Omega: You’ve written that, “Lyme is the great imitator.” What do you mean by that?

Richard: Lyme imitates many other diseases. So many of the patients who have come to see me have been through 10 to 20 doctors, and they've been told that they have chronic fatigue syndrome, fibromyalgia, autoimmune diseases like this rheumatoid arthritis, multiple sclerosis, and ALS. Or they've been told they have a whole host of psychiatric conditions—that they are anxious or have OCD—because Lyme can mimic every psychiatric manifestation also. 

So they basically go from doctor to doctor and are put on many medicines to treat the symptoms, and they don't get better or they have side effects from the medicines, and then I see them in my office. And I discover that what was really underlying the symptoms of the chronic fatigue or the fibromyalgia or the autoimmune manifestations was in fact what I call MSIDS, which stands for Multiple Systemic Infectious Disease Syndrome.  

Omega: How do you work with a disease that’s so difficult to diagnose?

Richard: I’ve developed a 16-point, multifactorial model, which means that patients who come to see me usually have many reasons, multiple overlapping issues as to why they are sick. For the most part, that usually implies multiple infections from a tick, not just Lyme disease, but other bacterial, viral, and parasitic infections, too.

So what's happening is that people are being misdiagnosed with all of these syndromes, which is in fact, from what I'm seeing, turn out to be Lyme. When doctors give patients prednisone for rheumatoid arthritis, for example, they're just treating symptoms. Sometimes, the drugs that they're giving for symptoms work; sometimes they don’t. And that is a basic problem that I see in the way we are dealing with people who have chronic medical conditions in the United States and in the world. The model I developed is a paradigm shift to look at these chronic disease patients in a completely different way, trying to get to the underlying reasons of why they would be ill. 

Omega: What led you to work with Lyme disease?

Richard: I was finishing up my residency at Mt. Sinai, New York, when I was offered a job at a medical practice near Vassar. I loved the Hudson Valley with the mountains and the river. It also allowed me to continue studying Zen Buddhism with my spiritual teacher at his monastery nearby in Wappingers Falls. 

One of the first precepts from my Buddhist training that they really stress is, of course, compassion and working for the betterment of others. When you're working with the mind, you're always trying to get to the source of suffering. As doctors, we're trying to alleviate physical suffering, or sometimes emotional suffering, and sometime we try to do it through medication, herbs, or going through therapy. As doctors, our job is to relieve suffering.

So when people walked in with the rash of Lyme, and 75 percent got better with antibiotics, but 25 percent stayed sick, I felt it was my job to ask, “Why are these people sick and how can I help them?”

Omega: You’ve said that the M.D. is also an abbreviation for Medical Detective. Can you say more about the significance of that designation?

Richard: It's a new way of thinking. I think maybe years ago this is what medicine was supposed to be because we all were taught in medical school that 90 percent of diagnosis is taking the proper history.

I'm working with a team now to create a nonprofit organization called the Lyme Navigator which will create an app. You can input your symptoms into the app and it will give you an initial diagnosis of what it could be. It will give you and your doctor ideas of which test to do. So the app will help people to act as a medical detectives. It will help lead you to the multiple underlying epidemiologies causing the disease, which should save people a lot of money and improve people's health. 

Omega: What is it like to receive both positive and negative feedback based on the new approach and perspective that you bring to the medical community?   

Richard: Yes, there’s controversy. But if you take the point of view that you've discovered something that is clearly healthy for people, it is my job at this point to continue to do the research and to do my best to help my patients and help society. 

For the doctors that find it controversial and don't believe it, usually I tell them, “Wait until you or your family members get Lyme disease and you're not well. You've seen the infectious disease model. You're the first ones to come around to my side when you see that your model doesn't work and mine does.”

The problem is that this is a political disease, not just a medical one. I always try and bring people together and work to the benefit of others when I can. My goal is to bring all sides to the table, the CDC, the NIH, the insurance companies, because if we all don't get to the table in the middle of this spreading epidemic, we’re going to have an even larger problem than we have right now and it’s going to be too late. 

Omega: Outside of helping patients get healthy, how do you help yourself stay healthy? Can you share some of your personal health practices?

Richard: Well, it's happened over the years. If I snap a picture with my phone, you would see about 45 supplements sitting on my table. Every few years I discover more and more about how to keep the body healthy. We eat organic. We eat as many fresh fruits and vegetables as possible. I have an exercise regimen. I think for me the most challenging aspect is my medical office and stress, but I have a regular spiritual practice to balance that out.