Host Dr. Flowers, Co-Host Robin French and VIP Guest Dr. Catherine Karmel discuss how Dr. Karmel incorporates the physical, emotional and spiritual aspects of a patient in her treatment and diagnosis. Dr. Karmel shares with the audience “for better or for worse” she’s been blessed with a diagnostic 6th sense which is why she loves partnering with the J. Flowers Health Institute team.
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Listen to the podcast here
Treating The Whole Person With “The Global Gynecologist” Dr. Catherine Karmel [Episode 29]
Welcome to Understanding the Human Condition with your host, Dr. James Flowers.
I’m super happy that Dr. Catherine Karmel is with us. She’s a good friend of mine, a personal friend, and works as a consultant, a provider with us at J. Flowers Health Institute. Welcome.
Thank you. I’m so excited to be here. I’ve been watching all of the podcasts.
Have you?
Thank you.
You actually have?
I have.
I love it.
I watch them and listen when I’m on my walks since I can never get in touch with you anymore.
Which one’s your favorite so far?
Usually, we were having our Sunday morning walk together.
We have to get back to that.
My favorite so far?
Put you on the spot.
Rex Marco was incredible and so inspiring.
Wasn’t he amazing?
Yes.
Yeah.
So much overlap with what we’re doing with patients. I’d love to get him involved if we can.
I would too. I’ve told him that, and he said just reach out. We need to talk about how to do that and what to do because it was my favorite so far as well.
Dr. Landau also, for me, when I watch him, it’s interesting because you’re finding people to interview or to talk with on your podcast. Many of us have overlapping ideas and approaches and philosophies. Like with Dr. Landau, a lot of my experience and my perspective are similar to hers for similar but different experiences.
I completely see that. You all are very similar, and of course, she’s from South Africa, but a little bit different experience. I think you all’s philosophy is probably really very similar.
I have a little bio to read if I may, then we’ll get off to some more. For those who aren’t aware of who Dr. Catherine Karmel is, Catherine Karmel is a medical doctor with a specialty in gynecology. She is known as the global gynecologist because she treats the whole person and not just the symptoms. She incorporates the physical, emotional, and spiritual aspects of a patient in her treatment and diagnosis. Dr. Karmel has been in private practice since 1995 and works in the Texas Medical Center focusing on women’s health care. She is also the gynecologic consultant for the Triangle Area Network Clinics, which provide care to the underserved areas of Beaumont and Orange, Texas. She has been practicing for 25 years, and each year she grows more passionate about medicine and taking care of her patients.
It shows.
Thank you.
It does.
Do you do the Beaumont and Orange at Triangle Area with Dr. Schrader?
I do.
That’s so cool. I didn’t know that.
He’s been doing it for so many years. This is a clinic that started out as a free, it is a free clinic. It’s federally funded, but it started out as an AIDS clinic for many years. It’s expanded to include women’s health and children and wellness.
That’s so cool. Do you go every week?
No. Every other week.
That’s so cool.
It’s really nice that you do that.
It’s fun. The people are so awesome. Very nice.
Global Gynecologist
You all are incredible for doing that every week. The title is Treating the Whole Person with a Global Gynecologist. What is a global gynecologist? I always refer to you as a gynotherapist, which we’ll talk about later, but talk about global gynecology.
When people ask me what I do or what’s different about my practice, it’s very hard to put my finger on it. I was trying to come up with a description. The definition of global is of or relating to the entire world. Approaching a patient in a global fashion means you’re approaching them in terms of who they are as a person, whether it’s emotional, physical, spiritual, or cultural. All of those factors come into play. You have to evaluate globally to treat locally. You can’t just treat a reproductive organ. A lot of things go into that.
Approaching a patient in a global fashion means you are approaching them in terms of who they are as a person. Their emotional, physical, spiritual, and cultural factors come into play.
That’s right. So cool.
It’s like holistic, except that I think the word holistic has been pirated.
It has and overused. You should trademark quick.
You should.
The global gynecologist.
I will. We give out lollipops.
How did you choose your career? Did you choose it, or did it choose you?
That’s an interesting question. I would say both. No, I would say it chose me. When I was a kid growing up, I used to think about being a doctor. There’s a famous picture in our family lore of me curled up in a chair, and I’d fallen asleep reading a book called Great Women of Medicine. My father had a blown-up poster-size of that, even when he was in his 80s before he died. That was always something interesting. I realized as I got older that I was always interested in medicine, but I was also interested in travel and language and literature and music and spirituality.
During college, I was a comparative literature major, and I played the violin. That’s about as liberal artsy as you can get. I realized that you could study things that are fun and not torturous like chemistry, but then I had the opportunity to work in a medical clinic in India when I was in college. I took a semester off. At that time, I just realized that that was what I was meant to be.
I love that.
Did you switch majors, or did you finish with liberal arts?
Yes. I came back. I spent the whole year abroad. I studied in France and Italy, and it was a nice, wonderful time, and then I came back, and I just had one semester left. I started my pre-med. I had to go back for a couple of years, and there I was with the 250 freshmen in chemistry. That was challenging.
Your father was a physician?
Psychologist. Both of my parents were Ph.D. psychologists. So is my sister. So is my best girlfriend. She’s a psychoanalyst from college. My best girlfriend here is a therapist, so I’m inundated with psychology.
Also your best boyfriend.
There you go. That’s true. You called them on the phone the other day, intellectual hippies.
Sometimes I like to call them non-drug-doing hippies because when people think of hippies, they think peace and love, let’s get high or whatever. We moved to North Carolina when I was seven. It was in Greensboro, North Carolina. There wasn’t a big intellectual community there. My parents were great readers and writers. They wrote textbooks together about psychology and educational testing. We had our own garden. My mother made her own granola and yogurt, and we weren’t allowed to have medications, which I can get to in a minute.
We were exposed to a lot of different things and a lot of different kinds of people. I think that my mother also had a degree from the Art Institute in Chicago, so there was a lot of art in our house. I played music. All of these things surrounded me when I was growing up. I think it’s contributed a lot to helping me be a better doctor.
You’re such a big part of what we do at J. Flowers Health Institute and our Comprehensive Diagnostic Evaluations program and then also in our wellness program. However, I always tell Robin and friends and everyone, I brag on you all the time, because when women finish the evaluation, we always say, “Tell us about your experience and how was your experience.” They never say, “Dr. Flowers was amazing.” You were brilliant. Every single woman says, “I’m coming back for Dr. Karmel.”
They love you. Thank you. You’re been here with our patients.
Psychology
I learned more from Dr. Karmel than anything else because you bring in the medicine, and you bring in the therapy piece of it, including hypnotherapy. I lost my place here. We were talking about psychology being a big part of your practice. I know that comes from your parents and your background and your upbringing. I love the way that you fit that in with every single patient. I love the fact that you do hypnotherapy because the patients with whom you’ve done it with us just have progressed so much, even in the short time that they’re with us. Tell us a little bit about the psychology in your practice.
First of all, thank you for the compliments.
All true.
It’s true.
I don’t think about things like that. I’ve always been very sensitive to people. I always felt that I could easily connect with just about anyone, regardless of their gender, race, or age. All of my travels all over the world just felt like that, and I think you’re similar in that way. But then, as I got older, I realized that I had a gift for healing and a desire to help people. Healing and treating patients can’t happen without a personal connection. It’s a nice combination.
Healing and treating patients cannot happen without a personal connection.
I think that’s really important because when I meet a patient, first of all, I meet them with their clothes on before we do any kind of exam. It’s important to establish a rapport with a patient and the trust before you can proceed toward any diagnostics or examination or evaluation.
So, they open up?
Right. I think that’s what a lot of women maybe were missing with their other gynecology appointments. Maybe people are in a hurry. Boom, boom, boom. Got to get out of there. As far as the hypnosis, so, my hippie parents were into breastfeeding and Lamaze labor instruction back when it wasn’t popular. Since they didn’t like us to take medications or eat junk food, by the way, which I hated until I became an adult, I remember during one period, I was having headaches, and my father hypnotized me for the pain to go away. I was having recurrent headaches, and so that was my first exposure. As time went on, he was using it in his practice. We talked a lot about it.
This was a time when the American Society for Clinical Hypnosis only accepted MDs, and then they added Ph.D. psychologists. It was a pretty rigorous training at that time. When I decided that I wanted to go to medical school, I had to change the way that my brain worked. I had to spend many hours memorizing, which is not what literature studies are about. It’s more about thinking and coming up with ideas. Instead of taking Adderall, because that wasn’t available so widely, then I did hypnosis for memory and concentration.
I went to another psychologist, a friend of my father’s. We did several sessions in his office. We made tapes that I used all the way through residency and board exams because, when you’re a doctor, you never stop having to take exams. We have every year board renewal. That’s how I got into it, and it’s just amazing. It’s an amazing tool.
Headaches
You mentioned that you had pain as a child, and your dad did hypnosis with you. What was your pain, and what happened with that?
I’m not really sure why I was having headaches, but I do know that he got rid of them. But being a psychologist, he was very good at reading people. He was a Freudian psychologist. My mother was a child psychologist with an interest in Piaget. They ended up getting divorced because, you can see, totally different. But I can tell a funny story about the psychological environment. One thing is that we never got spanked. We got analyzed. When we got in trouble, literally it could be an hour or two sitting in the study with them discussing what you did, why you did it, what have you learned? How were you feeling when you did it? I learned a lot about that.
Just spank me, get over it.
Exactly, and that would have been me. But then I remember, I think I was maybe around eleven, or I think fourth grade. We had given my father a set of darts for Father’s Day, and it was a big deal. We didn’t grow up in a super fancy way at that time. We had got him a really nice dart set, and it was summertime. I was home, so I took the darts out one day, and I was playing with them, and I lost the yellow dart. I couldn’t find it anywhere.
Later that summer, I got strep throat like lots of kids do. I went to the doctor, and I got antibiotics, and then I just wasn’t getting better. I went back, and the doctor was like, we’ll just give her more antibiotics. I don’t know what’s going on. And so finally, after about ten days, which is a long time to have strep throat—my father came in, and he sat down, and he’s like, Catherine, is something else going on that you’d like to talk to me about? The next thing you know I just lost it, “I lost your yellow dart.” I confessed the yellow dart, and boom, the next day I was fine.
Isn’t that amazing?
It really is.
It is. Our bodies keep the score.
He was just trying to help me get better, but I think that stuck with me because I understand how we can internalize things. It’s the same thing. If a patient comes in, for example, someone comes in with recurrent vaginal infections, and they’ve taken ten different treatments, and they’ve seen four different doctors, and what’s going on? Every test is negative, every culture is negative, but they keep having this discomfort and these infections, and it’s torture. You really have to just dig deeper. Maybe something else is going on. Maybe they’re being abused at home, or maybe they are diabetic, or maybe they are very stressed out. There could be so many things that play into it. That’s part of the global approach, too.
Family Life
There’s got to be a lot of stress as well in the work that you do, and working with women who are having issues, and then your husband is a cardiologist. For your children, it must be a lot of stress being a child of a gynecologist and a cardiologist with psychologist grandparents.
Actually, no, but sometimes driving around in the car, I have two seventeen-year-old daughters and a fifteen-year-old son. They’ll be like, Mom, stop being such a gynecologist. Do you have to talk about the vagina again?
I wondered if we were going to say the V word in this.
My husband’s pretty laid back.
He is.
We are very therapy-oriented.
What do you guys do for fun in your house or outside of your home? What do you guys do to de-stress?
A lot of cooking and eating. My inspiration is not as strong as it used to be, but especially at the beginning of the pandemic, I was making all kinds of fancy meals. You may have seen pictures of them.
I think I had a couple of the breakfasts.
We have a screened-in porch that we’ll hang out there. We have family that lives next door, my 97-year-old father-in-law, who I adore. They come over a lot, and he plays the piano, so music is a big part of my life.
You still play the violin?
I started again since COVID. I had Facebook-messaged my old violin teacher, who was from Duke, when I was living in North Carolina, and she answered me one year later. Which was last March. It was the pandemic, and I was stuck at home, and we connected, and I said, I’m going to start playing my violin again. It had been 30 years. She’s 83.
That’s so cool.
We do FaceTime lessons every Sunday morning. That’s been my COVID perk.
COVID-19 Pandemic
Clearly, you had to close your practice for a while, but how did COVID affect your practice and your own psychological health?
I’ve been fine, thank God. Partly because of my practice and my patients. I love what I do, and I love my patients. It’s like going to a cocktail party every day. You just get to hang out and talk to cool women. But with the practice, we’ve had to close intermittently. I think part of the reason why I feel more sane than some people is because I get to go to work and interact with people.
In terms of my patients, I would just say anxiety, because so much uncertainty, so much, the rug has been pulled out from everyone, and it’s hard. You can’t get back into your routine. Especially people that may have had a tendency towards OCD behaviors, having to wash everything and clean everything, it really has been a significant issue for so many people. I’m still seeing them come in. A lot of anxiety and stress.
Gynecological Exam
This question is for you, Dr. Karmel, because for the audience to hear, why does J. Flowers Health Institute incorporate a gynecological exam as part of the comprehensive diagnostic evaluation?
First of all, I only see the women that come in. Just want to make sure that’s clear. I have helped out some male patients along the way. I’m a licensed medical doctor, so that’s okay to do. I think that it’s a nice window into what’s happening on other levels, just the same thing as the global gynecology. It’s a window, and it’s an opening for me to begin a dialogue with the patient. We always talk in my office. We start with just routine things. How old are you? When was your last period? What are your periods like? As you begin talking about things like that, just familiar, sort of normal things, then you can easily segue into other things that come up.
This was my thought in the beginning when I heard that that was part of the process, that there’s just a lot of women out there who don’t go to see their gynecologist on a regular basis.
That is definitely true. I think that also a relationship with your gynecologist can and should be a very close relationship. Many women suffer from anxiety, but also low self-esteem or shame. I’m sure you know Brene Brown. She’s done amazing work in helping us understand about imperfection and accepting imperfection. Women have a tendency to try to be perfectionists, even little girls. They want to have the nice handwriting, and they want to behave well in school. I think that’s where it opens the door to so many things.
Sixth Sense And Collaboration
I think one of the reasons we do it at J. Flowers, is because of her belief in that global health, and my belief in that global health. We also have talked that we both share something else together, and that is we both have this odd, odd or not, but we have this sixth sense for diagnosing. You talked a lot about that in your own career, and I’ve talked about it in my career, and having this sixth sense. Tell me a little bit about that, and where do you think that that comes from, and do you nurture it? I’d love to know more about that.
That’s a great question. To prepare for our podcast, since these are things I use, I looked up the definition. Sixth sense is the natural ability to know things before other people, or to see things that others do not see. This is what I love about the J. Flowers Institute. Really, what it is is you’re taking all these different clues, and you’re bringing them together. Studying comparative literature, you had to study literature in different languages, you had to come up with your own theories, you had to bring philosophy, history, all these things in. I learned how to weave things together, plus with the music background.
Sixth sense is the natural ability to know things before other people, or to see things others do not see.
The sixth sense, probably, if you dissected it, is taking all those signals and putting it in, putting a puzzle together. You don’t know how you pick up on it, but meanwhile, you meet me, and you’re picking up on so many different things, including the person’s energy. You’re very empathetic, and you can feel certain feelings that people have. That’s really why, to me, it’s so exciting to work with the J. Flowers Institute. I wanted to say this is so important because it’s collaborative, and medicine has changed so much. It’s not collaborative. Everybody’s in their own little office. We’re under so many regulations that you don’t get to get together and discuss patients like we used to. We used to be in the doctor’s dining room, and we would meet, and people would present cases, and so I just love that collaboration.
We do too. That’s what makes this so successful. Even some of the larger hospital systems around the country that do assessment programs started when they were smaller and grew into these huge hospital systems. When you grow that large, and you can’t go to the dining room all the time, and you have 50 patients that you have to see, or even 25 patients in a day, you see the patient, you write the report, and you upload it to the chart. Then, at the end of the evaluation or the assessment, someone reads it and gives it to the patient and goes over it. What I love about the way we collaborate is, even though we can’t see each other in person all the time, we get together on Zoom like the rest of the world.
Every week.
We get together every single week on Zoom, and it feels just like we’re in the same room, so that’s kind of cool.
It’s awesome.
We have so many different providers in different fields, and we each have different perspectives. I also appreciate input that I might get from our nutritionist, Moe. I think he’s got amazing insight, and then people will appreciate my insight. Sometimes it might even be about a male patient because we’re discussing issues that are just human issues. All humans are the same. The human condition is universal. I had something I wanted to say.
What was it?
About your travel?
No, it was about him and his sixth sense.
I see.
Shoot, I forgot.
You know what I was going to say is it’s weird that, whether it’s a sixth sense or whatever it is, how we all visualize things? I’m very visual. When I think about my sixth sense, and what you just said hit the nail on the head for me, sometimes, I literally feel like my brain is clicking. It’s like when I listen to someone, it’s going tick, tick, tick, tick, tick, tick, like adding things.
Really?
Yeah, and it’s almost like this little calculator coming up with an algorithm or something and feeding it in and coming out. So I don’t know. That’s the way I visualize it for myself.
What I was going to say is, you said when you listen to someone, I think a lot of the sixth sense and a lot of being a helpful and good caretaker or provider is listening. Listening and letting the patient say what they need to say, because they tell you. Patients will tell you. They tell you everything that you need to know, but you have to listen. So like you were saying, a lot of times, people are in a hurry, and there’s boom, boom, boom, here’s your prescription, goodbye.
Patients will tell doctors everything they need to know, but doctors must know how to listen.
Self-Acceptance
What’s the best advice that you could give the female audience? One word of advice for their female health? I know what you told me earlier. See a therapist.
I was going to say call your shrink. There’s not one word because it’s so individualized, but I think that working on self-acceptance is paramount for women and girls. It’s a journey that we all go through, and a parent can definitely help with that. A lot of parents can be critical of their children or send a message that makes the children less accepting of themselves. If you have self-acceptance, then you can really just blossom.
That’s the key, self-acceptance, and it’s hard to get there.
Patients’ Age Range
What are the ages of the patients? What’s the youngest and the oldest that you accept?
I see patients from adolescence through menopause and post-menopausal. I no longer do deliveries. I did many years of OB, which I loved, but I had to give it up after having three of my own children and felt like I needed to spend time with them. Any age, but not pediatric. I would say, for me, the ideal age is around sixteen, although the American College of OBGYN says to start between 14 and 16 to establish a relationship.
It makes sense.
All the way through reproductive years and post-reproductive.
Developmental Milestones
That’s so cool. We’re running low. I was like, no. I can’t believe that went by.
I have a couple of questions. Is that possible?
Yeah, come on. This is Jordan, everybody.
Come on over here.
When you say self-acceptance, what does that look like? I have a daughter who’s two years old. She likes to look at her vagina sometimes. My husband thinks that it’s weird, but she’s exploring her body. The first time she saw it in the mirror, she was like, so can you talk to mothers with children? What does self-acceptance look like? How can you give that to your child or for yourself? What does it look like? What does it mean?
That’s a big question. That could be a whole podcast issue. As far as your two-year-old, I would say that that’s completely developmentally appropriate. For your husband, reading developmental milestones and understanding what is appropriate, I think that might be helpful. It’s hard because little boys who are two, if they’re playing with their penis, that’s totally normal because it’s right there and they can see it. So why aren’t we allowed to look? I think also accepting whatever you have. Like, I’m short and you’re 6’5″. I won’t hold it against you.
I remember the first time I tried to go to the bathroom like a boy. I saw my brother do it. I was like, why am I not going like that? You’re just curious when you’re a kid.
When I see teenagers for their first gynecologic visit, you don’t get a pap smear until you’re 21, but we have a long discussion about female anatomy, reproductive health, and everything. Then we do an external exam where I show them their anatomy and show them what’s normal, because some girls don’t realize that there are three separate organs down there. There are three separate holes.
You said they don’t get an exam until they’re 21, a pap smear?
Pap smear, right.
Why?
We found that we were over-treating young women. If you have an abnormal pap smear when you’re seventeen, most likely you’re going to clear it, and it will go away on its own. We were over-treating. We were being too aggressive, and that can cause complications later.
Gotcha.
We wait until they’re 21, which is much better because if you’re a 16-year-old or 18-year-old girl and you’ve never been, it’s not very much fun to have a pap smear.
Rapid-Fire Questions
Since we’re running out of time, we always do a few fun questions just to find out a little bit more about you as a person, as a woman. Where’s your happy place?
I think I really like the beach. Not any particular beach, but I love the beach.
I do too. I love the beach.
For sure.
When I do hypnosis, a lot of times we’ll use a place like that. I’ve come up with a beach that has magic sand that doesn’t stick to your feet.
Nice.
It’s magic sand.
That’s great to do that in hypnotherapy because people take things so literally, and someone that has a hate of sand being on their body, and you’re taking them in through hypnosis, they can’t concentrate on it because they hate sand so much. It’s perfect to incorporate.
That just happened with a patient, and afterward, she said that she hates that sticky sand on her. I said, that’s why it’s the magic sand.
Who would play you in a movie?
I have no idea.
Come on.
I really don’t know. Give me a suggestion. I’m the worst for that.
I am too.
I don’t know. I’m trying to think.
Probably a gay man.
There you go. A gay man.
My friends used to always tell me I’m a gay man in a woman’s body.
There you go.
We’ll talk about music.
What’s on your playlist right now?
What’s on my playlist? This is not very hip, but I’m really into classical music. I love classical music, and that’s what I usually play in my car. That’s in the kitchen when I’m cooking, except for when my kids are around. I’d say right now, I’ve been listening to certain pieces that I’m learning. One is the Samuel Barber Violin Concerto. Typical Mozart, Chopin, Bach, Beethoven, all of those.
Very cool.
What is your most, not favorite meal you’ve ever cooked, but what is your most accomplished meal you’ve ever cooked?
I can tell you that one because I do cook a lot. One night, I had a dinner party, and I made Moroccan food, which is my favorite food, but it’s very complicated to make. We literally had fourteen dishes, and my husband said that was the last dinner party we’ll ever have because we were still doing dishes at 2:30 in the morning. I have a lot of Moroccan teapot, and I have tagine pots and all that, so I really enjoyed that.
That is so fun.
Cool.
That was worth it to stay up till 2:30 doing that.
When she invites you over, be sure to ask her for Moroccan food.
Ask her husband. We are having Moroccan food.
Episode Wrap-up
If someone wants to reach you, how should they reach you? Is there a phone number, an email, a website?
Yes. I would like to say that we do not have an automated system at my office, which I am proud of because I hate automated systems. However, if they’re on the lines, it will send you to a recording. Our office phone number is 713-520-9580, and it’s KarmelWomensCare.com. Our email is [email protected].
Perfect.
That’s perfect. Good. You ladies, reach out to Dr. Karmel. She has an amazing practice, and it’s worth it.
If they want to reach you, Dr. Flowers, how do they reach?
Unreachable. JFlowersHealth.com.
Gotcha. Thank you so much, Dr. Karmel.
Thank you.
Thank you very much. This was so fun.
I know.
I love it. Thank you, Jordan.
