Or perhaps in one word: choices.

When the Kahala naturopath talks about her book — as she did a couple of weeks ago over an appropriately nutritious salad and fruit lunch at a "sisterhood" of health-oriented friends organized by one of her patients, Wendy Crabb — "choices" is her opening segment.

"I feel very strongly that every moment of each and every day we have the ability to make choices ... and those choices accumulate and can literally change your life," she told the 50 women at the Pacific Club.

Steelsmith has a doctorate in naturopathic medicine and a master's degree in acupuncture. Her practice is based in Kahala, and though her book may appear a bit daunting because of its physical size, it's written in a straightforward and conversational manner with frequent explanatory graphics and other breakouts. It opens with an all-important overview chapter, "Creating Health," that summarizes the four foundations. It explores the body's various systems in 10 subsequent chapters with titles that derive their poetry from the metaphoric nature of Chinese medicine: "Flowing Water" (kidneys), "A Fire Within" (heart and spirit), "Gifts of the Earth" (digestive tract). In each, she offers practical suggestions for correcting the body's imbalances.

Steelsmith said she believes life is all about finding balance. "Balance of yin and yang, balance of home and work, balance in diet," she said. "Nothing extreme. Extremes make us ill because they create stress."

Crabb said achieving balance in daily life is one reason she and her friends are interested in Steelsmith's work: "We talk about our health all the time when we're walking, working out, lifting weights together. It's a challenge for us to balance our lives with our jobs and our families. Women went through a period when they just stayed home. Then they just worked. Then we got this idea we could do both. But it takes a healthy body to keep all of it (work and family) going."

Steelsmith keeps her own life free of excess by exercising daily, seeing patients only four days a week, limiting the number of new patients she takes and making her marriage and spiritual life priorities.

She grew up in Connecticut and was first introduced to a closer-to-the-earth lifestyle when she was an exchange student in rural Norway. This led to a job in a health-food store on her return to the United States. An encounter with a naturopathic physician and a bout of serious illness led to her decision to pursue natural medicine. A graduate of Bastyr University in Seattle, she and her artist husband, Alex, moved to Hawai'i for what she thought would be a short internship with a naturopathic physician here.

That was 15 years ago. "It's my patients that keep me here," she said.

As a naturopath in Hawai'i (provisions vary from state to state), Steelsmith can prescribe natural medicines but no pharmaceuticals, and she cannot perform surgery or use intravenous therapies. When such procedures are called for, she refers patients to medical doctors who are understanding of natural medicine.

What Steelsmith brings to her patients is the ability to weave together three traditions: natural medicine, conventional Western approaches and Chinese medical tradition, including acupuncture.

Crabb said a number of women in the group have faced, or are facing, serious health challenges such as breast cancer. "When you have been through a life-altering experience like that, you become open to a lot of things, you think differently, have a different perspective," Crabb said. She has come to believe that blending Eastern and Western medical traditions makes sense. "There are times for one and times for the other," she said.

Steelsmith's new patients fill out a lengthy intake form, including not just a medical history but also a three-day diet diary. They answer questions designed to elicit information about their joint, skin, digestive, liver, pelvic and hormonal health, and undergo an interview focused on their health concerns and goals.

For those patients who are open to Chinese medicine, Steelsmith explores the state of their qi (pronounced "chi," meaning life force) and their yin and yang (the opposite forces of darkness and light, masculine and feminine, contracting and expanding, which must be kept in balance).

And, as she does in detail in her book, Steelsmith introduces her patients to a Chinese tool called the Five Elements, which posits that each of us has a kinship for a particular element — wood, fire, earth, metal or water. A person's key element indicates their predominant health system (the one most likely to manifest symptoms in the case of stress and ill health) and is associated with certain tendencies, needs, traits and qualities. "It's a way for me to better understand the patient and it helps the patient to understand where their strengths and weaknesses are," Steelsmith said.

Steelsmith said conventional Western health systems tend to be focused on diagnosing and treating symptoms and illnesses, while naturopathic medicine takes into account the whole body. If a patient comes in with a rash, for example, she is more interested in what may be causing that condition of the skin than she is in prescribing a salve to alleviate the itch. She might well suggest a palliative, but she also would explore in detail possible causes such as environmental toxins or allergies. "It is a much, much more intimate relationship with patients," said Steelsmith. "You really become a team."

Reach Wanda Adams at 535-2412 or wadams@honoluluadvertiser.com.

Learn more: www.DrLaurieSteelsmith.com

Four foundations of good health

Diet: Eat high-quality, lean protein; 10 daily servings fresh fruits and vegetables; high-fiber, whole food carbohydrates; "friendly" fats such those from flax seed, fish and walnuts.

Exercise: Daily, including aerobic activity, stretching and resistance work

Emotional/Spiritual: Identify values, align life with these.

Detoxification: Shed toxins via sweat-inducing activities, careful nutrition and avoiding contaminants.

Source: Laurie Steelsmith

The Five Element Types

In Chinese medicine, each person's health choices are guided by specific elements. Which sounds like you?

Wood: Determined leaders; primary emotion, anger; predominant health system, liver

Fire: Loving empathizers; primary emotion, joy; predominant health system, heart

Earth: Compassionate careers; primary emotion, worry; predominant health system, digestive

Metal: Creative spiritualists; primary emotion, grief; predominant health system, immune

Water: Philosophical thinkers; primary emotion, fear; predominant health system, kidney