It's up to them to kind of figure out their way in and see what's best for their patients, which is surely nice to see. But what's that looked like, because you've seen it from the day where two, three embryos are being transferred to stuff we're seeing now. Mike: There's a lot of changes going on right now. Some new interesting discussion that's going on is the value of PGD. Spence: Preimplantation Genetic Diagnosis. Mike: Yes. There's a guy who's name is Jeffrey Braverman, also somewhere in Long Island, and he's not a reproductive endocrinologist, he was actually an OB-GYN, but he just quit being an obstetrician and just went into fertility treatment. And he specialized in immunological disorders and stuff. He did the study with somebody else, his name I don't recall, but they basically found that if you transfer bad embryos, meaning aneuploid embryos frequently healthy babies are born as a result of these bad embryos. So, there's no consensus on this either but kind of what some of the new thinking is, it’s just like, forget the PGD, just transfer it because it could be good even though it looks bad. If it's bad, you can abort. I'm going to ask you to hold on one quick second, I'm just almost out of power. Hold on a minute, sorry. Spence, No problem. We'll keep following with you here. I'm just going to touch on, I attend the same conferences you do, ASRM when I feel like I need to. The Canadian equivalent to that, which is CFAS. And these are all fertility and andrology related societies that are government, country essentially. And the way their practitioners practice and the debates that they set up between experts in the field and just the differences in opinions and thoughts on stuff that seemingly is super solid evidence-based, scientific reproductive medical practices just isn't the case. And it's nice as an acupuncturist to get far enough down our specialized rabbit hole to see that. Because it gives you confidence that, for me at least, I can speak for myself, that if I focus on my patients and use the medicine that we have, and integrated with these other people that I'm good friends with as well in these parts of the world, it really truly is that, how did you put that, it takes a village, the new gold standard. Because we're really focusing on different things and can really complement one another. So, hopefully that gives people confidence. Mike: Yeah, well, that's just very well stated. I mean, here's the bottom line, medically. The bottom line medically is this: let's just talk about in vitro fertilization. You give a patient gonado-tropins, develop follicles, retrieve eggs, do ICSI, create embryos and transfer them. So, the success of an IVF depends on several factors: no mitigating disease, like for example PCOS patients are twice as likely to miscarry as the non-PCOS population. Endometriosis can cause infertility even in the abscess tubular damage. So, no mitigating diseases, a healthy lining, a normally functioning immune system, good sperm and good egg. If you look at IVF, they give the patient gonado-tropins and stimulate folliculogenesis, retrieve eggs from the follicles, mix them with the sperm, get an embryo and transfer it. This is not to knock IVF because there's been more than three million babies born as a result of IVF. IVF is a great thing. But a lot of ideas, perhaps most, don't work, and here's why they don't work. Let me restate. The most essential piece you need is a good egg and a good sperm. So, when a reproductive endocrinologist does a retrieval and fertilizes the egg and then transfers the embryo, they're only transferring what the patient is presenting. You have this guy's sperm and you have her egg, but if neither one of them are good, if the sperm is bad or the egg is bad, the woman's not going to get pregnant or she's going to miscarry a chemical pregnancy. IVF is a very mechanical thing. The difference between acupuncture and IVF, from my perspective, it's a very interesting thing. What I say to patients, it sounds quite odd, but I'm not really here to try to get you pregnant, and they kind of have a perplexed look. Spence: Like, did I come to the right place? Mike Exactly. I specialized in back pain, what are you doing here? No. They said, what do you mean, and I said, listen, I can't get you're pregnant, you know, only you can get you pregnant, you and your husband or you and your partner. I can't do anything, I can't get you pregnant, but what I can do is, I can improve your chances of getting pregnant by potentially improving egg quality and lining quality, or trying to regulate the period because if the cycles are not regulated, you don't know when to have intercourse, when do you ovulate, this kind of thing. It's not really about getting the patient pregnant, it's about getting – look, let's talk about boxing. You can't say that you can make up your fighter, I'm managing the fight or make believe. I can't say I'm going to make my fighter to win, I can only say I'm going to train him to the best of my ability, give them all the knowledge that I have, but then it's up to him. That’s how it is with the patients. I'm going to try to improve the egg quality, I'm going to try to improve the lining quality and distress the patient, I admit. And then she's going to get pregnant or not. But with IVF, it's just taking the egg, taking the sperm, putting it together and transferring the embryo, so there's a lot more to getting pregnant than IVF. There's improving the constituent components that are necessary to get pregnant. Acupuncture is the best thing to do while going through IVF. Because most causes of infertility, the largest cause of infertility, the biggest cause is egg quality. Spence: Primarily because of age. In the efforts to produce video for my clinic website, etc, etc, I interviewed a couple of local REs, good friends of mine, and they of course talked about that stress piece. And anything that someone can do to relieve stress, it will benefit them in my treatment protocols, which is great step one. But step two, they say IVF basically is a tool or a technique that gets couples or women or couples over a hurdle, but we don't do anything really to help with prevention of miscarriage unless we go into some of this PGD maybe. But what acupuncture and Chinese medicine is doing for people is creating more of an optimal environment for eggs to flourish in, for sperm to flourish in and for a pregnancy to carry. Mike: Absolutely. I love that. Mike: Yeah, 100%. By the way, just getting back to PGD for a second, just briefly. Spence: Can you explain that to people because that might be a little bit beyond? Mike: Well, PGD, as you said, is Preimplantation Genetic Diagnosis, and what they do is they do PGD on day five. In the old days, they did a PGD on an embryo on a day three, and they took out a blastomere, which is a cell, and the general consensus was taking out one cell from an embryo wasn't going to harm the embryo, and it probably didn't. And the reason they switched to day five was because they would find these minor mosaicisms, the eggs weren't good, they were aneuploid on day three, and they would throw them in the garbage. But what then they discovered is that if you have a day three embryo that has a minor mosaicism, and you let it stay in the Petri dish for two days more, many times the mosaicism corrected, so they had a good embryo. Now, what they do is they don't do that anymore. They do PGD on a day five embryo which is a Blastocyst, and they don't take a cell, they take a little bit of the Trophectoderm, which is going to be the placenta essentially, So, it’s not really invading the Inner Cell Mass, if you will, of the embryo, they're just taking it from the edge, and they're looking for chromosomal abnormalities. Trisomy 18, trisomy, 21 trisomy 13, etc, etc. But the interesting thing about PGD that I find fascinating is that patient gets their embryo as PGD, and they come back good, meaning negative, there's nothing wrong with them. They're euploidic. I don’t know anything about these grading systems, but it's like four triple B, it's like a great embryo, whatever. And they transfer the embryo and she gets pregnant. So, the big question then therefore is why not, and the answer is nobody knows. But what I put through consideration is that reproductive medicine today is not what it was 40 years ago, but it's not what it's going to be ten years from now. Reproductive medicine today is based on the current capability of the diagnostics available today, but the diagnostics in five or ten years are going to be much better and much more efficacious. PGD is a very iffy thing. It can tell when there's a chromosomal abnormality so you can tell when it's bad. But I don't believe you can necessarily tell if it's good. Spence: That's maybe God's work a bit, or it always remain that way, I don't know. Mike: Yeah, who knows. But it's real interesting, and like you said, it's all about creating a better environment for the whole body and the whole mind, for the whole soul. By the way, I want to talk a little bit about stress. I've always had a big pet peeve about it, with acupuncturists, with reproductive doctors, a lot of people talk about stress, stress, stress, stress, stress. But check this out. Let's talk about Syria right now, there's a war going on in Syria. The Russians are there, we're probably there, the Syrians are there, this guy Bashar, is that his name? He's poisoning his own people with toxic gas killing, kids all this stuff. So, here's my question, not for you, but it's just a general rhetorical question: are there any women living in the village that's getting pregnant? And the answer is many, many, many, many women are getting pregnant. Let's talk about New York City, which is where I live. I can't talk too much about Canada, I've only been there a couple times, but I've lived here for 50 years. So, certain parts of New York are beautiful and expensive, you have to be really rich to live there and certain parts are like bad hoods, like the projects, abject poverty, everybody's getting high, the women are prostitutes, crack addicts, they got no money. If they've had money, they’d buy crack and not feeding their kids with it. I mean, tough times. Guess what? They get pregnant all the time. I'm very curious, in fact, what the relationship is between stress and infertility. And I think that I have an answer, which is completely not based on any evidence or any studies, it's just based on my own experience. Here we go. I think stress affects different people differently. I think the stress may be a mitigating factor of infertility but it may not be at all. And I think that as acupuncturists, it's important to try to distress the patient. That's not the most important thing. The most important thing is to improve the egg quality. Spence: Right, and if stress is a part of that, that's a part of that. But if it's not, it's not. Mike: Look, everybody's stressed. I ask every patient to run my intake. I say, using the words mild, moderate, severe, which word best describes your anxiety level. And they all say either moderate or severe. And then I say, are you depressed and most of them will say yes. And I'll say that's good, and they'll look at me like, what do you mean it's good. I'll say, well, if you weren't anxious and you weren't depressed, you'd be insane. Spence: You’d be lying to me. Mike: You’d be lying to me, right. How can anybody in 2018 not be depressed and anxious? I mean the world is in bad shape. In any event, stress is a little bit in my opinion overplayed. Get the embryos good, get the eggs good, get the lining good, get the sperm good, then she's going to get pregnant. Spence: If people know that you're working toward improving a quality, improving sperm, improving the reproductive environment, that in turn is going to help with their stress anyway. Mike: Absolutely. Spence: That's their goal, well, their goal is baby, but their health-related goals to get there are clear, and often in life, maybe stress is just from chaos, from lack of direction. If we can gift-wrap what we're trying to do for them, a little bit put a bowl on it, that in turn would help with the stress and their ultimate goal. Mike: I agree. That's a very, very well-stated piece of information. I agree with you completely. Spence: You can reach us super logistics. The Berkeley Center’s been around for two decades now. Congratulations on that. Mike: Thanks. Spence: Number two, can you explain a bit of its progression, like it started with you and a buddy from school but then lots has changed since obviously. You brought on associates, you expanded, you went into an IVF clinic you said for a bit. Mike: Yeah. I started right out of school with this fellow, this partner that I had, and it didn't work out. We were kind of thrown out of the building because they were going to turn the building into a hotel, so that was the perfect time for he and I to separate. And so then, I went and took another office, and my office was two treatment rooms with a waiting room that could house about two people, three people, a small office for myself. Spence: This is Manhattan, this is expensive square footage, I’m expecting. Mike: Yeah. I mean, it was pretty cheap actually at that time, but then my lease was coming up and they didn't want to renew my lease because they didn't want any medical on the building. They were trying to get rid of all medical. So, I was always taking these offices for like two year of leases and stuff like that. And so I decided that I was actually going to do something big and I was going to literally build a space. That's the space that you saw. The space that you were in, you have to realize, was like a disgusting, horrific garbage dump. Like, the broker took me up to the real estate broker, and I'm like, dude, are you kidding me. Spence: It was nice when I was there. Mike: Here's the thing. I have no foresight, I can never envision what something is going to look like, I'm very bad at that. Some people can like look at something and just see it. I can't. I look at an empty, horrible space and that's all I can see. So, this real estate broker was a really cool guy. He says, wait a minute, and he's not an architect, he’s a real estate broker. He takes an envelope out of his pocket and he says, Mike, have you got a pen. I get him the pen and he draws out a plan on the back of the envelope. I'm like, holy crap, man, this could work. So, then I call an architect and I get the architect up there, and he says, yeah, you know, it's going to be a big job because we're going to turn this place into something nice. Spence: Big job like 50 to 100? Mike: Oh, man, I put a lot of money, like 18 grand. The floor you were standing on, I put it in. The ceiling, I put it in. Spence: The lights, the HVAC. Mike: The front desk, I mean, it was just endless. I would go there to run the build-out and I would like get a panic attack. Eight guys in there and wires would be hanging from the ceilings, and dust and plaster would be around, this guy is drilling, this guy's sawing, and I'm like, you got to be kidding. This is never ever going to manifest. I mean, this is just like insane. It was like bombing the place. I just couldn't picture it. And they built me a beautiful space, and I spent a fortune of money to do it. I took a 10-year lease, which is a frightening thing. What happens if you're doing bad and you're screwing the rent, and my rent is a lot, my rent is about $15,000 a month for that space. Spence: Wow. How did you get through the anxiety of that? I mean, you knew what was coming, you must have had a fairly busy practice by that point. Mike: Yeah, I had a busy practice. Like I said, I did a lot of martial arts, it's like when you're fighting somebody, you can counter punch and stuff, but at some point, you have to like go in and like take this guy out. You just have to go in, you have to walk forward, and just like, you make it, you got to step up. I said, I don’t care, I'm going to put this all on my credit cards, I'm going to borrow money from the bank. If I fail, I fail. That's it, screw it. Spence: You just wanted to take that leaping. Mike: Yeah, I just did. It hasn't always been easy. I mean, business is like for me and for everybody else. Any acupuncturist that tells you they are busy all the time, they're probably not being truthful although some are. But I'm not. I'm not busy all the time. I am a little dismayed, I must admit to you, I'm a little dismayed about my rent. So, I have my apartment rent, it's just like I kind of sometimes think I'm working just to pay my rent. But anyway, so I decided to leave and take this space, and it's benefited me in many ways. Now, when I invite a reproductive endocrinologist to come and visit me, they're thinking they're going to walk into like some one room, like disgusting five-story walk-up, and my clinic is five times nicer than their clinic. Spence: With the acupuncture poster on the wall. Mike: Yeah. Exactly. That's cute, that's great. Now, they come in and they're like, holy goodness. It gives me credibility also. And not only with the docs, but with patients. I have patients that have come from other practitioners, and they are like, oh, I was in Chinatown, I was paying $35 a visit, but you have to walk up six flights of stairs and it was dust all over the floor, the guy didn't speak English. When they come into my clinic, they know they're going to place, and so, I'm proud of that. I'm doing well enough. So, yeah, I just went from this little office, a two-year lease into a complete build out with a 10-year lease, and I've renewed the lease twice, not for ten years but three years. Now I renewed it for two years because I don't know what I'm going to do after those two years. I mean, I'll keep practicing but maybe I'll get out of that $15,000 a month space and just like sublease a space to somebody for 2,500 a month contract. I don't need this. My waiting room can hold 20 people. Spence: Well, you have built your credibility, you are respected, these REs know you, and it took, like you said, you stepping up, you jumping in to the fight to show that you were committed that you had the balls to do it, and that gains a lot of respect. And bottom line, you studied your ass off, you know your shit better than anybody that I know probably as far as reproductive medicine is concerned. I mean, Michael is brilliant, absolutely brilliant. Correct me if I'm wrong, but your relationships with these REs stem from them seeing these qualities in you. You basically do business with people you trust and then people you like. And Mike's very likeable. And that you trust, and that trust came from you showing that you are ready to play. Mike: I keep it very real with doctors. I don't know when they're like, I'm God's gift infertile patient. Basically, I said, you're a mechanic, and I don't mean that in a disrespectful way. I have nothing but respect for you. You spent 15 years in school, you're like the other man or the other woman, I get it, but you're a mechanic, and all you can do is you can use what's presented to you, the sperm and the egg. I said, if you do a transvaginal ultrasound with a color Doppler before a patient gets acupuncture, you see like this tiny little blood in the uterine cavity, the lining, whatever, and then you do acupuncture on the patient, then you do a transvaginal ultrasound with a color Doppler, it's completely red. So, what does that prove? It absolutely perfectly proves non-negotiable, undeniable that acupuncture improves hemodynamics and it does so trophically. If you have Lateral Epicondylitis -- that's this -- you put a needle in there, and why do you put the needle in it? Well, let's just talk from western medicine. It's bringing blood to the area, it's the body that says, help, I'm being invaded by something. And all this blood flow and immunological mitigators come to the area, and now your elbow feels better. It's trophic, you know. When you do the correct acupuncture points, you're trying to reach the ovaries and more importantly the follicles and the eggs. So, I tell them, look, what I do can't hurt your patients. I may not help your patient, but I won't hurt your patient. But I may help your patient. So, let's just do it, man. I'm happy to refer patients to you, and if you think it's appropriate, I'd be totally grateful for your referrals, and I just keep it low-key and straight up, and they're cool with that. Spence: Can I ask you -- because there's people watching, saying I want to talk to doctors, and I'm going to be relentless like Mike was, I'm going to keep on them, and luckily, acupuncturists today have a massive body of research, which wasn't there 10, 15, 20 years ago, which they can lay out in front of them and say, this may not be perfect but at least there's a start. I think acupuncturists when they first get out of school are very caught up in the sinophilia or that passion that Chinese medicine can help everything. And when you spoke to these specialists, how often did you use the word chi or yin or yang? Mike: Never. Spence: Thank you. Mike: Never ever once. Spence: You have to reframe it. Mike: As soon as you get in front of a doctor, and in fact, I don't even talk that way to patients. Once you talk like that to a patient, they just think this guy's an idiot, he doesn't know what he's doing. Do you speak German? Spence: No. Mike: Neither do I. Let's just make believe that I did. If I just started speaking to you in German right now, you wouldn't know what I was talking about. So, how could we have a conversation, how could we relate to each other? You have to have a common ground that enables good back-and-forth communication. Patients don't know what Chi is, and yin and yang, yin deficiency, yang deficiency, they don't know what that stuff is. So, I only talk Western medicine. Now, sometimes a patient will ask me how does acupuncture help, and I'll explain it in western terms. I'll say, look, basically what acupuncture does in my hands is it improves hemodynamics to your ovaries, which improves the delivery of blah, blah, blah, blah, blah, and improves the excretion of debris. And as a result, as a possibility that we can improve your eggs, the egg quality. We're working on primordial follicles, not follicles at 7mm or 8mm or 10mm, we're working on follicles that are measured in micrometers, not millimeters. And hopefully by the time it becomes a mature follicle, it may be better than the last cohort of follicles. And so, I never talk that way to a patient, I never talk that way to a doctor, I basically tell the doctor the same thing I tell to a patient. And the doctor can understand that. And then when the doctor says to me, well, how do you know that it improves blood flow? I just told him the story that I told you about the transvaginal ultrasound with a color Doppler, and it's undeniable, they can't say anything to me. I say, bro, let's do it together. Spence: Yeah, they've all got them in there office. This is great but we could go on forever, and I'm excited to see you in a couple months so we can hang out, have some dinner and carry on this conversation. Mike: I forget you've been going to the courses. Let's meet at 8:00 in the morning, have breakfast and just have drinks all day and dinner at night and we'll just hang out. Spence: Tell Lauren to sign us in. Mike: Exactly. Spence: I'm excited about that but I don't want to take up too much of your time today, I know you've got some personal nourishment plans, but what are you doing these days, what are you passionate about? I see the articles that you write, that you post on LinkedIn and Facebook, they are brilliant. Anyone wanting to treat fertility with acupuncture, could just follow Mike and there's your education, but what are you up to? Mike: That's very kind of you to say. I'm so grateful, it's so sweet, thank you very much. My life is a little different now. For years, I was doing nothing but Chinese medicine. I mean, just studying, going to every ASRM --what is it called? It's a thing in Canada that we're going to. Spence: It’s CFAS is our Western medical counterpart to ASRM. Mike: Yeah. That was just my life, and now it no longer is. I mean, it's now a part of my life. I trained judo, which is completely insane based on my age, but that's probably why I chose to do it because I'm one of these guys, like, I jumped in and built the clinic. I don't care, I'm 61 years old and I'm fighting with 25-year olds, bring it, bro. I'm just having a great time with that, I'm in the gym two to three days a week, I do judo four times a week. I'm about staying in good shape, I'm about learning this new martial art. I mean, I'm doing it for six years, but it's really hard for me and I'm not very good at it. But I still enjoy it, it's fun for me, and I'm being a lot more social. Like in the past, I wouldn't even see anybody, I can't, bro, I can't. I got to study, man, tomorrow. Now, I go to parties, I'm just, like, more human, I'm just more relaxed, I'm just chilling as we say in New York. I'm working hard, but I'm not working that hard. Like, today's Monday, I'm not at work. I take Mondays off. I give myself a three-day weekend. So, there's a lot that I want to do. I love to sing, I'd like to take voice lessons. I never seem to get to do it just because I can't do many more things, I'm just always involved. I really like photography though I've never taken many pictures, but I wanted to take a photography class. Spence: You are finding balance. Mike: Yeah, I'm finding balance after all this time. Spence: You are practicing the medicine personally more. Mike: That's such a cool thing you just said. I couldn't do that in the beginning. In fact, I don't think any of us can do it in the beginning. Like it takes years to get to that and I'm finally there. I'm not sitting here saying to myself, Spence, check this out. If this was 10 years ago, I'd be like, dude, what are you doing home, what is wrong with you, get your butt up and get into the office. Even if you don't have any patients, go in there and do something, be productive. Let me tell you what I'm doing when you want to hang up. I'm going to get into bed and I'm going to finish reading some silly novel that I'm reading. Then I may decide to shave if I can get the energy up to do it. Then I'm going to this wonderful food store called Whole Foods, and I'm going to go shopping. And then tonight, I'm going to have dinner with a friend, have a couple of glasses of wine and come home, go to sleep at 11 o'clock and then go to work tomorrow. That's what I'm doing with the rest of my day. And I have to tell you that I absolutely love it. There's a lot of like tension of having to build the practice and having to be on stage every single day that's just gone like this. I'm much more mellow, I'm much more comfortable in my own skin. And you know, I just want to give one more message, which again, I'm just segwaying here. Some things I see online on these acupuncture things on Facebook, you know, there's different acupuncture sites, acupuncture for infertility, all these different pages and groups. I see something like this. I see it not infrequently, like, I have a patient and I think she has endometriosis, what's the best way for me to treat her? Now, when I read that, it causes me tremendous dismay because it shows me that you don't know what the hell you're talking about or what the hell you're doing. First of all, you don't know if the patient has endometriosis. If you do an ultrasound and she has endometriosis on the ovary, you can see it. If you can't see it on the ovaries, you can still have it. How do you see it? Through a diagnostic laparoscopy exactly. And number two, you cannot treat it. What can treat it? Laparoscopy. Here's another thing. Oh, my patient has a 10cm fibroid, can somebody recommend like an herbal formula to like shrink the fibroid. Listen, are you tripping, are you like smoking that ganja? She needs to go to the hospital and get a surgery and get a myomectomy. So, my message, this is not to the brilliant acupuncturists, it's to the ones that have the potential to be brilliant, the ones who would just let me out, it's stay in your lane, know what you can do, but more importantly, know what you can't do. This is not about you, it's about your patient. It's not about you proving that you can shrink a humongous fibroid. It's not about you thinking you can treat endometriosis. You can't. So, just give it up, do what you can do and that's a really important lesson. You don't have to be God, you're not God, you're the acupuncturist. Do your job. That's a very important thing for acupuncturist to know. Spence: If I can reframe, you've seen acupuncture really fall into finding its place, and what it can help with and what it can't, and that is wisdom that should be out there now because of people like yourself, you know, that have done the work, and seeing what's possible and what's not. And that information is out there. So, there's no excuse to be making these ridiculous traditional Chinese medicine can treat anything promises. Mike: Absolutely. Spence: I couldn’t agree more. Why would you ever want to pretend that you can do something that you have no idea? Mike: I don't think they're pretending, because pretending is like a malicious act. What they actually think is they believe that they can do it. There's two things if they play into this. One is ego. I can fix anything, and the other thing is, oh, I hate Western medicine, I hate drugs, these doctors, all they want to do is surgery. Listen, I'm going to tell this listening audience the following: if Western medicine was not extent, we would all be dead by the time we're 35 years old. Western medicine is brilliant, it's important, its life-giving, its life-saving, it is to be embraced. Do doctors give out inappropriate prescriptions for opioids? Yes. Do doctors do some bad things? Yes. Many acupuncturists hate Western medicine. I mean, that's a sure sign of ignorance. Remember, it takes a village. They can do things we cannot do. Don't forget that. And we could do things they cannot do. Don't forget that. And that's why this is how it should look, not this. This is how it should look. I tell acupuncturists, embrace Western medicine, embrace reproductive medicine, embrace Chinese medicine. Dan Inosanto who was one of Bruce Lee's trainers and teachers and friends, he wrote this book, I think it was Dan Inosanto, might have been Bruce Lee, but the name of the book is Absorb What Is Useful and discard the rest. And that's good information, you know. If your patient is trying to get pregnant and she can't, send her to a reproductive endocrinologist. I don't treat a patient, I will not treat a patient unless she's being seen by an RE. Listen, how do you know her tubes are good? How do you know she doesn’t have five big polyps, how do you know she doesn't have fibroids in the fundus, how do you know the guy's sperm is good, how do you know she doesn’t have some autoimmune stuff that's attacking the embryos, activated natural killer cells? You don't know anything. Oh, I know. I know, excuse me, you're going to get all the data from the pulse in the tongue. Not. Spence: I couldn't agree more. This is great info, and thank you for your willingness to share and be honest, because that is what people are searching for these days. You've been in this racket for twenty years and you have seen a lot. You didn't sit on the outskirts, you needed to be the primary breadwinner of your life, so this had to be a career, not a hobby. You just did what it took and you were at the start of a curve. You are the right guy to be there because you got the balls in the drive and the passion. Mike: Thank you so much, it’s so kind of you. Spence: We appreciate you, and the newer practitioner should even more so about the realistic nature of what you're getting into and how it shouldn't be some sort of dogmatic baloney. It's about what can you help, find that out and deliver it and be honest. Mike: 100% I agree. I'm with you, man. Spence: Awesome, that's great. Thank you. To gift-wrap what you're passionate about, now, these days is you and your health and your life. Mike: That's right. I love to eat, I love to go to good restaurants, I like to travel. And I've been to Barcelona, I've been to Florence, I go to Puerto Rico all the time, I go to South Beach Florida. Spence: Vancouver. Mike: Yeah, I love Vancouver, and you know what, I went to Montreal on vacation, which is lovely. So, yeah, it's true, I'm just spending more time enjoying me and my relationship to the world and to the community. I'm still very much involved in the medicine, but it's just not who I am in total anymore. And I must tell you it feels good. Spence: Do you believe that there's ways that people could fast forward to where you're at, or is there just a process that everyone has to go through it? You got to work hard, you got to persevere, you got to learn and gain wisdom, you just can't buy that. Mike: It's a great question and I'm not sure I have an answer. I can only talk about my journey, and there's like nothing that I did. It's like, well, let me tell you this thing. Ten years ago when I started meditating, that changed my life. No, that's not true. I never did that. There's nothing that I did that like flipped the switch. I want to tell you what I think. It’s going to sound kind of odd. I got tired physically and emotionally, I mean, I'm very good-shaped physically, but it's been like treating patients all day long, and I love my patients, I love to treat, but it's exhausting. And doing this like 21 years, man, I just got beat. I'm in the game still, but I just said, dude, listen, you could be dead tomorrow, you could have a heart attack, you've got to just start to pay attention to what you want to do. I want to do the medicine, but it's not all I want to do. No. Think that somebody has to get tired first, or else they have to be really, really wise. And I wasn't really wise, I just had to get beat up a little bit. And I said, okay, I'm going to start reading some novels again and like relaxing. Spence: Thank you. That's why I want to do these podcasts, mostly for selfish reasons, but learn from people, the people that are ripping it in different ways, and that I've grown to respect and that are respected in the industry and stuff, and find out like, well, what's the wisdom you've got now and what got you there. Maybe we can expedite our own journeys or the listeners’ or your journeys toward this rule way or whatever the hell you want to call it. Just taking care of yourself, practicing our own medicine on ourselves. Thank you so much, you are always honest, you're always great. I look forward to seeing you again soon at the IFS. It would be awesome. Mike: I want to thank you so much for this great opportunity, I've really enjoyed it. Just being able to see you, it's nice, because I miss you. It's great to see you and this was a lot of fun, just took a fun conversation. I hope that I made some kind of minor contribution to anybody that's listening. Man, thank you so much, and I can't wait to give you a hug, man, and have dinner and drinks and have a great time. Spence: We will for sure. Mike: Okay. God bless! Spence: I'm excited. God bless you too, and we'll chat with you again very soon. Thanks for being here today. Mike: I'll see you in April.