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12,000 Canaries Can't be Wrong
What's Making Us Sick and What You Can Do About It
By John Molot ECW PRESS
Copyright © 2014 John Molot
All rights reserved.
ISBN: 978-1-77041-133-3
CHAPTER 1
AN END AND A BEGINNING
Life is what happens while you're busy making other plans.
— Allen Saunders
I was 20 years old when I entered medical school. I was young and immature but willing to work hard and learn. It was the 1960s. I refused to wear a tie and grew my hair long enough to be told to wear a nurse's cap in surgery. Life was easy; my youthful rebellion was frivolous.
I was partway through my fourth-year obstetrics rotation when my brother Morris died. I was watching new lives being born into this world while my 16-year-old brother lay paralyzed on the living room couch at home, dying of brain cancer. On September 22, 1970, I came home from the hospital to find that he had stopped breathing. I listened to Morris's chest for the heartbeat that was no longer there and told my father, standing beside me, that the moment he was dreading had arrived. Then I went into the kitchen to break the news to my mother. I had just come home from assisting women in the birth of their children, and now I had to tell my own mother that Morris, the baby of our family, was dead. Not surprised but surprisingly stunned, I then went across the street to ask our neighbour, a dermatologist and one of my teachers at the university, to come to our home to officially pronounce my brother dead and help initiate the necessary processes and paperwork. At first he declined because he didn't know what to do.
Until that year the expectations that I had for myself as a physician were conventional, and encouraged by others. I was not going to be "just" a GP. After spending six weeks working with and being inspired by Dr. Wilbert Keon, a world-famous cardiovascular surgeon, I had chosen cardiology as my specialty, and I was accepted into the internal medicine residency training program at the Montreal General Hospital. But the person who had made the decision to follow that path had passed away with Morris on the living room sofa. Before I had completed my first year in Montreal, I realized that I was no longer suited for learning in that kind of environment. I was not the kind of person who could look at medicine from that same, conventional perspective anymore. I had been given too strong a dose of humility — even bitterness — that prevented me from feeling the enjoyment that my peers seemed to feel. I felt alienated as they displayed their knowledge by citing authors and journals that provided all the allegedly right solutions for treatment of the sick.
I needed to get away, to take some time off to decide what kind of doctor I wanted to be. I had become a 26-year-old licensed physician, armed with the latest medical education and understanding of how the human animal functioned. I had been taught to diagnose, to find the patient's pathology in some organ system, or otherwise to attribute what I could not explain to their alleged emotional flaws, and I was well trained to treat them accordingly. But being personally exposed to such an unfair death and witnessing the raw emotional pain that I observed in my parents had left me bewildered and cynical. Although consciously unaware of it, I had become bitter and contemptuous of the affectations of my superiors, the organ specialists. My brother died and they were no help. All I knew was that I needed to learn more, perhaps to see the human organism through a different lens. I spent many months catching up on the humanities, reading philosophy under a tree in the summertime, devouring novels, practising yoga and meditation, travelling in Europe, driving a tractor on a kibbutz in Israel, and finally returning home to start a general practice in a community clinic setting.
In the next few years I also became a husband and father. I nurtured a thriving practice as a family doctor in the city of Ottawa. Years later I remember sitting on top of a cliff on an island near Vancouver Island, watching the birds soar above the ocean below me, thinking how lucky I was to have a lovely family, two healthy, happy little boys, an interesting and wonderful profession, and a third child on the way. Life seemed rich and gratifying until four weeks later, when my daughter was born with severe hydrocephaly and a future life already impacted by significant brain damage.
Hydrocephaly is a condition in which an abnormal accumulation of fluid in the brain causes enlargement of the skull and compression of the brain. The neurosurgeon put in a shunt and fixed the hydrocephaly, but he couldn't repair her damaged brain. Anxious and confused, I wondered again how something like this could happen. Flooding back came those feelings of helplessness, bitterness, anger, and contempt for those who claimed to know the condition and to understand what had just happened to my family and me.
This was the start of my journey into the world of chronic illness. I have lived it on behalf of my daughter, because she didn't just enter our world — she obliged her family to live in and experience hers. I have learned to see what our world looks like under the burden of severe visual deficit, reduced physical strength and balance, and cognitive impairment. Unbeknownst to her, people stare because she looks different, but her life is enhanced by innocence, joy, a wonderful sense of humour, great communication skills, and sincere love for all the people in her orbit. Her view is unencumbered by her almost total dependence on others for care and protection, and she adds to the lives of those who allow her entry into their personal sphere.
How lucky she is not to fear for her future. Unfortunately, the government and its existing social safety network don't either. Well before I ever heard about the biopsychosocial model of health and disease I learned about the emotional and social impact of chronic illness, not as a physician learning from academia but as a father experiencing life. My mentor during this time was my mother. I remember telling her, after the birth of my daughter, how I now had a taste of her experience with my brother's illness. Her response was that it was the same, except for the outcome. I couldn't understand. Like any parent, I cannot fathom the concept of the death of my child. Thirty years after Morris died, when my daughter was 10 years old, my mother told me that eventually some healing had taken place for her, but she wondered how anyone can ever heal from the ongoing experience of parenting a damaged living child for the rest of their life.
This book is the outcome of my own experiences as a brother and a son, as a father, and as a student. I was traumatized enough by life's experiences to question the dogma of my medical school training. As a physician I was frustrated by awareness of my inability to be much help to those with chronic illness, except to provide pharmacological symptomatic Band-Aids. It is also the result of the fortunate twist of fate of being introduced, 30 years ago, to the fledgling concepts of environmental medicine and somehow having the inner strength or the anger to reject the criticism for accepting them. The rest of this book contains information from an environmental perspective that I hope will provide new and different insights on how to achieve and maintain a better quality of life for as long as possible, and perhaps to prevent the development of chronic illness in our children, even those as yet unborn.
New Concepts
To raise new questions, new possibilities, to regard old problems from a new angle, requires creative imagination and marks real advance in science.
— Albert Einstein
Most of us do not think about our inevitable demise unless its imminence becomes suddenly apparent in the doctor's office. We are never ready for that. None of us plans to die racked with cancerous pain and dependent on opium derivatives, or drowning in our own fluids because of a neurodegenerative disorder, or suddenly while shovelling the driveway before our kids have even finished with school, or slowly, after years of living in a nursing home, confused by the apparent strangers who keep calling us Mom or Dad. However it ends, our life is a journey to that point, and how we get there depends on our gene pool, our lifestyle, the environment we live in, and luck. Unfortunately, in order to live as long as we can in good health, all we can manipulate is our lifestyle and environment. For many of us it is already too late because we have developed a chronic illness and life has been permanently and negatively altered.
The problem with chronic illness is that it's chronic. It has an impact on our physical well-being, our emotional perspective on quality of life, and the lives of those near and dear. We can manipulate it, mask the symptoms, perhaps slow its progression, but we can't cure it. To make matters worse, once you have a chronic illness you are more likely to get another one. Chronically ill patients with multiple chronic illnesses represent the rule rather than the exception.
None of these concepts had yet entered my head when I returned from my travels and began my new career as a family physician. It was the 1970s. I was young and had a ponytail, and this image attracted young, healthy people to join the community clinic where I worked as a salaried physician. The clinic was funded by the Ministry of Health and run by a neighbourhood committee consisting of four laypeople from the community. Most of the medical problems I saw were due to acute illness, and the biomedical model that I had been taught worked well. Anything that model didn't understand was explained by stress, and teaching patients the relaxation techniques I had learned from yoga and meditation enhanced my professional reputation within that community. The clinic philosophy involved preventive medicine, educating our patient population, and promoting a healthy lifestyle. We were into wellness before the invention of the word. However, within five years the neighbourhood committee had grown to 15 lay members, and interpersonal conflicts grew accordingly. My colleague and I left what felt like a toxic work environment to start our own practices together. To enhance the services we could provide, we obtained hospital privileges. According to my father, I had finally grown up and the world of conventional medicine was once again a comfortable and stable place for me to work.
My first exposure to environmental medicine was lurking just around the corner. My ensuing curiosity from this experience would lead to criticism, insults, threats, and rejection by many of my colleagues, with subsequent augmentation of my dormant cynicism and frustration. My daughter's birth would add oil to the fire. It would lead to my rejection of the conventional biomedical model and eventual adoption of the biopsychosocial model of health instead.
What is environmental medicine? According to the American Academy of Environmental Medicine, it is the recognition, treatment, and prevention of illnesses induced by exposure to biological and chemical agents encountered in air, food, and water. According to the Canadian Society for Environmental Medicine, it relates to an area of medical practice that concerns medical treatments for individuals who have become ill because of adverse environmental factors such as pollution, and its purpose is to advance the health and well-being of individuals through the improvement of their environment and their relationship to their environment.
More than 80 percent of the patients we see are women aged 30 to 65. These patients have multiple symptoms, involving multiple systems in the body, and usually have no biological markers to aid in the diagnosis. There are no specific abnormalities that show up in blood tests or other diagnostic procedures. The most common organ system involved is the brain, with any or all of five complaints, including fatigue, chronic pain, disturbed sleep, changes in cognition (attention, concentration), and/or mood changes. Upper or lower respiratory complaints and gastrointestinal disturbances (reflux, constipation, diarrhea) are frequent. These patients are more likely to have allergies; food intolerances; sensitivity to some chemical odours (most common is perfume); sensitivity to heat, cold, noise, bright lights, or fluorescent lighting; drug sensitivities; and migraine headaches. They likely have already seen several organ specialists; the good but frustrating news is that no one can find anything wrong. The usual conclusion is that the cause must be stress.
Serendipity
The first time I became aware that environmental factors, other than emotional ones, could induce or influence this pattern of illness occurred shortly after I had left the community clinic to open my own practice. I happened to meet Dr. G., who was working in a clinic run by the most alternative doctor in Ottawa. Everything was treated with vitamins. I was quick to judge him unfairly as weird, and he amplified my perception when he told me that he successfully treated many patients who had arthritis and colitis by diagnosing food allergies. Any physician knows that those problems are not caused by food allergies. On a personal level I am allergic to nuts; exposure puts me in the hospital with a life-threatening reaction. That's a food allergy. Confirming my opinion of this doctor was his description of a test he used to aid in the diagnosis: he challenged his patients with different food extracts under the tongue to see if he could provoke a response. It was called a sublingual challenge test.
One day Dr. G. confided that he was not happy in the clinic where he worked and was moving out of town. He asked me if he could rent space in my office for a few months before leaving, and I could have his patients after he left. As my partner and I had recently opened the office, we welcomed his contribution to our overhead.
Shortly thereafter, one of my long-time patients, a woman in her early 30s, came for one of her many appointments. She had the symptoms described above, all her tests were normal, she denied emotional stress, and I had run out of specialists to whom I could refer. Her medical chart kept getting thicker. To buy some time, I requested that she change into a gown so that I could do a complete physical and left the room to confer with my partner, because I really didn't know what to do next. Dr. G., a thin, curly-haired man, was perched on the counter with his legs crossed, eating whole-grain wafers covered with some sort of beige spread. He overheard our discussion and exclaimed that she was a textbook case of food allergies; he felt that he could help. I went back into the examination room and told the patient there was a doctor who claimed he could help her. Because of my own skepticism, I advised her that if he didn't help I would reimburse her out of my own pocket, because the tests he wanted to perform were not covered by the provincial health insurance plan. I was also skeptical about the validity and reliability of the sublingual challenge test.
To my surprise, Dr. G. was able to help my patient considerably by placing her on an elimination diet based on the results of the sublingual challenge tests. I was fascinated by what he had accomplished, but shortly thereafter he left town, leaving behind his patients for me to treat. Being unable to treat them according to their needs motivated me to find and attend courses and conferences to learn more. I met the few other doctors in Canada who shared the same interests, and my professional life made a sharp left turn.
By the early 1980s I had a busy family practice. My perception was that it was conventional but that I was open to and supportive of alternative ideas if my patients requested that approach. I taught yoga and meditation techniques to patients who were stressed, or I prescribed tranquilizers and antidepressants when indicated. Conventional or alternative, I bridged the two worlds, and patients who thought they were having reactions to foods continued to seek my services and refer their friends.
I was seeing new patients with chronic complaints more and more frequently. I met with them in small groups in the evenings to test them for possible food sensitivities and then saw them in follow-up to observe their responses to the elimination diets. It seemed that the majority were happy because they felt better, unless they challenged themselves with eliminated foods. But I felt a level of discomfort as I sat on that conventional/alternative fence. I knew that these patients did not have true food allergies according to the definition, yet many of them felt better with the prescribed food-elimination diets.
(Continues...)
Excerpted from 12,000 Canaries Can't be Wrong by John Molot. Copyright © 2014 John Molot. Excerpted by permission of ECW PRESS.
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