MY BACKGROUND
I attended Phillips Exeter Academy and Yale University. As a pre-medical student and history major, I was influenced by Darwin’s decision to take five year off as a naturalist on the voyage of the Beagle. I made what was, in 1957, an unconventional decision to take a gap year. The US Army Reserves gave me a year off, too. I traveled in the Far East with my art history professor and finished the year as an apprentice for three months to Dr. Edgar Miller at the Shanta Bhawan Hospital in Kathmandu, Nepal. Dr. Miller’s voice stayed with me during my medical education and still today. After seeing each patient in tiny makeshift clinics around the valley of Kathmandu he would turn and ask “Sidney, have we done everything we can for this patient?” This question with its emphasis on the patient rather than the disease had a definitive and lasting effect on my practice of medicine. As Yale medical student I encountered the sharp contrast to the emphasis on treating the patients’ disease rather than the individual patient. In the midst of his specialty training in pediatrics I did a half-year residency in obstetrics to gain a better platform for managing the care of sick newborn.
After my second year of pediatric residency I took two years off to become a Peace Corps Volunteer. In Chad, Africa I treated patients and taught medical personnel in a small clinic on the outskirts of what was then Fort Lamy (now Njamena) and lead a team of Peace Corps volunteer nurses and lab technician posted in rural communities. In Chad I encounter patterns of illness very different from those found in the United States – notably the absence of allergic and autoimmune disease.
Upon returning to Yale I served as Chief Resident and then Assistant Professor of Pediatrics, Obstetrics and Medical Computer Sciences. After three years on the full-time Yale Medical faculty I switched to part time to be the family doctor in a new prepaid health care plan in New Haven. My patients’ stories gave me the bones of my get, avoid and get rid of questions. I will cover Yale medical colleagues’ aversion to anecdotes in this manuscript with the discussion of the coelacanth. My background in computer science led to methods for focusing on symptoms that define individuality as opposed to simply inviting a label for their disease. My mentor at Yale, Shanon Brunjes MD, had prepared me with two points: “When doctors get a hold of computers, they will just want to automate the status quo” and “symptoms – not labels - are the key to defining medical individuality and treatment.”
After seven years at the health plan I become Director of the Gesell Institute of Child Development where my practice embraced children and adults with chronic illness. During those years I created a coding system that helps patients and physicians understand the value of symptom patterns in guiding treatment options.
As mentioned, my departure from name-it, blame-it, tame-it prescription pad medicine, got me heat from my conventional medical colleagues and led to my attending annual seminars at Stanford where Linus Pauling as a faculty member whose birthday was celebrated by the attendees. A tiny friendship with him gave a big boost in the common sense of a two-time Nobel Laureate who provided a wise foundation to the get part of my paradigm. A quest for education on the avoid side led to Theron Randolph MD and the Society for Clinical Ecology, later to become the American Academy of Environmental Medicine, both of which were anathema to allergists who denied the medical relevance of chemicals and the allergenic roots of problems outside the circle of asthma, eczema, and, of course, zzzz.
I found a warm welcome to these organizations who saw me through a lens focused on my academic career where I had been elected to the medical honor society, Alpha Omega Alpha in my third year at Yale Medical School. I was the recipient of the Ferris Prize in Anatomy, the Ramsay Memorial Scholarship Prize in Clinical Medicine, and the Keese Prize for Best Thesis. ( the production of antibodies by cell cultures). Subsequently I have been honored by my colleagues with the Jonathan Forman Award presented by the American Academy of Environmental Medicine, Linus Pauling Award Presented by the Institute for Functional Medicine and the Life Time Achievement Award, presented by The Medical Academy of Pediatric Special Needs (MAPS).
I am one of the founding fathers of functional medicine and I have successfully treated thousands of patients with chronic conditions through the lens which I will describe though out this book.
I am starting work on a book to help everyone with a stake in medicine see the simplicity that underlies the landscape of illness and the questions and answers that support what Nature does: healing. The get, avoid and get rid of questions are not only in themselves simple. The uniqueness of each living thing is intimidating when it comes to tailoring the steps that promote healing. There are, however, only three paths on the map where the meaning of our symptoms guide us in our search for solutions: The names on the paths are bugs, dirt, and fire for which the fancier names are infection, toxins and oxidative stress.
The recipe for these problems is simple:
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Diet and detoxification to rid ourselves of toxins
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Dietary and antifungal steps to restore the microbiota and
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Helminthic therapy to restore immune system’s most precious feature: tolerance.
We have been taught to think of our immune system as equipment for fighting germs of all sorts. That’s true, but its main job is tolerating all the friendly germs, foods, pollens, dust, and innocent stuff we contact all the time. We have an epidemic of autoimmune and allergic diseases for which the cause has to do with becoming sensitive – intolerant - to parts of our own bodies and our environment. When we understand the underlying cause – loss of immune tolerance - of nearly all chronic illnesses we find simple, healthy steps instead of enormously expensive and toxic medications that we see advertised on TV.