Frustrations of Being a Plant-Based Cardiologist
I finished my cardiology fellowship in 1993 and then did three years at a University Hospital as a clinical assistant professor. I decided that I would be better suited in private practice, and after a few years in the group-setting decided to go out on my own. My motto has always been ‘treat the patients as you would like your family members to be treated.’ In addition, I have always followed the rule of not performing any procedure that would not add quality or quantity of life to an individual. In essence; do no harm. I prescribed medications and followed the Standard of Care set forth by the American College of Cardiology. My practice was adult cardiology with patients having the realm of diseases such as coronary artery disease, cardiomyopathy, hypertension, hyperlipidemia, peripheral vascular disease, and diabetes. Patients were followed and managed predominately with medications. I would suggest they “eat a low fat diet” and exercise. I even framed and hung my marathon medals in the office hoping to encourage exercise.
I was attracted to cardiology because both of my grandmothers died from the cardiovascular complications of diabetes. Hyperlipidemia and diabetes was throughout my family and I wanted to help others from suffering a similar fate. I also wanted to avoid those diseases in my life. So I maintained a healthy weight and I ran marathons. I had heard about Dr. Pritikin and Dr. Ornish and their use of dietary modification to treat heart disease, but felt it was too extreme for most of my patients and of course myself. Then I read A Diet for a New America by John Robbins. I decided to become vegan for the health reasons, as well as the ethical reasons he discussed. I still did not think it was something my patients would do. In fact I was becoming quite discouraged wondering if my patients even had a desire to change or help themselves. I was falling into the belief system that everyone just wanted to live their lives and take pills to fix what was broken. I was also becoming bored with the practice of medicine where the same medications were prescribed over and over again, without any reversal of disease. The biggest win for a patient was not losing any more health.
And then it happened. I was running and listening to a podcast discussing a documentary called Forks over Knives. Dr. T. Colin Campbell described the health of a population in relation to dietary intakes of animal products-namely dairy and animal flesh. But what really caught my attention was Dr. Caldwell Esselstyn’s work on reversing coronary artery disease with a whole foods, plant-based diet. He just didn’t suggest this way of eating, he lived it. His whole family lived it. He taught his patients ‘the how’ and ‘the why’ of no-oil added, whole foods, plant-based nutrition. They were successful. They reversed their coronary artery disease, their high blood pressure, their diabetes, and their peripheral vascular disease. They became healthy and happy. This is what I wanted to do! I wanted to win the war against these lifestyle diseases. They were called lifestyle diseases because the cause was directly related to what a person ate, inhaled and was exposed to. He showed quite eloquently that patients wanted to be healthy and were more than willing to help themselves if given the education to proceed. So that was it. I would start a nutrition course to educate my patients.
I first needed to educate myself more. I read numerous books by Dr. Esselstyn, Dr. T. Colin Campbell, Dr. Fuhrman, Dr. Bernard and Dr. McDougall. I took the Plant-Based Nutrition Certificate in partnership with eCornell as well as the Diet and Lifestyle Intervention course by Dr. Pam Popper. I discussed what I learned with every patient. They came to see me for medicine, not dietary advice of all things. They were surprised. Some were intrigued. Most told me they already ate healthy. I had to politely explain had they eaten healthy they would not have made it to my office. I was not making that much headway giving book references and sharing my dietary history with them.
So I started a nutrition class. I educated them on the science of reversing lifestyle diseases through plant-based medicine. I used pictures and drawings of anatomy and quoted scientific studies. I gave menu advice and discussed how one would transition to a whole food, no added oil, plant-based diet. There were about 16 people in the classes. They could bring their partners at no cost. There were a total of six classes per session and on the third class we all went shopping. People loved it and so did I. I developed closer relationships with my patients and was energized by their enthusiasm. They started seeing results. The blood pressure and glucose readings were dropping as well as their weight. Their aches and pains were gone and diabetic neuropathy was improving. Medications were being eliminated. The cholesterol readings were normalizing. All because of plants. I never witnessed this degree of health improvement practicing traditional medicine. I started my own podcast; Jami Dulaney MD Plant Based Wellness Podcast, to get the word out to more people. I became leaner and healthier than ever before. My endurance improved. My chronic indigestion went away, as did my stomach and cholesterol medications. I wanted to tell everyone. I also wanted the hospitals in my area to offer this plant-based diet.
My cardiology colleagues response was and I quote “what would we do if we cured everyone of heart disease?” I answered that would be great but we have plenty of competition from the fast food and chain restaurants, and it will probably take longer than we have left to practice. But, I now know this is a great way to practice. Patients are happy and are getting healthier without the risk of stroke, heart attack or death. How do you make any money talking plants they ask? The hospital’s greatest source of income is from “cardiovascular services” and surgical weight-loss procedures. The hospital administrator said “it was everyone’s right to eat meat.” In fact it is the job of the hospital to provide protein to the patients so they can “heal” from their procedures. I visited a bypass patient and was dismayed when I noticed their first post-surgery meal was roast beef and gravy.
I decided the better way would be to keep people from getting sick in the first place. I continued to evolve with my nutrition classes. I first brought food into class for my “students” instead of “patients” to taste. Then, I decided to cook in front of them- using an electric wok or electric pressure cooker. I demonstrated chopping and slicing skills and we talked menu planning. We discuss how to live in a world where others ate differently and the social aspects of change. We discussed how to go out to dinner and order off of a standard menu and how to make it through the over-eating holidays. More people have started coming to the classes. We have had two daylong Plant Based Nutrition seminars bringing in well-known, plant-based nutrition and disease reversal guest speakers. I am an organizer of a meetup group that is free so that people can socialize with other like minded people and gain support. I love every minute of educating patients and anyone who would like to hear about becoming healthy through plant-based nutrition.
I still go to the hospital. I try to help patients order the vegetables and fruit available off of the menu. The hospital administrators argument is that the patients may not receive the macronutrients they need. This is partially true given the limited options. However, I counter a whole foods, no added oil diet has been deemed a nutrient sufficient dietary choice by the academy of dietetics. It is their job to offer selections, yet somehow it is still not possible. If patients are lucky and have family that can bring food in, they have a slightly better chance. For the most part, I give references and suggestions and when discharged including inviting them join my nutrition class. Now that I know about this option, I cannot go back.
The medicines and procedures I was taught are not the solution to regain health or reverse disease. They are stabilizers at best with the potential for serious and potentially lethal side effects. Did you know that the third cause of death in the United States is medication error? I love helping people take back control of their health. The word ‘Physician’ means to heal and to educate. I will continue to teach whole foods, plant-based nutrition as a way to heal. I remain there for those struggling and unable (for various reasons) but am sustained by the hope of reversing disease through education. I am ever grateful for the Doctors who came before me such as Drs, Esselstyn, Ornish, Fuhrman, McDougall and Campbell helping so many patients against so much adversity. I must continue to forge ahead with the advice from my parents, “do the right thing.”
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