Born in Scotland at 318ppm CO2, Manda Scott trained as a veterinary surgeon, but is now an award-winning novelist, host of the Accidental Gods podcast and co-creator of the Thrutopia Masterclass. Best known for the Boudica: Dreaming series, her latest novel, Any Human Power, is a mytho-political Thrutopian thriller that explores the potential for a future we'd be proud to leave as our legacy. She believes that the way forward now is for everyone to craft open-hearted connections with all parts of ourselves, each other and the Web of Life. She lives with her partner, Faith, in the Shropshire Marches.

Show timings

00:00 Welcome and Introductions
00:10 A Polymath Path
01:10 Vet Medicine Meets Spirit
04:47 Energy Healing Foundations
06:48 Homeopathy and Belief
08:35 Self Knowledge and Balance
12:12 Autoimmunity as Story
13:14 Medical Dogma and Heresy
15:36 Redefining Reality
18:02 Breaking Paradigm Boundaries
21:31 Where Self Begins
26:28 Stories Shape Symptoms
29:25 Separation and Reconnection
32:20 Wholeness in the Web
33:37 Beyond Inner Warfare
35:31 Earth as Mirror
36:12 Metaphors That Heal
39:45 Creative Conflict Edges
41:45 Liminality and Emergence
44:05 Autoimmunity as Portal
45:45 Give Thanks and Ask For Help
46:57 Prayer for Guidance
49:24 Lessons from the Hill
52:19 Gratitude in the Body
54:08 Closing Reflections

References Mentioned

• Nora Bateson — wide-boundary and narrow-boundary thinking; founder of the International Bateson Institute; author of Small Arcs of Larger Circles (2016) and Combining (2023). Her concept of “warm data” insists that relational information — the interdependencies between contexts — is what narrow-boundary analysis systematically excludes. https://norabateson.wordpress.com/about/

• Donella Meadows — “Leverage Points: Places to Intervene in a System” (1997, Whole Earth), expanded in Thinking in Systems: A Primer (2008). The 12 leverage points ascend from parameters and buffers through rules and goals to paradigms, with the highest leverage being the capacity to transcend all paradigms. donellameadows.org

• Vanessa Andreotti — Brazil-born decolonial scholar, author of Hospicing Modernity (2021). Her work on the belief in separability as the core wounding of Western modernity draws on teachings from an indigenous grandfather. decolonialfutures.net

• Richard C. Schwartz — founder of Internal Family Systems (IFS) therapy. The “internal civil war” framing appears throughout his work on parts and the Self. ifs-institute.com

• Francis Weller — psychotherapist and author of The Wild Edge of Sorrow: Rituals of Renewal and the Sacred Work of Grief (2015). His distinction between trauma culture and initiation culture, and the image of the newborn expecting forty adoring gazes, draws on decades of soul-centered psychotherapy. francisweller.net

• Thomas Hübl — contemplative teacher and author of Healing Collective Trauma (2020). His reframing of trauma as “a moment frozen in time” and the thawing process that restores flow and relationality. thomashuebl.com

• N.K. Jemisin — The Broken Earth trilogy (The Fifth Season, The Obelisk Gate, The Stone Sky, 2015–2017). Three consecutive Hugo Awards. A far-future Earth where a sentient planet retaliates against civilisational extraction, and orogenes — people who can manipulate geological forces — are feared, enslaved, and used as living tools. nkjemisin.com

• Beverly Lanzetta — interfaith theologian and contemplative, author of Path of the Heart: A Spiritual Guide to Divine Union (1985, expanded 2014). The prayer Laure quotes is from this text. Described as “a rare combination of mature spiritual wisdom and poetic quality that transcends confessional lines.” beverlylanzetta.net

Classical Frameworks Referenced (by Laure)

• Svasta (Sanskrit: स्वस्थ) — the Ayurvedic definition of health: being established in oneself. Not the absence of disease but the presence of self-knowledge.

• Rakta Pitta (Sanskrit: रक्त पित्त) — a condition in which the metabolic fire (pitta) vitiates the blood (rakta), causing it to become too hot, too toxic, and to leak from its channels. The Ayurvedic frame for what allopathic medicine calls immune thrombocytopenia.

• Qi deficiency with heat in the blood — the Chinese medicine frame for ITP-pattern bleeding. A very different story than “the body attacking its own cells.”

Texts by Manda

• Accidental Gods — podcast exploring how humanity navigates the meta-crisis toward a regenerative future. 200+ episodes. accidentalgods.life

• Any Human Power (2024) — a Thrutopian mytho-political thriller, her most recent novel. mandascott.co.uk

• Boudica: Dreaming series — four historical novels (Dreaming the Eagle, Dreaming the Bull, Dreaming the Hound, Dreaming the Serpent Spear, 2003–2006) exploring pre-Roman Britain through a shamanic lens.

• Dreaming Awake — contemporary shamanic practitioner training, co-run with senior apprentice Louise Mayor. dreamingawake.co.uk

• Thrutopia Masterclass — teaching writers to craft narratives that map pathways beyond dystopia and utopia into viable futures. thrutopia.life

The host:

Laure Marin is an Ayurvedic consultant, bodywork practitioner, and writer based in Tiohtià:ke/Montréal. I have lived with autoimmunity for over twenty-five years. mxmarin.ca

Subscribe to the newsletter for long-form essays and episode companions: autoimmunetheory.com

Theme music: « Tremblement » de Michaël Boudreau, from the album Terre.

Link Tree: https://linktr.ee/michaelboudreau

The very idea of autoimmunity is predicated on fragmentation and separateness. I use the word autoimmune in order to change what it can mean. I am a patient researcher. I research from inside the autoimmune way of being and I make the thinking visible. For the last six months I have been rebuilding a platform to think in public. The platform is hosted on substack (for now), and its domain is autoimmunetheory.com. You are reading it right now.

My thinking draws on the practical knowledge that comes from decades of reading my own blood against geographic and seasonal movement. I produce essays, a podcast, and a weekly curation of research across whatever I am doing right now. Lately, that’s Ayurveda, immunology, ecology, pharmacology, biopolitics, and cross-tradition medical knowledge.

My body is prone to bleeding. The condition is manageable and incurable. I have lived with a diagnosis for over twenty-five years, over 80% of my entire life. Its name is immune thrombocytopenia, and all the cures in the allopathic arsenal were thrown at me over decades to manage it. Over the last 6 years, I have moved away from allopathic medicine for myself, with high levels of success.

Non-resolution held over a lifetime turns out to be philosophically productive. When your body continues to flow through a state medicine can describe but can’t resolve, the question stops being “how do I get better?” and becomes “what does this experience make visible that existing paradigms miss? How do I live this way for all time?” This reframe changes everything downstream.

Here is what the last few months have looked like on the ground:

I spent January in Thailand, walking the streets of Chiang Mai for delicious autoimmune-safe food, getting tutored in qigong for self-healing with the masterful Julie Liu. Then, February through April I was in Kerala, South India. I go to India for my own spiritual practice as well as field work for the Académie Québécoise d’Ayurvéda, where I have served as adjunct director since last summer.

The AQA trains Ayurvedic practitioners in Québec. I develop curriculum, research traditional source material, communicate with students, maintain infrastructure, and coordinate with our small teaching team. This winter’s work included restructuring the Ayurvedica Marma Therapy course, building course materials from classical texts, and sitting with a monastic sanskrit tutor who told me to focus on my therapeutic practice and making money before I devote too much time to the language.

I just completed a six-month training in Siddha marma, capstoned with a three-week residential intensive. Siddha runs parallel to Ayurveda without being derivative of it. Marma, in this tradition, is a precise and surgical method for activating prana. Its application is short, a treatment lasts fifteen minutes. The body is a strong gold box and marma is a high-karat gold key: precise, fragile, not to be forced. Massage may prepare the ground but marma is not massage. The therapeutic art lies in reading the present moment and determining the direction of balance. My training was explicit about this: five different healers will produce five different theories from one case. The healer’s own balance is the instrument. You must know your own channels before you can read someone else’s.

In late March and early April my bleeding condition left me desperately fatigued and inflamed. The doctors at the ashram told me to go to the big hospital in Kochi. I went to Kanyakumari instead, stood at the southern tip of the subcontinent where three waters meet. Then ten days of Takradhara and Njavaratheppu, medicated buttermilk poured over the forehead, rice and milk and bala root cooked into paste and slathered across the body. Cooling and nourishing treatments for blood that has become too hot, blood that has lost its container.

This month, the first episodes of the AITP podcast go live. The first episode is a technical interview with Ayurvedic research pharmacologist Dr. P. Rammanohar, in which we discuss autoimmunity as an ecological and planetary health concern within the paradigm of Ayurveda. Coming soon, my conversation with the writer and shamanic practitioner Manda Scott about the need for active relationally with the web of life.

Isolation is a painful illusion. As the cross-pollination of disciplines in my research attests, the body is an ecology in continuous dance with the ecologies it inhabits. Holons in holarchy. The terrain you live in and the terrain you are made of are the same question asked at different scales. Autoimmunity is a navigational state, a response to conditions that precede the individual body: conditions of terrain, of transmission, of what entered and could not be digested.

Here’s what I’m doing now:

My therapeutic practice has two arms. Remote consultation for people anywhere who want to understand their condition through a framework older and more metabolically precise than the one they were given. Consultation also means somatic education, coaching in qigong, Feldenkrais-informed movement, the slow work of teaching a nervous system to orient itself again.

Hands-on bodywork happens when we are lucky enough to be in the same room. The bodywork I do now rests on three pillars, drawing from Tuina (TCM bodywork), Marma, and Craniosacral Therapy, though no single modality name holds the whole thing anymore. My map of the body is Ayurvedic primarily, with TCM and allopathic as necessary. Recent trainings have changed my method significantly.

In Ayurveda, one definition of health is swastha, “being established in the self”. But which self? Capital S, Self, is available, if we listen to what is going on below all the noise.

My obsession is life force. Qi, prana, pneuma, spirit. What moves through tissue when tissue is alive and what departs when it isn’t. What the dhatu fires metabolize and what they fail to digest. What survives industrial fractionation. What a heart that is grieving leaks into the world.

I navigate. I do this within the legal frame Québec health law requires: no diagnosis, no prescription, no treatment. The nautical-ecological register that I’ve adopted to describe my work is both philosophically precise and legally necessary. The body of the autoimmune is a ship lost at sea. I am the navigator they onboard to help them steer the craft, but they are the craft. I’m building this in the open; you can watch this form, and you can join me in shaping it.

Write to me. Here is my email: laure@mxmarin.ca

I strive for inbox zero. I hover around inbox-fourteen. I never fail to respond to email from an actual person. Come on out and say hello. I will personally respond. If needed, behind PGP keys across high security servers abroad.

The rubber hand illusion is a classic experiment: you hide your real hand, put a fake rubber hand in front of you, and someone strokes both at the same time. Eventually your brain starts treating the rubber hand as if it belongs to you, your sense of where your real hand is actually drifting toward the fake one. How strongly this happens varies a lot between people, and nobody really knew why. Researchers found a piece of the answer: people with an autoimmune condition feel the illusion more strongly than people without one. Their brains more readily incorporate the fake hand into their body representation. The proposed reason is biochemical, of course. The same inflammatory messengers involved in the immune response also affect how the brain integrates sensory signals. When those cytokines are chronically elevated, the brain’s window for deciding “this sensation belongs to my body” stays open wider. The boundary between what counts as me and what does not is, at the level of tissue signaling, more permeable.

Reading that research gives me shivers. What does it imply about how we discern boundary? What does it mean that we feel so porous?

This permeability has been framed as a problem. The immune system’s core function is discrimination: self from not-self, threat from terrain, the familiar from the foreign. When discrimination falters, the clinical frame reaches for error. The body attacking itself. The self that has mistaken itself for enemy.

A destabilized boundary between self and not-self makes that boundary visible in a way the stable, bounded body never experiences. The autoimmune body arrives already positioned at the threshold that somatic education spends decades teaching people to reach.

Psychology has spent decades showing that much of what we think we know about ourselves, we don’t. In the classic studies from the 1970s, people could not accurately report why they made the choices they made. They confabulated reasons, reached for plausible stories, and sincerely denied the factors that actually drove their behavior. A vast set of mental processes handles perception, motor learning, implicit attitudes, social judgment, all of it running below awareness, never surfacing. We figure out our own attitudes largely the way a stranger would, by watching what we do. And we suffer from a systematic blind spot: we trust our own gut sense of ourselves deeply while dismissing everyone else’s, and we find no evidence of bias because bias operates below the level introspection can reach. The self, in this view, is a story assembled from scraps: partial data, observed behavior, gaps we fill without noticing. The strangeness is adaptive. Consciousness would overload if it had to process everything the unconscious handles. The limits are functional. This is how self-knowledge works, and it works fine, mostly.

Somatic education arrives at a parallel conclusion from the other direction. Feldenkrais’s foundational claim: the self-image is a body image, the integrated whole of movement, sensation, feeling, and thought as they organize themselves in a particular nervous system. And it’s plastic. It can be expanded. Lie on the floor and make a movement so small, so slow, so far from habit that the automatic motor program cannot run. At that moment of unfamiliarity, consciousness must intervene. What was preconscious body schema becomes available to body image. The implicit becomes explicit.

Thomas Hanna named the automatic pattern “sensory-motor amnesia”: muscles held in chronic contraction below the level of voluntary awareness, the sensory-motor cortex having surrendered control to subcortical reflexes. His method: voluntarily contract those muscles fully, then release them slowly enough that the cortex registers the change. The goal is restoring what had gone underground to conscious reach.

There’s a man known in the research as IW. He lost all proprioception from the neck down: no sense of where his limbs are in space, no tactile feedback. To move at all, he must substitute conscious visual monitoring for the automatic body schema that no longer runs. He has to watch his body to know where it is. Somatic education does this voluntarily: it brings schema into image so that making it conscious allows reorganization.

The autoimmune body lives at the intersection of these two ways of knowing without having chosen either. Our immune system processes vast amounts of information below awareness, discriminating, remembering, responding, a version of that unconscious processing running at the molecular level. The immune self is an ongoing process of self-definition. It knows itself by continuously constituting the boundary between what belongs and what does not.

When that boundary becomes unstable, when cytokines alter multisensory integration, when affected body regions feel less owned, when the internal signals that normally anchor the sense of being a body become less reliable, the autoimmune person is forced into the position that somatic education cultivates deliberately. The body image must be actively maintained. The body schema can no longer be taken for granted. What the stable body leaves unconscious, the autoimmune body must negotiate.

This is the fulcrum.

I cannot avoid the question of what is me and what is not me. For others, the question is philosophical, occasional, safely academic. For this body, it is continuous, practical, negotiated at the level of tissue. Every flare asks the question again. Every remission gives a temporary answer.

Anthropologists have a word for this: liminality. The state of being betwixt and between,, neither here nor there, suspended between established categories. Chronic illness researchers have mapped this territory in chronic pain, in cancer, in HIV, in fibromyalgia: people caught between sick and well, visible and invisible, diagnosed and not. Autoimmunity adds a layer that most other conditions cannot: the mechanism of the condition is the mechanism of self/not-self discrimination. The threshold is simultaneously a social position, a phenomenological state, and the biological function that has become a question.

From this position, certain things are visible that remain invisible from the stable center. Somatic educators may say: make the implicit explicit, and the self-image can reorganize. A psychologist may say: much of the self is structurally implicit, and this is functional. The autoimmune body lives both claims at once. The permeability that somatic practice cultivates through slow, attentive movement: I arrive with it. The self/not-self questioning practiced on the floor, I practice in tissue, continuously. The condition placed me here.

From that position, self-knowledge is something the body does. The flare is the body’s signal made visible. The remission is a temporary stabilization in a system whose boundaries are constitutively negotiated. The self is an active, continuous, tissue-level process, made and remade at the boundary. The fulcrum is the place where that making becomes visible.

Introduction

The Ayurvedic concept of “ojas” is not the immune system. It is an emergent functional coherence that arises when digestion, tissue nutrition, doshic balance, and mental stability are all operating optimally. When you reduce ojas to “immunity,” you lose stamina, you lose aging, you lose the capacity of the mind to support the body and be supported by it. Vaidya Dr. P. Rammanohar has spent decades at the interface of classical Ayurvedic scholarship and contemporary biomedical research, and he came to this conversation with a refusal: Ayurveda should not be validated by measuring whether its medicines activate T cells. That is a ripple, not the current.

This episode follows the argument through four movements. First, the four domains of ojas and why they cannot be captured by immunology. Second, the NIH-funded randomized controlled trial that preserved Ayurvedic clinical reasoning inside a Western study design, and what happened when it did. Third, the Ayurvedic description of autoimmunity as a body that is angry, not a body that is attacking itself, and the distinction between ama as metabolic stress and ama as toxin. Fourth, Janapadodhwamsa, Charaka’s model of planetary health, and the claim that ecological disruption and immune dysregulation are not analogous but the same process at different scales.

Dr. Rammanohar is the Research Director at ĀCĀRA (Amrita Centre for Advanced Research in Ayurveda), Amritapuri. He served as Ayurvedic physician-investigator on the NIH-funded randomized controlled trial of individualized Ayurvedic treatment for rheumatoid arthritis, the first double-blind, placebo-controlled study to preserve classical Ayurvedic clinical reasoning inside a Western trial design. His editorial “Research for Understanding as Opposed to Evaluating Ayurveda” shaped the episode’s central question.

Timestamps

00:00 Intro
00:36 Ojas Beyond Immunity
02:15 Meet Dr Rammanohar
03:19 Host Autoimmunity Journey
05:40 Translation Loss Question
05:57 Defining Ojas Properly
10:02 Four Domains of Ojas
18:14 NIH Trial Ayurveda Logic
24:42 Amavata Versus Rheumatoid Arthritic
28:46 Dual Diagnosis Research
31:54 Autoimmunity Beyond Agni
35:26 Ama Not Toxins
37:27 Ayurvedic Immune Homeostasis
39:55 Planetary Ecology Immune Rise
43:19 Ayurveda and Planetary Health
46:20 Dharma as Repair Path
49:58 Science Meets Ancient Wisdom

References mentioned:

• Rammanohar, P. “Research for Understanding as Opposed to Evaluating Ayurveda.” Ancient Science of Life 34, no. 2 (2014): 61–63. DOI: 10.4103/0257-7941.153456

• Furst, D.E., Venkatraman, M.M., Ram Manohar, P., et al. “Double-Blind, Randomized, Controlled, Pilot Study Comparing Classic Ayurvedic Medicine, Methotrexate, and Their Combination in Rheumatoid Arthritis.” Journal of Clinical Rheumatology 17, no. 4 (2011): 185–192. PubMed: 21617554

• Furst, D.E., Venkatraman, M.M., Ram Manohar, P., et al. “Well Controlled, Double-Blind, Placebo-Controlled Trials of Classical Ayurvedic Treatment Are Possible in Rheumatoid Arthritis.” Annals of the Rheumatic Diseases 70, no. 2 (2011): 392. ard.bmj.com

• Caraka Samhita, Janapadodhwamsa passage (Vimāna Sthāna 3)

• Caraka Samhita, Vatarakta passage: “Kṛpābhyāsa iva krodham vātaraktam niyacchati”

• Etuaptmumk (Two-Eyed Seeing): Mi’kmaq principle of layered knowing, originating from Elders Albert and Murdena Marshall and Dr. Cheryl Bartlett at Cape Breton University. Referenced in WHO-affiliated integrative health frameworks. Wikipedia; Tremblay & Martin, “Etuaptmumk/Two-Eyed Seeing,” in Global Handbook of Health Promotion Research, Vol. 3 (Springer, 2023).

  Texts by Rammanohar:

• “The Translational Framework of Ayurveda as a Knowledge System”, Ancient Science of Life 35(4), 2016

• “Backing Up Ayurveda with Good Science: The Modus Operandi”, Ancient Science of Life 34(3), 2015

Sanskrit Glossary

Terms appear in the order they arise in the conversation.

Ojas — The net functional coherence that emerges when digestion, tissue nutrition, doshic balance, and mental stability are all operating optimally. Not a substance. Not the immune system. Rammanohar identifies four domains: resistance to disease (Vyādhi Kṣamatvam), stamina and endurance, slow biological aging, and mental stability. The analogy is gravity: you cannot see it, but when an object falls, you know it is functioning. Ojas is what the body has when all its systems are working in concert, and what it loses when they are not.

Balam — Innate strength or capacity. Sometimes used as a functional synonym for ojas, but balam refers more specifically to the observable power of the body to act, endure, and recover. Where ojas is the principle, balam is what you measure.

Vyādhi Kṣamatvam — The body’s capacity to tolerate disease. Not immunity in the Western sense of pathogen-specific defense, but the ability to remain functional when disease is present. One of the four domains of ojas identified by Rammanohar.

Vyādhyutpādapratibandhakatvam — The body’s capacity to resist the onset of disease. Distinct from tolerance (kṣamatvam). Where tolerance describes how well you cope with what has already arrived, this describes how well you prevent what has not yet arrived. Together, tolerance and resistance form two of the four domains of ojas.

Agni — The principle of transformation. Not an enzyme, not an acid, not stomach fire. Agni is what enables the body to distinguish self from non-self, to digest food into nutrient pools, and to separate what can be assimilated from what must be expelled. When agni is weak, ama accumulates. When agni functions well, ojas has the material conditions to arise. The analogy Rammanohar offers: agni is like gravity, a principle you observe through its effects rather than a component you can isolate.

Ama — That which has not been properly transformed. Neither waste nor essence. The word comes from the Sanskrit root meaning “to move” with the negative prefix: that which is not moving, not being digested, not completing its transformation. When ama persists in the body, it creates confusion: the tissue recognizes it as partially self and partially foreign, and inflammatory pathways activate. Ama is not a toxin. When ama becomes toxic, it is called amaviṣa. The common mistranslation “ama = toxins” erases the distinction between undigested metabolic residue and actual poison (viṣa), and with it, the Ayurvedic logic of how autoimmune conditions develop.

Amaviṣa — Ama that has become toxic. If ama were already a toxin, there would be no need for a separate term. The distinction matters: ama is metabolic stress that can still be cleared; amaviṣa has fermented into something that actively damages tissue.

Satmya and Asatmya — That which becomes part of you (satmya) and that which cannot become part of you (asatmya). The root of satmya carries the sense of dwelling with, cohabiting. Asatmya is what the body cannot assimilate. This is the Ayurvedic framework for allergies, intolerances, and autoimmune processes: not the body attacking itself, but the body unable to metabolize something that has entered it, and responding with inflammation.

Yukti — The physician’s clinical reasoning. In the context of the NIH study, yukti means the practitioner’s judgment about which medicine to prescribe for which patient at which stage of disease. It is the opposite of a fixed protocol. Rammanohar’s study preserved yukti by allowing individualized prescriptions within a pre-approved list of 150 medicines, rather than forcing a single drug for all patients.

Samprāpti — The full pathogenesis of a disease, from initial doshic accumulation through provocation, spread, localization, manifestation, and complication. Ayurveda does not describe diseases as fixed entities but as pathways. Amavata is a samprāpti, not a diagnosis in the Western sense. Vatarakta is a different samprāpti. A patient with what Western medicine calls rheumatoid arthritis may present with elements of both, and the Ayurvedic treatment follows the samprāpti, not the Western label.

Amavata — A disease pathway (samprāpti) in which ama combines with vata dosha. Classically described as affecting the axial skeleton: cervical and lumbar regions (trika sandhi), with stiffness and immobility of the spine. More closely resembles ankylosing spondylitis than rheumatoid arthritis, which affects the peripheral and symmetrical joints. Rammanohar’s clinical experience is that rheumatoid arthritis often presents with both amavata and vatarakta samprāptis overlapping in the same patient.

Vatarakta — A disease pathway in which vitiated vata combines with rakta (blood) dhatu. Classically described as beginning in the smaller joints of the hands and feet, symmetrically, and spreading from there. This matches the clinical progression of rheumatoid arthritis more closely than amavata does. The Caraka Samhita describes vatarakta as requiring the physician to treat the body “like an angry person” (Kṛpābhyāsa iva krodham vātaraktam niyacchati), with forbearance and persistent gentle treatment rather than aggressive intervention.

Rakta duṣṭi — Derangement or vitiation of the blood tissue (rakta dhatu). When ama in the body generates heat during treatment, that heat can disturb rakta, producing a secondary pathology that requires vatarakta treatment principles even when the primary condition is amavata.

Trika sandhi — The junctions where three bones meet. In the Ayurvedic anatomical context, trika refers specifically to the cervical (neck) and lumbar (lower back) regions. Amavata’s preference for the axial skeleton is described in terms of trika sandhi becoming stiff and immobile.

Dhātu — Not “tissue” in the Western sense, though often translated that way. Dhātu means support: the dynamic nutrient pools that sustain the body’s structures through continuous metabolic transformation. The seven dhātus (rasa, rakta, māmsa, meda, asthi, majjā, śukra) are stages of progressive refinement. Ojas is described as the essence of all seven dhātus. The Western translation “seven tissues” loses the metabolic, transformative dimension entirely.

Srotas (plural: srotāṁsi) — Channels of the body through which nutrients, waste, energy, and information flow. Not just blood vessels or nerves. Srotas includes functional pathways: the digestive channel, the respiratory channel, the channels of tissue nutrition. When srotas are clear, the body functions well. When they are obstructed (sanga), stagnant (atipravṛtti), or diverted (vimārga gamanam), disease processes begin. In the Ayurvedic approach to autoimmunity, clearing the srotas is one of the primary interventions.

Śodhana and Śamana — Two categories of Ayurvedic treatment. Śodhana is purification: removing ama and excess doshas through the five purificatory procedures of pañcakarma (emesis, purgation, medicated enemas, nasal administration, bloodletting). Śamana is pacification: calming the doshas without eliminating them, using diet, herbs, and lifestyle adjustments. In the NIH study, only śamana therapies were tested. Śodhana was excluded from the trial design as a first-step simplification.

Sadvṛttam — Right conduct, ethical lifestyle. The Ayurvedic framework for how daily and seasonal habits, interpersonal ethics, and environmental awareness contribute to health. When Rammanohar says that health is not just about what nutrients go into us but whether we are disturbing the ecosystem, he is invoking sadvṛttam.

Hitāhāra — Wholesome food. But not in the modern nutritional sense. Hitāhāra is food that is wholesome in the creating: that does not disturb the ecosystem in its production, harvesting, cooking, and distribution. The opposite is food that is nutritionally dense but ecologically destructive. Rammanohar makes this distinction explicit: what we call “good food” today means protein content. What Ayurveda calls hitāhāra means food whose entire chain of production is dharmic.

Dharma Hiṁsā and Kāma Hiṁsā — Dharma hiṁsā: violence within the limits of the food chain, the ecological order. An animal killed for nutrition within the natural food web, at a scale that does not disturb ecological balance. Kāma hiṁsā: violence for pleasure, for entertainment, for appetite that exceeds need. The industrial meat system is kāma hiṁsā. Ayurveda does not prohibit all animal protein; it distinguishes between sustenance that fits within the ecological order and consumption that breaks it.

Janapadodhvaṁsa — The destruction of communities. A passage in the Caraka Samhita (Vimāna Sthana 3) that describes a sequence of ecological collapse: first the land is damaged (deśa), then the water (jala), then the air, then the climate (kāla), and finally the society itself collapses. Rammanohar calls this the earliest model of planetary health. When the environment degrades, the body’s exposure changes, its food loses prāṇa, and the immune system, stretched beyond its capacity to adapt, begins to dysregulate. The current global rise in autoimmune conditions is, in this framework, not a collection of individual diseases but a single process at the scale of the population.

Prāṇa — Not just oxygen. The vital force that animates breath, food, and water. When Rammanohar says that even pure water may lack prāṇic energy if it has been stripped of its connection to its source, he is invoking a dimension of vitality that cannot be measured by chemical analysis. Air that is polluted does not merely lack oxygen; it lacks prāṇa. This is not a metaphor. In the Ayurvedic framework, prāṇa is a functional reality with direct consequences for the body’s capacity to maintain ojas.à

Theme music: « Tremblement » by Michaël Boudreau, from the album Terre.

To listen to the track, here:

Michaël’s link tree: https://linktr.ee/michaelboudreau

Field Notes are less polished than essays on Autoimmune Theory And Practice. Their goal is share what’s alive for me right now.

I read White Noise by Don DeLillo (1985) on the island of Koh Tao while I was recovering from the fever that laid me out into an autoimmune flare the first week of my trip. DeLillo is a satirist of American culture. White Noise is an acerbic take on the absurdity of the life of an academic whose sole purpose is the study of Hitler, and what befalls his nuclear family, suburban life, and the small town where he lives as natural and man-made chemical disasters. Reading DeLillo reminds me of reading Bret Easton Ellis, whom I loved as a teenager and have outgrown. You should read White Noise if you want to hold a mirror up to the monoculture.

In Chiang Dao and Chiang Mai I read The Sea Priestess by Dion Fortune (1935). Dion Fortune is interesting because she was an occultist in the early twentieth century, who was very influential in making magical theory and practice available in the English language outside of closed esoteric orders like the Golden Dawn. She self-published books and started a foundation to disseminate core teachings on magic. The Sea Priestess is a story that has as its actual purpose to teach about working with the land and the ocean. It is a love story between a Victorian suburban real estate agent and the Sea Priestess who is a sorceress of untold power. You should read Dion Fortune if you like camp and you like learning about the European magical tradition through story.

Also in Thailand, I read The Need for Roots by Simone Weil (1949). I did not read it for fun, but I also did not read it to learn about autoimmunity, so I’m including it here. I don’t know why I read it. I did not enjoy it. It is a treatise of moral philosophy. It outlines the obligations of each human being for each other. Simone Weil was a Christian, and her care was for the human labourers of society. Her opinion seems to me to have been that we need to take care of the earth only insofar as the earth is a resource for humanity. Insofar as she holds that position, I disagree with her. The earth is valuable regardless of us. But her description of the obligations of humans to each other is powerful, more so for having been written during the Second World War in exile from France. I agree with her conclusions about how society ought to be organized: decentralized, with spirituality at its center, and all of us doing meaningful work that directly benefits our communities. It was funny in a bleak way to read Simone Weil at the same time as White Noise because while Simone is in exile from occupied France, the protagonist of White Noise is a Hitler scholar. You should read Simone Weil if you’re interested in Christian mysticism and moral philosophy. In french if you can, because her prose is very precise.

When I got to Kerala I read The Left Hand of Darkness by Ursula Le Guin (1969) for, I don’t know, the fourth or the fifth time. I seem to read it every year or two. People always seem focus on the gender fluidity, the gender-bendy nature of this novel. Yes, it is an account of a world called Winter in which the human population has evolved such that their sexual impulse can drive them to have the sex characteristics of males or females depending on context and environment. It’s a wonderful epic of speculative fiction that is very relevant to the trans experience, and I love that, but that’s not the main reason I love this novel. Ursula Le Guin is a master of world building and The Left Hand of Darkness is the fourth novel in The Hainish Cycle. It is a potent piece of that puzzle, of the wider cosmology in the intergalactic cross-civilizational speculation that is also laid out in The Dispossessed, Rocannon’s World, and City of Illusions, among others. I love this novel in particular for its take on religion and spirituality. Surprise, surprise. The planet Winter is home to the Handdara, and to a form of contemplative practice that they have honed over millennia into an art. The main ritual of this cult is a foretelling, peering into the future in order to answer the question of a querent. The question almost never gets the answer that is desired. It gets a true answer, if it is answerable. As readers, we are shown time and again that knowing the future is not necessarily desirable. You should read The Left Hand of Darkness if you like speculative anthropology.

Then I read Wild Seed (1980) and Mind of My Mind (1978) by Octavia Butler, for the third time. I was astounded, absolutely astounded, again. I read them according to the story’s internal chronology, and I had no idea the whole Patternist series were published in roughly reverse-chronological order. These are the first two of a four-part saga. I decided to stop after the first two, this time.

Wild Seed is the story of two immortal Africans named Doro and Anyanwu. Doro is a spirit who was once human, who wears human bodies as clothes, and extends his life by taking human bodies and inhabiting them. Doro is drawn to power, and difference, among humans. He is a practicing eugenicist over centuries and millennia. He breeds humans together to get very specific potential outcomes. And this saga is set on Earth between the 1600s and the present. Because Doro is so long-lived, and his work spans generations. At the beginning he is drawn inexorably towards Anyanwu, in the deserts of Africa, where she is a powerful shape-shifting sorceress who has developed over her long life the capacity to change the molecular structure of herself. She can heal her body, create medicine in her body, create poison in her body. She can transform into a bird, a panther, a dolphin, any number of beings, and become those others for as long as she desires. Doro recognizes her power and convinces her to leave behind the life and the family that she has known all along. And thus the story begins, and it lasts centuries. This tale of these two hugely powerful people, hating and loving each other for their power and for their cruelty. I am particularly interested in Anyanwu because of her alchemy, because of her healing powers. She only really has control over herself. And she never forces that control on other people. She is beautiful.

Octavia Butler’s prose is entrancing and the books are impossible to put down. All of Octavia Butler’s books are impossible to put down for me. So you should read Wild Seed if you want to immerse yourself in historical speculative fiction that runs parallel to the horror of the last few centuries while emphasizing the brilliance of human ingenuity and the resilience of the soul in the face of cruelty.

Then I read The Dreamblood Duology by N.K. Jemisin. I had never read any N.K. Jemisin yet. I had meant to, for years, and it hadn’t happened before. And I cried. Over and over and over reading these two novels, I just sobbed constantly. These are high fantasy novels, inspired by the ancient Middle East. The feeling tone is the Thousand and One Nights meets Dune. This is a tale of dreams. It is a tale of nightmares. It is a tale of high desert political drama. It’s a tale of blood magic and tribal sorcery. It’s a lot of fun, it’s a wild ride. It is the best pair of atmospheric world building I’ve picked up in ages. It’s the most enjoyable reading experience I’ve had in years. I read the first one in one sitting. And I’m gonna read it again. It fascinates me, and I am going to have a lot more to say about it eventually, because blood is a central component. Dreamblood. The life force that keeps people alive. You should read the Dreamblood Duology if you like political intrigue and you don’t mind reading violence.

Then I read The Madonna Secret by Sophie Strand (2023). In parallel, I also read The Body Is a Doorway (2025), but The Body Is a Doorway is not fun. In her memoir, Strand wrote the illness memoir I needed five, ten, fifteen, twenty years ago. She put words to experiences I have repeatedly struggled to translate into a form I can share. She lapses into a lecturing tutorial voice only ever long enough for the reader to get the gist of the facts, and otherwise maintains the thread of story throughout sublime and harrowing life. She refuses to lie and deliver a neat package to the reader. In this she is strong. She wrote the book we needed about illness and ecology today. The text does not resolve, does not promise absolution. It dissolves, melts and, in her words, composts experience into soil. Where I am obsessing over distillation, the industrial alchemy of blood, she shows us blood is always dirt.

Strand’s novel, The Madonna Secret, is loads of fun to read, if no less harrowing and heartbreaking. It is exquisitely researched and textured historical fiction set during the life and times of the historical Jesus. It is told from the point of view of Mary Magdalene, who in this story was Jesus’ wife. It feels like reading a true story about Jesus, and it is a balm to the soul. As a lover of Christ as a teacher of the heart, and a hater of empire, this novel really soothed me. Strand’s prose is beautiful. She sets the stage through the smells and textures of the earth and the soil. Alongside her romantic tendencies, the sensorial nature, the sounds, it’s a very engrossing reading experience. You should read The Madonna Secret if you like historical fiction, and you want to think differently about the life of Jesus, to put him back in the context of the first century in which he was a naturalist magician.

Then I read Boudica: Dreaming the Eagle by Manda Scott (2003). Boudica is a historical fiction saga that reimagines the life of the Celtic warrior queen Boudica and her people. The story takes place in the British Isles and Gaul, at the edges of the Roman Empire. It is a story of dreaming. It is a fiction, largely because there is no written record of Boudica’s life and her people’s life. And, as both a fiction and a historical look at the horrors of Rome, it is striking. After reading this novel, I started dreaming again and taking my dreams seriously and writing them down, which I had not done systematically in years. Having read some of the context from Manda Scott’s writing this novel, I understand that dream initiation was in part her intention. In that, it is a complete success. As a page-turning adventure novel, it is totally engrossing. You should read Boudica if you love the earth, you love animals, and you want to read fiction that helps you feel closer to the land instead of further away from it. There’s a lot of horses in it. Manda Scott was a veterinary surgeon, and she’s really good at talking about animals.

I love books that are just for fun. When I need to take a break from studying all of the things that I study, I read novels. I read epic fantasy and speculative fiction and stories of dreams and magic and high drama. Stories of magicians and assassins and seduction and sorcerers vying for geopolitical power in fantastical lands. At no given moment is there anything I would rather be reading, and this has been the case for decades. For my whole life. For as long as I’ve been able to read.

Reading for fun is really important. It’s really important to feed the creative inner child with stories that are long form, complex, and emotional. I find myself crying during novels a lot. I do not weep and sob when I read political theory, ancient traditional medical texts, immunology papers, or substacks. Very rarely. So it is important to me that I foster my love of reading.

I occasionally get very romantic and whimsical about living in a pre-literate culture and wondering what it would be like if, oh damn, if I just had never learned to read, if we didn’t need books, if we didn’t need text, if I could just live in an oral culture, have amazing place-based ancestral memory, be so connected to the earth because I don’t have this medium between me and the world that is the written word. Wouldn’t everything be so much better? But that’s not necessarily true, you know. It’s a very romantic vision of things, to think things would be better if we didn’t have texts.

And, anyway, I can read. So I might as well do it. It is something that brings me a lot of joy. I feel enriched by using my time reading. I find that when I read novels specifically, I feel fulfilled and I feel a sense of purpose. And I feel a sense of escape, also, from the harder parts of the current reality, which are too many to list here. You know what I’m escaping from. While the point of this blog is primarily to talk about autoimmunity in a more framed way, more specifically about the health and the illness and the politics and the philosophy of it, I give myself space to read for fun. And I think you should too.

Okay that’s it! Now I’m reading The Broken Earth Trilogy by N.K. Jemisin. I’m heading back to Montreal this week.

At the same time, my mother noticed the petechiae: tiny hemorrhages under the skin, red-violet points that did not blanch when pressed. When we went to the hospital for my eyes, we entered a parallel track in haematology, and the blood test came back at functionally 0 platelets per microliter. Normal range is 150,000 to 450,000.

The hematologist told my mother that my immune system was destroying platelets faster than the bone marrow could produce them, and that I likely suffered from idiopathic thrombocytopenic purpura (a now defunct name). We learned some new words that day. One word in particular, idiopathic, which means: we do not know why your child is bleeding, with the subtext, but if we don’t act now, it will get worse.

I have had immune thrombocytopenia for twenty-five years. In that time I have been told many things about what my body is doing. The language offered has been almost entirely military. The immune system attacks the platelets. The body has turned against itself. Autoantibodies target glycoproteins on the platelet surface, opsonize them, mark them for destruction by macrophages in the spleen. The metaphor is friendly fire and civil war: a defense system that cannot distinguish friend from enemy, self from non-self.

I have never found this language accurate to the experience. The experience is not of being attacked. The felt sense is of dissolving; blood does not coagulate as it should, a bruise appears without impact, a cut bleeds longer than expected, gums are sticky and taste a little bit like iron. The sensation is less martial than hydraulic: a body whose fluid boundaries have become unreliable, whose containment leaks.

The language matters because it determines what questions get asked. If the immune system is attacking, the question becomes: how do we stop the attack? And the treatments follow that logic precisely. Corticosteroids suppress immune activity broadly, a pharmacological ceasefire. Rituximab depletes B cells that produce autoantibodies, eliminating the factory. Splenectomy removes the organ where tagged platelets are destroyed, dismantling the killing floor. Thrombopoietin receptor agonists stimulate the bone marrow to produce more platelets, flooding the field with reinforcements. Each intervention has a logic, and each logic is downstream of the metaphor. None of them asks why the immune system began treating platelets as wrong in the first place.^[1]

What the immune system actually does in a healthy body is more complex than the military metaphor permits. Half of circulating antibodies are not specific to anything in particular. They attach broadly, loosely, to many surfaces, recognizing not a single organism but the general texture of biological matter.^[2] Antibodies clear the debris that accumulates when cells die. They are composters.

A quarter of the antibodies produced in the gut target the bacteria that live there permanently, not foreign organisms, and maintain a molecular boundary that permits coexistence rather than demanding elimination.^[3] Regulatory T cells exist specifically to suppress immune responses, continuously maintaining the conditions under which the immune system does not react to self.^[4] Tolerance is not a default state. It is ongoing labor.

The self/non-self model that structures biomedical immunology was first articulated by Macfarlane Burnet and his team in the 1940s. It frames the immune system as a border patrol that identifies foreign material and eliminates it. In this model, autoimmunity is border patrol turning on its own citizens.

But the immune system manages the maternal-fetal interface, tolerating genetically foreign tissue for nine months. It clears billions of apoptotic self-cells daily without triggering inflammation. It maintains a working symbiosis with trillions of commensal organisms. The relational work the immune system performs, the composting, the boundary-tending, the tolerance of the foreign and the clearing of the self-that-has-died, dwarfs its defensive function.

The Brazilian immunologist Claudio Viera Da Silva recently published a cutting analysis of immunology’s colonial metaphors, and he identifies this framing as a product of the coloniality of power: the field’s language of defense, attack, soldiers, and enemies imports assumptions from a specific political cosmology and projects them onto biological processes that precede that cosmology by several hundred million years.^[5] The military metaphor makes certain interventions obvious (suppress, eliminate, remove) and renders others invisible (restore relationship, re-establish boundary, support the regulatory function that maintains tolerance). The vocabulary constrains the pharmacology.

My body does not experience autoimmunity as warfare. It experiences it as a kind of porousness, a failing of the containment that healthy tissue provides without anyone noticing. Something not holding.

In August 2001, my spleen was removed. The logic was straightforward: the spleen is where antibody-coated platelets are filtered from circulation and destroyed by macrophages. Remove the primary site of destruction, and platelet counts should rise. Mine did, at first. The surgery was considered successful. Temporarily, sure, it was.

What was accepted as “collateral damage” at the time is that splenectomy permanently altered my immune terrain. The spleen is the largest secondary lymphoid organ in the body. It is where marginal zone B cells reside, where blood-borne antigens are first encountered, where the immune system generates its responses to encapsulated bacteria.^[6] Its removal means lifetime vulnerability to overwhelming post-splenectomy infection, a risk managed through vaccination and preventative antibiotics but never eliminated. The surgery solved one problem by creating another, trading hemorrhagic risk for infectious risk. In biomedical terms, an acceptable exchange. In the terms of the body living it, a permanent reconfiguration of the conditions of being alive.

I began studying traditional Asian medicines when I was in my twenties. When I did, the splenectomy and the bleeding all acquired a different legibility.

In Ayurvedic pathophysiology, what I carry is not called immune thrombocytopenia. It is called Raktapitta: a condition in which Pitta, the principle of heat and transformation, enters and vitiates Rakta dhatu, the blood. The blood becomes too hot, too fluid, too sharp. It cannot be contained by the vessels. It hemorrhages.^[7]

Pitta is not an entity that can be isolated under a microscope. It is a functional principle: the body’s capacity for transformation, digestion, discrimination. It governs the conversion of food into nutrients, of sensation into perception, of experience into understanding. When Pitta is in its seat, it performs these transformations cleanly, the way fire refines ore. When it is vitiated (excessive in quality, displaced from its location, increased beyond its proportion) its sharpness begins to damage what it should be refining. The classical texts use the image of fire burning its own vessel.

The pathogenesis traces a sequence that begins not with the blood but with Agni, the digestive fire, and with the conditions that disturb it: excessive intake of hot, sour, and pungent foods; excessive exposure to sun and heat; anger and grief; suppression of natural urges; exhaustion.^[8] These factors first disturb Agni, then vitiate Pitta, which enters Rakta dhatu through the relationship between Pitta and its tissue host.^[9] The two are not separate things that interact. They are aspects of a single physiological process: heat living in blood, transformation dwelling in the tissue that carries it. When Pitta’s heat exceeds what Rakta can contain, the blood escapes the vessels. The hemorrhage is not a failure of the blood. It is an excess of the fire the blood was built to carry.

The organs that the Ayurvedic tradition identifies as central to Raktapitta are the liver and the spleen. These two are the root sites of the channels through which Rakta circulates and transforms.^[10] The liver is the seat of a specific transformative fire that gives blood its color, its quality, its capacity to nourish. The spleen participates in the filtration and renewal of Rakta.

The organ they removed from me at five was, in Ayurvedic terms, one of the two root sites of my blood’s channel system. The biomedical act was precise and justified within its own logic, but it altered the Ayurvedic terrain permanently, in ways the biomedical frame can not register because it does not recognize the terrain. My platelet count rose. Something in the conditions of transformation shifted. Both statements are true, and they are not the same truth.

A case report documents chronic ITP treated as Tiryaggata Raktapitta. The patient’s platelet count rose from 9,700 to 50,000 over the course of Ayurvedic treatment, with no recurrence during follow-up.^[11] The Ayurvedic approach framed the condition as a consequence of prior Vishama Jwara (irregular fever, likely malarial), suggesting an infectious trigger consistent with biomedical understanding: most ITP follows a viral or infectious stressor, though most infections do not lead to ITP.

The convergence is real: both traditions recognize that something, likely fever, preceded the bleeding disorder. The divergence is in what comes after. Biomedicine treats the mechanism of platelet destruction. Ayurveda treats the vitiated terrain, the sustained conditions of heat and sharpness that allowed the destruction to begin and that perpetuate it.

Ayurvedic treatment of Raktapitta addresses the system: Virechana (therapeutic purgation) to remove excess Pitta from the gut, its primary site of accumulation; cooling herbs and diet to reduce Pitta’s qualities of heat and sharpness; In classical practice, bloodletting was indicated, Raktamokshana; Then, rejuvenation therapy to restore the quality of Rakta dhatu after the acute phase has resolved.^[12] The aim is to restore the conditions under which heat and blood coexist without the heat damaging the vessel. Restoration of a relationship that had become unsustainable.

In Chinese medicine, the same condition is read again differently. A TCM practitioner does not begin with the platelet count. They begin with the pulse at three positions on each wrist, the tongue body and coating, the quality and color of the bleeding, the emotional state, the sleep, the digestion, the temperature preferences. They arrive not at a disease name but at a pattern.

A recent study classified ITP patients into three TCM patterns and correlated each with immune markers, providing objective biomarker correlates for what Chinese medicine has differentiated clinically for centuries.^[13]

Blood Heat (Xue Re Chu Xue): acute onset, bright red bleeding, fever, thirst, rapid pulse, red tongue with yellow coating. These patients had the highest Th17 levels, the lowest Treg/Th17 ratio, the most severe inflammatory dysregulation.

Yin Deficiency with Fire (Yin Xu Huo Wang): chronic course, low-grade fever, night sweats, dry mouth, thready rapid pulse. Intermediate immune disturbance.

Qi Deficiency Failing to Govern Blood (Qi Xu Bu She Xue): chronic course, fatigue, pale complexion, bleeding worsened by exertion, pale tongue with teeth marks, weak pulse. These patients had the highest Treg percentages and relatively preserved regulatory function, but inadequate production.

What Chinese medicine has differentiated by pulse and tongue maps onto measurable immunological states. Blood Heat corresponds to acute inflammatory disease with regulatory failure. Qi Deficiency corresponds to chronic stable disease with production impairment.

The pattern is not a metaphor for the immunology, and the immunology is not a validation of the pattern. They are two descriptions of the same phenomena, legible at different resolutions.

The TCM framework holds that Qi governs blood: it generates blood, it moves blood, and critically, it holds blood within the vessels.^[14] When Spleen Qi is deficient, blood escapes. This is not the biomedical spleen.

The TCM Spleen (脾; pí) governs transformation and transportation: the conversion of food into nourishment, the maintenance of tissue integrity, the holding of things in their proper place. Worry and overthinking damage it. Fatigue depletes it. The TCM Spleen is closer to the biomedical concept of digestive and absorptive function combined, with a principle of structural containment, than it is to the lymphoid organ in the left upper quadrant of the abdomen.

When Liver Qi stagnates, it can transform into Fire, which scorches the vessels and drives blood out of them. When Kidney essence is depleted, the marrow that produces blood is impoverished at its source.

Treatment addresses whichever pattern dominates: cooling and clearing for Blood Heat, tonifying and holding for Qi Deficiency, nourishing and settling for Yin Deficiency with Fire.^[15] Multiple clinical trials document the efficacy of these formulas in ITP, both as standalone treatment and as adjunct to corticosteroids, with higher response rates and lower recurrence.^[16]

Three traditions, three entries into the same clinical territory, and what spans across all of them is heat.

Biomedicine describes inflammation: elevated Th17 cells, elevated inflammatory cytokines, complement activation, the cellular and molecular machinery of immune dysregulation producing measurable heat and tissue damage.^[17]

Ayurveda describes Pitta vitiation: heat excessive in quality, sharp, spreading, entering blood tissue and rendering it unable to stay contained.

Chinese medicine describes Blood Heat: bright red bleeding, fever, thirst, rapid pulse, a pattern that, when correlated with immune markers, shows the most severe inflammatory dysregulation of the three TCM subtypes.

The three traditions did not consult each other. They arrived at heat independently, through different epistemological methods: controlled trials, pulse diagnosis, textual lineages spanning over a thousand years. The convergence is not proof that one tradition is correct. It is evidence that the phenomenon is robust enough to be legible from three vantage points, each with its own resolution and its own limitations.

What also converges is the centrality of the spleen and liver. Biomedicine identifies the spleen as the primary site of platelet destruction (Fc-dependent macrophage phagocytosis) and the liver as the secondary site (Ashwell-Morell receptor clearance of desialylated platelets).^[18] Ayurveda names Yakrit and Pleeha as the root sites of the blood’s channel system. Chinese medicine assigns the Spleen the function of governing blood and the Liver the function of storing it.

Three maps, each marking the same two organs. But when the hematologist says “spleen,” she means the lymphoid organ whose macrophages phagocytose opsonized platelets. When the Ayurvedic practitioner says “Pleeha,” they mean a root site of Rakta formation and filtration participating in the transformation of rasa into blood tissue. When the TCM practitioner says “Spleen,” they mean a functional principle that transforms food into Qi and Blood and holds Blood within the vessels, damaged by worry and depleted by fatigue.

These are not three names for the same thing. They are three descriptions of overlapping but non-identical territories. The places where the overlap fails carry as much information as the places where it holds.

Biomedicine sees mechanism with extraordinary precision. It can identify the specific glycoproteins the autoantibodies target (GPIIb/IIIa, GPIb/IX), the specific immune cell populations involved (Th17 cells, cytotoxic CD8+ T cells, regulatory T cells, follicular helper T cells), the multiple pathways of destruction operating simultaneously or sequentially in different patients.^[19] It can quantify. It can intervene with molecular specificity. What it cannot do is explain why tolerance failed in the first place. The cause of most ITP remains idiopathic. The mechanism of disease is mapped, but the origin is not.

Ayurveda sees terrain. It sees the condition as emerging from a specific relationship between digestive function, metabolic heat, tissue quality, and the channels through which these relate. It asks not what is destroying the platelets but what conditions of heat, sharpness, and excess produced and sustain the disorder. Treatment addresses the terrain rather than the mechanism. What Ayurveda cannot do is quantify: it does not count platelets, it does not distinguish antibody-mediated from T-cell-mediated destruction, and the relationship between Ayurvedic intervention and measurable hematological outcomes is still a field of emerging research rather than established evidence.

Chinese medicine sees differentiation. It recognizes that the same diagnosis contains multiple distinct patterns requiring different treatments. A person with Blood Heat and a person with Qi Deficiency both carry the label ITP, but their conditions are immunologically distinct, their treatments are pharmacologically different, and their trajectories diverge. What Chinese medicine cannot do is unify: the empirical differentiation is powerful, but the theoretical framework for why these patterns arise operates at a different epistemic resolution than the biomedical account, and the bridges between the two remain under construction.

I carry this condition in a body that has been materially shaped by interaction with all three frameworks. The splenectomy, penicilin, cortisone, IVIG, Revolade, all of that was biomedical, and it kept me alive. The dietary and lifestyle practices that hold my Pitta in relative equilibrium today are Ayurvedic. The Chinese physical practices I do and formulas I take address Spleen Qi, Liver Qi, the holding of blood in the vessels.

None of these traditions tells me why I developed ITP at age five. The trigger was likely an infection and high fever, a common etiology in pediatric onset. Why that infection led to tolerance failure in my body and not in others remains unknown. Genetics and epigenetics play a role. The conditions that preceded my body’s own formation play a role that none of the three traditions can fully articulate, though all of them, through Autoimmune Ecology, Ayurvedic Deshaprakriti (constitutional) theory, and TCM essence theory, gesture toward the ancestral and ecological dimensions of the question.

What the three traditions together provide is not an answer but a richer set of questions. The biomedical question: which mechanism dominates, and which molecular target will address it? The Ayurvedic question: what conditions of heat, digestion, and tissue quality sustain the disorder, and can those conditions be altered? The TCM question: which pattern does this person present, and what does their body need to restore its own capacity to hold blood in the vessels?

The questions are not interchangeable. They operate at different scales, address different aspects of the condition, and lead to different interventions. A person who can hold all three has not solved the platelet problem. They have more directions from which to approach it, more ways to read what the body is doing, and a clearer sense of what each intervention can and cannot reach.

My condition continues, platelet count fluctuates, and bruises appear then fade. Twenty-five years of this has produced familiarity with the cycles. I know what my body does, I know the texture of a count dropping before the lab results confirm it: a heaviness in the gums, a tendency to bruise at the slightest pressure, a fatigue that is less about energy than about porousness. The body leaking what it should contain.

Three traditions look at this and see three fires. Biomedicine sees the inflammatory cascade: Th17 elevation, cytokine dysregulation, the measurable heat of immune activation. Ayurveda sees Pitta vitiated and displaced, sharpness where there should be refinement, fire burning the vessel it was meant to temper. Chinese medicine sees Blood Heat, or Qi too depleted to hold the fire, or Yin too diminished to cool it.

What I see, after twenty-five years of living inside it and a decade of studying it through multiple frameworks, is that the condition is not one thing. It is not the platelet count, though the platelet count matters for whether I can undergo surgery or survive a car accident. It is not the vitiated Pitta, though the heat is real and responds to cooling. It is not the TCM pattern, though the pattern differentiates in ways that determine which herbs will help and which will not. It is the place where three descriptions converge without collapsing into one, where each tradition illuminates what the others leave in shadow.

The military metaphor cannot reach this place. In the language of warfare, the body is a theater of conflict, and every intervention is tactical: suppress, eliminate, remove. What all three traditions approach from their different directions is something closer to an ecology: a terrain in which relationships between heat and blood, between transformation and containment, between production and destruction, have become disturbed. The disturbance is real. It produces real consequences, real bruises, real hemorrhages, real trips to the emergency room with a fever and a platelet count of essentially zero. And it can be addressed from more than one direction, not because integrative medicine is fashionable but because the condition itself is legible in more than one framework, and each framework reaches what the others miss.

The platelet count is a real number. The heat in the blood is a real phenomenon. The pattern in the pulse is a real finding. The person holding all three is not performing academic synthesis, they are navigating a chronic bleeding disorder.

Footnotes

1. For a comprehensive review of ITP pathophysiology and the heterogeneity of destruction mechanisms, see Farhid F, et al. (2025). “When the victim becomes the villain: Platelets as drivers of immune dysregulation in ITP.” Journal of Translational Autoimmunity 100268. The title itself reproduces the military metaphor the field cannot leave behind.↩︎

2. Lutz HU, et al. (2009). “Naturally occurring antibodies in homeostasis and disease.” Trends in Immunology 30(1):43-51.↩︎

3. Macpherson AJ, et al. (2008). “The immune geography of IgA induction and function.” Mucosal Immunology 1(1):11-22.↩︎

4. Sakaguchi S, et al. (2008). “Regulatory T Cells and Immune Tolerance.” Cell 133(4):519-521. Tolerance as active process: Tregs are constitutively engaged in maintaining the conditions under which immune cells do not react to self. They are not a backup system that activates when something goes wrong. They are the ongoing labor of self-recognition.↩︎

5. Da Silva EO. (2026). “The Coloniality of Power in Immunology.” The field’s military vocabulary (defense, attack, soldiers, enemies, invaders) is not metaphorical convenience. It shapes which mechanisms are investigated, which drugs are developed, which interventions appear obvious. The warfare frame makes suppression and elimination visible as strategies while rendering restoration and relational repair invisible. Da Silva’s analysis extends Quijano’s coloniality of power into the epistemology of biological science: the concepts the field uses to describe the immune system import the political cosmology of the colonial encounter.↩︎

6. Bordoni V, et al. (2025). “Impairment of Innate Immunity and Depletion of Vaccine-Induced Memory B and T Cells in the Absence of the Spleen.” American Journal of Hematology 100(1):E1-E5; Borgers JSW, et al. (2020). “High-Dimensional Analysis of Postsplenectomy Peripheral Immune Cell Changes.” ImmunoHorizons 4(9):563-574. The immunological consequences of splenectomy extend far beyond susceptibility to encapsulated bacteria. Marginal zone B cells, a population unique to the spleen, are permanently lost.↩︎

7. Ujjwal D, et al. (2023). “Conceptual Review of Raktapitta in Ayurvedic Classics with Modern Correlation to Hemorrhagic Disorders.” Journal for ReAttach Therapy and Developmental Diversities 6(2):347-354.↩︎

8. Pooja D, et al. (2025). “Critical Analysis of Raktapitta: A Review.” International Ayurvedic Medical Journal.↩︎

9. Anoop M, et al. (2025). “Ashraya-Ashrayi Bhava Unveiling Physiological Significance and Therapeutic Application in Panchakarma.” International Ayurvedic Medical Journal; C. M, et al. (2025). “Sharira Kriyatmaka Study of Ashraya-Ashrayi Bhava and its Clinical Significance.” AYUSCRIPT.↩︎

10. Yakrit and Pleeha are the Moolasthana, the root sites of Raktavaha Srotas. Pawar PD. (2024). “To Study the Anatomical Aspect of Raktavaha Srotas W.s.r to Its Moolasthana as Per Ayurveda and Modern Science.” International Journal for Multidisciplinary Research 6(2).↩︎

11. Gupta K, et al. (2023). “Ayurvedic Management of Immune Thrombocytopenic Purpura: A Case Report.” International Journal of Complementary & Alternative Medicine 10(2):45-48.↩︎

12. Swati, et al. (2025). “Raktapradoshaja Vikara and Their Upakrama.” Journal of Ayurveda and Integrated Medical Sciences.↩︎

13. Zheng X, et al. (2015). “Correlation between Treg/Th17 and Traditional Chinese Medicine syndrome differentiation classification in patients with immune thrombocytopenia.” Academic Journal of Second Military Medical University 35(11):1235-1239. This study is the empirical linchpin: objective biomarker correlates for what had been subjective pattern differentiation.↩︎

14. Zhou X, et al. (2026). “Integrating ‘Yang transforming Qi and Yin constituting the body’ with immune regulation: an evidence synthesis of multidimensional traditional Chinese medicine therapy for immune thrombocytopenia.” Chinese Medicine 21(1):12.↩︎

15. Sun FY, et al. (2025). “Exploration of biological essence of blood heat syndrome and mechanism of blood-cooling traditional Chinese medicine from combination of disease and syndrome.” Zhongguo Zhong Yao Za Zhi 50(2):321-333.↩︎

16. Ding MY, et al. (2022). “Effectiveness of shengxuexiaoban capsules combined with glucocorticoid therapy for immune thrombocytopenia: A meta-analysis.” PLoS ONE 17(10):e0275873; Wang W, et al. (2025). “Clinical efficacy of Guishao Shengxue decoction in the treatment of pediatric immune thrombocytopenia: A randomized controlled trial.” Explore.↩︎

17. Li Q, et al. (2024). “Autoimmune effector mechanisms associated with a defective immunosuppressive axis in immune thrombocytopenia (ITP).” Autoimmunity Reviews 23(1):103383.↩︎

18. Li J, et al. (2015). “Desialylation is a mechanism of Fc-independent platelet clearance and a therapeutic target in immune thrombocytopenia.” Nature Communications 6:7737. The hepatic clearance pathway via the Ashwell-Morell receptor explains why some patients do not respond to splenectomy: their dominant destruction mechanism was never splenic.↩︎

19. For the multiple destruction pathways operating in ITP, see: Malik A, et al. (2023) on CD8+ T cell direct cytotoxicity; Zheng S, et al. (2022) on desialylation and apoptosis; Petito E, et al. (2024) on megakaryocyte impairment. The heterogeneity of destruction mechanisms is itself evidence that ITP is not one disease but a convergent phenotype arising from multiple etiologies.↩︎

Women develop autoimmune conditions at rates that should stop conversation.

Condition-weighted reviews put the figure at roughly four in five: 78% of autoimmune patients are female.^[1] A 2023 population study of 22 million people in the UK found the gap between women and men widens sharply by diagnosis: lupus at 9 to 1, Sjögren’s at 6 to 1, Hashimoto’s at nearly 6 to 1, primary biliary cholangitis at 10 to 1, rheumatoid arthritis at 2 or 3 to 1.^[1-1][2] Conditions, geographies, study designs: the ratio holds.

The standard explanation is biological. It goes like this: The molecular architecture exists. Women have two X chromosomes. Estrogen promotes autoreactive B cell survival, which promotes female sex-biased autoimmunity.^[3]

But architecture and causation are different orders of claim. Lungs make emphysema possible. What causes it is what fills them. XX chromosomes make lupus possible. What actually causes lupus is whatever fills the body with a stress response that cannot resolve. The biological explanation accounts for susceptibility, it does not account for incidence. Why do so many more women develop these conditions than men, by ratios as extreme as 9 to 1?

One in three women worldwide has experienced physical or sexual violence. The WHO’s numbers: 840 million women across a lifetime.^[4] The range by region runs from 20% in high-income countries to 33% in Africa and South-East Asia.^[4-1] Even the floor is staggering: more than one in five women in the wealthiest nations on earth. Intimate partner violence alone affects 27% of women who have been in relationships. White and colleagues’ 2023 meta-analysis of 201 studies confirmed the mental health consequences: doubled odds of depression, 2.6 times the odds of
PTSD.^[5] Thirty-eight percent of all women murdered are killed by their partners.^[4-2]

The autoimmune ratio and the violence ratio are the same number, read differently. The violence that produces the first number includes the childhood experiences that produce the second.

The Adverse Childhood Experiences (ACE) Study: 15,357 adults, followed from the mid-1990s through 2005. Dube, Fairweather, and colleagues published the dose-response in 2009. For every additional adverse childhood experience, a woman’s risk of hospitalization for autoimmune disease increased 20%. Two or more ACEs: more than double the hazard ratio. The gradient was linear, and steeper for women than for men.^[6]

Köhler-Forsberg and colleagues replicated this in 2025 across two cohorts totaling 108,915 women: 22,423 Icelandic, 86,492 in the UK Biobank. Each additional ACE raised the prevalence ratio by 10%. For Sjögren’s, 34%. For polymyalgia rheumatica, 20%. The ACEs most consistently associated with autoimmunity: sexual abuse, physical neglect, emotional neglect.^[7] A quarter of the association ran through depression, anxiety, and PTSD. Three-quarters passed through a channel the psychometric instruments could not reach.

The same dose-response, gender-amplified pattern appears over and over: the more ACEs, the higher the risk of illness, with the steepest rises in the conditions most skewed toward women. ^[8]

The mechanism runs through the hypothalamic-pituitary-adrenal (HPA) axis. With an acute threat: cortisol spikes, immune function modulates, the organism survives.

With a chronic threat, an ongoing sense of danger: the whole body degrades. Glucocorticoid receptor resistance develops. Cortisol’s anti-inflammatory signal weakens. The body stays inflamed because it cannot hear the signal to stop.^[9][10] Juster and colleagues describe this as a temporal cascade of dysregulations accumulating across neuroendocrine, immune, metabolic, and cardiovascular domains.^[11]

Palma-Gudiel and colleagues found the molecular proof: Lower methylation meant higher TNF expression when immune cells were stimulated. The stress had rewritten the gene’s responsiveness at the molecular level.^[12]

Neigh and Ali found that PTSD patients carry roughly 50% fewer regulatory T cells, the cells responsible for maintaining self-tolerance. Inflammation wins.^[13] Maihofer and colleagues’ 2024 Mendelian randomization of 1.2 million individuals found that genetically predicted PTSD has a causal effect on autoimmune thyroid disease. The direction runs one way: trauma first, thyroid second.^[14]

Campos-Tinajero and colleagues measured this directly. In a Mexican hospital, 24.4% of women with lupus had experienced intimate partner violence in the past year. Lifetime prevalence: 36.5%. Abuse severity tracked precisely to lupus disease severity.^[15]

Yim and colleagues’ 2019 review found “emerging evidence of stress-related endocrine and immune-inflammatory dysregulations that are in line with patterns typically observed among chronically stressed individuals.”^[16]

Translated from the passive voice of academic caution: the biological signatures of intimate partner violence overlap the biological signatures of chronic stress, which overlap the signatures that precede autoimmune disease. One set of marks, one hand.

Violence against women receives less measurement, less funding, less academic publication. Stubbs and colleagues’ 2021 systematic review of 52 studies on IPV and physical health found increased risk of diabetes, sexually transmitted infections, chronic pain, CD4+ cell depletion, and chronic disease broadly. They noted “significant gaps in this field of research, particularly in relation to cardiovascular disease, endocrine dysfunction, and neurological symptoms and conditions.” ^[17] What has gone unmeasured would likely be stronger.

Ongoing and repeated violence produces chronic stress, which dysregulates the HPA axis, which reprograms immune gene expression through epigenetic modification, which erodes self-tolerance. Autoimmunity follows.

Sophie Strand collapsed at sixteen. Ehlers-Danlos syndrome, mast cell disease, gastroparesis, autoimmune comorbidities. Years of antibiotics that destroyed her gut biome. Doctors who called her body toxic. Wellness practitioners who diagnosed her as sludged with demons, then blamed her when their treatments failed.

She writes excruciatingly publicly about being an abuse survivor. Today, this week, she writes the connection directly: “This past month a rash has spread over my whole body. I’m told it is an autoimmune response to a cold virus. But I know it is also my anger spilling over my very cells. It has to move. It can’t be quiet.”

In “I Will Not Be Purified,” she names what both medicine and wellness culture share: a purity logic that frames illness as contamination and the sick body as morally failed. The doctors tried to clean her. The healers tried to clean her. The cleaning was itself the pathogen. She proposes ensoilment over ensoulment: compost instead of purification. “In order to grow a garden, you need manure.”^[19]

The Caraka Samhita spelled this out two thousand years ago. Anger, krodha, is classed among the urges that must be restrained, dharaniya vegas. Not because restraint is virtuous, but because the unrestrained urge does what unrestrained urges do: it burns through tissue. Caraka lists what anger does to the body. Muscle laxity. Joint looseness. Heat in blood. Fat melting. Marrow hollowing out. Semen depleted. Vitality lost.^[20] The Saṃhitā does not moralize about anger. It maps its consequences and its vicious effects on health. Anger is āgneya, fiery. It aggravates the body’s capacity for transformation. It disturbs the digestive fire, so that food is no longer digested but fermented and turned to metabolic waste. It vitiates the blood, and from that vitiation: skin disease, metabolic collapse, bleeding disorders, cardiac damage.^[21] The text is explicit. Anger is not a feeling that happens to live in a body. It is a thermal event with physiological consequences, and the body that cannot metabolize it carries ongoing combustion in its structure. Anger is also a correct response to grave systemic injustice and the millenia-long pandemic of violence against women and queer people.

If you have forever been embedded in systemic abuse and suffering, where do you turn your anger? If no one around you knows what it means to fear one’s own body rather than one’s own mind, how do you share it? If the slightest discomfort reminds your body of what is has intimately known through coercion, and the cells scream death by internal trauma, how do you find a way to relax?

The Ayurvedic mapping and the epidemiological data describe the same process. Caraka takes the anger at face value, while the adverse childhood experiences studies read the dose-response and mental distress, and the endocrine axis studies on regulation and epigenetic programming describe the stress at molecular scale. They are describing the same bodies.

Sophie’s point (which is also my argument), is that the body records what was done to it, and the record is legible in the immune system. The anger that cannot move metabolically becomes autoantibodies. The grief that cannot be released becomes chronic inflammation. The body becomes what it cannot release. Autoimmune markers are the body’s record of what it could not metabolize. Estradiol and XIST describe the terrain. Violence describes the ignition. The hormonal and chromosomal explanations account for why the female body can develop autoimmunity. The violence data accounts for why, in such numbers, it does.

Thirty percent of women worldwide physically or sexually violated. A direct mapping between ACEs and autoimmune hospitalization, replicated across cohorts totaling over 100,000 women. Direct correlation between partner violence severity and lupus disease activity in a clinic in Monterrey. Causal arrow from PTSD to autoimmune thyroid disease in a Mendelian randomization of 1.2 million people. How can you not be angry? How can we live in any state except perpetual anger, with this being the state of the world?

Men are taught we can hurt women and face nothing. This teaching has a biological output. It shows up in stress genes rewritten, in the immune cells that should maintain self-tolerance depleted by half, in the cortisol receptors that stop listening, in the hospitalization records of 100,000 women across two continents and thirty years of data. The body keeps what was done to it. The immune system is the transcript.

Why do women develop more autoimmune diseases? The cause has a name. The cause is violence. Not the kind that makes the news. The kind that is so common it registers as background: the childhood abuse, the intimate partner violence, the sexual assault, the daily threat that keeps their stress response permanently activated. The women worldwide who carry this in their blood are bearing the cost. The autoimmune markers are visible effects. The physiology is clear enough. The overwhelming silence of men, myself included, is the only thing left to explain.

1. Voskuhl R. “Sex differences in autoimmune diseases.” Biology of Sex Differences 2:1, 2011. PMC3022636↩︎↩︎

2. Incidence, prevalence, and co-occurrence of autoimmune disorders over time and by age, sex, and socioeconomic status: a population-based cohort study of 22 million individuals in the UK. Volume 401, Issue 10391. 2023. Lancet↩︎

3. Dou DR et al. “Xist ribonucleoproteins promote female sex-biased autoimmunity.” Cell 187(3):733–749, 2024. Duke↩︎

4. WHO. “Violence against women prevalence estimates, 2023.” WHO↩︎↩︎↩︎

5. White S et al. “Global Prevalence and Mental Health Outcomes of Intimate Partner Violence Among Women: A Systematic Review and Meta-Analysis.” Trauma, Violence & Abuse 24(2):465–482, 2023. Consensus↩︎

6. Dube SR, Fairweather D, Pearson WS, Felitti VJ, Anda RF, Croft JB. “Cumulative Childhood Stress and Autoimmune Diseases in Adults.” Psychosomatic Medicine 71(2):243–250, 2009. PMC3318917↩︎

7. Köhler-Forsberg O et al. “Adverse childhood experiences, mental distress, and autoimmune disease in adult women: findings from two large cohort studies.” Psychological Medicine 55:e36, 2025. PMC12017369↩︎

8. Sarnai Arlud et al. “Gender differences in the association between adverse childhood experiences and early onset psoriasis.” Scientific Reports, 2025. Consensus↩︎

9. Gutierrez Nunez S et al. “Chronic Stress and Autoimmunity: The Role of HPA Axis and Cortisol Dysregulation.” International Journal of Molecular Sciences, 2025. Consensus↩︎

10. Alotiby A. “Immunology of Stress: A Review Article.” Journal of Clinical Medicine, 2024. Consensus↩︎

11. Juster RP et al. “Allostatic load biomarkers of chronic stress and impact on health and cognition.” Neuroscience & Biobehavioral Reviews, 2010. Consensus↩︎

12. Palma-Gudiel H et al. “HPA axis regulation and epigenetic programming of immune-related genes in chronically stressed and non-stressed mid-life women.” Brain, Behavior, and Immunity, 2021. EuropePMC↩︎

13. Neigh GN, Ali S. “Co-Morbidity of PTSD and Immune System Dysfunction: Opportunities for Treatment.” Current Opinion in Pharmacology 29:42–48, 2016. PMC4992603↩︎

14. Maihofer AX et al. “Effects of genetically predicted posttraumatic stress disorder on autoimmune phenotypes.” Translational Psychiatry, 2024. Nature↩︎

15. Campos-Tinajero E et al. “Impact of intimate partner violence on quality of life and disease activity in women with systemic lupus erythematosus.” Lupus, 2024. Consensus↩︎

16. Yim IS et al. “The psychobiology of stress and intimate partner violence.” Psychoneuroendocrinology 105:45–54, 2019. Consensus↩︎

17. Stubbs A et al. “The Effect of Intimate Partner Violence on the Physical Health and Health-Related Behaviors of Women: A Systematic Review.” Trauma, Violence, & Abuse 22(4):935–949, 2021. Consensus↩︎

18. Sophie Strand. “After The Fire, A Memoir.” Substack. Link↩︎

19. Sophie Strand. “I Will Not Be Purified.” ART PAPERS. Link↩︎

20. Caraka Saṃhitā, Sūtra Sthāna 17.73–77; Vimāna Sthāna 4.8. Krodha listed among dharaniya vegas (urges to be restrained). Physical consequences enumerated: māṃsa-śithilata (muscle laxity), vimuchyati sandhi (joint looseness), rakta-vidāha (heat in blood), meda-vilayana (fat melting), majja-kṣaya (marrow depletion), śukra-kṣaya (semen depletion), ojakṣaya (loss of vital essence). See also Madhavi & Khobragade 2025; Pandit & Kolarkar 2021.↩︎

21. Caraka Saṃhitā, Cikitsā Sthāna 15.30–36; Sūtra Sthāna 17. Krodha as āgneya (fiery), Pitta-aggravating. Effects on Agni (digestive fire disturbance leading to ajīrṇa, amlapitta), Rakta dhatu (vitiation producing vyanga/melasma, paittika prameha/diabetes subtypes, bleeding disorders). See also Hardik et al. 2022; Shukla et al. 2021; Sud 2017.↩︎

Each week I follow what emerges from a set of Scholar Alert queries tuned to this project’s framework, pull the papers that are relevant, and trace what connects them. The prose sections make claims that no single paper makes alone. If that’s not interesting, the curated list still tells you what to read and why it matters. Everything here is free. Zotero collection links for paid subscribers are at the bottom.

This week’s subjects:

• Gut-Immune Axis / Microbiome

• Traditional Medicine + Autoimmunity

• Healing Frameworks / Ethnomedicine

• Immune Mechanisms / Ecological Frameworks

Gut-Immune Axis / Microbiome

Doyon-Laliberté makes the structure visible: BAFF, a signaling molecule that drives B-cell activation in the immune system, doesn’t just respond to gut disruption in long COVID. It feeds back into the gut barrier and the microbial ecology that produced it. The immune system reshapes the terrain that shaped it. Once you see that feedback loop, you see it everywhere in this week’s papers. Fu finds that aging itself passes through a microbial phase transition, a threshold crossing where the interior ecology shifts character and autoimmune prevalence shifts with it. Jung extends the frame to the oral cavity. Wang to the reproductive tract.

The body is a series of mucosal surfaces in ongoing negotiation, and immunity is the pattern of those negotiations. Ecosystems within ecosystems, each layer shaping the conditions for the one above it.

• Microbiota-induced intestinal barrier disruption drives BAFF-mediated B-cell dysregulation and autoimmunity in long COVID — Doyon-Laliberté et al., Preprint, 2026. This week’s structural key. BAFF feeds back into the intestinal barrier and the microbial ecology itself. Bidirectional causality: the immune system reshapes the terrain that produced it. From the abstract: “Here we show that non-hospitalized individuals with long COVID have intestinal barrier dysfunction associated with increased B-cell activating factor (BAFF), perturbation of the B cell compartment and autoimmunity that peak at 12 months after infection and begin to resolve by 24 months.” (Preprint)

• The dual roles of microorganisms in inflammatory diseases: initiators and regulators — Liao et al., Critical Reviews in Clinical Laboratory Sciences, 2026. Collapses the pathogen/commensal binary. Microorganisms are both.

• From dysbacteriosis to ecological remodeling: a new breakthrough in microbial treatment of IBD — Xie et al., iScience, 2026. Research on Inflammatory Bowel Disease. The gut is an ecology to be remodeled, not a system to be corrected.

• A global metagenomic atlas of aging identifies a microbiota phase transition associated with disease risk — Fu et al., npj Biofilms and Microbiomes, 2026. The aging microbiome passes through a phase transition, a sudden threshold where the interior ecology shifts character, and autoimmune prevalence shifts with it. From the abstract: “This perturbation was associated with a decline in ecological stability and substantial changes in the abundance of core species. Notably, the association between gut microbiota age and diseases was identified to be significantly altered before and after this inflection time.

• Oral Microbiome in Systemic Autoimmune Diseases: A Systematic Review — Jung, Militsi, Huck, Oral Diseases, 2026. Another mucosal surface (the mouth, which like the gut is lined with tissue that manages the boundary between inside and outside), another ecological conversation. 42 studies met inclusion criteria: 19 on rheumatoid arthritis (RA), 18 on primary Sjögren’s syndrome, 5 on systemic lupus erythematosus (SLE), and 1 on anti-neutrophil cytoplasmic autoantibody-associated vasculitis

Ayurveda + Autoimmunity

Shripat names Ojas explicitly. The concept is already there in the classical texts, already doing the work of describing vitality and metabolic capacity rather than surveillance and response. The vocabulary predates the discovery of the biomedical mechanism, which raises a question that all of the papers leave unaddressed: what kind of observation produced the vocabulary? What kind of attention produced the knowledge that this plant does something worth remembering?

Rajendran’s beverage plants paper touches something more specific than hormesis. The rasayana principle is sustained low-dose challenge that maintains the system’s responsiveness. Stimulation and suppression are both wrong frames. Ecological conditioning: a small regular demand keeps a muscle capable of more. The vocabulary of “immunomodulation” misses it, because modulation presupposes a system that needs adjustment from outside. Rasayana presupposes a system that can be strengthened from within, given the right conditions. This is a different model of what immunity is.

• Role of Ayurvedic Principles in Addressing Malnutrition and Non-Communicable Diseases — Shripat et al., Cureus, 2026. South Asian field research. From the abstract: “This review critically examines Ayurvedic principles as a complementary, systems-based framework for addressing shared nutritional and metabolic determinants underlying both conditions. Drawing on conceptual foundations and available empirical evidence, the analysis evaluates how dietary regulation, digestive optimisation, lifestyle modification, and Rasayana-based preventive strategies can be operationalised using locally accessible foods, herbs, and community-level delivery models.”

• Phytochemistry, pharmacology, and traditional uses of beverage plants with dietary hormetic potential — Rajendran et al., Food Chemistry Advances, 2026. Hormesis (the principle that a small dose of a stressor strengthens the system’s response) meets rasayana (the Ayurvedic practice of sustained low-dose tonic intake that maintains vitality). Low-dose challenge that maintains responsiveness.

Healing Frameworks / Ethnomedicine

Ethnomedicine papers consistently say: other knowledge traditions have been describing what Western immunology calls autoimmunity, using vocabularies that preserve the body as ecology rather than reducing it to a machine. This is the territory where autoimmunity is a set of disrupted relations.

• Decolonizing Mental Health in Algeria — Memchout, Culture, Medicine, and Psychiatry, 2026. Jinn (spiritual beings in Islamic cosmology that can possess or afflict), baraka (blessing or spiritual power), sorcery as structured knowledge practices. From the abstract: “Algeria’s mental health system still bears the scars of a colonial asylum regime that delegitimized indigenous cosmologies and ruptured ties among self, family, community, and the sacred.” What happens when you take indigenous practices on their own terms?

• La Recta Provincia and the Logic of Resistance: Magic as Decolonial Heterotopia in the film Brujería — Ávalos, The Latin Americanist, 2026. Healing as cultural resistance. Colonial epistemology calls it sorcery. The Huilliche had their own categories, their own logic for why ritual works. 1. magic as epistemology; 2. magic as justice; 3. magic as territory, where physical and symbolic places resist the colonial hierarchies and mechanisms of domination.

Immune Mechanisms / Ecological Frameworks

• Decoding the exposome for type 1 diabetes prevention — Rollet et al., Diabetes & Metabolism, 2026. The exposome (the totality of environmental exposures a person encounters across their lifetime) as the field in which autoimmunity emerges. “Infectious agents, air pollutants, and early-life diet are well studied and consistently associated with T1D onset. However, little is known about the role of cumulative and combined exposures, or the exposome’s influence on disease progression and complications.” The gap they find is onset versus progression. The Ayurvedic and somatic practices live in that gap: what sustains dysregulation, not just what triggers it.

Bonus:

• The Body Is A Doorway, by Sophie Strand

  Make Me Good Soil

  The Body Is a Doorway: A Journey Beyond Healing, Hope, and the Human is available for pre-order!

  I am SO excited to announce that my memoir about ecology and chronic illness The Body is a Doorway: A Journey Beyond Healing, Hope, and the Human is available for pre-order on all online bookselling platforms ahead of its release in March 2025. You can find different ways to order…

  Read more

  2 years ago · 220 likes · 50 comments · Sophie Strand

That’s it for this week! I’ve finally got a workflow that makes it reasonably possible for me to put these together on a regular basis. Hopefully you find something that piques your curiosity.

Before the lungs fill, before the cry, before the skin meets open atmosphere, the body has already been written. Every year, the spleen remembers. I lost mine in August of 2001, and still the pattern holds. My bruises arrive on schedule. The count drops according to a geometry I can describe but not exit. Whatever the spleen encoded, the rest of the body learned it by heart.

I know this the way you know weather in a joint: not as information but as pressure arriving before the language to describe it. Twenty-five years of immune thrombocytopenia^[1] have taught me to read the season in my platelet count. The bruises come first. Then petechiae, the fine red scatter across the shins that means the count is dropping. The haematologist will call it relapse. The general practicioner will tell me to see the haematopathologist. The Ayurvedic framework names the condition Rakta Pitta, the blood’s own fire turned against its vessel. Pitta gets aggravated and the blood cannot stay in the channels.

I have spent twenty-five years as a subject of the biomedical literature on why this happens, and the literature keeps arriving at a threshold it cannot cross. The data points backward through time, through bodies, through landscapes, and the frameworks keep insisting on linearity. I want to tell you what the data actually says, because it says something the researchers cannot quite bring themselves to conclude.

Autoimmunity is ancestral. Autoimmunity is ecological. It is the immune system operating exactly as it was built to operate, but built under conditions that no longer exist.

If you were born in April in the Northern Hemisphere, your risk of developing an autoimmune disease is measurably higher than if you were born in October. This holds across more than a hundred thousand patients, across multiple diseases. The wave rises and falls with the calendar like a tide.^[2] The reason is light. Vitamin D, made in the skin when ultraviolet light hits it, is the molecule that teaches certain immune cells to be tolerant. It changes their posture and calms them. Without it, those cells never learn to recognize the body’s own tissues as safe.^[3] If you were gestating during the dark months, if your mother’s skin saw almost no ultraviolet light during the trimester when your immune system was learning what to tolerate, the teaching simply didn’t happen. The architecture was never built. The darkness is not a risk factor. The darkness is the shape of the immune system itself. This may be why it is now recommended pregnant women take Vitamin D supplements.

I was conceived in May. My second trimester fell across the autumn. My third, the one that matters most for this, landed in deep winter. February in the Northern Hemisphere.

At the same time, another system was being set. A gene builds the receptor for cortisol, the stress hormone, and this receptor anchors the feedback loop that tells the stress system to stand down: cortisol rises, the receptor catches the signal, the system dials back.^[4] In babies born to highly stressed or traumatized mothers, a small chemical tag drops onto the DNA at this gene before birth and the gene goes dark. The receptor never gets built. By three months, these infants flood with stress hormones in response to mild stimuli, regardless of how the mother is doing after birth. The alarm was set before the child met the world that was supposed to cause it. This has been documented in the children of depressed mothers, survivors of the Rwandan genocide, and families of Holocaust survivors.^[5]

My mother was a traumatized woman, an abuse survivor. The cortisol in her blood during those nine months was not a metaphor for stress. I would not even need to know the content of her story for the biology to carry over. It was the physical substance of it, crossing the placental barrier and landing in me as chemistry.

If both these systems fail at once, if the immune cells never learn tolerance because there is no vitamin D and the stress-response feedback loop has no anchor because the cortisol receptor was silenced, then both brakes are gone.^[6] What gets diagnosed years or decades later as autoimmune disease is the consequence of an architecture that was set, in darkness and in cortisol, before birth.

The data goes further back than one generation. In Sweden, researchers tracked over four hundred and fifty thousand children and found that when men experienced bereavement in childhood, the children of those men, conceived years or decades later, developed autoimmune disease at significantly higher rates. No social or economic factor explained it. The transmission was biological and direct.^[7]

In a separate study, mice trained to fear a specific smell produced pups and grandpups who startled at that same smell despite never having encountered it. The researchers removed every possible route of social learning by extracting the sperm, fertilizing in a dish, and having the pups raised by unexposed mothers. The fear persisted. It was written into the sperm itself.^[8]

And in Holocaust survivors, a gene that regulates cortisol sensitivity carries an epigenetic tag elevated compared to controls. In their children, born decades later on a different continent, the same tag is lower. The adjustment moves in the opposite direction, as if the offspring’s biology is preparing for an anticipated environment of extreme stress it has never directly experienced.^[9]

This is what I mean by ancestral. My paternal grandparents were the sole survivors of their respective families through Auschwitz.

The grandfather’s grief is in the grandchild’s platelet count. Not as metaphor. As chemistry. As a molecular tag on a stretch of DNA that says: the cortisol flooded in. Not when, not where, not to whom. Just that it happened. The mark does not encode time as a sequence. It encodes time as structure.

In 1998, a five-day ice storm knocked out power across southern Quebec. Researchers tracked pregnant women through the disaster and separated what objectively happened to them (days without power, temperature drop, caloric disruption) from how they felt about it (fear, emotional distress, cognitive appraisal). Thirteen years later, the children’s immune cells showed massive epigenetic rewriting across nearly a thousand genes, and these changes tracked precisely with objective hardship. How frightened the mother felt, how she narrated it to herself, was completely uncorrelated.^[10] The fetal immune system did not record the story. It recorded the cold. The thermodynamic fact. The number of days without heat.

A 201-country study confirmed that average annual temperature predicts the prevalence of five major autoimmune diseases with overwhelming statistical strength.^[11] Cold environments concentrate autoimmune conditions. But the same nutritional deprivation in the Gambia produced no equivalent immune shift, because the ecology is different, the microbiome is different, the endemic organisms are different, the soil is different. The environment does not surround the body as context. The environment is the body. The gut lining is an internalization of the soil. The respiratory membrane is an internalization of the atmosphere. That is what I mean by ecological.

I was born to a blood bath. My mother hemorrhaged during her 30 hour delivery and had to be transfused, someone else’s blood entering her body as mine was leaving it. Then her milk was insufficient and I was fed by surrogates. Other women’s milk, other women’s microbiomes, seeding my gut with ecosystems that were never meant to be mine. At five, I was diagnosed. The treatment: spleen removal and prophylactic antibiotics, which burned the gut flora to the ground. Intravenous immunoglobulin pooled from the plasma of thousands of donors, infused directly into my bloodstream to modulate the immune system that could not recognize its own platelets. The treatment for the failure of self-recognition is the introduction of thousands more selves.

Auschwitz in the germline. Cortisol in the placenta. Winter in the genome’s folds. A stranger’s blood in the veins. Other women’s milk in the gut. Thousands of strangers’ immunity in the infusion bag. The boundary between self and other was crossed and re-crossed before I had language. The self was never one thing.

It is not the cold that triggers the relapse. It is the transition. I left Montréal on December 31st and was sick in Thailand by January 3rd. I left Thailand in February and relapsed when I landed in Kerala. Last April, I went south to New York and got a severe flu. The bruising showed up in Montréal three weeks later with the thaw.

The pattern lives in the crossing from one thermal regime to another, the sudden change in temperature that cracks the fire pot. The immune system, calibrated to the cold, meets the heat and cannot recalibrate fast enough. ITP peaks in spring alongside viral triggers, at exactly the moment when vitamin D stores are at their lowest after the winter trough.^[12] The system, unable to complete its tolerance signaling, meets a routine pathogen and the absence of the background condition turns the encounter into a cascade. The fire at what used to be the spleen still works through the blood, but the fire is calibrated to a thermodynamic reality that no longer matches the present season. The platelets are consumed not because they are foreign but because the apparatus that would have recognized them as self was never fully assembled.

The perceived contaminant is the self, but which self? The one that arrived through the placenta, already formatted by winter and cortisol and the long shadow of Auschwitz? The one reconstituted by a stranger’s blood on the first day? The one colonized by another woman’s milk? The one periodically flooded with the pooled immunity of thousands of donors? The one whose gut microbiome was decimated by antibiotics and rebuilt from whatever remained?

The immune system is not failing to recognize the self. It is performing an exact calculation on a self that was always plural.

I should say plainly that every time I use English to describe Ayurvedic concepts, I am already mistranslating. The frameworks do not map onto each other. When I say ojas and gloss it as “the luminous substrate of immunity,” I have already lost something essential. The word carries a density of meaning that belongs to a knowledge system structured by different axioms, different observations, different millenia of clinical reasoning. When I draw parallels between epigenetic data and desha prakriti, I know I am doing something that risks flattening both. I do it anyway, because I know no other way to begin to make sense of my own experience than to translate as I learn. The translation is imperfect. The experience is not.

The Ayurvedic tradition calls the continuity of body and land Desha Prakriti, the season threading through the embryo’s blood vessels, modifying the solvent before the solute crystallizes. Winter tightens the tissue. Summer loosens it. The flesh is weather held under a dermis.^[13] It names my condition Rakta Pitta and classifies it clearly: manageable, but incurable.^[14] There is no promise of restoration to some imagined original wholeness. There is care, precise and ongoing.

And it says something the biomedical literature cannot say, because the biomedical literature does not have the vocabulary for it. Caraka lists, among the primary factors that deplete ojas and open the body to disease: chinta, bhaya, shoka. Worry. Fear. Grief.^[15] Not stress, which is mechanical. Not trauma, which is an event. These are placed not among the psychological complications of illness, not as downstream consequences, but as root causes, on equal footing with excess fasting, with adverse season, with exposure to wind and sun. Before the inflammation, before the cascade, before the fire at the spleen burns through the blood: grief. And its antidote, also from Caraka: dhee dhairya atmadi vijnanam. "Intellect, courage, and self-realization are the supreme medicines for disorders of the mind." What the gut cannot break down, the mind cannot clear. What the mind finds the courage to face, the channels can begin to process.

I carry an incurable condition. It is manageable. The spring bruises come and the spring bruises go. The count drops and the count recovers as the fractal geometry repeats. This is not a story of healing, it is the story of tending to a garden.

What strikes me is how long it took Western science to arrive at what Caraka stated without fanfare. The passage on ojas depletion lists the causes plainly: excessive exercise, fasting, worry, fear, grief, dry and scanty meals, exposure to wind and sun, insomnia, adverse season.^[15-1] Read that list after reading the epigenetic literature and something shifts. Adverse season is not a metaphor for seasonal affective disorder. It is the angle of the ecliptic during the second trimester. Grief is not a psychological complication of being ill. It is a primary cause of the depletion of the body’s deepest reserve. Fear is not an emotion to be managed. It is an etiological factor, written into the same list as fasting and wind, granted the same clinical weight.

The biomedical literature needed the ice storm, the Swedish cohort, the mice startling at their grandfather’s fear, the Holocaust methylation studies, and a 201-country regression analysis to begin to see what Caraka organized into a single verse. I do not say this to diminish the science. The science is extraordinary, and its precision matters. I say it because the convergence itself is the point. Two knowledge systems separated by millennia, geography, language, and epistemology arrive at the same claim: the body is not separate from the conditions that formed it. The environment is not backdrop. It is etiology. And grief, fear, and worry are not secondary to the physical causes of disease. They are physical causes of disease.

Caraka also offers the antidote, in a formulation so compressed it could be missed: dhee dhairya atmadi vijnanam. Wisdom, courage, and self-knowledge are themselves therapeutic.^[15-2] Not as psychology. Not as positive thinking. As clinical intervention, placed in the therapeutic literature alongside diet, herbs, and seasonal regimen. The treatment for an incurable condition shaped by ancestral grief, adverse season, and a self that was never singular is not a drug that restores the architecture. It is the cultivation, ongoing and precise, of the capacity to understand what happened, to face it without flinching, and to know the self clearly enough to navigate what cannot be repaired.

I do not know how to end this essay because the condition does not end. The geometry repeats. The springtime bruises will come again. What I know is that the body I carry was written before I was born, by the light and the cold and the grief of people I never met, and that the work is not to undo the writing but to learn to read it.

1. Immune thrombocytopenia (ITP) is an autoimmune condition in which the immune system destroys the body’s own platelets, the cell fragments essential for blood clotting. It is classified as a rare disease. In Ayurvedic clinical terms, it is understood as a form of Rakta Pitta, but Rakta Pitta is a broader category than ITP.↩︎

2. Goldacre et al., 2013. 115,172 UK patients across multiple immune-mediated diseases. April peak (OR = 1.045, P < 0.0001), October trough (OR = 0.945, P < 0.0001). Second trimester UVB correlation: Spearman’s rho = −0.49, P = 0.00005.↩︎

3. Hsu et al., 2018. Vitamin D Receptor (VDR), activated by calcitriol, forces dendritic cells toward a tolerogenic phenotype: upregulating inhibitory molecules, suppressing CD80/CD86, dampening IL-12 and IL-23. VDR binds at CTCF motifs dictating borders of topologically associated domains (TADs), restructuring chromatin architecture. Six MS risk genes co-localize with VDR binding regions in dendritic cells.↩︎

4. Oberlander et al., 2008. Glucocorticoid receptor gene NR3C1, exon 1F. Methylation at the NGFI-A binding site silences receptor expression, disrupting HPA axis negative feedback and Th1/Th2 cytokine balance. Altered cortisol reactivity at three months independent of postnatal maternal mood.↩︎

5. NR3C1 methylation replicated across cohorts: Rwandan genocide survivors (Perroud et al., 2014), Holocaust survivor families (Yehuda et al., 2016), domestic violence-exposed mothers (Radtke et al., 2011).↩︎

6. Morante-Palacios et al., 2021. Coordinated glucocorticoid receptor and MAFB action in tolerogenic epigenome remodeling. Dual absence of VDR-mediated calcitriol signaling and GR-mediated cortisol feedback simultaneously strips both primary regulatory mechanisms. Cao-Lei et al., 2014 (Project Ice Storm) demonstrated that objective hardship, not subjective distress, predicted genome-wide DNA methylation changes at 1,675 CpG sites across 957 genes in offspring T cells at age 13, enriched for NF-κB signaling and Th1/Th2 cytokine regulation.↩︎

7. Song et al., 2021. 453,516 Swedish children born 2001–2012. Paternal childhood bereavement associated with offspring autoimmune disease: HR = 1.31 (95% CI: 1.06, 1.62). No mediation by SES or mood disorders.↩︎

8. Dias and Ressler, 2014, Nature Neuroscience 17:89–96. F0 olfactory fear conditioning to acetophenone. F1 and F2 behavioral sensitivity, enlarged M71-specific glomeruli, CpG hypomethylation at Olfr151 in F0 and F1 sperm. IVF and cross-fostering confirmed biological inheritance.↩︎

9. Yehuda et al., 2016. FKBP5 gene methylation. Holocaust-exposed parents: higher methylation. Offspring: lower. Orthogonal transmission suggesting compensatory rather than mimetic epigenetic inheritance.↩︎

10. Cao-Lei et al., 2014 (Project Ice Storm). Objective hardship predicted DNA methylation changes at 1,675 CpG sites across 957 genes in offspring T cells at age 13. Genes enriched for NF-κB signaling and Th1/Th2 cytokine regulation. Subjective distress uncorrelated. Dancause et al., 2015.↩︎

11. Rademacher et al., 2024. 201-country regression. Robust linear correlation (p < 0.0001) between average annual temperature and age-standardized prevalence of alopecia areata, type 1 diabetes, IBD, psoriasis, and rheumatoid arthritis.↩︎

12. Moulis et al., 2015. Seasonal peaks in adult ITP: 35.8% spring, May = 18.2%. Corticosteroid resistance in spring-onset: 52.1% of resistant cases (p = 0.001). 62.7% of chronic patients diagnosed in spring.↩︎

13. Charaka Samhita, Sharira Sthana. Embryological formation as negotiation between inherited seed and atmospheric conditions. Seasonal modulation through Rtu: Ashtanga Hridayam, Sutra Sthana. Desha Prakriti: the constitutional type shaped by the geographic and climatic conditions of conception and gestation.↩︎

14. Charaka Samhita, Nidanasthana 2.4. Jwara (fever) has as its cause vitiation of doshas (V, P, K, VP, VK, PK, VPK). Fever causes Rakta Pitta. Pitta gets aggravated and blood cannot stay in the channels. Curable if of Kapha type, palliable if of Vata type, incurable if both.↩︎

15. Charaka Samhita, Sutra Sthana 17.73–77 (Kiyanta Shiraseeya Adhyaya). Ojas is described as the very first substance created in the body, situated in the heart, clear and slightly red-yellowish; its destruction leads to death (17.74). Symptoms of its decrease: timidity, debility, constant worry, discomfort of the senses, loss of lustre, dryness, emaciation (17.73). General causative factors for depletion of ojas: excessive exercise, fasting, worry (chinta), fear (bhaya), grief (shoka), dry and scanty meals, exposure to wind and sun, insomnia, excessive excretion, adverse season, and major mental illness (bhuta-upaghata) (17.76–77). Cf. Charaka Samhita, Sutra Sthana 25.40: dhee dhairya atmadi vijnanam.↩︎↩︎↩︎

Autoimmunity is a heart that is breaking.

I mean this physically. The heart, the muscular fist behind your sternum, is the reservoir of something the body cannot function without, and when that reservoir cracks, the body loses its capacity to recognize itself.

In Ayurveda, the heart is called hṛdaya. It is the seat of ojas, the final distillation of everything the body digests. Every sensation, every encounter, every piece of information you take in gets processed through a sequence of tissue layers, each one refining the input further, and what arrives at the end of that long metabolic cascade is ojas: a small, luminous, unctuous substance that the classical texts describe as honey-coloured, sweet, and cool. Eight drops of it live in the heart. It never moves. It is the anchor.

The rest circulates. It coats your tissues and lines your vessels. It is what allows your immune system to scan the body and say: this is me. This belongs. Ojas is a recognition system. It is the substance by which the body knows itself.

When ojas is depleted, the body loses that knowing. The immune system scans the tissues and finds something it cannot read. It encounters its own marrow, its own nervous tissue, saturated with material that was never fully digested, residue from experiences the system couldn’t metabolize. The body reads itself as foreign. The inflammation begins. The joints swell and the skin erupts and the fatigue descends like a door closing, all at once or in sequence over months. This is autoimmunity: the body attempting to purify what it can no longer recognize. A desperate, burning effort to clear the archive.

And ojas, the substance that would prevent this, the substance that holds the self together, lives in the heart.

So when I say autoimmunity is a heart that is breaking, I mean the container is cracked. The reservoir is leaking. The place where the body stores its most refined capacity for self-recognition has been damaged, and what damages it is grief.

The classical texts are explicit. Charaka, one of the foundational authors of Ayurvedic medicine, writing over two thousand years ago, lists the causes of ojas depletion: excessive exertion, prolonged hunger, harsh exposure to the elements, intense worry, fear, anger, and shoka. Grief. He also names vishada, despair, as the single most potent aggravator of disease. The foremost one.

Grief depletes ojas through a precise mechanism. When you grieve, the body’s principle of movement, vata, which governs everything that shifts and dries and contracts and cools, surges. It moves like a cold wind across the digestive fire. The fire gutters. Digestion falters. Instead of producing the refined, nourishing substance that eventually becomes ojas, the system produces ama: a heavy, sticky, toxic residue. The incomplete product of incomplete processing. At the same time, that cold wind dries out the existing ojas. The reserves evaporate. The container empties from both ends.

You know this in your body. You have felt what grief does. The heaviness. The fog. The sense that your skin is thinner, that sounds are louder, that you cannot tolerate what you could tolerate before.

The vagus nerve is the longest nerve in the body. It runs from the brainstem through the throat, past the heart, into the gut. It is a living tissue, a wet rope of fibres, and eighty-five to ninety percent of those fibres run upward. From the viscera to the brain. The heart is issuing reports. It reads the blood, the rhythm, the hormonal tide, and it tells the brain what is happening in the body.

When vagal tone is strong, when the parasympathetic system is doing its work, it holds inflammation in check. The way a riverbank holds a river. The channel keeps the water where it can move, where it can nourish. When the channel erodes, the water goes everywhere. The fields flood. Nothing is reached and everything is saturated.

This is what happens when grief overwhelms the vagal channel. The inflammatory signalling that the parasympathetic system normally regulates spills into every tissue. The cytokines, the body’s alarm signals, rise and stay risen. The immune cells, bathed in distress signals, begin to read the body’s own tissue as debris to be cleared.

There is a cardiac event called Takotsubo, named for the Japanese octopus trap, because of the shape the left ventricle takes when it balloons under acute emotional shock. It happens after the death of a spouse or a child, after witnessing something the heart cannot metabolize. The catecholamines surge. The vagal tone collapses. And in the heart itself, in the actual muscle, inflammatory cells flood the tissue. The organ that holds ojas becomes the site of its unravelling.

Grief is a physical event. It happens in the flesh of the heart, in the lining of the gut, in the wet fibres of the vagus. Complicated grief, the kind that does not resolve, that sits in the body like a stone the system cannot pass, produces its own specific pattern of immune reorganization, distinct from depression, distinct from post-traumatic stress. The body does not merely “react” to grief. It reorganizes around it. It takes the shape of what it cannot digest.

The rivers are poisoned and the forests are burning and the ice is gone. The air carries particulate matter into the deep tissue of the lungs and from there into the blood. Microplastics are in every human placenta ever tested. The soil, stripped of its microbial intelligence by decades of industrial agriculture, produces food that fills the stomach and starves the cells.

You feel this as a weight in the body. A fog that is visceral, not cognitive. Something saturating.

Ecological grief has a name now. The psychological descriptions proliferate, the scales are being adapted across cultures, the interviews are being transcribed. And no one has drawn blood. No one has measured the inflammatory tide in farmers watching their land die, or the vagal tone of communities watching their rivers turn. The question has not been asked in a form that crosses the disciplinary walls. The immunologist does not read the climate grief literature. The environmental psychologist does not measure cytokines. The Ayurvedic practitioner holding the classical understanding of shoka and ojas-kshaya is not in conversation with the researcher measuring vagal tone in bereaved spouses.

The body is not waiting for these conversations to happen.

Children who lose a parent, who experience attachment disruption, the grief-shaped wound at the foundation of self, carry measurably altered immune landscapes into adulthood. The loss itself is the sensitizing event, more so than other forms of adversity. The grief reshapes the immunological soil. The inflammatory baseline shifts. The capacity for self-recognition narrows. And decades later, autoimmune conditions emerge at higher rates. The grief you carry from childhood is still alive in your immune system. It has been there the whole time, shaping what the body can and cannot tolerate.

If you are living with an autoimmune condition, you have likely been told that your immune system is confused. That it is overreacting. That it has made a mistake.

Your body has not made a mistake. It is responding to the weight of what it has received. The grief you carry is the felt registration of real damage to the real world, processed through a real organ, along a real nerve, into an immune landscape that reorganizes around what it cannot metabolize.

The grief is real. The body is real.

The heart is grieving the world. The grieving heart is no fit container for ojas. And from that vessel, the conditions of autoimmunity emerge as echo: the body registering the state of the earth it inhabits. Deha to desha. The body to the land.

The first gesture of navigation is to stop treating the body’s signal as noise. The vessel is carrying something. The sea is rough, the cargo is real, and the signal your body is sending is not confusion. It is the weight of accurate perception, and it will not stop until it is received.

There are trans-cultural principles to guide healthful decision-making when eating. Recognize first that the manner and content of eating has a direct and cumulative effect on autoimmune balance. Accepting that for a fact, it becomes extremely important to take care in order to avoid autoimmune relapse. And even then, I know I am not fully in control. I am a picky eater. I rarely accept food offered to me that I did not explicitly choose or implicitly trust because I know the person offering it. You’d think I’m trying to avoid getting poisoned. In some ways I suppose I am. Perhaps I am overcautious, but I do not trust the dietary choices of industrialized nations.

1. I need food that avoids deep frying (heating in nature + free radicals = inflammation = āma (toxins) = autoimmune relapse).

In damp and hot climates, tending jatharagni (जठराग्नि, the Central Digestive Fire) in the stomach and small intestine becomes exponentially important.

Agni is the Sanskrit word for fire, both in the cosmos and in the human body, our capacity for transformation and heat, for assimilation and transmutation. Adapting to moderate spice levels is not only a matter of personal taste; it keeps digestion functional, keeps Tejas (तेजस्, the subtle essence of fire and radiance) manifesting physically as jatharagni. Eating local food is the surest way to co-regulate with the environment. And I check: how many people eat there? A busy restaurant is a safe restaurant.

Heat is a double-edged sword. Enough of it will support Pachaka Pitta (पाचक पित्त, “that which digests”) and Agni, enabling the body to handle food, absorb nutrients, and separate waste. Too much of it, and patterns of disharmony begin to emerge. My specific condition, immune thrombocytopenia, involves complex signs of heat in the blood and on the skin. Purpura and easy bruising are signs of Rakta Pitta, a category of bleeding disorders in Ayurveda caused by an excess of Pitta dosha affecting the blood, appearing as purple discoloration or tiny red spots under the skin due to capillary breakdown and “leaking” of vitiated blood.

2. I need vegetables to be my primary food group, in close equivalence with whole grains. Fiber, vitamins and minerals.

I don’t eat like a monk. Some monastic sects are vegetarian; they are considered strict. Then there is eating Jay. If vegetarianism is a dietary choice, Kin Jay is a karmic firewall. No meat, no dairy, but also no “pungent herbs”—no garlic, onions, chives—because stimulation is the enemy of the spirit.

But I walk past the yellow flags of the Jay stalls and I see the glitch. It is not just vegetables. It is “fake meat” engineered to uncanny perfection. Fake fish, fake pork, fake shrimp that taste fresh off the boat but are born in a vat of soy isolate and flour. To compensate for the lack of animal fat, the food is swimming in palm oil. It is sometimes greasy, heavy, and ultra-processed. It is “pure” in spirit but difficult for the body.

I’ve eaten Jay many times since arriving in Chiang Mai. It’s a good option, as long as I stick to the rice, tofu, and vegetables. Again, back to basics: skip the deep-fried foods, skip the overly processed. With the fake breaded meats, my Agni would drown in the oil, and my blood sugar would spike on the simple starches.

City monks, village monks, are expected to eat whatever they are given. In the morning, they leave their temple and walk around the neighbourhood carrying an alms bowl. People offer them what they have. Often rice, curries, portions individually packaged in plastic bags. So if you peeked in their bowl you may see whatever happened to be available that day. It may include meat, or not. More important than content is apparently timing: Thai monks are forbidden to eat after noon. In some temples, meat broth may be taken as medicine. Medicine, including herbs and pharmaceuticals, may be taken at any time it is needed. Ultimately, the abbot decides. How do they survive this? The randomness, the stochastic input of the street? Ayurveda has a word for it: oka satmya (ओकासात्म्य)—acquired habituation. It is the biological truth that a body can learn to tolerate the unwholesome through repeated, small-scale exposure. The monk has trained his physiology to accept the chaos of the alms bowl as self. It all becomes nourishment because the system has expanded to include it. He has immunity. I have no oka satmya. Oka satmya is built through risk. The monk risks illness to gain immunity, while I have chosen safety.

3. I need to remain aware of viruddha ahara (विरुद्ध आहार), an Ayurvedic concept referring to incompatible food combinations, preparations, or habits that disrupt the body’s metabolism, impair digestive fire and tissue metabolism (धात्वाग्नि dhatvagni) and cause the building of ​​toxic, undigested metabolic waste, āma (आम). It is described as a sticky, morbid, and harmful substance that accumulates in the body when digestive fire (Agni) is weak, resulting in incomplete digestion of food. There are 18 types of viruddha ahara. They are virtually impossible to completely avoid.

400 years of plantation-driven colonialism and global trade in processed foods leave our present-day options in a sorry state. The palate is habituated to empty, cloying, dampening foods. Sugar has been refined to the point of lacking all nutrients, being pure sucrose, the white poison. This isn’t news; it’s the ultimate dietary villain now.

Sugar caused such a craze in 17th century Europe that the Royals and aristocrats hired chefs to create elaborate statues and maquettes out of the stuff. They fought eloquent battles of prestige, outdoing each other in riches. It was, in effect, white gold. So infamous was the Royal love of sugar that they would never smile, for the stuff had rotted their teeth black and holey.

As plantations grew off the back of the transatlantic slave trade sugar became widespread as a commodity, and the plantation owners grew wildly rich. At first, it retained its prestigious status symbol. To add a teaspoon of sugar to your cup of tea in 19th century Britain after your 15-hour factory workday was to show you were one of the good folks, one of those respectable people. You were akin to the King. But as sugar was used as a primary sweetener all over the globe, everywhere industry’s tendrils reached, it replaced the nutrient-dense sweeteners traditionally used by most people. Palm sugar, jaggery, coconut nectar, maple syrup, honey — all of them lost their place to pure refined white sugar. And with the sweet tooth came the propensity for diametrically opposed rich and fatty foods. Deep-fried, clogging, metabolically chaotic industrial oils were created first as byproducts of refinement and then packaged as “cooking vegetable oil.” Fat and sweet in ever greater proportions, intensifying flavours and making impossible a nuanced taste.

White rice is analogous to white sugar. Everywhere it replaced its whole-grain cousin as the staple food in a monodiet, data shows lack of B-complex leading to beriberi, severe thiamine deficiency. And, like sugar, white rice was the food of the ultra-rich, the ruling class. So the ruling class lost their health first, and then once the factory-food was available, everyone else did too. Processed food is directly correlated to poor health outcomes. White basmati rice has the amusing position of currently being considered highly “ayurvedic” despite its lack of nutrient density. My teacher explained to me that it’s because it’s easy to digest. Fair enough. Where I can get them, I choose whole grains, but I eat white rice almost every day in Chiang Mai.

The simple foods of our pre-industrial ancestors are now unpalatably bland, but at least we have better hygiene than the Middle Ages. Have you ever had an everything-flavoured potato chip? What could you possibly compare that with? The spike in blood sugar is a physiological echo of the colonial extraction economy: a rapid boom followed by a devastating crash. So yeah, I eat sugar when I travel – it’s omnipresence gets the better of me.

4. I need to ensure that Bhutagni (भूताग्नि), the 5 elemental digestive fires located in the liver, remain sufficiently strong to clean and nourish the blood. I do this by eating phet nit-noi (เผ็ดนิดหน่อย, mildly spicy) and I am taking herbs for digestive function and to support my blood. TCM is readily available in Thailand, so I found pills: Dan Zhi Xiao Yao Wan (丹栀逍遥丸, Enhanced Free & Easy Wanderer Pills) acts as a systemic coolant, extinguishing the excess liver fire (Ranjaka Pitta) that “cooks” the blood and destroys platelets. Meanwhile, Gui Pi Wan (歸脾丸, Restore The Spleen Pills) reinforces the structural integrity of the blood vessels (Raktavaha Srotas), providing the necessary “holding” energy to prevent the blood from leaking out into the tissues. I ended up consulting a TCM doctor and she approved of my choices, using her own reasoning. She recognized my “heat” pattern and saw impaired digestion as the root of my bleeding issue, and added Shen Ling Bai Zhu Wan (参苓白术丸, Ginseng and Atractylodes Formula) to the stack. It’s a classic formula designed to strengthen the Spleen, boost Qi, and, crucially, eliminate dampness. Excellent, I finally have a combination of herbs to deal with all this Damp Heat.

Think of it like this: I am operating a manual transmission for a missing automatic organ (the spleen), balancing the need to hold Blood (immune thrombocytopenia) against the risk of accumulating Dampness (toxins in the blood). I’m using Dan Zhi Xiao Yao Wan in the morning to ease the taxed Liver heat and stagnation. Then, Gui Pi Wan at noon to build platelets when my digestive fire is at its peak, and utilizing the doctor’s addition of Shen Ling Bai Zhu Wan in the evening to actively drain the swamp and form my stool while I sleep. This medicinal tripod is fueled by easily digestible foods like congee and fish soups, while strictly avoiding the damp trap of too many coconut milk curries or the metabolic crash of fasting. When I transition to India next month, I’ll just swap the herbs: replacing the Chinese cooling agents with Mahatiktaka Ghrita (Bitter Ghee) and the builders with Drakshadi Ghrita (Raisin Ghee), ensuring I continue to cool the vessel without extinguishing the fragile fire keeping me going. Use the tools available wherever you are. This is a rather syncretic approach to herbalism, don’t try it at home without baseline knowledge of the systems.

With the networked ease of access to information, people who care about their health can easily know “what to eat.” However, in the west, only the wealthiest among us (including, unfortunately, anyone who can afford to buy and eat local+organic food in Canada or the USA), and those who are part of the neopeasantry of biodynamic farmers can eat food that is worth calling nourishing. The rest of us are just surviving. It’s a sorry state of affairs.

5. I need to stay hydrated. I ensure hydration by carrying a bottle, and drinking electrolytes in the form of coconut water or dissolvable powder added to my water. This helps cool me in hot climates. I make sure not to snuff out jatharagni by over-drinking or drinking anything ice cold. Cold water possesses the qualities of Sheeta (cold, सीता) and Drava (liquid, द्रव), which directly oppose the Ushna (hot, उष्ण) quality of the central fire. The urge to cool off by drinking cold/iced drinks is a paradox. When you drink cold drinks, you get a shot of cold, but then your body’s capacity to thermoregulate by itself is diminished. You are trading acute relief for chronic weakness.

6. I supplement essential nutrients that I may not be getting from whole foods because I cannot control provenance and quality when eating at restaurants: Brand’s essence of chicken, wheatgrass, spirulina, chlorella. I am a walking paradox. I decry the industrial food market while directly benefiting from its products each day. In a conversation with a language model, the ghost of Susan Sontag told me I am “running on a Cyber-Ayurvedic Operating System.” The AI said: “You are keeping your open system alive with closed-system logic. You call the “Jay” diet a glitch? You are the glitch. You are a biological entity that requires a global supply chain just to stop bleeding.”

Am I romanticizing the past? Sure I am. But I have an opinion based on my reading of history and my understanding of the development of agriculture since the combustion engine and petroleum-derived fertilizers; since the rise of the plantationocene, the global container-shipping industry and the trade in factory-refined food: our capacity for “choice” in rich countries has gone through the roof, but the quality of food available to all but very few people has plummeted to be worse than it was at any time except the worst decades of the early industrial revolution. And now, the poorest on earth are living with analogous food-source loss as we were subjected to in the last 200 years. Everywhere, local food sources, perennial plants, whole grains, wild game, fish — they are vanishingly few. The soil is depleted, the ocean is empty.

7. I eat fish a few times a week. Never deep-fried; ideally steamed or in soup. This pacifies Vata, ensures adequate iodine intake, B12, omegas, and complete proteins. Fish is also the only meat that will build tissues without introducing dampness. This means that it is easy to digest and will not damage jatharagni or Meda-dhatu-agni (metabolism of fat tissue), or lead to accumulation of āma. I eat ideas. I eat Agni and Vata and Omega-3s. I am not eating fish; I am eating a textbook definition of pacifying Vata. Does the fish know it is medicine? Or is it just a dead fish?

How can food be medicine in a case like this? Is it better to simply do as the monks do, to take all that is available as a gift, to be grateful that we get to eat today at all, to recognize that hunger and starvation are two different beasts, and eat what is given? Would I be better off if I just gave up my picky eating and accepted all food still existing as “prasad”, a gift from Gaïa, Mother Earth, the Goddess? Or should I take a hard-line ecological stance, and refuse to eat anything that does not meet my standards of sustainable purity, anything that did not grow within 200km of where I eat it? This is the principle of desha satmya (देश सात्म्य), geographic suitability. The food of the land is the medicine for the people of that land. It is a beautiful, coherent theory. But what happens when the land itself has changed? When the soil is depleted? And what happens when I am the variable that doesn’t fit?

I am a transplant, biologically displaced. The land of Thailand is hot, damp, and spicy (Pitta-increasing). My body is Pitta-aggravated (bleeding). By the laws of desha satmya, I should leave. I should go to a cold, dry climate, but I’m here, and I love it here. And because I’m here, I must create an artificial micro-climate inside my body using imported herbs and local foods. I’m not vegetarian anymore. I am terraforming myself, but don’t call it health, call it solitary confinement. I am playing with fire. The “local” here is a complex negotiation between tourism and deforestation. The air in Chiang Mai contains particles from Beijing. The fish in my soup contains microplastics from California. Is it better still to be vegan; to refuse all animal-derived products, but risk severe B12 insufficiency, anemia, and what TCM calls “blood deficiency”? What about the vegan reliance on industrially isolated supplements and factory-made protein replacements, wrapping virtue in petrochemicals?

8. I eat no raw food except occasional fruit. Raw is good for pacifying Pitta in moderation but difficult for Agni in the tropics, and it also carries a greater risk of bacterial infection. I minimize dairy, unless it is fermented and traditional. Even then, industrial dairy is usually mucus-forming and inflammatory. I eat the darkest chocolate I can find, and I drink rare and superlative matcha; Chiang Mai has a vibrant chocolate and matcha culture. Today I had a 100% dark chocolate and matcha oat-milk latte, and it was absolutely amazing. I love my treats, too. Mango sticky rice? Oh My God.

What matters more: ecology, or health? Am I forced to choose? The ecological imperative is to eat local, eat what is given, and reduce the carbon footprint. The biological imperative is to eat specific, imported foods, and optimize for micronutrients at a global radius. These two ethical frameworks are perpendicular and incompatible. To eat ecologically is to expose the sensitive, autoimmune-compromised body to the ravages of the degraded environment. To prioritize health is to sever the link with the local soil and hook myself up to a global IV drip of Health Food.

Any sound ecology, boasting the traditional and contemporary knowledge of what makes “health” in the human organism and the complex assemblage of the food supply chain, should be organized in such a way as to optimize the symbiosis of human and non-human flourishing, in full respect of the natural hierarchy known as the food chain, which has been the determining organizing factor in human societies for all time.

But that’s not the present reality. Small, pre-industrial cultures could and did do better, but they also fucked up at smaller scale. Civilizations and empires have always despoiled the earth. The Mayans had their polycrisis, too: drought, warfare, soil depletion and deforestation, they ruined the Central American rainforests. Cities are heat engines, they demand and facilitate a division of labour, land, and resources that will always create waste and over-consume neighbouring (or distant) territories. Ken Wilber made the point succinctly: modern technology, bigger problems, bigger potentials.

The paradox is amazing: I am intellectually disgusted by the modern food system, but I am physically dependent on its advances in nutrition science to know what to eat, and supply chain efficiency to find so-called health within the system itself. The monk walks the neighborhood, holding a bowl, and eats whatever falls into it. If it is rice, he eats. If it is poison, he eats. He has no self. Me? I have so much self. I am dripping, heavy, burdened with self.

How do I eat? Given my history, prakriti (प्रकृति, constitution), vikriti (विकृति, current state), and means (modest by western standards, but still in the global top 15%), I do the best I can to prioritize health. It’s simple. I follow these rules. Otherwise, I start bleeding. Literally. If I don’t eat right, according to the principles that I have learned through extensive study of TCM, nutrition, and Ayurveda, as well as ongoing evaluation and observation of my body’s reactions to the decisions I make day to day, week to week, month to month: I bleed. It shows up in bruises, in hemorrhoids, in my gums. I have no leeway. I cannot fuck around and find out just how totally scrumptious those deep-fried King Prawns are. I cannot just try1 what is given to me without knowing what it is. And that’s okay. It is rigid, it is artificial, but it leads my biology towards sattva (सत्त्व, goodness/purity), simplicity, ease. I am trying to treat a spiritual famine with factory-produced essence of chicken and farmed spirulina. I am eating supplements to replace a world I have deemed poisonous at the crossroads of history and science.

It’s all still just illness as metaphor. Sontag would have a field day. The monk has no fear of food poisoning because the monk has already accepted the poisoning of the world. I have not. The illness may be a metaphor, but the bleeding is real. Maybe it’s better to be honest: I’m afraid of getting sick and dying. I’m afraid of food poisoning. I’ve built an elaborate cultural theory to justify the fact that I am unable to digest pork belly dumplings. If I didn’t bleed, would I still eat this way? Or would I be deep-frying the fake shrimp too?

Health is not the irreproachable moral conduct of your nation. Health is not an ethical attainment. Health is not the sword of Damocles hanging above your head. Health is not a series of protocols to follow, a formula to repeat, or a positive affirmation to memorize and stick on the bathroom mirror as a sticky note.

Health is not your market value. Health is not the supplements in your medicine cabinet. Health is not the vaccines that are either good or bad depending on who you ask. Health is not a series of codewords. Health is not the wealth of your family. Health is not an investment property.

Health is not a long-term savings plan. There’s no retirement project that doesn’t involve the presumption of health, and health is not in itself a project. Health is not a postcard destination to send your distant relatives: “Wish you were here”.

Health is not the food you eat, be it grown or bought. Health is not the dirt under your feet, nor the pavement. Health is not the topsoil. You cannot look at a vegetable garden and say, with confidence: “This is health.”

Health is not a guarantee, and it is not a blessing. Health is not to be trusted, and it is its own best advocate. Health is not the intravenous needle, not the blood, not the transfusion. Health is not the antibiotics. It is not the hospital bed, but it is also not the beachfront resort.

Health is not the result of some meandering spiritual quest. Health is not found in the jungles of Paraguay or the peaks of Patagonia. You cannot hold health in your hands on the temple steppe of Kathmandu nor in the Diwali celebrations of Chennai. There is no health to hold onto in the Red Sea or in the forests of Britain. Health is not a place.

Health is not a common good or private property. Health is not the public sector’s effort to reduce the spread of disease or control the population’s viral load. Health is not the herbal dispensary in Chinatown, nor the acupuncturist’s pulse-taking, nor the time spent under the needle. Health is not a deep tissue massage. Health is not the abhyanga and the panchakarma. Will health result from these things? Maybe. Only to slip away again, again, always.

Health is not a spatiotemporal orientation device. Health is not a way to look at the world. Health is not an ethical framework. Health is not the cosmogony passed down by oral tradition from ancestors to descendants over deep-time.

Health is not the stomach, the heart, the brain, and the lungs. Health is not the liver and the feet and the hands. Health is not the body in its totality. Health is not the tears shed in grief, upon hearing of yet another young friend dead too soon. Health is not the co-regulative response of the nervous system as described by polyvagal theory. Health is not the mere balance of the doshas.

I saw my grandmother today. She repeated her old refrain: “Health is the greatest good, the most important thing in life. You don’t think about it until it’s far too late, and you’re far too old—.” I interrupt: “Mamie, you know, I thought about it pretty early. I know what it is you’re talking about.”

Mamie: “Yes, well, you’re the exception. I grew up working the soil, threshing the wheat. We worked day in day out, and look at me now. [she gestures to her stooping ninety-six year old figure] People say all the time they wish they were like me. When I was taking care of my mother in law, she was 90 years old, and I had to wash her, wash her hair, she couldn’t do anything herself. Me, at least, I can still take my shower by myself, I can still put in my hair curlers.”

Health is not a home you buy. It is not the self-therapizing undertaken with the emergent empathy of large language models. Health is not the meds I’ve taken, the bone marrow I’ve given up, and it is not the prescriptions written in shorthand for the pharmacist. Health is not the hepatitis injection I received to prepare for tropical travel. Health is not the quality of life outcome of decisions made day in and day out. Health is not a series of good habits.

“Then what the fuck is it, Laure?”

I’m still trying to parse that out. I think health might be Being itself.

This has been my last post of 2025.

Thank you so much for reading me this year, and for your thoughtful responses and engagement with my process. Over my upcoming travels in Thailand and India, I will be posting once per month, or maybe slightly more. The themes and content of this blog will remain largely the same. I do not intend to blog a travelogue, but I expect to find inspiration in a change of scenery. I am bringing my Sanskrit study materials and a small copy of the Bhagavad Gita with me, as well as my ayurvedic schoolwork. I am also packing a pocket edition of Swami Vivekananda’s Jñāna Yoga.

To close, here is a list of some of my impactful reads from 2025.

Novels:

• Chronique du Pays des Mères by ​​Élisabeth Vonarburg (absolutely incredible speculative fiction, I highly recommend)

Essays & Philosophy

• Petit éloge de l’errance - Akira Mizubayashi

• Corpus, Jean-Luc Nancy

• Sand Talk by Tyson Yunkaporta

• Money and The Souls’s Desire by Stephen Jenkinson

• The Dawn Of Everything, Graeber and Wengrow (still unfinished)

• The Palliative Society, Byung-Chul Han

• Non-Things, Byung-Chul Han

• Psychopolitics: Neoliberalism and New Technologies of Power, Byung-Chul Han

Vedanta & Spiritual

• Autobiography of a Yogi, Paramahansa Yogananda

• The Bhagavad Gita, translated and commented by Paramahamsa Yogananda

• Path of the Heart, Beverly Lanzetta

• Awaken Children, many volumes, Mata Amritanandamayi, compiled by Swami Amritaswarupananda

• Karma Yoga, Swami Vivekananda

• Many other essays by Swami Vivekananda from his Complete Works.

Ayurveda

• The ayurvedic course texts from the Academie Quebecoise d’Ayurveda where I am studying.

• Noteworthy source text I’ve begun to peel a bit: Vagbhata’s Astanga Hrdayam (Heart of Medicine)

• The Cambridge Introduction to Sanskrit (used in a course I took with Dr. Antonia Ruppel, the book’s author.) Unfinished, but an incredible resource. Also the Assimil Method’s Le Sanskrit.

It’s worth also noting the podcasts or people that I love to listen to, that have nourished me much in the last year

• Vedanta Talks by the Vedanta Society New York and specifically Swami Sarvapriyananda’s lectures on the Bhagavad Gita and the Gospel of Sri Ramakrishna, and

• Acharya Dr. Sthaneshwar Timalsina’s many talks on Saivism in theory and practice.

• Accidental Gods with Manda Scott for incredible and nuanced dialogue about the possibility of cultural renewal in the wake of disaster.

• Many conversations with Joanna Macy, and especially the We Are The Great Turning mini-series.

• The Emerald Podcast

• The Green Dreamer Podcast

Many blessings to you and yours.

I remember my first blood test, first needle in the arm, first IV. The walls in the waiting room at BC Children’s were blue, and heavy CRT screens hung in the corners playing cartoons. There were tables with crayons and scrap paper. Maybe 25 chairs where sat patients. A service desk was cut into the far wall, and a nurse welcomed my mother and our paperwork. A requisition had been issued to piece together the differential diagnosis puzzle. Two questions hung heavy in the air: why was my recently injured right eye still bleeding, and what were the red marks on my skin?

The spleen is an organ located in the left upper quadrant of the abdomen, protected by the lower left ribs, below to the diaphragm and behind to the stomach, in close proximity to the pancreas. By those with knowing hands, it can be palpated on the back side of the body. It serves many functions.

It was 2001, and I sat in a chair too high for my feet to reach the ground, for the first of many hundred times, and waited. That’s when we started keeping score, keeping track of the numbers representing the chemical balance of my bloodstream as the single most important indicator of my health.

Eventually, my name was called, and a woman in scrubs took us through back rooms full of recliners. She explained the procedure, showed us the vials, and eventually pulled out the butterfly needle. Seeing its translucent tube, I wept, I screamed, I tried to convince them not to do this. But the nurse and mother coaxed me through, and my initiation was complete. The pinprick pain was nothing, but the young child knew how blood matters, that the channels flow full of life.

The energetic role of the spleen is to provide rhythm and flow. It grounds you, it is the seat of discipline and concerted effort. It is related to Manipura chakra, the third energy center located in the upper abdomen, the Solar Plexus Chakra. It grounds our personal power, self-esteem, and transformation. It is fiery, yellow in color. It governs digestion, metabolism, and the sense of self, fostering confidence and purpose when balanced, but leading to issues like low self-worth or ego problems when blocked.

The test tubes went off to the lab, and we went back to the haematology ward to wait for results. My blood was quickly quantified, and found to be miscalibrated. This was an emergency. I had severely injured one of my eyes, and I was bleeding. My mother was told I was at risk of spontaneous cerebral hemorrhage. The diagnosis came quickly, the most important symptom being severe platelet deficiency, the lack of an essential clotting factor.

In the allopathic paradigm, the spleen is a filter for blood, and it stores blood to be used in case of hemorrhage. It is a vital organ in the body’s blood-production and immune system. It produces white blood cells to fight infections. The spleen breaks down old red blood cells and recycles components.

Mine was surgically removed because it had a chance of inducing remission of acute immune thrombocytopenia. The theory was that my spleen was responsible for miscalculated destruction of platelets, and haematological procedure at the time was to remove it, as splenectomy had been found to restore regular platelet counts in roughly 50% of cases.

So my mother made hard decisions and followed the doctor’s recommendations. Within days I was medicated, immunomodulated, and set for a laparoscopic splenectomy, the surgical removal of my spleen.

The procedure was common practice in the late 90s, but now the existence of new immunomodulatory pharmacy has rendered surgery an absolute last resort except in cases of splenic rupture. Not only that, but the medical consensus is now that the spleen is of vital importance for the function of the organism. Splenectomy leaves the patient at lifelong risk of infection and sepsis. To counteract this potential post-surgical infection, I was prescribed preventative antibiotics, which I took every day for 10 years.

Modern surgery found that it could restore a semblance of homeostasis in my bloodstream by removing an organ that is considered absolutely vital to the creation and circulation of blood in two other major health sciences. Whenever I’ve told a TCM doctor or a Vaidya that my spleen was removed, they’ve gasped, aghast.

In Chinese medicine, the spleen (Pi 脾) serves the functions of storehouse and digestion. The Spleen is a key Zang organ responsible for transforming and transporting food into nutrients and governing fluids, controlling blood in vessels, and distributing them throughout the body. It is associated with water metabolism, muscles, and thoughts. The spleen has a distinct channel (or meridian) pathway that runs along the inner leg, thigh, and abdomen to the chest and tongue. When the spleen’s function is impaired, you can expect digestive issues, poor appetite, bloating, loose stools, as well as excess worry, rumination, and anxiety. Loss of capacity for grounded presence.

The synthesis picture of the spleen we get with these three paradigms is this: this organ is of primary importance for the regulation and production of blood. Surgery’s solution to my blood clotting problem, which it diagnosed was potentially caused by the spleen, was to remove the organ entirely, to excise the organ traditionally profoundly linked to the function of controlling the blood. The paradox boggles my mind.

I need to pause here. I hate this mode, where I’m supposed to be the expert on my own condition, on the anatomy and physiology of 3 different paradigms. This is exceedingly difficult for me. Wouldn’t it be enough to say that removing my spleen was a medical mistake? How am I supposed to find the ground when it was removed from within my trunk? A colleague tells me I’m disciplined, to have so much drive for “wellness.” I tell them I don’t have a choice. I outsource my rhythms to my practices because my body’s drummer was excised as a “cure.”

We—my mother and my 5-year-old self—knew nothing of the efficacy of herbalism as practiced by TCM and Ayurveda. We knew nothing of acupuncture, Abhyanga, marma, or Tuina, so many techniques used to balance the body’s vital forces. The knowledge was simply not available to our cognitive map of medicine in Vancouver in 2001.

My mother let the doctors do what they could. What would you do for your sick child? Would you gamble with their life, just because you have a bone to pick with vaccines, pharmaceuticals, and surgery? Would you say “Oh, no thanks, we’ll keep the spleen and visit the homeopath” ?

I am working with material that was shattered from the outset by misguided and highly technical interventions of a “healthcare system” that knew nothing about how to treat me, and did more long-term harm than good. I accept my changing body. I accept that my childhood and my 20s were spent entirely on “fighting illness” to “get better.” I accept that I’ll never know what it’s like to be healthy, to have in my bones the full vitality of youth.

The truth is, we do the best we can with the information and resources available to us at a given time. When a crisis comes, we react. We do whatever seems right based on all the experience gathered until that point.

No matter how much “better” my health outcome than anyone would ever have predicted, I am a product of my time. The supercrips overcoming illness and returning to work for the banks have missed the point entirely. It’s not that I am sick or you are sick: the whole pattern has been poisoned, and we are living the results.

What if the crisis is eternal? What if it is present all the way down, and began centuries before your birth? What if you were given consciousness because the crisis pushed your parents together, and all you can do now is witness, accept, and move forward?

Autoimmunity (to get to the point of this blog) is the global polycrisis in microcosmic form, existing within the human body. The breakdown of normal life functions in response to the profound dysregulation of the social-ecological patterns between humans, the earth, and the cosmos. The rupture of the covenant. The unravelling of Logos, bios, and zoe. The loss of cultural memory. The poisoning of the water table. The generations of concerted ethnocide. Autoimmunity is all of these events, over and over again.

Are you taking someone else’s word for how you feel? Are you outsourcing your blood as much as we’ve outsourced horticulture? Are you in a hurry to move beyond sickness or injury so you can get back to living? Are you letting someone else do the work of grieving your loss? What if Nietzsche was right, and this life is meant to eternally recur? How would you do it, what would you do, if you had to do it forever?

Do you long for health because it is your perceived birthright? Do you think, have you been told, you deserve to be healthy? Did the numbers on the screen tell you you aren’t? Did you find out on your own? Did the blood in your stool point the way? The ache in your joints? The haze in your eyes? The fire in your guts? The swelling of your limbs?

Is there such a thing as ideal health? According to who? For what? When? Where? How do you know what health is and how do you know you don’t have/are not it? It is superstition to spout theory about protocol, to say: “Well, this influencer says that if I just do this and take that, I’ll be healthy.” It’s imperial religion, all over again.

That is why there is no cure. That is why I’ll be sick for the rest of my life. My symptoms and the destructive actions of the industrial society exist in complete enmeshment and can never be without one another.

“Okay, great. Thanks Laure, that’s awfully depressing. Now what?”

I can speak only for myself and my actions. I seek truth and joy. I prioritize being of service to projects and people that have a net positive social-ecological impact. I consume little. I practice the recognition that I am a small strange attractor in a much larger series of embedded systems, and I welcome dialogue that changes the way I perceive reality. I set boundaries, and I respect my own limits. I love my family, my friends, and the people I meet. I look people in the eye when we speak. I get help with my trauma and my symptoms. I attempt to recognize when I have done wrong, and learn not to repeat my mistakes.

Renouncing health is the only way to find it. Is life merely the productive development of competencies? Why? To what end? Why desire health? Health is more beautiful for having been lost. The cracks are where the light gets in. Contradiction: knowing illness brings you closer to knowledge of health. How can this be?

Health precedes all signs, symptoms, and pathologies. It is the underlying experience of joy emerging with aliveness. The experience of health is an expression of your relationship to yourself and your world. By that definition, health is available to you in the wake of all disease.

I’ve learned that to know health, I must live in my own body. Health is, simply, a felt sense of unimpeded vitality. What I mean is health is the internal experience of self/body being alive without restrictions. But what if restrictions are about how I relate to the world, rather than my physical body? What if health is about accepting my situation?

In the present moment, still, I am reliant upon the medicine of the plants, and the careful tongue analysis of my doctor. I am reliant upon my habits. I am the picture of health, but it is an illusion.

If I had critics, they may accuse me of simplifying the solution, of encouraging people not to “get better”, as if accepting their illness were enough to find peace. But acceptance is broad proposition. Even in my revulsion, I accept the broken food system; it exists. I accept that I was once dependent on synthetic pharmacy, and my quality of life was quickly improved by a pill; that happened. I accept that I was subject to a now obsolete surgery which leaves me vulnerable for life because my spleen was removed; it is true. I can’t do anything about the past but witness.

To know a state, one must know its limit, its boundary, its end. A fish knows water, but not its end. It takes water for granted. Maybe we should ask the fish what it thinks of immersion. Health is often defined in opposition to illness. What of its flourishing? I am “healthy” now, thanks to the modern applications of traditional medicines. But can health be true if it depends upon global supply chains, farms in China, and shipping infrastructure? Can I call myself healthy merely because I have energy today? Is health the control of symptoms and the tendency towards balance? Or is it the long tide, the quiet below the storm?

I suppose this project is an effort to share what my years of sickness and health are teaching me. The learning is infinite, more than I’ll ever have time to write. If you’re reading and you’re sick, know this: illness is solitary, but you are not alone, and it is the social fabric which has failed, not you.

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In Byung Chul Han’s Palliative Society, he meditates on pain today. In Han’s words: The palliative society is characterized by an unlimited permissiveness. [...] Boundaries are removed. Thresholds are torn down. The immunological resistance to the other …

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They wanted to know: “How can I know if what I’m doing for my child’s health is helping, beyond the effects of the medication?”

A classic of Ayurveda dating to the time of Late Antiquity, the golden age of the Gupta Empire in India, describes health this way:

“One who knows health is one whose elemental forces, bodily tissues, appetite, and elimination are balanced; one whose mind, body, and spirit are filled with simple joy.” (Suśruta Samhita, sutrasthana (vol. 1), 15:10)

How do you know if what you’re doing is helping? Take stock of yourselves each day, and measure how close you are to the above statement. Insofar as you are experiencing various degrees of balance, you can learn to sense how your daily life, habits, consumption, medication, practices, and disease are faring.

In Ayurveda, the fundamental concepts for measuring your state of balance are termed prakriti and vikriti.

Your prakriti, constitution, is an epigenetic heritage. It is ancestral. You are gifted with what your forebears had to give, and life’s own intelligence moves through the generations. Ayurveda teaches that our prakriti is determined in the first years of life. You may be predominantly Moveable, Fiery, or Stable. You may be prone to anxiety, bloating, diarrhea, sluggishness. Discovering your constitution is a quest for self-knowledge. Prakriti is stable. It is set in early life, and then the lay of the terrain is set. You have to walk the territory and get oriented.

The present moment is defined by vikriti, your current state, which is subject to change.

Sometimes, you’re so far from your point of origin that you don’t know what you need at all. Why are you sick? Why is your body on fire? Why can’t you digest bread? Why are you bloated after every meal? Why are you anxiously insomniac? Why do you flare to rage at the drop of a hat?

Vikriti is a formula. It is your prakriti layered with everything that’s accumulated over your lifetime.

I might think of myself as an angry, hyperactive person, but what if I’m just performing a state that has been applied as a mask on top of my being? Culture took me as a child and did what it could. I’m left picking up the pieces and puzzling out the pattern.

How do you know if what you’re doing is helping?

Well, in theory, all of us have the same solution: follow a set of principles described by a system such as Ayurveda, Chinese medicine, Integrative medicine, macrobiotics, intuitive eating, yoga, siddha medicine, naturopathy, bioenergetics, and on, and on, and on until your head spins. The theories are rife with contradictions, and they disagree between themselves, and anyway, maybe you don’t live in south India, or northern China, or Japan, or the Mediterranean.

In practice, our lives are different, and your actions will be uniquely yours. You live on a world that is changing every day, and the practices described in the ancient traditional texts on health and longevity may seem all well and good, but entirely inapplicable to your daily life.

You have your own unique path to attain your happiness. You cannot reach your desired goal through another’s path, even if it is a good path. What works for me won’t necessarily work for you. Your experience is a fresco; there’s no isolated stroke that explains the effect of the whole.

But you have to ask yourself what you’re actually looking for. Is it health? Is it safety? Power? Control?

The only way to answer any of these questions is to live true to your own self, unchangign and stable from birth. The path to wellness involves learning how to manage circumstances, always evolving with what is accruing over the years. The way to heal profoundly is to heal the cosmos, to repair the fabric that weaves humans to each other and to the earth.

So how do you know if what you’re doing is working?

Ask yourself, inside: are your elemental forces, bodily tissues, appetite, and elimination balanced? Is your mind, body, and spirit filled with simple joy?

What do you need in order to move towards each of those things?

That depends entirely, uniquely, on who you are.

If you are sick, the land is sick. If you are sick, and doctors can’t help you, it is the culture and the doctors that are disabled, not you. The vital flux of your body is a cycle of waxing and waning. You have done nothing wrong. You are living the results of a traumatized culture. You are the sunrise, the sunset. Your state of being is a shifting river. You cannot grasp it, you cannot control it, you cannot push it to hurry up.

Are you trying to heal? Stop, just for two minutes, don’t put any force of will into changing anything. You are not a home improvement project. The self-help and self-improvement cult will not save you. You do not have to work on yourself.

Your body is a fulcrum among billions of people, plants, and animals who are beset by systematic exploitation and extraction.

Are you trying to heal? Stop it. This whole endeavor is not a project to manage, nor is it homework. There is no such thing as health, that imagined perfection is a burden, the weight of hyper-productive consumerist culture. All it takes is a bit of momentum, and suddenly you’re trying to do it all. It’s too much. You’ve sacrificed all leisure at the altar of work.

There’s nothing to grasp, no fixed, solid state to remodel. Your body is not a fractured marble statue in need of restitution.

Are you trying to get better? Why? Who are you trying to please? Who do you think you’ve disappointed by needing care and rest?

If you had to ask the future a question, in its greatest depth, what would you like to know?

Healing is not an end goal, it is a process. It asks of you to remain present to yourself today, practice active hope for what the future may hold, and be ready to accept the changes that your daily actions bring about.

Things will change. It is the nature of reality, time, inertia, and momentum will bring about an evolution in the world. What if it was enough to collaborate in its dynamic unfolding?

Others are dangerous. They are not to be trusted. They are intruders, they are invaders, and oh no, turns out, they are in my body, they are my body itself. In the human body, so it was explained to me when I was a toddler in the oncology ward, my immune system’s job is to defend myself against those invaders. My body was a warzone. My body’s defenses have troops, barracks, garrisons, and fields of battle. My body, in fact, is the other, is the danger.

Just writing those few sentences is exhausting. What a tired story. Maybe you’ve heard it before.

Autoimmunity is not embodied civil war. It is a response to aggression; it is self-defence. What’s the use of fending off the outside world when it constantly permeates everything already? Defence is a boundary, a cell membrane, but it is not a barricade.

Self-defence implies, of course, that there is an assault happening, preparing to happen, having happened. The unfortunate reality is that violence is, in fact, directed at each of us. Your body, all our bodies, are fighting a toxic environment which is a byproduct of ecologically irresponsible resource extraction and industrial production. I’m not saying anything new.

Your body is constantly in combat against the 40-hour work week. It is in protest against the treatment of animals and industrial farming. Your body is raging at the loss of your connection to its ancestry. It is struggling to reckon with the collapse of cultural threads and narratives held in collective memory since the dawn of time.

All our bodies are caught in a skirmish that began many generations before we were born, long before the word autoimmune took on its medical meaning: “disease caused by antibodies or lymphocytes produced against substances naturally present in the body.”

The situation is untenable, the body says no, but who knows what it is refusing? The suffering is too much to bear, but where do you begin to untangle a mess that has roots dating millennia?

To better understand autoimmune diseases, which often involve chronic illness and pain, let’s explore different models for conceptualizing disability, drawing from the field of disability studies.

The medical model of disability, applied to chronic illness, operates from a normative standard. It views a difference in body or capacity—be it mental, autoimmune, or physical—as an inherent, isolated pathology. This lens diagnoses the individual as “abnormal” and frames the problem as residing in the person, with the solution being to either “fix” them with medicine or accept that they simply don’t fit the established mold. It places the burden of correction squarely on the individual, to make the person conform to society’s expectations. The purpose of medicine is thus to shape individuals into their expected shape, and the onus of cure is on medicine.

The moral model of disability, at times referred to as the religious model, interprets disability as a direct reflection of an individual’s or family’s character, actions, and overall morality. This perspective is deeply rooted in various cultural and religious traditions. For instance, in some Abrahamic beliefs, a disability may be seen as a divine punishment for sin, while in Hindu tradition, it might be understood as the karmic result of misdeeds from a past life.

This model can manifest in two distinct ways. On one hand, the moral model can cast disability in a positive light. It can be viewed as a symbol of honor, a test of faith, or a testament to an individual’s strength in overcoming immense life challenges. This globally prevalent model is frequently reinforced in media, with portrayals ranging from using physical disability to symbolize evil to celebrating individuals with disabilities who achieve extraordinary feats that surpass typical human limitations.

On the other hand, it often leads to significant stigma, shame, blame, and distrust of disabled individuals. This is especially prevalent when a disability is linked to conditions where personal actions are perceived as a contributing factor, such as addiction. In these cases, the condition is viewed as a moral failing rather than a systemic issue.

In sharp contrast, the social model of disability accepts the reality of diverse human capacities but shifts the focus entirely. It asserts that the body isn’t the issue; it’s the environment and the structures we build. Disability, under this model, is a product of systemic barriers and a failure of the social framework to accommodate the sheer variety of human experience. This is crucial because it allows us to see the experience of varying ability as a structural, social, and even ecological phenomenon—not just an individual affliction. This understanding immediately forces us to consider the ecological impacts that trigger systemic illness, providing a direct lens for examining autoimmunity.

What I’m proposing, the practice I’m upholding, is a social-ecological view of autoimmunity, which takes for granted that the large and nebulous category of diseases currently labelled “autoimmune” are caused by systemic factors, and must be treated by healing one’s relationships to systems as well as the systems themselves. This is akin to the social model of disability’s overall view that the variety of human abilities is a structural, systemic, and ecologically complex set of phenomena, and that human society has a responsibility towards its members to adapt to their capabilities.

The presence of auto-antibodies is not a sign that your body is wrong or dysregulated. It is a sign that the hegemonic death cult of predatory capitalism has seeped into your cells, and your body is struggling to save you. Autoimmunity is your body defending itself against the accumulation of toxins in the biosphere in your blood, bones, breath, and brain.

When the medically standard definition of autoimmunity mentions “substances naturally present in the body,” it does not recognize the entangled life of the biosphere. The naturally occurring cells of my body are always born and always dying in relationship with the rest of the earth. My biomatter has been exposed to poison, and my body is defending itself.

The prevailing metaphor that depicts autoimmunity as a fierce civil war, where the body has turned against itself, is a fundamentally flawed narrative that demands to be dismantled.

That perspective, while dramatically evocative, misrepresents the true nature of the “self” that is being defended. It is not the physical body, nor is it a constructed social identity that is at stake.

Instead, the “self” we are truly endeavoring to protect is the deeply grounded self, as illuminated and thoroughly explained within the framework of Internal Family Systems (IFS) therapy.

In IFS, the Self is seen as an inherent core of wisdom, compassion, courage, and clarity that resides within every individual, untouched by trauma or life’s challenges. It is an unburdened, resourceful, and healing presence that is always accessible, though often overshadowed by our protective or wounded parts. The journey of self-protection, from this perspective, is not about shielding a fragile ego from external threats, but rather about cultivating a deeper connection to this innate, powerful Self, allowing its qualities to lead and guide our internal system towards healing and wholeness.

Alternatively, it can be understood as the essential Self, a core concept within the philosophical tradition of Vedanta. This is the subtle, whispered confirmation that resonates persistently, residing beneath and beyond the cacophony of everyday noise and external distractions, simply affirming its existence with the profound declaration, “I am.”

Alternatively, this concept can be understood as the essential Self, or Atman, a core tenet within the ancient philosophical tradition of Vedanta. This Self is not a fleeting thought or emotion, but the subtle, whispered confirmation that resonates beneath the cacophony of everyday noise. It is the profound and simple declaration, ‘I am,’ an affirmation not of ego, but of an inherent and unchanging nature. In Vedanta, this individual Self, the Atman, is ultimately understood to be identical with Brahman, the ultimate reality of the universe, suggesting a profound unity between the individual and the cosmos.

Autoimmunity is your body saying: “No, I refuse this situation. I refuse to play the game. I refuse to have my dharma stripped away so that I may run after individual gain. I refuse the imperative of the imperial dream. I refuse to be a productive citizen of the mono-culture, the trauma culture. I refuse the narrative that pins me as only a cog in a machine. I refuse a life prescribed within the entrails of a decomposing leviathan.”

I am, and you are. Our bodies matter, intrinsically, because they have been born. To be sick, to suffer, is human, and it is right that those who need care receive it.

Your body, all our bodies, are lodging loud, perhaps unclear, screaming complaints against the current state of affairs. This isn’t about who’s in power, or about the wars, or about the economy — though it includes all those things — this is about the systemic accumulation of social-ecological wrongdoing that has accumulated over the last few thousand years, and the resultant impact left in your earthly living flesh.

Transience? The human body is a focal point of change. Moving through space and time, never adhering to a place for long. Shifting, liquid states of being. Not so different from a river. Remember, the human body’s cells are always dying and birthing.

The idea that the human body completely regenerates every seven years is a popular myth, but it is not entirely accurate. The rate of regeneration varies significantly among different cell types. Your skin moults and renews in full every 2-3 weeks. Your gut lining is replaced every 3-5 days. Your red blood cells have a lifespan of around 120 days. Your fat cells may be around for up to 10 years, same for your bones. Your heart’s cells mostly last your whole lifetime, and your neurons decline over your lifespan. The human body replaces approximately 330 billion cells each day. While the average age of cells in the body may be around seven to ten years, this does not mean that all cells are replaced uniformly within that timeframe.

And in their mitosis, cells copy their memories to the next generation. The cloning is inexact; it is an interactive, evolutive process. What I was not taught, what I had to learn through trial and error, is that each cycle of cellular renewal is an opportunity for greater sickness or greater health.

The memory passed across the cycle of cell death accounts for all the learning that occurs in the meantime. Each passing lunation, how is my relationship to to my present and my past evolving? What have I integrated about my trauma and my success? How have my prayers changed? What is the same, and what is different?

It’s not that it happens once every 7 years—the cycle of birth and death is the constant, ongoing reality of my body, and yours.

I was surprised to learn taht the words “holy” and "health" share a common Proto-Indo-European (PIE) root, *kailo-. Its likely meaning is "that must be preserved whole or intact, that cannot be transgressed or violated." This root led to Old English hal (from which "health" is derived) and Old High German heil meaning "health, happiness, good luck."

After the Anglo-Saxon conversion to Roman Christianity in the late 6th century, "holy" was used in Old English for the Latin sanctus. I wrote last time about the word sanctuary, which we got from sanctus: the sacred, inner space. In Middle English, holy was also used for pagan gods, the Hebrew temple or tabernacle, and in the Quran and Muslim doctrine.

Holy refers to what is unbroken, which is whole at the source of life.

Transience is an unassailable fact. For all the cultural attempts to behave as if things are eternal and static, there is nothing but change in this realm. The monadic, advaitic God is All that Is, and is therefore also Elohim Chaim, the Living God, who is the force behind and within decay itself. God is change.

On this late summer day, I sit in Mooniyang surrounded by wasps, harmless in their buzz. The island holds the weight of transient culture, with all its beauty and diversity, with the millenia of growth and change and decay, the impositions of the forces that took this land and bulldozed it over generations for us millions of humans from across the globe to eventually settle here and make what home we can, in this momentary existence.

There are beings among us on this earth whose lives span mere months, whose purpose is only to gather sweet nectar. There are ancient trees with centuries of youth under their belts. There are mountains, whose earthen skin of rock is infantile when compared to the age of carbon. There are eternal stories of rise and fall, of flood and harvest. Holiness is a profoundly religious word. It is perfection, beyond human intervention. Holy is the realm of the gods. But I’m suggesting that natural events—birth, death, renewal, decay, the movement of the tectonic plates, the rise and fall of mountains—are holy precisely in that they are supremely inevitable and true. Truth is a phenomenon before its interpretation by the judging mind. Holiness is perfect and needs no validation by a human institution.

My bones are in the shape of the earth. The minerals in my water result from the sewage here. The ancestral dreams of hearth and kin were realized and lost, and many songs have been forgotten. This little life of mine longs for a context unfractured, yet accepts that I was born of fragments. The transience of my body is holy, because it lives and breathes with the tides. The rhythm of storms come and gone, the aquifers filled and emptied.

My transit through the years is a great chance. It is an opportunity to be changed, to witness the transitions in the cycle of life. The seasons of civilization are as consistent as my body’s, with its hiccups and sputters. Nearly as predictable as the seasons, even in this disrupted ecology, with climate collapsing everywhere I look.

Not one thing in this world is permanent, and I am no exception. It’s intelligence of a scale beyond reckoning, one that takes no quarter nor plea. That I may be born and bleed for years is only the gift of this life for me. Nothing more or less is asked, that I may learn what is to be learned. It’s a dance, this ephemeral art of living, a great prayer sung to the winds. All I ask is to decompose gracefully, to return to the soil in peace. Maybe when we’re all composting, the next culture will be flourishing at last.

When I wake up, as the transient dreams are departing, If I listen closely they are full of lessons. I may be different each new waking moment, forever changed by my here and now. What if this isn’t to be mourned or bemoaned? What if instead, it’s an opportunity for rapture? If you listen closely, the transience of the body is holy.

I was wondering about the word’s journey through time and language. It began as a word for a sacred place, something sanctus—consecrated and set apart. It evolved to mean a place of true refuge, offering immunity and safety to those who sought shelter within its bounds.

It’s not an external place you escape to, it’s an inner realm where you find the resources to nourish yourself.

My partner Shanthi and I are offering our third somatic nervous system regulation retreat this fall, and we’ve named it Sanctuary. But why the name?

At its heart, the word contains the sanctum, the 'holy of holies'—the sacred, inner space. The original Hebrew root of that idea, qodesh, קֹדֶשׁ, doesn't just mean holy; it means to be set apart for a sacred purpose. Its form as a verb, qiddesh, קִדֵּשׁ‎, means to sanctify. This is an act, and it is an internal process. The sanctuary I believe we all carry within us is not a place we run to, but a part of ourselves where we find resource.

Much the same, Bayo Akomolafe wrote recently, Sanctuary is not a place. He says that in these times when the very pillars of our world are trembling, perhaps the definition must evolve once more. He writes that "we will not merely claim sanctuary, we will make sanctuary." He suggests that perhaps, in the midst of it all, we will learn that "sanctuary is not a place, but a practice, a way to become-with a world that is never not broken.”

The theme of our retreat, Sanctuary, is nervous system regulation through yoga, qigong, and somatic practice.

Polyvagal theory highlights how our physiological states profoundly influence our environmental perceptions. Safety is as much an internal perception as it is an external reality. Safety is a perception, as much as it is or is not an external reality. To make sanctuary, to practice it, means that no place will be a true sanctuary if our own systems perceive danger everywhere. The practice, then, is to learn how to come home to ourselves, even when the world feels loud and our inner sanctuary feels distant.

This is where true self-regulation begins, in the moment-by-moment act of shifting our internal state back toward balance. Not to fix ourselves, but to remember what it feels like to be safe, resourced, and truly at ease in our own skin, so we can take what is present and move into the next cycle.

It is with this intention that my partner Shanthi and I are designing this retreat, a somatic journey home to yourself, from December 5th to 7th, 2025, at the beautiful Centre Arc-en-Ciel in Sutton, QC.

This retreat is an opportunity to deepen. I come away from each one with a renewed sense of purpose. This is an invitation, if you’re longing for quiet. For a reset. To get in touch with the theory and practice of listening to what your whole system needs. It is for the heart that craves more than just a break, but is looking to let go of old patterns and return to a more grounded, vibrant state. It is an invitation to come home, and make sanctuary with us.

One of our last participants said this: “[The retreat] Dégel was very meaningful for my personal journey and fit perfectly with the therapy I have been doing for several years now. I now feel confident that I can take action, step by step, to get myself out of my rut.” -I.S, Spring 2025.

We wake to the quiet autumn stillness of the forest. Greet the morning with an invitation to a silent walk in near the river. Transition through gentle Qi Gong and Yoga, soothe the body, and appreciate the connection of self and other. Shanthi leads us through the unique weightlessness of warm water aquatic somatics, releasing layers of tension that we may not have even realized we were holding. Oh, and there’s a sauna, along with fully cheffed meals.

If these words resonate with a quiet knowing inside of you, we would be honoured to hold this space with you. The circle is intimate, limited to fifteen participants, to ensure a supportive and deep experience for all.

To reserve your place in this circle, you are invited to read more details here, or reply to this email.

Blessings,

Laure