The Complete Patient

If you’re coming to this blog for the first time, or you haven’t read my previous post, I strongly suggest you take a look and focus especially on the exchange of comments following that post. They are not only tremendously informative, but also quite moving.

I commend Mary McGonigle-Martin and Tony Martin, the parents of a young California boy who became quite ill last fall after drinking raw milk, for their willingness to engage in this kind of open discussion. I commend others for their sensitivity, as well as their enlightening comments.

A few things that come out of this exchange for me:

--That “holistic” medicine, by viewing the entire body-mind system, is so totally at odds with how our culture views health as to be nearly from another planet. How easily we (yours truly included) may look to holistic approaches for answers, yet still fall into the traps of our conventional system, sometimes without realizing it, of misunderstanding and misinterpreting illness and turning it into something to be avoided at all costs. So I could especially appreciate the notion of our society having turned occasional serious illness into ongoing chronic illness.

--How much there is to learn about health care, and how the learning should be a positive thing, rather than something to be disparaged. I say this from the perspective of how the subject of raw milk is treated by public health authorities: that it’s dangerous, to be consumed at your own risk, case closed. That many of these public health individuals are scientists makes their attitude even more unpsetting. Why not further exploration as to why raw milk is so powerful in easing various conditions, and under what conditions it potentially becomes a danger? Maybe some of the lessons about its power can be transferred to other areas of health and medicine.

--The danger of extrapolating major conclusions from individual situations. We do that a lot in our culture, and as a media person I’m as guilty as the next journalist. Not unexpectedly, the individuals affected—whether by raw milk, an auto accident, a crime—extrapolate from their own experiences. Individual examples can be helpful in explaining complex situations, but they also run a danger, well articulated in the comments.

For additional discussion, take a look at the Honest Human by Suzanne, who launched the exchange on my previous posting.

After I wrote my postings last weekend about my raw-milk dilemma with a neighbor, I had an opportunity to chat at some length with Mary McGonigle-Martin, the California mother of seven-year-old Chris, who nearly died last fall after consuming raw milk. His bacteria was never identified for certain in tests, but Mary feels certain it was raw milk from the Organic Pastures dairy that made him and several other California children ill.

I held off writing about the conversation because I wanted to let it, and the entire discussion here, settle a bit. I think I was bothered some by the fact that I felt so strongly about treating raw milk differently from other foods in serving it to others, kind of giving it a big red warning sign.

Listening to Mary recount what happened to her son reinforced my strong feelings…to a point. She recalls how she took a month late last summer to finally decide to purchase raw milk for Chris. “I thought, ‘What if…’ I went on the Organic Pastures site and read all the dairy stuff. I thought, ‘He (Mark McAfee) really runs a good dairy. He tests every bottle.’ But I went against my instinct and let my guard down.”

For three weeks after serving Chris raw milk, everything seemed to be going okay. The big benefit was that his symptoms of attention deficit disorder disappeared.

But then he became very ill, and Mary and her husband spent two months in the hospital watching him nearly die and, finally, recover fully. Mary wonders not only about the raw milk, but about the antibiotics doctors used to treat Chris, which may well have exacerbated his illness. The doctors, not surprisingly, won’t entertain that notion.

“There is no accountability,” she says.

More significant for her now, “I have to live with the fact that I gave my child raw milk that nearly killed him.”

Yet what occurs to me now in re-examining Mary’s story is that such drama plays itself out in many cases of food-borne illness. Whether individuals become ill from spinach, Taco Bell, seafood, or raw milk, the illnesses can take patients to the edge of death, or sometimes all the way there.

Because we don’t learn about each of these individual illnesses, we don’t get caught up in the drama of most of the situations. Then, when we hear the details of one or the other, it hits us hard, especially when it involves a young child. It moved me to a super-cautious position.

What I found refreshing about speaking with Mary was that she has retained her open-mindedness. While she feels she can’t in good conscience serve her son raw milk again, she backs the right of others to make that decision for themselves.

And she doesn’t try to create a climate of fear. “We live in a toxic world,” she says.

She’s still speaking with the medical people involved in treating Chris, trying to get them to examine their treatment methods so they won’t repeat possible mistakes again. “We’re not suing, but we want to get them to understand what may have gone wrong.”

As for the raw milk debate, she says, “We have two extremes. The raw milk people say you can’t get sick. The public health officials say that’s why we have pasteurization. I think there is a middle road.”

If that middle road is one that encourages us to explore the best food choices and sources possible, and recognizes the fact that even after making our best efforts, there is a slight bit of risk associated with all foods, then I’m okay with that. And just as there are no guarantees the most nutritious and carefully produced food won’t make us sick, there are no guarantees it will keep us healthy, either. I say this because of Michael Richard’s comment at the end of my original posting, where he laments “my first health setback since starting to drink real milk last summer.” I’ve heard health-food adherents express surprise, and disappointment, when they contract one or another illness, and I try to tell them not to blame themselves or their diet. Illness is just another inevitable risk of life.

A few odds and ends:

--Thanks to Linda Diane Feldt for her suggestions about herbs and diet shifts (regarding my post about Elizabeth Edwards) that can be helpful in dealing with breast cancer. This is exactly the kind of educational information I wish we’d see more of (or even a little bit of) from the mass media. There has been some attention paid to lifestyle changes that can help prevent breast cancer, but most of the coverage is about the standard treatments of chemotherapy and radiation. And some is just totally uninformed. I saw one reporter speculate about whether removing the rib where Elizabeth Edwards’ cancer was detected might solve the problem.

--Thanks also to Ken Conrad for his highly readable explanation about the benefits of bacteria, and how their interactions help maintain balance in the natural world around us. I suspect that the move to pasteurize almonds involves more than nudgy bureaucrats. It is symptomatic of a number of problems in our society, including the unfortunate distance we’ve moved from the farm and other parts of the natural world, our need to control ever more of our environment, and the nearly hysterical fear around so much of life that’s been fomented by the media, lawyers, and government officials. I think this latter problem has its origins in our legal system and media structure, both of which encourage laying blame and assessing penalties on those found to be “at fault.” Lots of business and government officials are simply covering their rear ends.

--Are doctors who work for insurance companies to aid in denying patient claims violating their Hippocratic oath to “first, do no harm”? A physician whose claims for treatment of his five-year-old daughter with cerebral palsy were denied asks this question in a recent Boston Globe Magazine article. It’s encouraging when doctors who experience patient outrages respond with their own outrage. Unfortunately, doctors don’t generally gain the full patient experience, since they push each other and family members to the front of the lines for sophisticated tests and treatments, and then heavily discount any charges.

--Finally, there's some encouraging news on the raw milk front. Ohio's appeals court agreed to the state government's request to withdraw the appeal of the Carol Schmitmeyer case, in which her cowshare arrangement was upheld by a lower court. And in both Ohio and Maryland, there are aggressive efforts to gain legislative approval of cowshare arrangements...and both seem to have realistic chances of succeeding.

I’ve been observing the avalanche of publicity about Elizabeth Edwards, wife of the presidential candidate, and her breast cancer, and have been struck by the mixture of emotions I feel. Like most people, I’m tremendously impressed by her courage in discussing the disease so candidly.

I’m even more impressed by her willingness to discuss the taboo subject of death so openly. She’s spoken about “that unknown number of days each of us has.”

Sometimes her openness is disarming to the media hordes, many of them struggling to maintain pained expressions as they speak about Elizabeth, and wanting only that the subject of death hang out there, tantalizingly, teasingly.

At one point in last Sunday's 60 Minutes interview with the Edwards, Katie Couric observes dramatically to Elizabeth, “Here you’re staring at possible death…” as if the most unspeakable is occurring. And Elizabeth responds, “Aren’t we all, though?”

Katie can’t take the bait, of course—to discuss further Elizabeth’s views on death—and simply ignores the question, inquiring further about Elizabeth's mindset as affects her husband.

All of which leads me to another question that doesn’t seem to have been raised even peripherally: what sorts of alternative treatments are possible options in cases of metastatic breast cancer (and other terminal cancers)? I heard Elizabeth say in an interview yesterday something to the effect that she has faith that her doctor is looking out for her interests and thus she will be looking to this doctor for the right protocol to follow.

The media treat her situation as if the only experts are the oncologists and other conventionally-trained medical specialists of the world. There is another approach, though.

I know a woman now in her late 50s who has had metastatic breast cancer for nearly 15 years. She and her husband, who is an acupuncturist, took the approach early on that she would explore and select alternative treatments for as long as possible, with the intention of forestalling conventional chemotherapy and the side effects and time-limited effectiveness it entails.

She has been to Germany and Mexico for treatments not allowed in the U.S. She has traveled around the U.S. for specialized treatments by holistic physicians.

Most significant, she has gone on living a reasonably full life while all the other women in a support group she joined many years ago have died.

Her cancer returned last year, and she has begun receiving conventional chemotherapy, but in a very deliberate protocol designed to keep it as weak as possible so as to hopefully gain significant effectiveness before fully opening the spigot.

I’m not trying to suggest that Elizabeth Edwards, or any other woman with breast cancer, should follow this woman’s path. I am pointing to this woman’s example as illustrative of an individual researching ALL the options and then taking charge of her medical care, rather than leaving it to a conventionally-trained physician to decide for her. In terms of the public discussion, this subject appears to line up somehwere behind the subject of death.

The timing of news that the California Almond Board will as of August 1 begin requiring pasteurization of almonds is interesting from the perspective of the discussion that's been going on here over the last few days.

This news, troubling as it is, helps us appreciate the intensity of the agriculture industry's desire to eliminate any and all risk from the food system. (Thanks to the Weston A. Price Foundation for the news tip.)

The reason for the new pasteurization requirement? It seems that over the past six years, there have been two outbreaks of salmonella poisoning linked to almonds (no deaths, as far as I can determine). So the association, which oversees the production of all America’s almonds, and 80% of the world’s supply, has decreed that the best way to make consumers feel that almonds are absolutely safe is to pasteurize them.

Because "the California almond industry is taking every precaution to provide the safest, highest quality almonds in the world, almond suppliers must have the certainty that all almonds reaching consumers have undergone" pasteurization, says the CAB's web site.  

What will pasteurization do to the nutritional value of the almonds? No one knows for sure, and the CAB's web site interestingly avoids dealing with this question in its FAQs, but the Weston A. Price Foundation speculates such processing will deplete almonds’ considerable nutritional value.

This development relates directly to one of the underlying questions that's been discussed here over the last few days: must we as a society remove all risk from food consumption (such as by sanitizing food to such an extent that it becomes lifeless), or is a bit of risk a necessary part of consuming natural unprocessed foods?

What bothers me as a media person is that situations such as the one I’ve described involving Mary McGonigle-Martin and her young son, Chris, seem to wind up sparking these regulatory crackdowns. People read about others becoming ill from food, and say, “That’s horrible. Can’t they stop this from happening?”

So they, the government and association officials, go looking for scapegoats and “solutions,” and adopt a machine-gun approach: just kill all the bacteria, and the problem is gone. It all sounds logical to consumers who may not appreciate fully that their food is gradually becoming less nutritious.

The other thing that happens in this kind of scenario is that choice is eliminated from the equation. All almonds must be pasteurized, just as all milk must be pasteurized. So will those of us who want unpasteurized almonds need to trek to California almond groves to purchase them?