The China Study (51 page)

BIG ME 0 I (I NE: WHO SE HE ALT H ARE THE Y PRO TE CT IN G?   335
should be giving my heart patients beta blockers and ACE inhibitors,
two classes of heart drugs, I don't know whether it's true. I honestly don't
know if its true because {drug research] is so tainted."
Do you think the following headlines are related?
"Schools report research interest conflicts" (between drug companies
and researchers)28
"Prescription use by children multiplying, study says"29
"Survey: Many guidelines written by doctors with ties to companies"3o
"Correctly Prescribed Drugs Take Heavy Toll; Millions Affected by
Toxic Reactions"3l
We pay a high price for allowing these medical biases. A recent study
found that one in five new drugs will either get a "black box warning,"
indicating a previously unknown serious adverse reaction that may re-
s u l t in death or serious injury, or will be withdrawn from the market
within twenty-five years. 32 Twenty percent of all new drugs have serious
unknown side effects, and more than 100,000 Americans die every year
from correctly taking their properly prescribed medication?3 This is one
of the leading causes of death in America!
DR. MCDOUGALL'S FATE
When Dr. John McDougall finished his formal medical education, he set
up a practice on the Hawaiian island of Oahu. He began writing books
about nutrition and health and established a national reputation. In the
mid-1980s John was contacted by St. Helena Hospital in Napa Valley,
California, and asked if he would accept a position running its health
center. The hospital was a Seventh-day Adventist hospital; if you recall
from chapter seven, the Seventh-day Adventists encourage followers to
eat a vegetarian diet (even though they consume higher-than-average
amounts of dairy products). It was an opportunity too good to pass up,
and John left Hawaii and headed for California.
John had a good home at St. Helena for a number of years. He taught
nutrition and used nutrition to treat sick patients, which he did with
fantastic success. He treated over 2,000 very sick patients, and over the
course of sixteen years, he has never been sued or even had a letter of
complaint. Perhaps more importantly, John saw these patients get well.
Throughout this time, he continued his publishing activity, maintaining
a national reputation. But as time passed, he realized that things weren't
quite the same as when he first arrived. His discontent was growing.

THE CHINA STUDY
336
Of those later years he says, "I just didn't think I was going anyplace.
The program had 150 or 170 people a year and that was it. Never grew.
Wasn't getting any support from the hospital and we had gone through
a lot of administrators."
He had small clashes with the other doctors at the hospital. At one
point, the heart department objected to whatJohn was doing with heart
patients. John told them, ''I'll tell you what, I'll send everyone of my
heart patients to you for a second opinion if you'll send yours to me." It
was quite an offer, but they didn't accept it. On another occasion John
had referred a patient to a cardiologist and the cardiologist incorrectly
told the patient that he needed to have bypass surgery. After a couple
of these incidents, John had reached the limit of his patience. Finally,
after the cardiologist recommended surgery for another one of John's
patients, John called him and said, "I want to talk with you and the
patient about this. I would like to discuss the scientific literature that
causes you to make this recommendation." The cardiologist said that he
wouldn't do that, to which John responded, "Why not? You just recom-
m e n d e d that this guy have his heart opened! And you're going to charge
him 50,000 or 100,000 bucks for it. Why don't we discuss it? Don't you
think that's fair to the patient?" The cardiologist declined, saying that it
would just confuse the patient. That was the last time he recommended
heart surgery for one of John's patients.
Meanwhile, none of the other physicians in the hospital had ever
referred a patient to John. Not once. Other physicians would send their
own wives and children to see him but they would never refer a patient.
The reason, according to John:
They were worried [about what would happen when] their pa-
tients would come to see me, and it happened all the time when
patients would come on their own. They'd come to me with heart
disease or high blood pressure or diabetes. I'd put them on the diet
and they'd go back off all their pills and soon their numbers would
be normal. They'd go to their doctor and say, "Why the hell didn't
you tell me about this before? Why did you let me suffer, spend all
this money, almost die, when all I had to do was eat oatmeal?" The
doctors didn't want to hear this.
There were other moments of friction between John and the hospital,
but the last straw involved the Dr. Roy Swank multiple sclerosis pro-
gram mentioned in chapter nine.

BIG MEDICINE: WHOSE HEALTH ARE THEY PROTECTING?                337
John had contacted Dr. Swank when he learned that Swank was
about to retire. John had known and respected Dr. Roy Swank for a long
time, and he offered to take over the Swank multiple sclerosis program
and merge it with his health clinic at St. Helena Hospital, preserving it
in honor of Dr. Swank. Dr. Swank agreed, much to John's excitement.
As John said, there were four reasons that this would be a perfect fit for
St. Helena's:
• it fit in with the philosophy of the Adventists: dietary treatment of
disease
• they would be helping people who desperately needed their help
• it would double their patient census, helping to grow the pro-
gram
• it would cost almost nothing
In thinking back on it, John said, "Could you think of any reason not
to do this? It [was] obvious!" So he took the proposal to the head of his
department. After listening, she said that she didn't think the hospital
wanted to do this. She said, "Well, I don't think we really want to in-
t r o d u c e any new programs right now." John, dumbfounded, asked her,
"Please tell me why. What does it mean to be a hospital? Why are we
here? I thought we were here to take care of sick people."
Her response was a doozy: "Well, you know we are, but you know,
MS patients are not really desirable patients. You told me yourself that
most neurologists don't like to take care ofMS patients." John could not
believe what he had just heard. In a very tense moment, he said:
Wait a minute. I'm a doctor. This is a hospital. As far as 1 know our
job is to relieve the suffering of the sick. These are sick people. Just
because other doctors can't help them in their suffering doesn't
mean that we can't. Here's the evidence that says we can. I have
an effective treatment for people who need my care and this is a
hospital. Will you explain to me why we don't want to take care of
those kinds of patients?
He continued:
I want to talk to the head of the hospital. I want to explain to her
why 1 need this program and why the hospital needs this program
and why the patients need this program. I want you to get me an
appointment.

338                          THE CHINA STUDY
Ultimately, though, the head of the hospital proved to be just as dif-
ficult. John reflected on the situation with his wife. He was supposed to
renew his contract with the hospital in a couple of weeks, and he decid-
e d not to do it. He left on cordial terms, and to this day he does not hold
personal grudges. He just explains it by saying that their directions in
life were different. John would prefer to remember St. Helena for what it
was: a good home to him for sixteen years, but a place nonetheless that
was "just into that whole drug money thing."
Now,lohn runs a highly successful "lifestyle medicine" program with
his family's help, writes a popular newsletter that he makes freely avail-
able Chttp://www.drmcdougall.com), organizes group trips with past
patients and new friends and has more time to go windsurfing when the
wind picks up on Bodega Bay. This is a man with a wealth of knowledge
and qualifications, who could benefit the health of millions of Ameri-
cans. He has never been challenged by any of his colleagues for physi-
cian "misbehavior," and yet the medical establishment does not want
his services. He is reminded of this fact all the time:
Patients will come in with rheumatoid arthritis. They'll be in
wheelchairs, they can't even turn the key on their car. And I'll
take care of them and three or four weeks later, they'll go back to
see their doctor. They'll walk up to their doctor, grab their hand
and shake it hard. Doctor will say, "Wonderful." The patient, all
excited, will say, "Well, I want to tell you what I did. I went to
see this Dr. McDougall, I changed my diet, and now my arthritis
is gone." Their doctor simply responds, "Oh my goodness. That's
great. Whatever you're dOing, just keep doing it. I'll see you later."
That's always the response. It's not, "Please, my god, tell me what
you did so I can tell the next patient." It's, "Whatever you're doing,
that's just great." If the patient starts to tell them they changed to a
vegetarian diet, the doctor will cut in with, "Yeah okay, fine, you're
really a strong person. Thanks a lot. See you later." Get them out
of the office as qUickly as they can. It's very threatening ... very
threatening.
ESSELSTYN'S REWARD
Back in Ohio, Dr. Esselstyn retired from active surgery in June of 2000
and assumed the position of preventive cardiology consultant in the de-
p a r t m e n t of general surgery at the Cleveland Clinic. He has continued

BIG MEDICINE : WHOSE HEALTH ARE THEY PROTECTING?                 339
to do research and to visit with patients. He holds three-hour counsel-
i n g sessions in his home with new heart disease patients, gives them re-
search evidence and provides a delicious "heart-safe" meal. In addition,
he gives talks around the country and abroad.
In March of 2002, Ess and his wife Ann, whose grandfather founded
the Cleveland Clinic, drafted a letter to the head of the cardiology de-
p a r t m e n t and the head of the hospital at the Cleveland Clinic. The letter
started off by saying how proud they were of the reputation and excel-
lence of the Clinic and the innovation of the surgical procedures, but
that everyone recognized that surgery was never going to be the answer
to this epidemic of heart disease. Ess formally proposed the idea that he
could help set up an arrest and reversal dietary program in the depart-
m e n t of preventive cardiology at the Cleveland Clinic. The program
would mirror his own and could be administered by nurse clinicians
and physician assistants. Ideally, a young physician with passion for
the idea would head the program. Ultimately, every patient with heart
disease at the Clinic would be offered the option of arrest and reversal
therapy using dietary means, which costs very little, harbors no risks
and puts the control back into the patients' hands.
You'd think that if an opportunity arose to profoundly heal sick
people, and one of the most reputable people in the country was going
to help you, a hospital would jump at the opportunity. But after being
one of the star surgeons at the Cleveland Clinic for decades, after initi-
ating a heart reversal study that had greater success than anything ever
done at the Clinic, and after graciously offering a plan to help heal even
more people, neither the head of the hospital nor the department head
had the respect to even acknowledge that Ess had written to them. They
didn't call. They didn't write. They completely ignored him.
Seven weeks passed, and finally Ess called the department head and
the hospital head, and neither of them would take his call. Finally, after
seven calls, the head of the hospital got on the phone. This man had
praised Ess for years for his research and seemed excited by his results,
but now he was singing a different tune. He obviously knew exactly
what Ess was calling about, and told Ess that the head of the cardiol-
ogy department didn't want to do it. In other words, he just passed the
buck. If the head of the hospital wanted it to be done, it would be done,
regardless of what the head of cardiology wanted. So Ess called the head
of cardiology, who finally took his call. The man was abrasive and rude.
He made it clear he had no interest in what Ess was trying to do .

340                          THE CHINA STUDY
Ess hasn't talked to either of these doctors since, but he still has hope
that he can change their minds as more and more research supports
what he has been saying. Meanwhile, many people at the Clinic are still
excited about Ess's work. Many of them want to see a wider application
of his program, but the powers that be will not let it happen. They get
frustrated, and Ess is frustrated because the current program in preven-
tive cardiology is a disaster:
They still eat meat, they still eat dairy, and they don't have any
cholesterol goal. It's all just so vague. Preventive cardiology takes
great pride when they are able to slow the rate of progression of
this disease. This isn't cancer for God's sake!
An interesting situation is now developing: just as with Dr. McDou-
gall, many of the Clinic "bigwigs" with heart disease have themselves
gone to Esselstyn for treatment and lifestyle counseling. They know it
works, and they seek out the program on their own. As Ess says, this
could be developing into a very interesting crisis:
1 have now treated a number of senior staff with coronary disease
at the Clinic-senior staff physicians. I have also treated a number
of senior staff trustees. One of the trustees knows about the frustra-
tions that we've had trying to get this into the Clinic, and he says,
"I think, if the word gets out that Esselstyn has this treatment that
arrests and reverses this disease at the Cleveland Clinic, and it's been
used by senior staff and he's treated senior trustees, but he's not per-
m i t t e d to treat the common herd, we could be open for a lawsuit."
For the time being, Ess, with his wife's help, will continue to run
counseling sessions out of his own home because the institution to
which he gave the greater part of his life does not want to endorse a
dietary approach that competes with its standard menu of pills and
procedures. This past summer Ess spent much more time than usual
at his upstate New York farm , making hay. As much as Ess likes a more
relaxed life, he would also love to continue to help diseased people get
better with the aid of the Cleveland Clinic. But they won't allow him
to. As far as I am concerned, this is nothing short of criminal. We, the
public, turn to doctors and hospitals in times of great need. For them
to provide care that is knOwingly less than optimal, that doesn't protect
our health, doesn't heal our disease and costs us tens of thousands of
dollars is morally inexcusable. Ess sums up the situation: