The Nutrition Debate #206: “Health without Healthcare”

“Health without Healthcare” is the sub-title of the Epilogue of Deep Nutrition: Why Your Genes Need Traditional Food, by Catherine Shanahan, MD and Luke Shanahan. I reviewed that book in my last column here. The book is generally a well-reasoned and cogent argument from an epigenetic and biochemical viewpoint. It addresses eating “traditional food,” with do’s (“The Four Pillars of World Cuisine”) and don’ts (“vegetable oils and sugar”). It is not a polemic or diatribe.

Then, Dr. Shanahan wisely includes a separate 2-page Epilogue: Health without Healthcare, a devastating indictment of medicine as it is generally practiced today. There wasn’t a clue it was coming. The only reference to medicine in the first 288 pages was, on page 9, “But medicine is different from other sciences because, more that being a science, it is first and foremost a business.” In the Epilogue, though, she really “takes the gloves off.”

She begins with a quote from Selling Sickness, by Ray Moynihan and Alan Cassels: “There’s a lot of money to be made telling healthy people they’re sick.” They then quote a retired Merck chief executive, Henry Gadsen, as saying, more than 30 years ago, “it had long been his dream to make drugs for healthy people, because then Merck would be able to ‘sell to everyone.’” “This kind of corporate thinking,” Shanahan says, “trickles down from the boardroom to your local clinic, contaminating local doctors – like yours,” as you’ll see.

She goes on to explain with examples from her personal experience. “When I was building my practice, my boss explained to me that to be ‘successful’ I would need more chronic patients in my panel. He explained that putting people on blood pressure and other medications, which would need periodic monitoring, was key to building a practice. I understood that from his perspective keeping my patients healthy – and medication free – was bad for business. The entrepreneurial mentality is endemic in today’s healthcare model.” Okay, you might have suspected as much.

She goes on to relate: “When I interviewed with the chief of family medicine at a large medical corporation on the West Coast, he explained that, since he was part of a team of people who arranged for pharmaceutical companies to issue cash grants, he was in a position to offer me a particularly enticing salary.” The grants, he explained, are for a “quality improvement program that tracks physician prescribing patterns. We call it ‘quality,’ but it’s really about money,” he said. “The doctors who prescribe the most get big bonuses. Those who prescribe the least get fired,” he told Shanahan.

But Dr. Shanahan was just getting started. What follows is so powerful and damning that I want to quote it verbatim:

“Merck CEO Henry Gadsen’s 30-year-old dream was to make healthy people buy drugs they didn’t really need. But he was dreaming small. What I see happening now is more sinister, more profitable, and promises to have longer-lasting repercussions than merely creating diagnoses that lead to unnecessary prescriptions. What I see is a massive campaign of nutrition-related disinformation that has reordered our relationship with food and reprogrammed our physiologies. Industry has moved past selling sickness and learned how to create it. Whether by intent or simply fortuitous coincidence, today’s definition of a healthy diet enables corporations to sell us cheap, easily stored foods that will put more money in their pockets and more people in the hospital. By denying our bodies the foods of our ancestors and severing ourselves from our culinary traditions, we are changing our genes for the worse. Just as corporations have rewritten the genetic codes of fruits and vegetables to better suit their needs, they are now in effect doing the same thing to us.”

She then concluded, “But there’s one thing they’ve overlooked. Fruits and vegetables can’t fight back. We can.”

Wow. If I hadn’t just read her really intelligent, scientific justification for the epigenetic and biochemical basis of eating “traditional foods” that “people the world over have depended on for millennia to protect their health and encourage the birth of healthy children…,” I might conclude she was “mad,” and I don’t mean angry. But I think she is absolutely correct. And the exhortation to us all to fight back is also right on, because I too believe we really do “control the health of our genes,” because “you…have control over what may be the most powerful class of gene regulating factors: food.”

In 2001 Dr. Shanahan and her husband moved to Hawaii, where she has a clinic in Family Medicine on the island of Kawai. She also travels across the country to share this information with fellow physicians at lectures and meetings.  Check her out on YouTube as Dr. Cate.