Redwood: Have you had ever patients who were dead set against having surgery, where you felt it important to make the case for going under the surgeon's knife?

McLanahan: Oh yes. I practice integrative medicine, which I believe is the best choice for the future. This combines alternative approaches with the best of Western medicine. There are times when drugs and surgery can be life-saving. But we want to shift, and I am happy to say the President Bush has made a statement that he wants to shift our medical establishment toward prevention and make it the number one priority. We don't have a health care system in the country right now, we have an illness care system. Once you're sick, they try to fix things. But it makes more sense to keep Humpty Dumpty from falling off the wall in the first place. The kinds of information we included in this book are aimed at helping people act preventively. And yes, at a certain point surgery can be the very best choice. Appendicitis, for example, is a simple case where surgery is the best choice.

Redwood: What forms of complementary medicine have you found to be most helpful for people undergoing surgery, or preparing for it?

McLanahan: Dr. Mehmet Oz is a surgeon at Columbia who is using a variety of techniques before and after heart transplants, and has been studying them. He has discovered from his research that the most powerful is yoga, because these are tools that patients can use for the rest of their lives. Basically, yoga consists of five components: stretching, deep relaxation, breathing, meditation, and visualization. These various components can be used before your surgery, during surgery through use of a tape cassette played while you're having the surgery, and then afterwards to help you recover. Then, they can also be used for the rest of your life to help prevent the disease that got you in trouble in the first place. Because even though we know what may be helpful in terms of diet, cigarettes, alcohol, and exercise, we may not do these things if we're under stress. So we need to address the stress component in all of our lives.

Redwood: In his foreword to your book, Dr. Bernie Siegel points out that patients who receive risk information from their doctors in the hospital hallway immediately before surgery (rather than the night before) have higher rates of cardiac arrest. What does this tell us, and what are some of the other things that patients should ask for if they are facing surgery?

McLanahan: In our book, we give a list of questions to ask your surgeon. Then we give a list of things to request from your surgeon. You need to ask a certain number of questions at first to understand and have a good relationship with your surgeon. Surgeons want a good outcome from their patients, so many are willing to do whatever the patient would like in order to achieve that outcome. For example, one patient had a music cassette that he wanted to play, and the surgeon said, "Okay, I'll just play it to the entire operating room." This patient did so well under his surgery that all the doctors and nurses came to him afterward and requested copies of the tape, because they enjoyed it so much. We've found that surgeons who operate with music do better. So that's one thing you can discuss with your surgeon.

It's a good idea to get the risk information ahead of time rather than right before the surgery. It's also important to have a good connection with your anesthesiologist, because that's the person who's going to put you to sleep and wake you up again. Then, there are cassette tapes that you can use for deep relaxation. You can make your own tape of music that you like, and suggestions such as "I'm going to wake up feeling well," "The surgery will go well," "I will feel happy and good," or "My body will assist the surgeon by moving the blood away from the surgery site." We have already prepared tapes or you can make your own with the music that you like.