Small Steps Add Up

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Waves crest and roll in, filling the room with soft “shh-shh-shhhh” sounds. With the press of a button, visitors can switch to the pinks and blues of the aurora borealis streaming over a mountain lake, or a starry night sky that moves with their bodily motions, creating a trail of light. 

This is the recharge room at the Andrew Weil Center for Integrative Medicine at the University of Arizona, an immersive space for relaxation and recovery designed by Mirelle Philips of the New York-based firm Studio Elsewhere. Proven to reduce stress by 60% in just 15 minutes, these rooms will join a litany of evidence-based therapies from acupuncture and meditation to more conventional treatments like prescription drugs and surgery in an effort to fulfill what Dr. Weil and his colleagues call integrative medicine. 

Spanning 30,000 square feet, the center was designed to represent seven core tenets of integrative medicine: exercise and movement, social relationships, spirituality, healthy nutrition, sleep quality, stress reduction and resilience. Visitors and staff will discover spaces and gardens dedicated to supporting activities in each of these areas.

This is what coaxed Dr. Stephen Dahmer away from his nice life in New York. An integrative and family medicine physician serving as the assistant dean of wellness and chief of the Division of Integrative Medicine in the College of Medicine – Tucson, Dahmer joined the AW-CIM team in March as the center’s new director, leaving behind more than 10 productive years on the east coast. “After fixing up a mid-century modern with a view of the Hudson, there was only one thing that would take me away,” he says. “And that was this job.”   

Dahmer has often approached his work in a slightly unconventional way. As medical student at the University of Wisconsin, he took time off to shadow a small team — including a psychiatrist, an internist and a medical anthropologist — in a densely populated, low-income area of Fortaleza, Brazil, where he learned the value of things like community-based healthcare and music therapy in addressing the challenges of an overburdened healthcare system in an under-served community. His dean in Wisconsin worried the break might derail him. Instead, it helped define him. 

In 2006 he became a fellow in integrative medicine at AWCIM, driven, in part by “a recognition that it embodied the core reasons I entered the medical field.” He later worked as a hospitalist in Chinle, Arizona, before beginning his career in New York and coming back to Arizona in 2024. Enchanted by the desert, he hiked in Sabino Canyon every morning of his first two weeks back in the Old Pueblo to watch the sun rise, discover waterfalls and generally, in his words, “feel the canyon.” He was particularly taken with the smell of creosote after rain. “Geeked out,” even. 

Dahmer’s fascination with plants goes back to his days volunteering in Brazil, where he learned about “farmácia viva,” or the use of locally grown plants in medicine. Before joining AWCIM, he collaborated with U of A researchers Todd Vanderah and Mohab Ibrahim on a cannabis re-search grant, and he has studied plant-based medicine and cannabis use for chronic pain management throughout his career.

“Most discussions of cannabis highlight the negative effects of the cannabinoid THC, which can cause intoxication,” Dahmer says. But while the cannabinoid CBD is now an FDA approved medication, the plant also contains hundreds of other valuable constituents whose potential health benefits are unknown. “Cannabis is a prime example of a plant that is often misunderstood.” 

Dahmer was emboldened to take a different path in part because the conventional ones weren’t always leading where they’re supposed to. Life expectancy in the U.S. is falling. Infant mortality is rising. Even softer global health indicators like happiness aren’t where they used to be. 

“If I have an infection or break a bone, there is no place I would rather be than a major hospital system in the U.S.,” he says. “But we haven’t done as well in addressing chronic diseases, and even less well in the prevention of them. The same goes for things like personalized care, complex disorders and healthcare disparities. In my experience, in order to improve, we need to in-novate.”

But with innovation comes pushback, or at least skepticism. Even with a practice like acupuncture, where the risks are low and the evidence of positive effects on certain symptoms is strong, Dahmer finds resistance. “As a physician, I’ve been criticized for recommending it,” he says. 

This is where data comes in. Simple interventions — like taking 10,000 steps a day, for example — aren’t just pleasant ways to spend time, they’re activities with “compelling data supporting their ability to prevent and mitigate disease,” he says. Or take a breathing technique like the four-seven-eight breath: inhaling for four counts, holding for seven counts and exhaling for eight counts. The positive effects of these techniques compound the same way an investment grows through compound interest, Dahmer says — a comparison that makes them easy to grasp and appealing to try out. 

The new center — as well as a new integrative medicine clinic being developed in conjunction with Banner Health in Tucson’s Catalina Foothills — should only help Dahmer and his colleagues strengthen their cause. “One of the best ways to gather more definitive data on the positive impact of integrative health is to have your own clinic,” he says. 

Dahmer doesn’t just introduce his patients to these tenets; he subscribes to them in his own life. He joined a Tucson group practicing capoeira — a Brazilian martial art and dance — to combine exercise, theater, music, and socializing. He also creates simple morning rituals — coffee and a sun salutation or meditation (and not looking at his phone). He is big fan of daily readings and small rituals throughout the day that “help you to remain in the right mindset,” whether that’s a meditation, a prayer, tea or a mantra. 

“Twenty-five years ago, when I started, and decades before when Dr. Weil coined the term and concept of integrative medicine, there was less mainstream science related to the field and far less overall support,” Dahmer says. “We’ve certainly seen marked changes in momentum.”

Dahmer himself doesn’t follow all seven tenets every day and advises his patients that it might not be possible. But he also knows that the small steps add up.