Dr. Raphael Balbino, MD
Originally born and raised to the age of 12 in Rio de Janeiro, Brazil, I moved with my immediate family to the US in 1996 as my dad came to work as a music minister for a Brazilian church in California. Initially, we thought we would only stay in the country for a few months to a year, but as his work thrived, we eventually would be sponsored for our green card and the rest, as they say, is history. As I graduated High School, I had not yet decided what I wanted to go into for a career, so I decided to peruse the catalog of my community college in search of interesting classes for me to start building momentum towards my AA. Among those classes was Human Anatomy & Physiology and it was my absolute favorite class for that entire semester. This wasn’t completely random, either. I grew up watching my oldest sister studying for nursing and I would often leap through her anatomy books, and I found it all a world of wonder and awe. Such was its impact on me that by the end of the school year, I would be strolling into the counselor’s office inquiring about the steps I needed to take to enroll into medical school. Despite the discouragement I received, I pressed on, took notes, and began my long and not always smooth journey to become a medical doctor. And while I’ve never regretted it, there have been times when I would feel like that day would never come since overall, from the first year of college to finishing all my training, it took a total of 14 years!
As I contemplated which area of Medicine to go into, the decision came gradually with a combination of experiences, introspection, and listening to counsel from others who were mentors and friends in the field. At first, I recall that a good friend of the family who both did Family Medicine then went on to become an ENT told me as I was dropped off at the airport when about to move to Chicago to attend the University of Illinois School of Medicine in ’07 that I first needed to become a good generalist before thinking about any sub-specialty, otherwise I may not become the best specialist. I always held that dear and near to me as it resonated and made good logical sense. With that in mind, I naturally considered either going into one of the three primary care fields: Pediatrics, Family Medicine, or Internal Medicine. Ironically, while I ended up going into the Geriatrics track eventually, I at first thought I’d be going into Pediatrics, but I soon found out that there was a major difference between liking and even loving children to being cut out to be their physician especially in times of acute illness—the Emergency Room rotation revealed that Peds was not in my future. Even before I had to decide my path though, during the only summer we have off in Med School, I was awarded a great opportunity to move back to California for about 10 weeks and work with a mentor from the UC San Francisco Department of Geriatrics doing qualitative research on Alzheimer’s care at a local affiliated nursing home in the area. That program planted the seed that would later germinate and become the first phase of my career, namely becoming a Board-certified Geriatrician. When it was time to make a final decision, we were resolute in going into Family Medicine and were very much open to the idea of going on to do a Geriatric fellowship thereafter, but we needed to take one step at a time. We left Chicago and moved Southeast to Durham, North Carolina, where I attended Duke University for Family Medicine Residency, and there we had more opportunities to do home visits with a Geriatrician as well as see a lot of patients who were terminally ill in the hospital and really connect with those grieving families in a spiritual way as we consoled them and treated them as family. At the end of the program, I knew I had to follow my heart into Geriatrics. I then crossed the proverbial “street” to attend the University of North Carolina at Chapel Hill for Geriatrics and loved that extra year of training. Much of Geriatrics training requires putting on a new mindset to see everything from a balanced perspective that places the patients’ current situation with their whole lives in view and a significant portion of the time, we become their counselors and those who help them make sense of how they got to where they got in their life’s journey. Unfortunately, however, in the field of Geriatrics, apart from a few acute conditions such as UTI’s, we don’t get to offer much in the way of healing. So, over time, it does tend to weigh heavily on full-time practitioners, as deep inside the reason why most people go into medicine is to heal, relieve, and help restore.
I married my wife 16 months after I enrolled into Medical School and since then I would become familiarized with various ailments, symptoms, and even syndromes (clusters of symptoms) that my wife would have that would be seemingly “all over the place”, disconnected from anything that I was studying at the time and despite my furthering my training, getting my MD, finishing Residency, and even a Fellowship program, her health journey has not been helped by my conventional and traditional training—obviously, this is quite humbling. Yet, through her own research in talking to other women who had similar experiences, through reading books and journal articles, websites and blogs, she has learned so much about nutrition, how the body works, hormones, the digestive system and all of that led her to discover the field of Functional Medicine. This would eventually lead her to want to help others in similar situations who suffered with a lot of fatigue, brain fog, etc. so she took a course in life coaching and has seen great results with her clients. Over time, despite my initial resistance, I began to read more and more of the materials that she was consuming and for the first time would come across concepts that I had never learned in medical school such as intestinal permeability leading mechanistically to auto-immune activity, various dietary approaches and the scientific basis for them, adaptogens and their homeostatic roles within the body, the outsized influence of toxins that are all around us in various forms in the water we drink, the air we breathe, the deodorants we put on, and sadly, even the foods we eat, etc. This began a quiet revolution within me that would take years to well up, but I would sense a growing sense of discontentment in seeing how the medical industrial complex has not been at all set up to discuss these matters in depth with patients. In fact, over the last several years, as I learned these things, I would share them with my patients and began to see results whether it would be healing someone’s Irritable Bowel Syndrome, seeing first hand the effects that essential oils had in dampening the toxic aftermath of chemotherapy, witnessing testimony of patients putting Fibromyalgia into remission by overhauling their diet completely, seeing a husband’s tears as he shared about the power of Magnesium in giving his wife a much better quality of life instantly despite suffering from a neurodegenerative condition, using our Florida’s own native Saw Palmetto plant extract to get a patient in his upper 80’s to make fewer trips to the bathroom overnight while stopping the Rx medicine simultaneously, or successfully substituting toxic medicines such as NSAIDs for the natural food-based Curcumin and seeing dozens of people actually getting better—needless to say, I have been hooked ever since and in my practice, nothing has given me more pleasure than seeing my patients be released from the shackles of toxic medicines to live a more natural lifestyle and better enjoy their lives at the same time.
Enter the year 2020. With it, comes the COVID-19 global pandemic. And just as it provided much time for reflection to so many around the globe, especially with so much restructuring of how we spent our time and how we worked, it would be no different with me. I too had a lot of time devoted to reflection—where I’ve been, my yearnings for my career, the kind of impact that I wanted to have in people’s lives, the type of medicine that I was practicing now and what that told me about where I wanted to go with it, etc. Then, late summer of 2021, I had the fortuitous gift of a godsend introduction to Dr. Shirley Hartman by a mutual friend. We connected right away and summarized our journeys to each other, got to tour the office space, hear her heart and desire to slow way down even as she heard my longing for a functional medicine approach to care and truly treat patients holistically. This hour-long conversation over the phone led to several conversations, discussions, reciprocal trips to each other’s homes, meeting each other’s families, and for months we engaged in conversations transitioning into the clinic even as she prepared to retire from full time practice. I asked her to send me book recommendations of the most impactful books she’d read which have informed her practice and I have read through them and that’s when I discovered the world of Lyme and associated disorders as an open-minded physician, because up to then, all I knew about it was what I had learned in medical school and superficially about a couple of friends who had suffered through it, but I wasn’t privy to the details. Learning about Lyme and its historical underpinnings not only helped me make more sense of the pandemic we were going through but it also opened various doors to consider the field of medicine holistically and from a functional perspective because the body is fully integrated and a condition like Lyme which can involve essentially every body part must be treated thusly, otherwise it won’t work in a sustained fashion. As I continue along this latest chapter of my career committing to a lifetime of learning and service to my community, I am humbled at the unique opportunity to pour myself into partnering with my fellow neighbors integrating every tool that God has given us with the goal of ending suffering and facilitating a healthier aging experience for who have battled premature disease.