An Interview with Dr Dilis Clare - The Year: 2005
(*Readers please note that regulations have changed since this interview. Seek advice from a medical herbalist.)
Ruth: In simple terms what did your life look like before you became a herbalist?
Dr. Clare: "Pretty much the same. I did my surgeries everyday. Went home,cooked for the kids, they are grown up now. Looked after the garden. Being a herbalist just meant I had a different tool box to use at work. And one that’s more in keeping with my interests and patients stories, it’s much more related to people’s narrative about their own health. So that’s the difference, and I have time, instead of having 15 minutes for an appointment I have an hour with 30 minutes follow up. That’s time for the patient, for me to figure out what they need to do. I see myself as a sign post. A lot of General practice was very like that as well. But just more concentrated. A lot of it is still the same. It’s more fun."
Ruth: Can you remember the magic moment that shaped your decision to study herbalism?
Dr. Clare: "There was probably two. There was one moment in my garden. I had been thinking about the limitations of pharmaceutical medicine, for a while, for a long while, and mulling over alternative or complementary therapies and wondering what would I do. Homeopathy or Acupuncture were the two I was thinking of, I don’t think herbal medicine entered my head at that point, or massage, going back to when I was a medical student, I couldn’t understand why doctors often made me feel worse after seeing them, I was thinking “oh this massage would make people feel better” [Laughs]. So I was sitting in the garden, under my pergola, in my London suburban garden, thinking, “I think some of these plants must do something”. So I thought I would find out."
Ruth: And you’re saying that before that you didn’t know anything at all about herbs?
Dr. Clare: "No, nobody was talking about herbs at that time, there wasn’t herbs in every shampoo, in every carpet cleaner, in every gift box, not like it is today, nobody was talking about them. "
Ruth: So it was just intuition then, that made you think that the plants in your garden could heal?
Dr. Clare: "No, I blame the herb fairies. [Laughs] I researched what herb courses were available. There were only a few and most of those ones, were very ‘lay people's’ courses, in that they didn’t have the depth that I needed. Then I found out about the National Institute for Medical Herbalists in England and that they accredited a course based in Sussex, and it’s now a degree course. It was a correspondence course and I loved it. I loved the packages coming through the post, I loved the poetry of the language.
Then I got sick. By the time I got better and went back to work I faced a conflict with my partners in general practice. One day there was a meeting, with the health education advisers and in order to just be annoying I took up a load of space talking about herbal medicine, but without thinking that I would ever be supported in that, really it was just to annoy one of the other partners. [laughs] But the advisor said that if I could get an accredited course, that of course the department of health would finance me.
In the meantime, there had been a BSc degree course in the Clinical Practice of Herbal Medicine started in the Middlesex University. This was around the corner from my general practice. So when I talk about the ‘herb fairies’ getting me involved they really did roll out the green carpet. The college was around the corner and the course was paid for by the department of health. I had an apprenticeship for a clinic each week with some of the best known herbalists, the movers and the shakers, in herbal medicine in London. They actually came and taught me in my general practice. It was amazing. So I did the degree. The other wonderful thing about it was that I could come back to work in Ireland with a new energy. The idea of giving up a well established general practice in London to start another similar practice here didn’t really appeal to me. I wanted something that had new energy. So I got off the plane in Shannon, knew nobody in Galway, had no idea whether anybody wanted or needed or had ever even heard of herbal medicine. I expected to spend two years worrying about the mortgage, only to find that my new venture absolutely took off. Galway was a very good choice. Galway welcomed me with open arms. I was very well taken on board by local GP’s and health food shops, not to mention the general population."
Ruth: Why did you pick Galway of all places?
Dr. Clare: "Initially I chose Waterford. I am originally from Dublin. We had actually bought a place in Tramore. What actually happened was I was on holidays in Malta, having the worst holiday of my life, and it suddenly came to me, "No! We are moving to Galway". Which sounds very wacky, but I had been speaking to people and had described what I wanted to do and many of them said, it sounded more like it would suit Galway. I had always liked the place.
But it was 15 years since I had been here. I said we will move to Galway unless I can find a good reason not to. So when I came and I saw that there were thriving health food shops and many alternative practitioners it seemed like a good choice. I couldn’t exactly do market research, because there wasn’t anything to research. No other doctor had ever done something like this in Ireland. I did visit Napiers in Scotland, and Dee Atkinson was extremely helpful. Napiers would be the closest equivalent to a herbalist running a retail shop, clinic and dispensary."
Ruth: A lot of people don’t realize that herbs are so powerful. They can really affect the body in a good way but they can also have serious adverse reactions. Tell us more about this.
Dr. Clare: "If somebody is pregnant or breastfeeding, children, the elderly, or on medication, then they would need to have specialist advice. We have a belief that people can look after their own health with herbs. They can create their own blends or choose blends of loose teas or tinctures (liquid herb medicines) I have developed. Eg. If they want to use herbs for their digestive systems, they can just use the digestive blends that I have formulated. Obviously if anybody has symptoms that are persistent or have not been investigated, they need to seek medical advice. If they are on prescription or over the counter medicines they can seek advice from a well trained herbalist with a degree in herbal medicine who has an understanding of drug pharmacology and plant pharmacology.
I can confidently say that well trained medical herbalists are aware of the limitations of herbs and aware of the potential of herbs. If you have somebody well qualified you won’t be told to stop your asthma medication, you won’t be told that herbs are safe when they are not. For further information www.iimh.org ,this is the site of the Irish Institute of Medical Herbalists, the entry criteria for which is currently BSc in clinical herbal medicine."
Ruth: What was your biggest fear when you started your new enterprise?
Dr. Clare: "My biggest fear was of not earning a decent living. Not being able to pay my bills [laughs] I was leaving a very financially safe environment, basically the equivalent of a pensionable job, to come to Ireland and set up a herbal practice."
Ruth: So you took a very big risk letting something go that had taken so long to build up?
Dr. Clare: "It probably sounds riskier than it was because I always knew I could do locum, nights on call and that kind of thing, so I knew that we would never go hungry. But it was a huge security blanket to give up. I had a wonderful practice in London. I really liked my patients, I felt terrible leaving them. But I realised that none of us are indispensable. That was hard. Leaving the two oldest boys in England was hard too, but I wanted to come home. "
Ruth: What do you love most about what you do?
Dr. Clare: "What I love most, which is a very selfish thing really, is that I have to think. I can use my brain. I get to treat every patient differently and make up a unique prescription for each patient. So it’s not like writing a prescription according to a protocol for say high blood pressure. Each persons high blood pressure is high for a different reason.
Although there is a lot in common, and there are always the common herbs that you might use, that you will always use to treat high blood pressure. But the fact that every patients story is different makes it more interesting."
Ruth: You have a range of herbal teas and tinctures on the market, tell me how that started.
Dr. Clare: "Well I was getting a lot of queries about the common complaints in our herbal dispensary www.drclareapothecary.com , like irritable bowel syndrome or sinus problems, or whatever, gradually it emerged there were common herbs that are likely to help many people. To make it easier for staff I started blending herbs for the staff to dispense over the counter. Then you (Ruth) came into the shop one day, and said why don’t you put nice labels on the bottles and have nice boxes for the teas so that people know they can ask for them. You came back a week later with the newly designed labels and handmade boxes and if it weren’t for you they would still not be there, it was something. So thank you Ruth!"
Ruth: [Laughs] You're welcome. So basically you made what you could see people needed?
Dr. Clare: "I made what people needed most commonly. It was a sort of a short cut."
Ruth: And you are constantly coming up with new blends?
Dr. Clare: " Yes, well I am still tweaking them, you know, things develop and I read more and understand more. Always learning."
Ruth: There are still new discoveries with herbs, do you ever hear about a herb that you have never heard of before or has that day past?
Dr. Clare: "We might have people coming in saying Maca (the media’s latest darling herb) is brilliant but Siberian ginseng does nearly everything that Maca does, and I know where I get my Siberean ginseng. But with Maca, it’s just suddenly being imported and is not controlled by any regulations. Where as the with the established herbs, like ginseng, we know their trading routes, and we know that nobody is being exploited or that no environmental damage is being done. Well established herbs have standards and we know there are going to be no big surprises. With the new ones there might not be any research done. Basically with the established herbs we know their track record and that in the right hands with traditional formulations nobody has died yet.
The other issue with ‘Global Herbalisation’ is that there is a small percentage of herbs that are being researched and they are being put forward in every herbal degree college in the Western world. Those ones are being over utilized. We have herbs everywhere, but say for example in Ireland we have herbs like “Selfheal” Prunella vulgaris, that have been around forever and nobody is cultivating them. Nobody is doing research. So if we don’t do our own research, if we are relying on researchers in Australia and Germany researching the same herbs over and over again you’ll get very uniform herbal medicine. Which might not be in the patients best interest. One of the reasons why I am very much into going down the “An Irish College of Herbal and Traditional Medicine” path and education to Masters and hopefully PhD., is that we start researching our own traditional herbs. Herbs that have been written up in herbals since the the 11th century, but are totally ignored by modern science. Why should anybody else be responsible, why aren’t we doing it ourselves?
Global Herbalisation is a very useful term."
Ruth: So you have coined a new term there!
Dr. Clare: "Get it out there on the web. [Laughs]"
Ruth: Which one of your herbal teas is most commonly prescribed?
Dr. Clare: "The Digestive Tea, Detox tea, Hayfever tea, Sinus tea, Women’s tea, they are all for common complaints. The least one is the Anti-snoring tea. That’s because it tastes absolutely horrible. The very bitter taste is essential to the action, so I can’t take the bitter herbs taste out, I would be doing a disservice. If I took all the bitter herbs out I would probably sell more but it wouldn’t do the job. So that’s it, it stays in. A lot of people who snore have a very sluggish digestion. They are often people who are a bit overweight, and maybe who have got into a sluggish lifestyle, so that tea is really a kick start to the bile and the gallbladder. It’s very tonic and nourishing for mucous membranes and that includes all of the digestive tract. So it’s like middle aged people take aperitifs before dinner on the continent, this is like an aperitif tea, to get all of the digestive juices going and benefit the mucus membranes, because of course the mucus membranes in the nose are the same as mucus membranes all the way down to the stomach, there’s no dividing line. I tell people "If you really want to do something for the snoring, take this tea for six weeks, but you are taking it as a medicinal water, it’s not a nice cup of after dinner tea.""
Ruth: Most people know what herbal teas are but are not as familiar with tinctures, what are tinctures and why would I take a tincture instead of tea?
Dr. Clare: "Tinctures are a way of preserving the tea in a concentrated form. So you get the essence of the herb in a dose of alcohol and water, so that it’s more like a shot, it’s easier to take. There are some differences with what goes into a solution with alcohol and what goes into a solution with water but the main reason is compliance. A lot of people are too busy to be running around with flasks of tea. Although the longer I practice the more I use teas. They cost less for the patient, and they give people a feel for what they are taking. It gives people a feel for the fact that these are real live plants and that they came from some bodies field and they begin to form a real a relationship with them. For the patients coming in I often use both tinctures and tea. The tea for the patient to sip on regularly throughout the day and then a shot of the tincture at intervals are especially useful for the very bitter herbs. You can knock it back fast. One of my biggest problems with the teas is that people think because they cost so little that they couldn’t possibly do the job. People are used to having to spend so much on medicine. The philosophy in the shop, the way that I train my staff, is to give people only what they need. Partly because it’s what I believe, but also because it’s good business. The clinic and shop are thriving because people know that we don’t rip them off. I hate to be ripped off myself."
Ruth: Is it enough for people to just take the teas and tinctures to sort out their health problems?
Dr. Clare: "I would say it’s actually like 50:50 ie. 50% lifestyle changes, diet, exercise, what have you and 50% herbs. A lot of what I do is a kind of mentoring, health coaching. People often think that they have to be perfect, I tell them “ah it’s not about never eating a biscuit, it’s about not eating too many biscuits”. I tell people not worry about the other things, they’re not perfect, start with the fact that none of us are perfect and we will look at the three best value things that you can change so that you can move your physiology into another gear. Herb teas and tinctures of simple herbs are safe but if not helping or the symptoms are chronic or severe consult a medical herbalist for a professional opinion."
Ruth: And you ask the person to kind of come up with the answers themselves?
Dr. Clare: "Well we sort of work it out together but they do the work!"
Ruth: So they come out feeling more relaxed about themselves, and more accepting of themselves rather than beating themselves up about things?
Dr. Clare: "And every so often I’ll give people a kick in the arse and I’ll say, “you’re not doing anything I tell you, you’re wasting my time and you’re money”.
My life is too short for dealing with people who are not willing to make any kind of change. I will say to them, don’t waste my time. I don’t need your money that badly. [Laughs]"
Ruth: So what’s your favorite herb?
Dr. Clare: "Chamomile and Dandelion.
These are simple herbs that never go out of fashion. They are also very safe herbs. Dandelion is great when we are feeling over bloated and we need a good shift of the gallbladder. There’s a story about a Naturopath in Hungary, who had a student with him and the student said, "have you any new herbs", and the naturopath answered, “when I was young I thought I was really clever and I used 150 herbs in a blend, now I am old and I am still clever, I use only 3. “Keep things simple!"
Ruth: I have a young family, if I were to buy five herbs for my home medicine cabinet what would they be?
Ruth: With St John's wort, is that the actual dried herb itself? Or is it the flowers?
Dr. Clare: "The best way to buy that would be the tea or tincture. The problem for Irish people is that you have to have it prescribed by a herbalist or by a doctor. But in fact it is a very effective very simple herb. The problem is with taking some pharmaceutical medicines at the same time. Otherwise it is a simple and safe herb."
Ruth: Is there anybody that herbs cannot help?
Dr. Clare: "Herbs have their limitations, they can’t do everything for everybody, but there are very few people that they can do nothing for”. The ones who won’t take them. There are people who have a fuzzy image of herbs and think, oh that would be a nice thing to do, but they can’t get the herbs into the teapot for their sore throat. They like the idea but don’t like the effort. They are the ones that come back to me and say “it didn’t work “ and I’ll see by their prescription that they haven’t been filling their prescription. So if you don’t take the prescribed does of course they won’t work.
Ruth: Even the herbs you prescribe for PMS they would have to be taken regularly for how long?
Dr. Clare: "For two to three months. They will help with cramps initially, but if you have serious PMS then you need to take the tea for three cycles to see an effect." So I say to people "I do the thinking and you do the work."
Ruth: Tell me about The Irish Institute of Medical Herbalists (IIMH), what does it do that is so special?
Dr. Clare: "What the IIMH are doing is ground breaking in Europe in terms of patient safety, recognised training, and moving herbal medicine forward to the future. We are providing a training framework where people train to become herbal medical practitioners. We have developed a Herbal Sciences BSc degree in conjunction with the Cork Institute of Technology www.cit.ie . This is a four year Science degree leading to a Masters in Clinical Herbal Medicine”.
Ruth: So you are saying there is nothing like that in Europe, or in the World perhaps?
Dr. Clare: "There is no course worldwide that gives clinical training to masters level with that such in depth apprentice based clinical training in conjunction with academic standards that we are offering."
Ruth: So because it’s in Ireland, it puts Ireland at the forefront professional standards of clinical herbal medicine? That’s exciting!
Dr. Clare: "This will be the first time that medical herbalists will be able to stand up to scrutiny because we will be having clinical practice that will be subject to audit and every other thing that you can expect to find from your private healthcare team. Also the emphasis will be in clinical research. All of the training clinics will have databases that will be suitable for research. So for the first time a when a drug authority says “this herb is harmful”, we will have the clinical evidence to prove otherwise."
Ruth: When does this training start or is it happening already?
Dr. Clare: "The first students will be taken on in September 2009. The entry will be degree standard knowledge of subjects in anatomy, physiology, plant and drug pharmacy, botany, pharmacognosy, philosophy of herbal medicine, pathology. There are 8 subject. If people pass the entrance exam in those subjects they can register for the MSc."
Ruth: Who founded the IIMH?
Dr. Clare: "It’s a follow on from an association of medical herbalists. It was founded on a core identity based on educational standards with external accreditation. In the absence of government regulations what can patients rely on to find a well qualified herbalist? externally validated education is the only safeguard that people have. Graduates are welcome to join the IIMH as their professional organisation. People can also click on the IIMH website www.iimh.ie to find a herbalist in their area. All members of the IIMH have a degree or the equivalence of a degree in clinical herbal medicine. We would like to have a medical herbalist in every sizable town in Ireland so that it is a real alternative for people in terms of primary health care."
Ruth: You are one of the main people developing the course?
Dr. Clare: "Yes. We are currently looking for investment of €208,000.00. If anybody is interested in being a ‘Business Angel’ or know of any philanthropist interested in this area they can contact me. If anybody wants to invest in the future of education in herbal medicine in the form of a business investment please contact me at my clinic in Galway."
Ruth: What’s the address?
Dr. Clare: "9 Sea Road, Galway. Ireland"
Ruth: Tell me about your Clinic in Sea Road?
Dr. Clare: "The clinic is a dispensary, and we also sell the kind of foods that I recommend to patients, so that they don’t have to go hunting, it helps to keep their stress levels down. I work there with my colleague lára jónasdóttir. Lara Has the same degree in Herbal Medicine (BSc) as I have and has an independent practice seeing all medical problems. BOOK AN APPOINTMENT HERE If people have a very complicated history she will send them on to me. I also work with Naturopaths, Life Coaches, Accupuncturists, Nutritionists, Reiki Practitioners, Counsellors/psychotherapists, Massage therapists. I am sure I am going to forget somebody. They are all registered with a governing body and have professional qualifications as well as insurance. The clinic is unique in Ireland. You can visit the website, www.drclare.ie"
Ruth: So what’s your philosophy on life? What keeps you laughing so much?
Dr. Clare: "A life with good intimacy and good food! Enough exercise helps, otherwise I get cranky! [Laughs] It’s about enjoying life, we all face mortality so it’s about enjoying life. That’s what I like about herbalists. They are a laid back bunch and they are not like many health practitioners who are full of stuff about what you ‘shouldn’t’ do. Herbalists I know are like “pass the digestives”. Everything in moderation, including moderation, lets live the good life. Most people have what we call the “bully in our forebrain” telling us what we shouldn’t do. An awful lot of what I do is tell people what it’s good to do and don't worry about the rest. We often need to like ourselves more and be as kind to ourselves as we would be to others. Graciousness can be noticeable by its absence. So have a good time!
I have this theory that we get to heaven and St Peter is there with his pen and notebook, and he says “tell me why you should get into heaven?” And we’re kind of going, “well you know, I was good, I looked after people, I did my best for the kids, I looked after my patients as well as I could, I tried to be a really good person. “ And Peter says, “Well, that’s all very well but how much of a good time did you have?” And we go, “ what’s that got to do with anything?” And he says, “ Well God put you down there to have a good time!” One of the questions I ask my patients is “when was the last time "”? you had a good laugh