Medicine, for me, is a quest for my healthier self, and healthier patients. I am learning something new every day. In a way, I feel sorry for my patients of so many years ago – now, I think, I could help them so much better.
This also implies that you – the patient – could possibly be a step ahead of your physician, if you are trying to figure out what makes your body feel better and stronger and more awake, and happier. With the Internet, we all have more information at our fingertips, flawed and good information, for sure – but more of the latter. If you ask me.
Take for instance the stomach problems that plagued me when I was younger. Setting out with conventional drugs like H2-receptor blockers (Tagamet, Zantac) and proton-pump inhibitors (Prilosec, Prevacid) years ago, I at least got the problem under control. Then, twenty years the, I found that at the root of my heartburn and stomach aches were allergies: I left out the offending foods – and I dropped all meds, and never looked back.
Forward a bit, and I discovered probiotics – bacteria that are helpful for the intestines. They improved my bowels, and I took them faithfully for many years. I still recommend them to nearly every patient I encounter. Many studies link probiotics to good clinical outcomes, even if we have not yet quite figured out all the intricacies of how they work. One thing is sure: What you eat helps or destroys the microbiome that coexists in your body. A microbiome is the whole entity of bacteria, good or bad, that thrives with you, in you, on you.
Don’t worry – the good guys are winning right now. Otherwise you would be dead. But that the good guys are winning is not guaranteed – it could change any moment. You could crowd out the good guys with sugar, or commercial dairy, or destroy them with a course of antibiotics) or meat from one of those inhumane, antibiotic-resistance breeding feed lots – the list is long how you can hurt your microbiome inside and outside; cosmetics and household cleaners are high on the list. But even if we did everything right in our personal lives, outside forces can destroy your good bacteria – pollutants in water, air and soil.
Not to be an alarmist, but no man is an island, and if we don’t preserve our Mother Earth, we surely can forget about the intricacies of feeding our coworkers - our good bacteria - the right amount of this and that.
Health comes down to the health of our gastrointestinal tract. Lately, I have found that probiotics can be applied not just as capsules or caplets, but as probiotic foods. A big group which I just mention in passing are fermented foods – sauerkraut, miso, kimchi, tempeh, and so on. “Fermented” can be taken as another word for “loaded with gut-healthy bacteria”.
I have argued widely against the dangers of dairy – and still do. Ninety-nine-point nine percent of dairy is bad for you because of the highly inflammatory proteins and cancer-breeding hormones (be it naturally occurring, or gene-technologically inserted). But there is a tiny fraction of organic dairy that contains live cultures. Examples are yogurt, kefir, buttermilk and sour cream. But only, if they truly are organic, contain live cultures and have absolutely no additives that turn a good food into a nightmare: sugars, sweeteners, fruit, fruit substitutes, tapioca, carrageenan, and so on. In my mind, to qualify as natural they also have to have their full fat content – nothing skimmed or improved or processed any way other than pasteurizing – and the good bacteria have to be added afterward. Fat is not the culprit in milk and milk products – milk proteins are. Not only are they inflammatory, but also addictive. Now you can even get dairy-free organic yogurts, made for instance from almond milk. Or probiotic powders, ready to be dissolved in warm water. But always read the labels for ingredients!
Good dairy bacteria do not take away dairy’s inflammatory proteins and cancer-causing hormones. Therefore these probiotics should be taken in small amounts – very small amounts, indeed: a sip or a teaspoon full is the serving size here. And you don’t eat or drink them. You swish them around in your mouth as long as you can stand it, or unless you forget about them, and finally swallow them.
Probiotics thus taken increase not only your gut health, but especially your oral health. Studies show that probiotics swished around in the mouth after brushing your teeth reduce caries and gum disease in most cases – and I bet the result would be even better if people would add a healthy, sugar-free diet on top of this.
Using this to fight caries sure beats taking poisonous fluoride. Fluoride made me always uneasy: Studies link fluoride to cancer and neurotoxicity. But other studies clearly showed that it reduced caries – and I had not yet come by a natural method to preserve my teeth. Granted, “primitive” societies usually boast perfect teeth, but I had not quite found out why. Not sure, why, but sugar-free nutrition was probably the main cause. Then again, who of us modern Americans can boast a totally absolutely sugar-free diet – since infancy? Not that I know anyone.
Still, I am a believer in brushing and flossing (and also with good results, I have to say) – and don’t want to get rid of that. But neither fluoride toothpaste appealed to me, nor the brutal cleaning of my teeth at the dentist’s office twice a year. There is nothing natural in putting sharp metal scraping objects in your mouth. Now I am using an organic, neem-based tooth powder most of the time.
With oral swishing probiotics we gently provide a mildly acidic environment in our mouths for a few minutes. That cleans your teeth of plaque and implants healthy bacteria into the lining of your mouth, which then can grow during the next hours, or overnight, and fight bad bacteria. The result is amazing. And natural.
We take for granted that with advancing age we will lose our teeth, and that diseases will creep up on us. Ever been to a nursing home? A certain old-age odor emanates from those old bodies. We think the odor is normal. It is not. If one eats well, nourishes one’s oral cavity and intestines, in their entire length, and not destroys the precious skin bacteria with harsh soaps and cosmetics, we would smell like babies until our final days (and those will come even if we take good care of ourselves, but I bet those final days with be sweeter and easier if you have lived your life well).
Working on the microbiome in my mouth – that has been the newest station on my medical quest. In a way, this quest has been a journey from mouth to anus - and still is. Read More
Blog: On Health. On Writing. On Life. On Everything.
News from My Summer Reading Pile
August 2, 2012
Four days of Maine made me a different person, even more alive than usual, quieter. Already I have finished two of the books on my reading pile – the Einstein I had already started in Boston.
1. Jürgen Neffe, Einstein: A Biography, 2009 (English) – a wonderful book – makes one think one really understand Relativity now …
2. Carol Shields, The Stones Diaries, 1995 (I know, I know – EVERYBODY has read it already! Somehow I was behind)
3. Claude Lanzmann, The Patagonian Hare: Memoirs (I am reading a German translation; if you can, read the French original, from 2009). A difficult book. An important book – how Man is murderer to Man.
4. Tama Matsuoka Wong, Eddy Leroux, Foraged Flavor: Finding Fabulous Ingredients in Your Backyard or Farmer's Market, 2012. I usually find cooking books boring. But this was given to me because it mirrors my philosophy: Thy garden bounty be your food and medicine!
5. Georg Christoph Lichtenberg’s Waste Books, 2000 (first printed in 18th century) (I read it in German). Lichtenberg is the perfect companion to my other philosopher friend, Moses Mendelssohn
6. Connie Palmen, I.M. Ischa Meyer In Margine In Memoriam, 2001 (German). Another present (originally Dutch). I am always eager to hear from new shores – and I know next to nothing about the Netherlands – the little stout democratic European country
7. Malidoma Somé, Of Water and the Spirit: Ritual, Magic and Initiation in the Life of an African Shaman, 1995. Another present – I was not aware how many books just trundle into my house because somebody thinks it is perfect for me. Of course, I devour everything about water. Don’t know about shamans, though. I like the herbal aspect. But am highly suspicious of the shaman side – that playing with power. As people do everywhere in politics and religion – only here more primitive, I fear.
8. Imre Kertész, Fatelessness, Novel, 2004. (From Hungarian). Kertész won a Nobel in 2002.
9. Hans Fallada, Alone in Berlin (also translated from German under the title: Every Man Dies Alone), Novel, 2010 (originally published in 1947). The reviews are raving about this old-new novel about the life of Everyman in Nazi Germany.
10. Herta Müller, Heimat ist das was gesprochen wird (translated by me: Home Is Where They Speak My Language, a very slim volume, but I am not sure this has been translated officially). Another Nobel recipient, in 2009.
11. James Hogg, The Private Memoirs and Confessions of a Justified Sinner, 1824. Allegedly a wonderful classic – I have to find out for myself
12. John Bayer, The Lazarus Project, Novel, 1999. Not sure I can stomach the philosophy – but someone recommended it to me, and I will try
13. Graham Greene, The Heart of the Matter, Novel, 1948. Gathering dust on my shelves for many years – now I want to tackle this classic, to find out for myself what made Greene so great
14. Jiddish Sayings (Je länger ein Blinder lebt, desto mehr sieht er – the longer a blind man lives, the more he sees), in German, 1965
15. Sarah Vowell, The Wordy Shipmates, 2008. New England history from a new perspective – funny and scathing, it seems
16. Kate Atkinson, Started Early, Took My Dog, 2010. This mystery caught my eye – it sounded like a good summer read.
17. David Markson, Wittgenstein’s Mistress, 1988. A weird novel, and something like a cult book – I wanted to read it when I heard that David Foster Wallace wrote the afterword
18. Gish Jen, World and Town, novel, 2010. Another present. People know that I am interested in everything Chinese – so, this book came leaping into my house
19. Albrecht Schöne, Aufklärung aus dem Geist der Experimentalphysik: Lichtenbergsche Konjunktive, 1982 (a book about the afore-mentioned Lichtenberg, who in real life was not a philosopher, but a physicist. Translated, this title would be something like: Enlightenment Grown Out Of Experimental Physics. It is very much a linguistic musing about how Lichtenberg used different forms of conjunctives in German to convey his sly critique of his time
20. Thilo Bode, Die Essensfälscher, Was uns die Lebensmittelkonzerne auf die Teller lügen, 2010. Translated, the title would be something like: The Food Forgers – How the Food Industry Heaps Our Plates With Lies. Of course, this is along the lines of what I am thinking and writing most of the time
21. Ha Jin, Nanjing Requiem, novel, 2011. A novel about the horrible Japanese invasion of China in 1937
22. Petra Oelker, Die Nacht des Schierlings, 2010. (The Hemlock Night) A historical mystery from my hometown Hamburg/Germany. This is a whole series, and my – still living in Hamburg - supplies me with them, knowing I will devour each new arrival. Don’t hold your breath for this ever being translated into English – there are not enough nostalgic ex-Hamburgers here in the States to make it worthwhile …
23. Hans Magnus Enzensberger, The Silences of Hammerstein, 2009. German history at its best, I have heard – people who lived through the Nazi times, and stayed decent
Compiling this list, I realize that I never can read all these books before we turn home to Boston! But it is a good feeling that I brought them all – I can find something for every mood, it seems.
However: Don’t send any more books! These will keep me busy until the winter holidays … Read More
A Last Look At The Body
June 7, 2012
Vienna, in the nineteenth century: At his teaching hospital – the Allgemeines Krankenhaus der Stadt Wien – a pathologist named Karl von Rokitansky institutes an autopsy on every single patient who dies there. After the autopsy, clinicians and pathologists sit down together to compare notes: The Morbidity/Mortality Conference is born.
New diseases were found, old diseases became better known, medicine improved greatly, and Vienna became a magnet for physicians who wanted to learn there - it still is Europe's biggest hospital. My father spend some semesters studying medicine in Vienna. In Europe, one is not as wedded to one's alma mater as one is in the USA; in Europe, it behooves everybody to seek out good schools and good teachers to learn as much as possible. For instance, I studied in Nuremberg (Nürnberg), Brunswick (Braunschweig), Kiel and Hamburg, and finished degrees in mathematics, philosophy, social sciences and medicine. Here, if you change schools, you are frowned upon. – Both methods seem useful in their own way – I am not sure which one I prefer.
Back to pathologist Rokitansky. For about a century after he made them mandatory, autopsies were the norm, especially at teaching hospitals. Now they are the exception: Barely one in a hundred dead bodies get a second look, to find out what the cause of their demise was. Autopsies are not “cost-effective”, and different imaging procedures, done when the patient is still alive give the patient a better chance to stay alive.
But medical knowledge and skills are in decline – and patients complain. It seems as if physicians don’t want to be confronted anymore with their mistakes. Before, a physician learned from every case. Now the physician just tries to handle the case load.
This time it seems it is up the patient to demand an autopsy … Read More