JPA Community Voices

In Kabala, it is believed that we have two souls: the godly soul and the animal soul. Well, if the godly soul is visible in our nails, as we discussed in our last article, I’d venture to say the animal soul, being carnal in nature, would be represented by our stomach. Thus, giving rise to the statement: we are what we eat. Think about why business transactions and meetings usually take place around lunch or dinner. As the saying goes: “The way to a man’s/woman’s heart is through his/her stomach.”

 

Researchers found the above to be caused by the stimulation of a nerve connected to our stomach heart and brain called the Vagus nerve. But can we examine a person and reverse engineer the process? Can we examine the skin and develop a gut feeling about the diet that caused his ailment?

 

As I sat down to eat my homemade sandwich, I watched with disbelief at how some of the employees jumped with craving onto the pork chops, one of the pharmaceutical companies provided for our staff meeting.

 

“Why don’t you eat this food?” one of my young employees asked in amazement (she was new and although Jewish did not know my particularities of diet). “It is so tasty!” she added invitingly.

I smiled quietly.

“You know,” a nurse chimed in, “today’s pork is even healthier than turkey.” She was commenting on my meager meal: a thin sliced black bread filled with only Turkey. 

“Perhaps you are right,” I replied. “But for me, it’s not about the health issue, although as I get older, I appreciate the health issue more and more. There are many other reasons for it that I could mention but would not get into for reasons of time.” Although I allot an hour for lunch, I always run late and use that time to catch up with my patients.

A silence ensued, and they all looked at me expectantly… Who does not like a good story? And, as you might guess, I definitely like telling one...

“When I lived in Africa, unknowingly, I ate pork salami. I can’t recall it’s taste, but somehow, I recall it was good. And then I learned the history of my people, the Jews. I read how hundreds and thousands of Jews were willing to sacrifice their lives to avoid the transgression of eating pork. And I asked myself. Who am I, that my pleasures would count more than their lives? I have so many choices! And if I eat pork, it is as if I find my caprice more important than their lives, their memory, their sanctity. If I ate pork, then their self-sacrifice would have been in vain. It isn’t that much to ask of me, as a Jew, a respectful descendant, is it?”

They all sat back quietly; the chewing stopped. Eventually, one nurse rolled her eyes and reached out rebelliously for another piece. 

“How old were you when you made this conclusion?” asked a young employee.

“I was around 10 or 11 years old,” I replied.

“Wow, she replied, I never thought of it like that. You know, I think I will stop eating it too.” Another college student nodded his head. “Yes, me too.” 

“It’s my choice, and God forbid I am not suggesting you follow it. I was just replying to your question.” 

Do you know, I continued, that there are families in Portugal that to this day do not eat pork on Saturday. They do not know why they had kept that tradition until recently when it was discovered that they were descendants of the Marranos (a derogatory term meaning pigs, given to Jews who converted into Christianity (most commonly by force, with the only choice being death or conversion. And after they converted although not through free will the church forbade them to change back when the “crusade” period ended.)

 

Our office is composed of a cosmopolitan group of all three major religions along with agnostics, and we all respect one another's beliefs. While we discuss religious topics openly, we do not judge people by their opinions or try to force ours on them.

 

With lunch over we went back to work, and the discussion was soon forgotten as we had to deal with the complex and beautiful world of dermatology.

 

-” There is a patient who insists on seeing you only. I told him he had an appointment with another doctor, but he insisted.” I walked into the room and looked at a man that looked familiar, but I could not place from where. He seemed profoundly serious as he looked at me.

-”I was going to wait as long as it took to see you, he said as I walked in and he stood half undressed without his shirt facing me.”

-” the spots you saw on me, I want you to check them. They have vanished.” He swallowed. “My family and I wanted to thank you again for insisting I get checked. They found I had lymphoma. I am now on chemotherapy and have achieved remission. Those lesions and the fact that you wrote about it in the newspaper made me go again and get retested and find the disease in time to be saved.”

I recognized the man. That was the same man about whom I had written my first article in the series “The Writing’s On the Wall.” That same man who looked at me proudly and with some arrogance and wondered in haste why I was wasting his time. He was back a year later. The inflamed lesions that pointed to the sign of Leser Trelat were gone. But the young man and his family were alive and well.

I felt ashamed I bothered him but grateful I fought my pride and insisted on calling his doctors and his home to find out whether he followed my advice and got checked. We doctors are humans too. I remember a case in NJ where the patient told me her blood tests were normal and I said to her that it cannot be as it showed she has thyroid disease. When I called her doctor, he was grateful to me for finding it and admitting to having missed it when signing her tests. Although I have a system of checks and balances in my office, I am not free of these errors too.

 

As I was musing this incidence, I was jolted back to the present time by one of my other physicians.

 

“I think she has some strange form of hives,” the physician who called me for my opinion to her room, said. “The patient said she was recommended to see you by the editor of one of the medical newspapers. I was going to take a biopsy but figured I will let you see her first” she continued. She was very smart, and if she called me, it was not going to be a straightforward case. I entered the examination room hoping against hope it was indeed a simple case of hives as I was told, not that hives are easy.

 

In the corner of the room sat a somewhat overweight woman with a brown cane propped up against the clean, soft, cream-colored wall. On her right side, on the floor, lay a black Chanel bag. An assistant was inputting data into the computer and turned towards us as we entered.

I introduced myself and asked to see the patient's rash. Unsure of its origin I agreed with the other doctor about a biopsy and was about to exit the room when I thought better of it and reprimanded myself for giving up that fast. I took a deep breath (relaxing my vagus nerve that innervates also the diaphragm), calmed my senses, cleared my mind from the pressured realization I had other patients waiting for me on my schedule and focused on the patient.

“How did your rash begin?” I asked.

“Well, I saw many doctors, and the rash has changed, but now it seems stable and localized on my back, as you see. For the last two years, the doctors were telling me it is an allergy, but I take no pills except what was prescribed for my rash. I changed my diet. I became a vegan and stopped eating gluten but still no results. The creams the doctors keep giving me do not make any difference and I feel they are constantly experimenting on me. First, try this steroid then this antifungal then both, then steroid pills then antibiotic then allergy pills. I became very frustrated and was recommended to see you by one of the medical journal’s editors. If you can’t help me, I’ll go back to my native country, Ukraine. They will help me there, she said exasperated. I wondered how she could find better medicine than here in the U.S.A. but remained silent. The patient was clearly frustrated and disappointed and thus felt angered and at a loss. 

-”Ok,” I said, “let us get your biopsy reports and then we will be wiser.”

-“No!” she said, “I can’t wait anymore. I’d rather do a biopsy if you think we need one.” 

I asked the staff to prepare a table for the biopsy. While it was being set up, I asked her to undress so I could check out all her skin.

She had a strange blanching reddish scratched-up rash on her lower back and some red patches on her arms. 

-”We will also need to do some blood work,” I said.

-”I did not think you would want to look at them, but I brought copies of all my blood work.” 

She took out a thick stock of bent and worn-out papers from her Chanel bag and handed them to me, and I noticed blood work from 4 years ago. Wait I said, this blood analysis begins four years back.

When did this rash start?”

-” Well it started four years ago but that was when I was in the hospital, and I was told it is unrelated to my skin.”

-”Ok. I said. “Why don’t you tell me the story of how it all began.”

She looked at me in silent disbelief. 

-“You mean like four years ago? You want to listen to my story?”

-I was surprised at her question. “Of course I do. How else can I understand what your problem is?”

-”Well, in the past the doctors did not want to let me tell them the story, cutting me off. You seem no less busy than they are so I figured…” her voice trailed off.

While she was talking, I was perusing through the 100+ pages of blood work at times stopping at one or another interesting information that seemed to be potentially related to her story.

Her story was somewhat disorganized but let me try to put it in chronological order for you, my readers.

Four years ago, she and her family went to Long Island for a few days. After that trip, she returned with a rash. At first, they thought it was poison ivy, but she reported falling on the gravel, and there were no trees or bushes there. Then she was believed to have Lyme disease when a few weeks later she developed neurological symptoms of severe muscle pain and weakness. But her Lyme tests were repeatedly negative. She became progressively weaker and paralyzed, and multiple MRI, CT scans of her whole body, as well as multiple blood works and skin biopsies, failed to help with the diagnosis. She had EMGs and EEGs (electrical studies of her muscle and brain), but again no neurologist or rheumatologist or infectious disease doctor could help her. Progressively bedridden she began to be depressed as her husband was changing her diapers. She gained much weight during that time.

Slowly her condition began to improve, and she could walk, but with severe muscle pains, at least she was able to go to the bathroom on her own.

 

-“Did you visit any other country?” I asked.

-”How did you know? I went to visit my mom in Ukraine. But that was after my Long Island trip.”

-”Did you eat anywhere in Long Island at a restaurant, when you were there?”

-”No, we made our own food and were cooking it in the picnic.”

-”What kind of food did you have I asked, smiling to myself.”

-”What do you mean? She looked from me to the rest of the group with shagreen. The rest of the medical staff in the room looked at me also with strange bewilderment. Where was my line of questioning going? Did I suddenly develop an appetite after my meager lunch? And what did that have to do with a rash four years out?

-”I ate “Shashlik,” she replied. “Shashlik- means meat on a spike. I marinated it at home.

-”What meat was it?” I asked.

-”It was Pork of course.” she replied.

-”Check out the symptoms of Trichinosis,” I asked the doctor who was with me.

She checked, and all were shocked at the symptoms that seemed to be written specifically for our patient.

I asked the patient to see one of the last remaining infectious disease doctors who could examine her stool properly under the microscope and render a diagnosis from it. His name is Dr. Kevin Cahill. A lovely older Irish physician who used to be in charge of the NY Health Department checking restaurants sanitary conditions. He has traveled the world treating parasitic infections in the remote and indigenous parts of the world. A professor in 7 different universities around the world he had his start as one of 13 children in a poor family living in Ireland with his father being too busy a doctor to give attention to any one kid alone. Now in his late 70’s he was still practicing and treating presidents and members of the United Nations, TV celebrities, and my patients. Princes, presidents, and poor patients alike would be ushered into a small cubicle-like space of a room in an unassuming small office on Central Park East. He spoke little but did much.

 

“Well, she can afford to see him with a Chanel bag like hers” said one of the girls as we walked out of the room. “It’s a fake Chanel bag,” I said. “Why now you are a bag expert,” she taunted. “No,” I said, “but people with a real expensive bag would hold it on their lap or hang it and not place it on the floor of an examination room.”

 

My patient saw Dr. Cahill at my request, and indeed she was found to have a parasitic infection but not only Trichinosis but also histoplasmosis and Giardia lamblia (as if one problem were not enough). She was given the correct treatment, and in 1 week she felt better, and in 1 month she was walking without pain and reported she felt she could “fly” again. Her strange body rash also cleared and remained cleared from that point on. As to her diet… we have not raised that question, but I am sure she is more selective with her food choices.

 

Ok. So perhaps I gave the pig too much credit. He only accounted for one-third of the pie but in my eyes, he was responsible for all of the sad past. In Manhattan streets in the 1800’s, they used to let the pigs run wild as they would eat the garbage the people would throw onto the street from their houses. They were the “sanitation services”

 

To be fair I am a pig myself, not in my animal soul but in my animal birth. If you believe in Chinese Zodiac signs, I was born a non-kosher pig. Yes, my birth year is 1971. The year of the Pig. My only consolation was that I was not a regular pig, I was born a golden Pig. Still, a pig is a pig, no matter what color you paint him. No wonder I am upset to see my kind being devoured. I guess it all boils down to basic tribal loyalties.

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