The Desperate Need for Nutritional Training for Doctors

This article is as much a tip of the hat to my Medium friend Ann Litts as it is an opinion piece.

As I was to find out just as I landed in Bali for what was supposed to be a big adventure, there was something brewing in my belly that apparently had been going on for a long time. A topic I like to write about on Medium, because it affects all of us, is our health. Part of that is nutrition, although I am by no means a trained nutritionist. Rather, my interest is in how we eat to be well, to fuel our bodies.

Since I dumped some eighty or so pounds thirty years ago, I’ve used nutrition to stay slim and energized. However, our bodies change with each passing decade. Not only can we not eat as many calories (this is directly dependent upon your activity level but it still applies, and doubly-so for those of us who have been obese) but the nature of those calories has to shift as well to meet the nutritional needs of an aging body. For example, women may need more calcium, many of us need more B12, and protein.

These are general guidelines, which are to a point, useful. Then there are specific guidelines which work ONLY for your body, my body, your partner’s body. Often the only way we can possibly find out what we need is when our body rebels.

Especially for women as we age, there are certain conditions that can develop and flare up if we eat the wrong things, drink the wrong things, or -damn it already- have sex. There are a myriad of instigators for the condition, but it seems that one of the primary causes seems to be certain foods.

As it happens, those foods are among my faves, such as pineapple and yogurt, tomatoes and tomato sauces….and this is the worst: chocolate.

Well, shit.

Then this: caffeine. If I study the National Institutes of Health papers on the topic, it’s very clear. No caffeine.

COME ON MAN.

Look. At least the list didn’t include warm Krispy Kreme donuts, but I’m sure it will eventually.

I wouldn’t have known this had Ann not written me a private note , as she is wont to do in her kind, attentive way. That sent me scurrying over to the informational site on this condition. There, lo and behold, was a rather exhaustive list of the potential comestible offenders.

As I perused the list with the above bird’s expression on my face, I noted just how many of those banned items were, in fact, a very big part of my diet.

That would explain a great deal.

That, and the fact that playing with the now ex-BF resulted in additional problems are indicators that some wholesale changes are in order.

Here’s what bothers me the most. The doctors I’ve seen both here in Bali and overseas (with the exception of the local GP) are woefully uneducated about the food part of the equation (https://health.usnews.com/wellness/food/articles/2016-12-07/how-much-do-doctors-learn-about-nutrition)

From the very first time I even mentioned symptoms to a doctor, the response was pharmaceuticals. Then, more pharmaceuticals. Then, a highly invasive, very painful procedure. I canned the pharmaceuticals after a few led to evil side effects and no relief. No way was I going to do a procedure when the doctors in question hadn’t conducted a single test, not a single ultrasound or CT scan. They looked at my age, heard a symptom, and BAM. Here’s your diagnosis.

Here’s my diagnosis? Turned out they were wrong. If they had bothered with an ultrasound or a CT scan, they might have found out.

Here, in Bali, precisely the same thing. I was even hospitalized, slammed with antibiotics that I didn’t need and more pharmaceuticals. And told that I should probably have a highly invasive procedure. The procedure in question this time has been settled in endless lawsuits because knife and profit-happy docs wielding persuasive power over desperate women who didn’t need the “fix.” Those doctors fixed ’em all right. More than one hundred thousand cases, and several billion in settlements so far. Not just damage. Death.

That this is such big business for the lawyers would put anyone on notice.

Perhaps what troubles me most is that when any one of us spends a bit of time online sleuthing, some possibly obvious answers often crop up when we consider our eating habits. In this case, the foods-to-limit list was chock full of staples in my diet. I figured they were healthy. Well, they are, for most folks.

But not if you have this particular condition. Not after a certain age. No matter how athletic or active I may be, there are some physiological changes going on in my body that are inevitable. Like it or not my parts are aging. Aging well, but still aging. Aging slowly but still aging. To deny or ignore that is foolish indeed. Those are some of the unavoidable, law-conformable subtle shifts that are indications that my organs aren’t twenty or forty or even sixty. So I can’t eat like I am, either (https://www.healthline.com/nutrition/nutritional-needs-and-aging)

Therein lies the problem.

A well-informed doctor, caregiver, medical professional genuinely believes in and lives by the Hippocratic Oath (to wit, here’s the appropriate phrase):

I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrong-doing. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course. (author bolded)

The words First, do no Harm do not appear in this oath, but were later added perhaps as early as the 17th Century. Still, the point remains the same. Assuming you’ve made yourself knowledgeable as a caregiver, you don’t suggest fixes that can damage, maim or kill, especially if you happen to profit on any aspect of that process.

Some of those fixes include having a baseline knowledge of the foods that you and I might consume out of good intention, but because of a bug, or age, or a changing body could end up being problematic.

That the vast majority of doctors have little to no knowledge whatsoever of the impact of diet (other than too many donuts might make you fat) is criminal. That the vast majority of doctors are fat-shamers because they are themselves clueless about nutrition should be a jailable offense. That so many doctors are themselves obese smokers, well, you get my drift (https://medium.com/s/story/whos-to-blame-for-fat-shaming-1257aafefdda)

Physician, heal thyself indeed.

In those cases, pills and procedures do NOT always need to be the first line of defense. If anything, the sometimes lengthy process of food isolation to find the bad boy, while not instantaneous, would be a more conservative and possibly kinder approach.

Now that said, let’s be clear. If you and I happen to be in dire straits, and in severe discomfort (which I was indeed) throwing something at it fast just to get it under control can be very important. To say the least, being unable to sleep at all, and being somewhat terrified by what your unruly body insists on doing without your permission makes for a level of stress that in every way exacerbates the situation. So. Does it make sense to do what’s necessary to bring you or me to a baseline so that a doctor can start doctoring? Of course it does. But once there- and this is the point, let’s look at the food first.

I am not saying that all doctors are lazy. I am saying that I’ve had too many experiences where someone with a white coat leapt to the wrong conclusion and insisted on a course of treatment that immediately began doing harm. They argued with me even as I was walking out of their office. In time I was proven correct. There’s no satisfaction in that. None whatsoever. Because that same doctor is likely continuing to misdiagnose other women just like me. He didn’t learn a thing.

But I did.

Part of understanding how to doctor is first, understanding the fundamental role that food has in the extraordinarily unique piece of machinery that is our body. It’s not just that we Americans ingest vast quantities of glop that any sane person wouldn’t refer to as food. The extraordinary variety expressed in the human body, our various allergies, our preferences, our sensitivities, whatever genetic predispositions we might have, how our bodies change as we age- all these bits and pieces are constantly changing. What that means is that not only the doctor, but also a nutritional advisor needs to have a hand in helping you and me as we run the courses.

As an athlete- as an aging athlete in particular, I have to keep in mind the shifting needs that my body requires as I head towards my seventh decade. Whether I CAN gorm the calories in a pizza isn’t the question. It’s not about calories at all. It’s whether the foodstuffs in a pizza, or a slice of lemon cake or any other goodie is the right thing for where I am in life. Whether the nutrients contained in that food support the inevitable changes that are going to happen no matter how many stairs I run, how many miles I jog, how many rivers I kayak. The hard work I do supports the cardiovascular system and my muscles, communicates to my body that I expect it to work well.

Given how I’ve abused my poor chassis over the years, it’s in remarkable shape.

We forget that the nutritional demands of an older body also reflect some of the wear and tear we visited upon ourselves. For me, decades of eating disorders. I’d be a fool to think I didn’t damage my body during those years. So should every woman who is now engaging in these deadly disorders. We may regain both our sanity and our health, but there’s no question we did damage. That will likely show up as we age.

We are fortunate indeed that so much information exists online. At least this way you and I can do the research our doctors neither have the time, nor in too many cases, the inclination to do. Their woeful lack of understanding about the critical role of food in our health is replaced by the wholesale belief that pharma cures all.

No. It doesn’t.

Pharma all too often creates a host of illness on its own, requiring yet more pills and procedures. Profits for the docs. Profits for pharma.

Misery for us.

While there are indeed quacks, kooks and crispy critters out there selling snake oil to those who really do need care, the truth is that being fully engaged in our own health is an ongoing challenge. It’s tough enough to get and stay in shape, find and do good work in the world, pay the bills, stay on top of what we need to in order to be engaged. As I constantly learn, doing my best to eat well is a moving target especially as I age.

The achingly sad part about it is that I cannot count on a doctor’s advice to help me in this regard. So in many ways we do indeed need to heal ourselves by being our own physicians- which is likely, not a bad rule of thumb.