The Garden and the Prescription Pad: On Different Ways of Knowing

Before I learned to write prescriptions, I learned to read plants. Not in the academic sense -- memorizing Latin names and pharmacological properties, but in the older, slower, and more natural way. Hands in soil, nose full of earth-scent, relishing the beauty of a cucumber seedling reaching up toward light and a valerian root burrowing deep into the dark humus below.

This might seem like romantic nostalgia from a psychiatrist who spends his days prescribing Lexapro and Wellbutrin, but I've come to believe that my garden taught me things about healing that medical school never could.

Modern psychiatry excels at isolating active compounds, standardizing doses, controlling variables. We've extracted Prozac from the complexity of human suffering and packaged it in 20mg capsules. This isn't wrong; it's helped millions of people. But it's not the only way of knowing.

In the garden, nothing exists in isolation. The tomato plant speaks to the basil beside it in chemical signals we're only beginning to understand. The soil microbiome influences what the roots can absorb. The angle of sunlight, the morning dew, the visiting bee,everything interacts with everything else in a relationality that resists reduction to mechanism.

Human suffering works similarly. Yes, serotonin matters. So do norepinephrine and dopamine and GABA and glutamate. But so does the story you tell yourself about your pain. So does what you eat breakfast. So does the quality of light in your bedroom and whether anyone provided real safety for you when you were scared as a child.

Traditional healing systems knew this. They might not have understood neurotransmitters, but they understood patterns, relationships, the dance between inner and outer worlds. An herbalist doesn't just prescribe St. John's Wort for depression: they consider your constitution, your lifestyle, what foods you crave, how you sleep. They see you as an ecosystem, not a collection of symptoms.

I'm not suggesting we abandon psychopharmacology for herbalism (though herbs have their place). I'm suggesting we need both ways of knowing. The precision of modern medicine and the wisdom of older approaches. The randomized controlled trial and the careful observation of how this particular person in this particular moment responds to this particular intervention.

In my practice, I prescribe medications when they're helpful. But I also ask about sleep and sunlight, movement and meaning. I consider not just what's happening in your synapses but in your relationships, your story, your days. I remember that you're not just a brain in a jar but a whole person embedded in a world.

The garden taught me patience; you can't rush a tomato to ripen. It taught me humility; despite our best efforts, some plants thrive and others fail for reasons we don't understand. Most importantly, it taught me that healing, like growth, happens in relationship: between seed and soil, between gardener and garden, between what we think we know and what remains mystery.

Sometimes the prescription pad helps. Sometimes what's needed is simpler and more complex: connection, purpose, time, the mysterious alchemy of one human bearing witness to another's suffering. We're all gardeners of consciousness, tending what grows and doesn't grow in the peculiar soil of our lives.

Dr. Ben Bregman is a psychiatrist specializing in integrative mental health. If you're looking for support consider reaching out to Washington Integrative Mental Health Services. Our clinic is located in Takoma Park, MD