After graduating first in her class at The State University of New York Medical Center, Dr. Mimi Guarneri began her career at Scripps Clinic, in San Diego, as an attending physician in interventional cardiology, where she placed thousands of coronary stents. Recognizing the need for more comprehensive and holistic approaches, she founded the Scripps Center for Integrative Medicine and served as medical director for 15 years, combining state-of-the-art cardiac imaging technology with lifestyle programs and alternative therapies like acupuncture, healing touch, meditation and yoga to diagnose, prevent and treat cardiovascular disease.   

Guarneri is board certified in cardiovascular disease, internal medicine, nuclear cardiology and integrative holistic medicine. She is a founder and president of The Academy of Integrative Health and Medicine; co-founder and medical director of Guarneri Integrative Health, in La Jolla, California; and a clinical associate professor at University of California, San Diego. In 2012, The Institute for Functional Medicine honored her with the Linus Pauling Functional Medicine Lifetime Achievement Award. Guarneri is the author of The Heart Speaks: A Cardiologist Reveals the Secret Language of Healing and 108 Pearls to Awaken Your Healing Potential.

What is holistic cardiology?

It’s about treating the whole person—body, mind, emotions and spirit. If you have a tree with sick fruit on it, you can keep cutting off the branches, or you can ask, what does the tree need? Does it need more sunlight or water? How is the soil? Does it have minerals? 

With patients, the question we should be asking is why does someone have diabetes, high blood pressure or heart disease? And then you ask, what is the soil of a human life made of? That soil is made of micro and macro nutrients, physical activity, having a purpose in life, joy and a good night’s sleep. At our center we call these the pearls of health.

How do you diagnose people by listening to their stories?

We know through research that relationships between patients and physicians affect outcome. People who bond with their physicians have lower cholesterol or blood sugar levels because they’re more likely to be compliant with medications. We also know that events don’t happen in isolation. When people have major, life-changing events—death of a spouse or child, divorce—all of a sudden, they start having cancer, sudden death and heart attacks. 

So, when I look at someone that had a heart attack, I don’t just want to know about their symptoms the day of the attack. I also want to know what was going on six months before, because that’s where you find the story. “I’ve been under stress. I lost my job. I lost my house. My wife told me they wanted a divorce.” This is where you start to get the stories that add up to the ultimate cardiovascular event. 

How do you translate that inquiry into the healing journey?

Everyone needs something different at a different point in their life. Some people need to change what they’re eating or start walking, but then you have to look at why they’re not taking care of their physical body. Depressed people say, “I have 20 friends in this pack of cigarettes.” They don’t say, “Let me eat Brussels sprouts and take a walk.” I have to deal with the underlying issue, which could be things like depression, stress or loneliness. I also want to know my patient’s spirituality, because if they believe in a higher power, we can tap into that to give them strength and help transform what’s going on. 

What tools do you have in your integrative medical arsenal?

The whole framework of integrative medicine is to understand and use the wisdom of other global healing traditions. For a patient with back pain, I may use healing touch, acupuncture, massage and medication. I may send somebody who is stressed to transcendental meditation training. I may pull from Ayurveda to help people with digestive issues.

The most important thing is looking at your life and finding joy, meaning, purpose, looking at where you can serve, where you can connect. This is the piece that is missing in many people’s lives. Also, look at where you are holding onto anger. Have you done your forgiveness work? How can you begin to practice gratitude?

Why do you say that patients are motivated not by fear but by caring?

They’re motivated by love. Love is the secret ingredient. People will do everything for three months after a heart attack, because they’re terrified, and then they go back to their old ways. They start to gain weight, because they never did the deep work to look at what got them there in the first place.

A perfect example is one of my heart patients who came in with a walker. She said she had sciatica, and immediately we gave her a shot for her pain. We also did some acupuncture. I got a beautiful message from her the next day, which made no mention of the shot or the acupuncture. Instead, she said, “I felt so much better from the second you gave me a hug.” It’s that kind of connection that makes all the difference.

Sandra Yeyati is national editor of Natural Awakenings.