Being Your Own Advocate: A Conversation with Dr. Lara Birk and Dr. John Stracks
Video: Watch the full session here → https://www.youtube.com/watch?v=TRABDIRIN5k
Dr. John Stracks: Hello and welcome. I'm Dr. John Stracks, a physician focused on the reduction and elimination of physical symptoms using mind-body medicine methods. If you'd like to learn more about working with me or our team, please visit cormendihealth.com.
I'm here today with Dr. Laura Burke, a certified health and wellness coach who has published extensively on the social aspects of chronic pain and illness. Laura had a catastrophic orthopedic injury at age 16 and then lived with debilitating, progressive chronic pain for almost 30 years before finding mind-body medicine healing. She now knows firsthand the profound healing power of the mind — even when pain is a complex combination of structural and neuroplastic.
You may have heard Laura's story from our first interview in December 2021. Today she's back to share what's happened since, and we're going to go deeper into three things: how to tap into mind-body healing when structural issues are also present, what to keep in mind when working through trauma, and how to build a healing community around you. Laura, thank you so much for being here.
Dr. Laura Burke: Thank you so much, Dr. Stracks. It's a real honor to be here and to speak with your listeners again.
A Quick Overview: Laura's Story
Dr. Stracks: For those who didn't catch the first interview, can you give us a brief overview?
Dr. Burke: Of course. I was 16, a soccer player and avid runner, when I had what turned out to be a catastrophic medical emergency — acute exertional compartment syndrome — on the soccer field. I wasn't believed at first because it wasn't well known at the time. It was devastating for my right leg. I was hospitalized for six weeks, had multiple surgeries, and they nearly amputated. Eventually got into a wheelchair, then onto crutches — and then it happened in my left leg too.
In the years that followed, there were constant interruptions. Recurrent ruptures of one kind or another — chronic fatigue syndrome, mono, mast cell activation disorder, CRPS, endometriosis. My whole nervous system had been traumatized. I think of it now as medical PTSD of the nervous system. My life collapsed multiple times over that period. I had something like five surgeries right at the beginning and over a dozen all told.
Dr. Stracks: And that went on for roughly 25 to 30 years — relapsing, remitting, feel a little better, something new pops up. How did you find mind-body medicine?
Dr. Burke: It was a Facebook ad for the Curable app, about four and a half to five years ago. I downloaded it, dove in completely, joined Curable groups — shout out to my Pit Crew, we just celebrated our fourth anniversary — and just immersed myself in pain science. I eventually pursued coursework, trainings, and certifications in that area because it helped me so much.
Dr. Stracks: And it did help significantly. You were getting back to activities, feeling more empowered, less suffering around the pain. When we wrapped up our first interview, we concluded that maybe 90 percent of what you were experiencing was driven by the mind rather than the body — despite all the physical history. My sense is that over the last two years we've learned that's not quite the full picture. Can you pick up from there?
When the Body Needed Attention Again
Dr. Burke: When we last spoke I was doing well — I'd gone jogging, I was getting back to life. I still had a significant knee contracture and daily pain, but things were better and I thought I was home free.
Then in spring 2022, things fell apart again. I felt a tweak behind my left leg, then a series of tweaks. The nerve got increasingly irritated and extremely painful. I ended up housebound for the spring and summer of 2022. I had low moments — army crawling to my freezer for more ice, thinking: but I'm a pain coach, I should be able to figure this out.
Eventually I realized something was genuinely wrong and I needed to trust that voice. And here's what I want to say about that: it was the mind-body work I had done that gave me the confidence and courage to speak up for myself and go back to the medical system — which had so traumatized me that I was scared to return. I credit that work entirely with being able to do that.
Dr. Stracks: How did you re-enter the medical system?
Dr. Burke: Once the pain hit eight or nine out of ten constantly, I contacted my old surgeon — now retired — who connected me with the person who had taken over his practice. I screwed up all my courage and went. I had to advocate hard. An initial MRI showed nothing. I pushed for a specialized MR neurography to visualize the nerve. Even then, when the surgeon showed me the results, he said there wasn't much on the report. But we went through it together on screen and I kept asking questions. I pointed to something and said, "What's that?" He said it was right in the area I'd described as most painful. I asked if it could be causing the pain. He said it really could.
We found it together. And I credit the mind-body work for getting me to a place where I had enough self-trust and agency to keep pushing until we found the answer.
Dr. Stracks: It takes real courage to sit in a room with a physician and say, "Go back — I want to know what that is." We can come across as all-knowing, and pushing back on that is genuinely hard.
Dr. Burke: There was old programming to overcome — this tendency to defer, to assume the doctor knows best. But I kept thinking: even if I'm wrong about this, I'd rather be wrong while backing myself and listening to myself than wrong because I listened to someone else.
I called you before the surgery, Dr. Stracks. I was getting cold feet. You said: you're disabled by this right now, you can't walk, and based on everything you've told me and the test results, surgery sounds like the most rational next step. That meant so much. I was scared, and having your blessing helped enormously.
Dr. Stracks: And what they found in that surgery — the 17th — was significant.
Dr. Burke: The surgeon's report described the nerve as completely encapsulated by a tremendous mass of scar tissue that was strangling it and adhering it to the adjacent lateral nerve and knee tendon. When he came out of the operating room, he said: "There is no way you would have been able to walk without releasing this." The contracture improved dramatically too — from about 30 degrees to roughly seven degrees away from fully straight.
Recovery: Using Mind-Body Tools Through the Physical
Dr. Stracks: The surgery was September 2022. How was recovery?
Dr. Burke: I'm allergic to all pain medications, so I won't pretend it was easy — operating on a significant motor nerve is brutal, and I had no opiates to fall back on. But the mind-body work genuinely saved me. Moment by moment I got through it with breathing and meditation. Once I moved into rehab, I was able to devise my own physical therapy program using graded exposure and graded imagery exposure. Eventually I was hiking two hours at a time. Deliriously happy.
Dr. Stracks: The graded exposure piece is worth unpacking. Can you give a concrete example?
Dr. Burke: After the surgery, my physical therapist had been told by the surgeon to have me do 150 heel slides a day. My amygdala was not having it — that was too much, too fast. So working with my PT and my mom, I devised a graded approach. I couldn't even picture straightening my leg without feeling nauseous. So I started by looking at Google images and short videos of people bending and straightening their knees — people smiling, completely fine, not in danger. That graded imagery exposure got me used to the idea that it was safe. Then little by little, a little bit more each day. Confidence builds on itself.
I also want to say: I'm not ashamed to admit I used medication as part of this process. Nerves take a couple of years to heal from this kind of surgery. I had nerve pain. Medication put a platform underneath me that allowed me to do the mind-body work and make real progress. I used everything as a tool.
Blending the Physical and the Psychological
Dr. Stracks: This is something I want to address directly for people who are listening. When people enter this world, it's very tempting to leave the physical side behind entirely. And for some people, that's appropriate — their body is physically healthy and the symptoms are entirely driven by the mind. But others have autoimmune conditions, surgical histories, structural abnormalities, tissue injuries. For them, both are real. Can you talk about what you've learned about navigating that?
Dr. Burke: I fell into the trap of binary thinking — it's either this or it's that. First I gave all my power to the medical world. Then I overcorrected and gave all my power to the idea that mind-body is the only paradigm. What I had to learn was to take my power back from both camps and see myself as the agent — using each as a tool.
Medical intervention is sometimes necessary. Mind-body work has tools for every stage of the process. The more I shifted to seeing myself as consciously choosing which tools to use rather than deferring to any one system, the more I was able to hold both at once.
Dr. Stracks: And the way I frame it for people is this: pain isn't about damage, it's about the brain's sense of danger. Sometimes that danger is psychological, sometimes it's a physical situation that genuinely needs to be addressed. My job is to assess which is which — and when there's a physical issue profound enough that you won't heal until it's taken care of, we need to address it. That's what happened with Laura's surgery.
The Three-Month Flare: Trauma's Role
Dr. Stracks: You were doing well after the surgery, then you had a significant three-month flare. What happened?
Dr. Burke: I was walking one day and felt that same tweak I'd felt the year before — the tweak that had started the whole spiral toward surgery. And immediately my brain went: I know this. The sky is going to fall. This is exactly how it started last year.
The pain escalated, and I became housebound again. Looking back, I think there was real physical irritation — the nerve is still healing — but there was an enormous amount of amplification from the trauma response. I essentially went back in time. I became a time capsule of my previous self, operating as if I was as helpless and powerless as I was in 1991 when I was 16, and this all began.
Dr. Stracks: That's exactly what traumatic memory does. The brain codes trauma differently — it stores it in a way that can pull us back instantly when we encounter something that resembles the original danger. That's what PTSD is. A veteran can hear a helicopter and be back on the battlefield. For you, a tweak in your leg was enough.
Dr. Burke: It's like a trapdoor. You're going along fine, and then suddenly it opens and you fall back to a previous version of yourself. I had another analogy for it too — the car wash. You pull in, your wheels get set on the track, and the car just goes. You don't have to do anything; you're just carried along on a predetermined path. My brain on trauma was like that: Oh, I know this track. I know exactly where this goes.
Dr. Stracks: So how did you find your way out?
Dr. Burke: A few things. First, I remembered the predictive coding piece — this is what brains do. This is the old tape playing. And then I literally sat down and made a list of all the ways today is different from a year ago. All the ways 2023 is different from 1991. Writing it down, not just thinking it. That started to ground me and remind me that a lot of what felt like certainty was actually prediction, not reality.
Then the desensitization work with my partner. The flare had made the nerve area so sensitive that I couldn't tolerate anything touching it — fabric, water, even being close to it. He worked with me in this very gradual, graded way, starting from a safe distance and over weeks slowly moving closer to the area. A month ago I couldn't tolerate it at all. Now the whole area is so much better. And it gave me this revelation: my legs don't only feel pain. They can feel good. I had almost forgotten that was possible.
Building a Healing Community
Dr. Stracks: Who else is on your team?
Dr. Burke: My partner, my surgeon, you, my physical therapist, and my mother — who is actually remarkably good at devising graded exposure programs. And my best friend. We send each other voice memos every day, quite extensive ones. She has given me unconditional love and support throughout all of this. She believed me. She stood by me.
I think about The Velveteen Rabbit — the idea that the little stuffed animal only became real through being truly loved. My best friend and I joke about that. We love each other real. And I cannot overstate how important that kind of relationship is when you're dealing with chronic symptoms. One of the hardest things about chronic pain is the isolation — feeling profoundly alone. That's almost as difficult to manage as the symptoms themselves.
Dr. Stracks: And for people who don't have that kind of support close by — how do you coach clients to find it?
Dr. Burke: Groups are a wonderful place to start. There's something powerful about being in a room — virtual or otherwise — with people who just get it. You don't have to explain. You don't have to justify. Working with a therapist can also provide that foundational experience of being seen and heard and valued. And the mind-body community has grown so much. When I first learned about this in the late 1990s, there were almost no people to connect with. Now there are millions of people in groups, apps, Facebook communities — supporting each other, sharing their stories. It's remarkable.
Staying Forward-Facing Through Setbacks
Dr. Stracks: Any advice for people who feel like they've failed because they've had a flare or a setback?
Dr. Burke: Please, no shame, no blame, no judgment. You are not a failure. Setbacks are not going backward — they're part of the journey.
Something that helps me is a quote I love: Nothing ever goes away until it has taught us what we need to know. Whether or not that's literally true, it puts you back in the driver's seat. It makes you the meaning-maker of your own story. Instead of asking "why is this happening to me," you ask "what can I learn from this, and how does this help guide me toward better alignment with my own life?"
My mom talks about the spiral staircase. We can look down and feel like we're seeing the same old stuff, going in circles, back at square one. But we're always moving upward. There's always more perspective, more depth. You genuinely cannot go all the way back to square one once you've done this work — even when it feels that way.
Dr. Stracks: And I'd add: the skills you've built don't disappear during a flare. Sometimes they're harder to access, sometimes they seem invisible, but they're there. And the difficult stretches are often where the deepest learning happens.
Dr. Burke: My dad went through many, many years of medical and psychiatric training, and I once asked him how he got through it all. He said: "I was living the whole time." And I've always held onto that. Whatever is happening with our bodies, wherever we are in this journey — we are living the whole time. That's where our agency lives. How do I want this life to look? What can I contribute to something larger than myself? Healing really is a social process. Trauma often happens in community, and it needs community to lift us back out.
Dr. John Stracks practices mind-body medicine via telehealth nationally and internationally. Dr. Laura Burke is a certified health and wellness coach specializing in the social dimensions of chronic pain and illness. To learn more about working with Dr. Stracks or the Cormendi Health team, visit cormendihealth.com. You can find Dr. Stracks and Dr. Burke's first interview on the Cormendi Health YouTube page.