My doctor stumbled upon Very Low Carb one Sunday
morning in July 2002. On the cover of the New
York Times Sunday Magazine, he saw a big juicy ribeye steak with a lump of
butter on top. His salivary glands began to secrete digestive juices and a
signal went from his hypothalamus to his pancreas to start secreting insulin.
The image alone was enough to start this autonomic process. Even the idea of eating will do it. It told him, “I
want to eat that!”
As an internist and cardiologist, however, my
doctor learned in medical school, and had reinforced in continuing education
throughout his professional life, that saturated fat and dietary cholesterol
were verboten. They would clog his
arteries. He saw atherosclerotic patients every day. They were a constant
reminder that eating so much protein and fat would be “the death” of him. We all
get that message drilled into us as well. The DEATH of US.
So, my doctor didn’t succumb to the secretionary
impetus because another part of his brain told him 1) it’s just a picture and
2) it would have been bad for his health. The rational mind has learned
to override the autonomic.
That particular morning, however, my doctor was
relaxed at home and engaged in one of his favorite pastimes – reading the
Sunday newspaper. Besides, he was intrigued because the title of the cover
story was, “What If It’s All Been a Big Fat Lie?” And the author, Gary Taubes, had
won the National Science Writer’s “Science in Society” award 3 times. So, my
doctor decided to read the cover story. It was a life-changing event (for me)!
But first, my doctor decided that he would try
the diet that Taubes described. It was in the tradition of medical
self-experimentation exemplified by Werner Forssmann, “inventor” of cardiac
catheterization in the 1930s. And in about 6 weeks, my doctor lost 17 pounds eating
just 20 grams of carbs a day. He tested his blood chemistry and lipid
panel before and after, and his n=1 self-experiment proved to “do no harm” (even
a little good). So, as luck would have it, soon afterwards, when I walked into
his office for my appointment, he saw me and said, “Have I got a diet for you!”
I needed it too. I had just discovered (on a Fulton Fish Market scale) that I
weighed 375 pounds!
So, where does Pauline Kael (correct spelling)
come into this picture? According to Wikipedia, Pauline Kael was “a film
critic who wrote for The New Yorker
from 1968 to 1991.” According to Harper’s,
“She is often regarded at the most influential film critic of her day,” and she
was known for her “witty, biting, highly opinionated” reviews. I read her every
week, but I remember her best for a comment she reportedly made in a lecture to
the Modern Language Association in December 1972. It was in the wake of Richard
Nixon’s 1972 landslide Presidential election victory.
“I
live in a rather special world. I only know one person who voted for Nixon.
Where they are, I don’t know. They’re
outside my ken. But sometimes when I’m in a theater I can feel them.”
I have to admit that that image is pretty funny, and certainly
“witty, biting, highly opinionated,” but Wikipedia notes that Kael was widely criticized for this
sentiment. It illustrated the isolation in which it is possible to
live, if you are surrounded by like-minded people, especially if you think of
yourself as being superior in education or intellect. In such cases it extends
to beliefs as well. Such elitism is common among the intelligentsia. New York Post writer John Podhoretz once
claimed that New Yorkers “can easily go through life never meeting anybody who
has a thought different from their own.” Under such circumstances, wouldn’t any
non-conforming thought be heresy?
The world of human
nutrition today suffers from these same constrained views, but the medical and
public health communities are where integrity and professionalism are supposed
to mean something. So, when my doctor was willing to try something that goes
against the teachings he had practiced and lived by – first on himself (like
Forssmann, whose self-experimentation led to his Nobel Prize), and then on his
non-compliant, heavily-medicated, morbidly-obese Type 2 diabetic patient (me),
I think there’s hope. And if others try it, and it works for them too, maybe the
time will come when it won’t be as creepy as it was for Pauline Kael in that
dark movie theater in 1972.
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