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.