by Lori L. Fryd
The art of healing comes from nature, not from the physician. Therefore the physician must start from nature, with an open mind.
Paracelsus – 15th century Swiss German philosopher, physician, botanist
You are entitled to your own opinions. You are not entitled to your own facts.
Daniel Patrick Moynihan
What do you do when you realize that much of what you’ve learned about being a doctor was wrong or, at least, incomplete?
What happens when you discover that what you thought you knew, relied upon and understood about your chosen career was – to put it charitably – not exactly the whole story?
How do you reconcile the fact that you have put in four expensive, arduous years of training in medical school, and then another three years of intense training during your internal medicine internship and residency, actively treated patients for twenty-five years, helped them with all your hard-earned knowledge and (you thought) expert skills and then – suddenly, unexpectedly, you discover that, all along, there had been a much better way? A safe and effective way of treating chronic illness you had never been exposed to in medical school or residency?
Something it had never even crossed your mind to consider?
Well, if you are Dr. James F. Loomis Jr. of Barnard Medical Center in D.C. here’s what you don’t do. You don’t waste time with anger, resentment, guilt or regret. You don’t worry about the “wouldas, couldas, or shouldas.” You don’t focus on what went wrong or why and you don’t get angry and demand explanations.
No. You just get on with it.
You slam down hard on the brakes of your life, you execute a swift 180-turnaround, switch gears, alter your course, roll up your sleeves and get back to work. You passionately spread the news of what you’ve learned to anyone and everyone who will listen.
You transform yourself.
And then you go about the business of becoming a true healer.
Looking back on his dramatic metamorphosis from conventional medical doctor to lifestyle physician, Dr. Loomis understands that he has experienced a miraculous transformation. “I’ve come out a different person, physically, philosophically, and intellectually,” he reflects. “Every aspect of my life has changed.”
In short, a paradigm shift.
What, exactly, constituted the old paradigm?
As a young medical student at the University of Arkansas and as an intern and resident at Barnes Hospital/Washington University in St. Louis, Missouri, Dr. Loomis received the kind of training most doctors these days still undergo.
Everything in my education and training was based on a treatment paradigm. When patients presented with an illness, the standard of care was to look for the best drug to treat the disease. Bottom line? We never received any meaningful training in nutrition or other lifestyle interventions. We only learned about vitamins and the biochemical makeup of macro-nutrients. That was it.
Upon graduation, Dr. Loomis began his career as a practicing physician in St. Louis, Missouri – and he did what he had been trained to do.
Someone comes in with high blood pressure, and you tell them that they need to the lose weight, exercise more and eat less salt, but the information wasn’t really actionable. And because we were taught that patients can’t really change anyway, we move on to trying to figure out the best drug they need to take to get it down. It’s all rote. The main dialogue was always centered around pharmaceutical treatments. We have institutionalized that kind of thinking in a lot of ways.
Did it ever cross your mind to recommend dramatic lifestyle over drugs to his patients?
It wasn’t like that back then. Nutrition was something different from disease. Food wasn’t real medicine. I just regurgitated the U.S. Dietary Guidelines of the day and showed patients government food pyramids, telling them to eat fruits, vegetables, ‘lean’ meats and low-fat dairy. The expectation was that patients couldn’t control themselves anyway. No one could really make those kinds of changes. We put them on pills as a surrogate for lifestyle change. In fact, we got them on meds so fast, we never waited to find out if lifestyle changes could work.
But why did you think people were so sick in the first place?
Our training taught us to look at illness through a pathophysiological lens. You had a heart attack because you developed a blockage in your artery and the plaque ruptured. You have high blood pressure because your blood vessels got stiff. We knew there were lifestyle risks, but they often weren’t acknowledge until after the fact; once patients developed the disease we just treated it with medications or a procedure and tried to fix it.
Dr. Loomis pauses for a moment and tries to put himself back into his old mindset, a mindset so diametrically opposed to the one he holds today that he strains to recall it.
I was completely ignorant. I did not make the profound, fundamental connection between nutrition and health. Everything was about moderation; you could eat unhealthy foods, but only in “moderation”. In retrospect this is completely misguided…if your car keeps breaking down because you are putting bad gas in it, and your mechanic keeps fixing it, but at the same time tells you “it’s okay to keep put bad gas in your car, just not too much,” you’d probably get a new mechanic! Yet that’s exactly how we talk to patients about nutrition! Besides, I knew there was no way I could spend hours counseling patients on nutrition anyway, so it wasn’t something I ever really thought about doing. That was the norm back then and still is. What I’m doing now is totally outside the norm; even considered “alternative medicine” by some.
A “Vague Feeling”
In the Fall of 2010, I tore a meniscus in my knee. The injury required surgery and I didn’t do a very good job with post-op rehab. The resulting decline in physical activity and continued adherence to a “standard American diet” (SAD) led to weight gain. In July 2011, I had a physical, which showed, much to my surprise, elevated cholesterol, borderline high blood sugar, and borderline high blood pressure. I actually had a pre-diabetic state known as “metabolic syndrome.” I had also developed sleep apnea, requiring me to use a CPAP machine at night. In addition, I developed an irregular heart beat due to the sleep apnea. I became a patient and started to collect doctors. None of them – not my sleep specialist, my cardiologist or my primary care physician – ever talked to me about my diet. In fact, my primary care physician talked about putting me on cholesterol-lowering medication, but I was reluctant.
Why were you reluctant to take statins when you had been frequently prescribing them to your patients for many years and knew of their effectiveness?
I can’t explain it exactly. It was this vague feeling that something was just not right. There had to be more than this. I somehow just knew that there had to be more to the story. I came to a cross- road, sensing that there had to be another path, but having absolutely no idea what it could be. I walked around with that prescription for statins in my wallet for weeks, but couldn’t bring myself to fill it.
Struggling to articulate those first tentative ripples of intuition that a better way to treat illness had to exist, Dr. Loomis proceeds haltingly:
Inside I started to realize that maybe I was doing this to myself. The only solution I could come up with was along the same lines of thinking I’d always had. Cleaning up my diet back then meant just drink skim milk, eat lean meats, maybe a little more salmon, avoid the donuts in the doctor’s lounge. But, even then, something inside just kept telling me that that wasn’t right. It wasn’t enough. At age 52, I knew good and well that whatever changes I made were only going to be temporary. In the past, when my pants would get a little tight, I’d start an exercise program, clean up my diet a little-stop eating cookies and French fries and ice cream for a while. Then I’d let up and the pattern would begin again. Now, for the first time, my health had started to seriously suffer from this up and down cycling. But, why was I on this continual roller coaster ride? The consequences to my own health had started to become significant. I knew from years of watching what my patients went through exactly what was in store for me-a life of pills and chronic disease.
Forks Over Knives = Fork in the Road
So, I’m in this searching mode about how to handle my health issues, I have an unfilled prescription for a statin in my wallet and I’m browsing through Netflix one night. I see this documentary “Forks Over Knives” being offered. I decided to watch it….
***Cue drum roll***
When the World Started to Turn
After watching the film, my first thought was, “It cannot be this easy!” After reviewing the medical literature regarding the health benefits of plant-based diets, I realized that it would be unconscionable to not give plant-based eating a try and see what the effects would be. I remember saying to my girlfriend at the time, ‘I really want you to do this with me.’ Together we embarked on a three-month experiment. I found that shopping for and preparing healthy, complete, flavorful meals was not nearly as difficult as I had anticipated. Eating out was more of a challenge, but many restaurants were more than willing to prepare a plant-based meal with advance notice.
At the end of three months, the results were nothing short of miraculous. My mood and energy markedly improved—no more sugar lows in the mid-morning and mid-afternoon! No more having to use soda as an afternoon pick-me-up. Also, with a minimal change in physical activity (as I was just completing my knee rehab that I had neglected previously), I lost 25 pounds, my cholesterol dropped from 240 to 150, and my blood sugars and blood pressure dropped significantly and were now in the normal range. My sleep apnea went away and even my allergies vanished – something I was never expecting would happen.
Wow, your doctor must have really been thrilled!
Actually, my doctor still insisted that I was doing something wrong.
Well, you have to remember that we, doctors, as a group, may be hardest to convince. I understand this. We are very evidence-based. It’s all about ‘Show me the double blind controlled studies.’ To admit and accept the fact that maybe, just maybe, I spent all this money and did all this training and maybe what I learned was misguided, that maybe what I’m doing is not the best way to take care of patients…well, it’s almost like questioning your faith. It brings a lot of things that people have based their whole professional careers around into question.
Think about being a Catholic priest and someone comes up to you and says, hey, this whole Jesus thing didn’t happen the way you were taught it happened. It would be very hard to accept. It’s that deeply ingrained in our way of thinking.
It Can NOT Be This Simple – It Just CAN’T Be!!
But, it was. Before very long, Dr. Loomis’ patients were noticing a dramatic improvement in his appearance and mood. They started asking him what was going on and he began freely sharing the plant-based message with them. Those who followed his advice began to experience the same miraculous results he was enjoying.
I didn’t really talk to patients about any of this for a few months. As I really started to lose weight (60 pounds in all) after being able to get back to exercising, the changes in me were obvious and some of them started asking. The forest had finally cleared and I saw the path I had been searching for. Once you know this stuff, you can’t ‘un-know’ it. As I really started to talk about the importance of plant-based nutrition, many of my patients became total converts, but almost none of the dieticians, endocrinologists, or cardiologists were buying into what I was saying. When I was able to take patients off their insulin, I’d hear back from them that their diabetic specialists were accusing me of dangerous malpractice – even through their A1C’s (a measure of blood sugar control) were coming back normal for the first time in years!
I realized a few things about the way medicine is practiced today. I had thought I was a healthcare practitioner. In fact, I realized that I had not been practicing “health care” at all. I had been practicing “sick care”. The whole paradigm of treatment is centered around drugs and procedures that have side effects, are expensive and are often painful.
And when we practice “sick care”, we can add years to people’s lives, but oftentimes end up taking away life from those years because of the drugs and procedures we use to treat them. We wait for you to get cancer and then we give you chemo. We wait for you to have a heart attack and then we put you in the ICU or perform bypass surgery. We wait for you to get Alzheimer’s and put you in a nursing home. In fact, the whole system is designed for practitioners to deliver “sick care” because of the way doctors are educated and trained, the influence of the food and drug industry on medical research and government policy, and the way health care providers are reimbursed by insurance companies. It’s just crazy.
So what does it mean to practice true “health care”, which adds years to live, but also sustains life in those year? The answer is so simple; it is by addressing the root cause of most chronic illness, and that is lifestyle, especially diet and nutrition. The fact is that the most powerful medication I can recommend for my patients are not pills for their cholesterol or blood pressure or diabetes, it is the food they put in their mouths!
So, I have become totally evangelical about this message. I cannot not talk about it. I will talk about it to anyone who will listen. It is so important because if we don’t figure this out as a society, we are going to bankrupt the health care system and the planet as a whole. Because it turns out that consuming meat and dairy is not only bad for our health, it’s bad for the world we live in -modern animal husbandry has a profound negative impact on the environment and is one of the leading causes of climate change.
Knowing what you know now, would you still have chosen to become a medical doctor?
Oh, absolutely! If I wasn’t a doctor and I hadn’t developed lifestyle-related disease which I reversed with a plant-based diet, the message would not be nearly as meaningful and my argument would not be as powerful.
I’m not religious in a formal sense, but obviously when I can do good, when I know that I can save someone’s life, it’s extremely rewarding. We are all put in this world for something. This is what I need to be doing. I can’t not be doing it. It’s that simple. It’s almost a spiritual calling. And it’s nice, because I don’t need to worry about finding work/life balance anymore, because my work is my life!
What’s the future for plant-based eating?
The way we treat illness in this country is not working. Rates of obesity and Type 2 diabetes are skyrocketing, despite knowing that at least 85% of the cause is lifestyle related. Seventy percent of the population is taking some kind of prescription medication for conditions that respond very well to lifestyle change. We’re spending $3 trillion a year on healthcare and we’re still sicker than ever. Yet, the C.D.C. estimates that 75 percent of health care spending is for chronic diseases that could be prevented.
People are starting to see that things are really messed up. And I’ve-seen a strong grass roots movement taking hold as a consequence of this.. Patients are realizing that there is another path, and it’s the same one I found. I feel very encouraged that patients are starting to demand changes in the way their health care providers approach the prevention and treatment of chronic disease, using lifestyle before pills. You also are starting to see more articles espousing the benefits of a plant-based/vegan diet in the mainstream media. In addition, on the provider side, there is more and more research being doing about the health benefits of a plant-based diet and there are now conferences for health care providers to learn about plant-based nutrition, such as PCRM’s Nutrition in Medicine Conference and the Plantrician Project’s International Plant-based Nutrition Healthcare Conference.
Because of these changes, I am hopeful that someday in the near future, it will be prescription medications, heart stents and bypass surgery that will be viewed as “alternative medicine!” But we still have a long way to go.
The doctor who refused to become a patient is a man on a mission. He healed himself and wound up becoming up a fervent and passionate spokesperson for the plant-based movement. He now works as Medical Director at The Barnard Medical Center in D.C., a role which allows him to emphasize the role of nutrition in the prevention and treatment of illness and chronic diseases to all of his patients on a daily basis.
When Dr. Loomis was asked if he felt any anger or regret because he hadn’t ever been made aware of the profound impact plant-based eating could have had on his health and his patients’ health many years sooner, he summed it up perfectly this way.
Look, there are things you know and things you don’t know and things you ignore. It’s not like I knew about the benefits of plant-based eating and chose to ignore it. If you know this stuff and ignore it, well, that’s bad. I simply didn’t have the knowledge back then. So, how did I feel when I did gain that knowledge and the truth finally hit me?
I felt enlightened. I felt empowered
I heard Kim Williams, MD, the immediate past-president of the American College of Cardiology, who personally follows a plant-based diet, speak recently and he said “I know I’m going to die, I just don’t want it to be my fault”. To be able to teach patients – to empower them to take back control of their own health, so that dying is “not their fault” is an incredibly powerful gift to be able to give. All this has taken me to a higher level of functioning that I can now share with the public, and hopefully, help both patients and other health care providers find and follow the same enlightened path. Feeling angry or bitter or resentful about any of this has never even crossed my mind.
“Frankly,” he concludes, “Thinking that way would only give me a headache.”
Apparently, Dr. Loomis has found a much better use of his time.