Whole Woman Health: Carrie Levine

Lisa Belisle: I am Dr. Lisa Belisle and you are listening to or watching Radio Maine, our video podcast where we celebrate creativity and the human spirit. Today I have with me really somebody I've known for such a long time, Carrie Levine, who in addition to being a wonderful human is also a Certified Nurse Midwife and certified functional medicine practitioner and the founder of Whole Woman Health, and, so exciting for me, the author of this lovely book that those of you who are watching on video can actually see. This is Whole Woman Health: A Guide to Creating Wellness for Any Age and Stage. Thank you for coming in today.

Carrie Levine: Thank you for having me. It's so good to see you.

Lisa Belisle: It's good to see you too. I feel like we intersected at this really pivotal point. The last time I interviewed you, a couple of radio shows ago, I told everybody, but it bears repeating because it's a great story, that I was a young medical student resident and you were a nurse on labor and delivery. I was obviously scared out of my mind with all these laboring women, where it got very intense at times. You were this calming influence and just great at helping bring me along as a practitioner. I love the fact that you have continued to evolve as your own practitioner along your lifespan professionally, and that you and I keep bumping up against each other like, oh, here you are again. Hi, Carrie. Good to see you.

Carrie Levine: I know, I know. Concentric circles. It's pretty lovely. My time at Maine Med when I was a nurse was like my crash course in high risk obstetrics. And the nurses there were so not happy to have me because they knew I was going to be a midwife and they were cranky that I hadn't done med surg for a couple years. The nurse who trained me, Diane, I will remember her forever, and boy did she give me some pearls, but it took me a while to get her to warm up to me. They just thought I didn't have any place without having done med-surg for a couple years. I'm grateful for all that I learned when I was there. And there's a handful of you all who were there at the same time, a handful of residents who every now and again I bump into and it's so heartwarming. I feel like we kind of grew up together in a funny kind of way.

Lisa Belisle: Yes, we were like little clinicians. We were like young clinicians.

Carrie Levine: Are we really grown up enough to do this? Is anybody watching? Shouldn't somebody be watching? That whole imposter syndrome. Oh my gosh, that's a real thing.

Lisa Belisle: I specifically remember when I was a fourth year medical student and I talked to one of my interns and I specifically said, how can I possibly know enough to actually do this job? And she's like, you don't need to know it all right now. You'll know it in a little bit of time, and that's why you have all these people working with you who can help you. There were the clinicians who were helping, but it broadened out. The nurses were so helpful to that educational experience.

Carrie Levine: Oh my gosh, everything. They were everything. So when you see a woman's toes curl, she's probably in transition. That was one of the pearls. And if a woman says the baby's coming, even if you just checked her, the baby's coming. So I carry that wisdom with me still.

Lisa Belisle: It's such an important thing, and it leads into the work that you've chosen to do. It really is about not only listening to women, but giving women the space to listen to themselves. When you're on the labor and delivery floor, a lot of people will sit out at the nurses station and watch the baby's strips and it's just a normal thing. You're like, oh, I can see the baby's heart rate, it looks great, no problem. But what was really valuable was exactly what you're describing, to actually be in there with the laboring woman and be like, okay, I know what the strip is showing, but I want to understand how your body is explaining this to you and how your body's explaining this to me as well.

Carrie Levine: Yeah. I remember charging into Hector Tarraza's office. For people who don't know who he is, he was the Chief of OB GYN. I remember charging into his office in all my youth and naivete and saying, you have to have those residents sit an entire labor from beginning to end, because they're walking in and they're seeing two minutes and they think they know what's going on and they often don't know what's going on. It has to be a requirement to labor sit one woman beginning to end. You really can't get a sense in two minutes, or from the desk, about the trajectory of what's happening in the room. And really, it took me many, many years at Miles Memorial Hospital, in a small town hospital with a really low volume of births, before I walked into a room and felt like more or less I could meet whatever was happening without feeling super scared.

It was probably five years before I no longer felt like an imposter. And then I only did births for another two and a half, so I wasn't in that space of comfort for very long. But there was a giant parallel between labor and birth and the work that I do now. It's so similar. Any woman in transition is essentially in a labor, there are just different ways to labor, and it has felt that way to me through my entire career. Different kinds of labors with different outcomes. Sometimes you get a baby, with any luck at a different point in life you get yourself, but they're intense processes and it's a space that for whatever reason I'm happy and comfortable in. I think it stems back to working with women in the outdoors, doing physically challenging things, which I did as a kid. I did my first outdoor trip when I was 13, and was hiking on the AT and biking in Nova Scotia and doing physically hard things that I didn't think that I could do, and learned how to do them, and then brought those skills to climbing and mountaineering with women, and then brought those same skills to the labor room, and then brought those skills to women in health crises, and bring those skills to midlife women. It's like the canvas changes, but the paintbrush is similar in some ways.

Lisa Belisle: When you describe this person charging in to see Hector, it speaks to this important fierceness in you that is a modeling that I think is really important. You provide space, but you're also like, no, we're not going to let other people tell us what we think. We're going to engage ourselves and we're going to figure out what we think ourselves and we're going to work on this. I love this visual of you sort of hiking side by side up this steep hill and you're like, nope, we're going to keep going. Let's go. You kind of have to be fierce to do that, right?

Carrie Levine: I think you do. I have to have an inner resiliency that I've kind of always had. I don't know exactly why or where it came from, but it's a darn good thing I've had it through my life, needed it for sure. It's the kind of resiliency that lets you run your own business even when you're like, I don't know, it's taking a really long time, and all the self-doubt floods in. I've had it from a kind of weirdly young age. I had trouble sleeping as a kid and I can remember being 12 years old and going to a used bookstore in Brookline, Massachusetts and finding The Relaxation Response by Herbert Benson. So at 12 or 13 years old, I'm reading a book about TM to try and figure out how to help myself sleep. I don't really know where that came from. It just came. And visiting the crystal healing store and going to yoga in 1985 before everybody and their sister was going to yoga. It's just been my inner compass. I don't know exactly where it came from.

Lisa Belisle: And functional medicine is absolutely an extension of that.

Carrie Levine: For sure, because that's one of the things that drew me to midwifery. I did my midwifery training through Case Western Reserve and an affiliate program called the Frontier Nursing Service at the time, which was started by a senator's daughter who wanted to care for the hills people in Kentucky. So she put nurses on horseback and sent them into the hills and they would teach public health things like, if you're doing your laundry here, you might want to get your cooking water from over there, and maybe you want to have your outhouse a little bit further away from the river. These are the kinds of things that these nurses taught to the hills people in Kentucky. When I went there, I have the most vivid memory of, during orientation, there was an instructor drawing a diagram on the board about all the disciplines that midwifery draws from, and we were brainstorming together all the disciplines, and it was nursing and medicine and herbalism and public health and social work and psychiatry, among other things.

I felt so at home in that way. It was so much less about the baby part and so much more about the interdisciplinary nature of midwifery. And then when I stopped delivering babies and went to Women to Women in Yarmouth, that was where I was introduced to functional medicine. The language of functional medicine was everything that I had understood about health but hadn't had the language for, because it's never been for me either-or. It's never been all natural or medicine. It's just never been that way. I think back to when I was an undergrad, I started at UMaine Orono and I worked as a counselor in the women's clinic. So this was 1988, and the director at the time was a woman named Ruth Lockhart, who was one of the founding mothers of the Mabel Wadsworth Women's Health Center in Bangor, a feminist health clinic.

At the time, there was no building. At the time Mabel was still alive and it was just an idea. And they were running conferences called Health in Our Hands. So at this conference, Chris Northrup, who was a Maine based OB GYN who wrote Women's Bodies, Women's Wisdom and was one of the founding mothers of Women to Women, who was iconic at the time, and Deb Soule, who is the founder of Avena Botanicals, a beautiful Maine based herbal apothecary, were on the stage together, and they spoke together. That was my aha moment of, it's not either-or. It is not either-or. It is what each woman wants for herself, and largely dependent on her circumstances. That was so clarifying for me.

Functional medicine gave me the structure to hang those ideas on, which has been amazing and has helped people get better, which is also amazing. And not just by a lengthening list of medications, but by really holding women as they change their lives and refine their lifestyle for their optimal health and wellness. It's quite compelling, when women come back. At Women to Women, we were an international icon. Women would show up from all over the world, they'd show up with their giant binders, having been to Mayo, been to Hopkins, been to Dana-Farber, had the executive workups, slide the binder across the table and be like, here's all the testing I've had. The doctors say I'm fine and I can't make my way through a day at work. And I'm like, okay, wow, I am really not qualified to help you. That's the feeling running through my body at the time. And the grounding principle of, start with the gut. Start with the gut. If you don't know where to start, start with the gut. And have women come back and say, I'm better. Not always, not always a hundred percent, I'm not inflating this in any way, but to hold women as they change their life, change what they eat, change how they manage stress, change how they move their body, correct underlying physiologic imbalances, and have them come back and say I'm better, is pretty compelling.

Lisa Belisle: One of the things that I'm struck by is that you wrote this book, and you suggested to me before we came on air that it was actually pretty easy to write this book. I look at it like, yes, it can be easy because all the information is flowing through you. It's like an artist. Somebody saying, well, why does that painting cost so much money? It only took you 10 minutes to make it. No, it took me my entire career to make it. So this book, sure, you had become so practiced in what you wanted to talk about that it was there, it was just below the surface, but it took you decades actually to write this book.

Carrie Levine: I totally hear what you're saying. It was only easy because all points led me to there, so to speak, is what I'm hearing you say. I think that's really true in so many ways. I have always wanted to write a book since I was a little kid. It was always a dream of mine. And on that first outdoor trip that I mentioned earlier, I started keeping a journal. So I've been a journal writer since the age of 13. And at every opportunity I would put myself through any writing book program that I could get my hands on, whether it was proprioceptive writing, which was started by a couple of Mainers, or the Artist's Way. Any writing program I could put myself through, I did over the years, through graduate school and delivering babies and having babies and nursing babies and all of that.

So the writing ebbed and flowed over the years, obviously depending on what was going on in my life. But I always came back to it. My husband likes to joke about, you have way more than 10,000 hours of practice writing, but it was never for anybody else. It was always just stream of consciousness. I had a great high school English teacher who taught stream of consciousness. So that was sort of another page in the book, so to speak. And after the passing of my daughter in 2018, a good friend of mine was like, you need to come to this writing group with me, that was held locally in our town with a woman named Jeanette Eaton, an amazing, beautiful woman who was trained in the Amherst Writers method. And I was like, okay. And went to that group, and there were sort of exercises at every group.

Sometimes they were creative, you could participate, you could write your own thing, you could really do whatever you want. But part of the practice was reading your writing out loud, which was horrifying for me because I had never really shared anything I had written before. So speaking it out loud was sort of a step into taking writing out of my body and making it available to other people. I had drafted an outline for a book called Inflammation: The Common Denominator a number of years ago, and had a friend look at it, because in functional medicine, the gut is sort of Grand Central Station, the home of inflammation. And inflammation drives everything, right? High blood pressure, chronic fatigue, fibro, cancer, depression, anxiety. Inflammation is everywhere. I really wanted to simplify some of these ideas, because in so many ways what I do is not really very complicated.

So I had that outline and had brought that outline to the writing group to get some feedback, which was super duper helpful. And then after a session or two of writing group, I don't remember the exact time, it must have then gone into Covid. And I was like, I'm just going to write the book instead of going to writing group. I see patients three days a week, so I've had time that was part of my sanity of raising kids and practicing. So I had some time on those days and I was like, I'm just going to sit down for four hours on Tuesdays and Fridays and I'm going to start writing. And found my way to a writing coach in New York City. So we would Zoom during Covid and we would talk about what was happening in Maine and what was happening in New York City, which was a super fun lifeline.

She helped me develop a book proposal. And once that proposal took off, then it mostly felt like filling in the blanks. It was filling in an outline. And I had had so many women ask me. People come to the clinic now, and they're like, okay, what do you mean my gut has something to do with my eczema? What do you mean my gut has something to do with my hormone imbalance? Where can I read more? Can I read more? Where can I find more information? Is there a book? And there really wasn't an overarching book. In fact, I was dissuaded from writing the book that I wrote, because I was told it's really hard for a person with a small public presence to write a really general book. And I realized that the book publishing industry has done to book writing exactly what healthcare has done to healthcare, which is it has siloed it, right?

You've got your endocrinologist, your gastroenterologist, your gynecologist, and in publishing, you've got your books on hormones and your books on weight loss and your books on digestion. But nobody had written an overarching book about the model. And that was the book that I felt was needed, because that was the book that people were asking me for. And the Institute for Functional Medicine has a teaching tool called the Matrix, which is outlined in the book. And I was like, well, there's a book outline that's easy. Anytime I wasn't sure what to write, I just would close my eyes and ask myself, if a woman was in the office asking you to explain this, what would you say? Because I know what I would say. And then I would just write exactly what I would say, as if I was sitting in the clinic with a woman.

I had done that for long enough that it came relatively easily. And then the other thing with writing the book was not just raising women's awareness about this model, and that there's another way of healthcare that does involve getting to the root cause of what's going on, but to increase access. I write about that a little bit in the book, that functional medicine has a little bit of a public relations problem as being elitist, because a lot of the practices are cash practices, a lot of the tests are not covered by insurance, supplements we all know can be a fortune. And again, so much of what I do is so basic. So I really wanted to give women five lifestyle recommendations, five nutrition recommendations, five nutrient recommendations that they could do for themselves before even getting to a healthcare practitioner's office. I'll use my mom as an example.

I don't think she'll mind if I throw her under the bus, but she had irritable bowel forever. It was terrible. She was pulling over on the side of the highway because she had to go to the bathroom, and she was an avid diet soda drinker. And I was like, mom, get off the artificial sweeteners and see what happens. And lo and behold, she was in huge measure better, and that was without taking a pill at all. So if enough women know artificial sweeteners can cause diarrhea, maybe you don't have irritable bowel, maybe you just need to stop artificial sweeteners. That's something someone can do, if they feel lousy enough they're willing to try things that otherwise seem unfathomable, and sometimes they get better and they never had to see anybody for it. So that was really part of the motivation, increasing access and lowering a price point, and putting, I often think about that Mabel Wadsworth Women's Health conference of Health in Our Hands, just putting health in women's hands. What can we do for ourselves? Are we doing the things that we can do for ourselves? Most of us know we probably could be doing a few other things. Some women are doing all the things and they still don't feel well, and that's a different conversation. They're out there too.

Lisa Belisle: Well, I hope that people take the time to get your book and read it. It's very readable and very accessible, actually. Even as somebody who has practiced medicine for a long time, I could see myself sitting down across the table with a woman and saying, let's look at this book together. I have some limited information about functional medicine, but I'm not a specialist the way that you are. But I feel like it's a way to create a conversation that women could have with somebody, if they can't access a functional medicine provider for whatever reason, they can utilize it. It's very practical. But I want to go back to something that I think is so specific to this book and to you, and you already mentioned it, so I feel like this is a place of opening. Your daughter passed very suddenly and very tragically at a young age. I have to say, I did not hear about this right away, and then I heard about it later, and honestly, I grieved for you after the fact. I'm sure you were still grieving. And in no way am I comparing my experience to yours, but when you brought this up in the book, I'm reading this and I've known you for such a long time, and I was like, oh, Carrie. I felt my heart kind of just stop. I had to stop reading for a minute. Your willingness to bring that into these pages and to speak to your humanity and your experience is so powerful. So it's not simply that you've provided access and information. You're also sharing this really important thing that happened to you in a way that I think can be so healing for other people who have had difficulties.

Carrie Levine: Well, there's this thing that happens that I'm sure you're aware of between people and their healthcare practitioners, and there's an illusion that we are exempt from some of the lessons of humanity, and we are not. I never want any woman to look at me and think she has it all figured out, because I don't. And when I say to women, I am right there with you, I mean it. I am right there with you. I have my challenges, my heartbreak, my troubles, and they're different. I also have sat with women long enough to know we all have them. No matter how anybody looks, we all have them. That can be a tremendous point of connection, and it's essential to healing, to bring those moments to the table. So I guess maybe I feel like, if I can share my vulnerability, maybe that will help someone else be vulnerable and help their healing. And it's lifelong. It doesn't go away. It doesn't go anywhere. She is right here right now, every day all the time, and a large reason why I wrote.

I feel a tremendous responsibility to live my life to the fullest in her honor, because hers got cut short by some measures. Other people might say she lived a lifetime in the 15 years she was alive, because she did, and she was full and passionate and loving and all positive things. Some people might say, well, she didn't need 50 or 70 or 80 years to do her life. That's not really a pill I can swallow, but I appreciate that perspective, because she did love life so much. And I feel like it's my responsibility, as I have her boots on earth, to be and do everything I can and to feel everything I can in her honor, because I'm still embodied and she is not. So she was a huge motivating factor in writing, and she's a huge motivating factor in my work, and she's a huge motivating factor in my healing, here in body or not here in body. She's still around, as the physics tenet would say, energy can neither be created nor destroyed. So that's where I land with it, and that helps me get through my days.

Lisa Belisle: This happened in 2018, and then we had Covid in 2020, not that long after this happened. Whatever structures you probably had in place socially around you, I'm sure some of those disintegrated, leaving you with yourself. And the fact that you channeled this energy toward this book and wrote this, I think it sounds like in her honor in many ways. It speaks to this sort of creativity and this birthing. The pain that you went through in her loss, and here you are creating again. I've read so many books and I've read so many health books, but I just think there's something so special about this particular book, because it's almost like we're laboring with you to some extent, that we're there, and you're like, here's the baby.

Carrie Levine: It's funny because, right in this couple of days, is the one year birthday of the book. So it's pretty funny. This is our first birthday, so we're having our party. A book birthday party.

Lisa Belisle: I love that. I love that. I've got to come to the party.

Carrie Levine: I mean, some people would say things happen for a reason. Of course they do.

Lisa Belisle: Yes. So if you are a woman in Maine or elsewhere, really, that says, okay, I would like to read this book, but I really want to connect with Carrie and really want to learn more about her, you do a lot of your work at this point, right?

Carrie Levine: I do, but I am limited to caring for women within the state.

Lisa Belisle: Okay. Oh, because of licensing issues?

Carrie Levine: Right. So there's the book, there's podcasts, which are fast. It feels fast and furious to me. They're happening a couple a month, and those are all on my website. There's blogging, which happens in varying fits and spurts depending on energy and season and time and other commitments. There's all of that, and I'm thinking about how can I increase access. If people are looking for a functional medicine practitioner, I generally point them to the Institute for Functional Medicine website, and there's a find a practitioner function on their website, so they can type in their zip code and see who is in their community, who can possibly give them this kind of care. I think that so much is personality. You probably know this, right? It's about finding the right match and finding the right personality. So not all family practice doctors, not all nurse midwives, and not all functional medicine practitioners are the same.

It's so much about finding that individual who you feel like you connect with and who sees you and hears you. So I think just because someone practices functional medicine doesn't necessarily mean it's going to be an awesome fit. You still want to have some discernment and filter through intuition and make sure that the person that you're working with feels like the right fit for you. So the Institute for Functional Medicine is a good website for people who are wanting to access this kind of practice model. And for me, there's all the typical social media channels for now.

Lisa Belisle: Tell people who are listening or watching, what is the best place to go?

Carrie Levine: Probably CarrieLevine.CNM on the internet, and then of course Instagram and Facebook as well. There's some posting that happens on LinkedIn. I have not gotten into other channels and probably won't. I'm a reluctant social media participator. I sort of accept that that's part of the reality of healthcare and business in the 21st century. But it's not really a place where I'm excited to put too much energy, other than that people find me there and find information and help, which is good.

Lisa Belisle: I agree. I guess I can say that I am proud of you the way that I would be proud of any laboring woman who actually did the work to bring something into the world. I don't think I am being maternalistic or paternalistic by saying I'm proud of you. I'm proud of you.

Carrie Levine: Thank you, Lisa.

Lisa Belisle: You worked very hard to bring this into the world, and it's just a pleasure to be able to celebrate this on the first birthday of your baby book.

Carrie Levine: Yes, exactly. Thank you for having me.

Lisa Belisle: Thank you for coming in. I'm Dr. Lisa Belisle, and you have been listening to or watching Radio Maine. Today my guest has been Carrie Levine, Certified Nurse Midwife, certified functional medicine practitioner, a longtime friend and author of Whole Woman Health. So please do read her book. It is just a lot of wisdom, practical knowledge, all kind of rolled into one. Please do check out her website. She and I continue to connect also through art related things, which we didn't even get a chance to talk about today. So maybe someday we can convince her to come down to the Portland Art Gallery to one of our openings, and maybe who knows what will happen on the second birthday of the book baby. Thank you for coming.

Carrie Levine: Thank you.