The China Study - T. Colin Campbell and Thomas M. Campbell

Big Medicine: Whose Health Are They Protecting?

WHEN IS THE LAST TIME that you went to the doctor and he or she told you what to eat or what not to eat? You've probably never had that ex- perience. But the vast majority of Americans will fall prey to one of the chronic diseases of affluence discussed in Part II, and, as you have seen, there is a wealth of published research that suggests these diseases are a result of poor nutrition, not poor genes or bad luck. So why doesn't the medical system take nutrition seriously?
Four words: money, ego, power and control. While it is unfair to generalize about individual doctors, it is safe to say that the system they work in, the system that currently takes responsibility for promoting the health of Americans, is failing us. No one knows this better than the tiny minority of doctors who treat their patients from a nutritional perspective. Two of the most prominent doctors in this minority have spent many years emphasizing diet and health, both in public within their profession and in private with their patients. They have had ex-
r ceptionally impressive results protecting their patients' health. These two doctors are Caldwell B. Esselstyn, Jr., whose work I discussed in chapter five, and John McDougall, an internist. My son Tom and I sat down with these men recently to discuss their experience advocating a whole foods, plant-based diet in the medical setting.
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322 THE CHINA STUDY
DR. SPROUTS
Long before our country was founded, Dutch pioneers had settled in the Hudson Valley north of New York City. One of these settler families were the Esselstyns. They started farming a plot of land in 1675. Nine generations later, that farm still belongs to the Esselstyn family. Dr. Es- selstyn and his wife Ann own the several-hundred-acre Hudson Valley farm, just over two hours north of New York City. They spent the sum- mer of 2003 living in the country, working the farm, growing a garden, hosting their kids and grandkids and enjoying a more relaxed life than what they're used to in Cleveland, Ohio.
Ess and Ann have a modest house: a large, rectangular, converted storage building. The simplicity of it belies the fact that this is one of the oldest family farms in America. Only upon closer inspection does it become apparent that there is something unusual about this place. Hanging on the wall is a framed certificate from New York State given to the Esselstyn family in recognition of their family farm, a farm that has now seen parts of five different centuries. Nearby an oar hangs on the wall. It is the oar Ess used in 1955 as an oarsman at Yale, when Yale beat Harvard by five seconds. Ess explains he has three other oars: two from beating Harvard in other years, and one for winning the gold medal in the Olympics with the Yale crew in 1956.
Downstairs, there is an exceptionally old photograph of Ess's great great grandfather on the farm. Around the corner there's an impressive- looking museum-style schematic of the Esselstyn family tree, and on the other end of the hall, there's a large black and white picture of Ess's father standing in front of a microphone, exchanging comments with
John F. Kennedy during a White House address. Despite its humble appearance, it is very clear that this is a place with a distinguished his- tory.
After touring the farm on a tractor, we sat down with Ess and asked him about his past. After graduating from Yale, he was trained as a sur- geon at the Cleveland Clinic and at St. George's Hospital in London. He remembers fondly some of his most influential mentors: Dr. George Crile, Jr., Dr. Turnbull and Dr. Brook. Dr. Crile, a giant at the Cleve- land Clinic, eventually became Ess's father-in-law upon Ess's marriage to Ann. Dr. Crile was a man of exceptional accomplishment, playing a courageous, leading role in questioning the macabre surgery called "radical mastectomy."l Dr. Turnbull and Dr. Brook were also renowned

BIG MEDICINE: WHOSE HEALTH ARE THEY PROTECTING? 323
surgeons. In addition, Ess's own father was a distinguished physician with a national reputation. But, as Ess remembers, despite being "health experts," all four of these men were "ravaged by cardiovascular dis- ease." His own father had a heart attack at age forty-two and Dr. Brook had a heart attack at age fifty-two.
These were the men he looked up to, and when it came to cardiovas- cular disease, all of them were helpless. Shaking his head, Ess said, "You can't escape this disease. These people, who were giants in the prime of their years, just withered." As he took a moment to remember his father, he said, "It was the last year or two of my dad's life, and we were just strolling along one day. He was saying, 'We are going to have to show people how to lead healthier lives.' He was right on it. He was intensely interested in preventive medicine, but he didn't have any information." His father's interest has been a driving influence in Ess's life.
Following in these men's footsteps, Ess went on to amass an extraor- dinarily impressive list of awards and credentials: an Olympic gold medal in rowing; a Bronze Star for military service in Vietnam; President of the Staff, member of the Board of Governors, chairman of the Breast Cancer Task Force, and head of the Section of Thyroid and Parathyroid Surgery at the Cleveland Clinic, one of the top-ranked medical institu- tions in the world; president of the American Association of Endocrine Surgeons; over 100 professional scientific articles; and inclusion on a
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list in 1994-95 of the best doctors in America. He remembers, "For
about a ten- to fifteen-year period I was the top earner in the depart- ment of general surgery. As Dr. Crile's son-in-law, I was panicked about not pulling my weight. I didn't get home until late at night, but I had a position that was secure." When the then-president of the American Medical Association needed thyroid surgery, he wanted Ess to be the one to operate.
But despite the accolades, the titles and the awards, something was not right. So often, Ess~ patients did not regain their health, even after his best efforts. As Ess described it, he had "this haunting feeling that was really beginning to bother me. I kept looking at how the patients were doing after these operations." Slightly exasperated, he said, "What is the survival rate for cancer of the colon? It's not so great!" He recounted the operation for colon cancer on one of his best friends. During sur- gery, they saw that the cancer had spread throughout the intestines. Ess lowered his voice ever so slightly in remembering this, saying, "You get there after the horse has left the barn." In thinking about all the breast