“It might be time to wean yourself off a cow’s teat,” he repeated several times. Having just read Toni Morrison’s novel Song of Solomon, I could not stop thinking about “milkman,” the young boy whose mother refused to wean him, the young boy who continued to breastfeed. Teased mercilessly by his peers and humiliated by the name “milkman,” he provided a cautionary tale. How was I any different? A cow’s teat, a goat’s teat, a human teat: Am I not old enough at thirty-six to wean myself from a cow’s teat, from any teat?
I began to see human disorders in a different light. How have we come to see lactose intolerance, a feature that affects 75 percent of the human population, as a disorder? A feature that develops in late adolescence, as if the food gods know that human beings need some powerful, negative reinforcement against drinking milk and eating concentrated milk in the form of cheese and against buttering our bread. These food gods are trying to protect us from heart disease and prostate cancer, but no one has been listening. Gas and diarrhea and abdominal pain have been delivering a message for several thousand years, a message mostly ignored.
A Eurocentric view of the world—yet it was only five or six thousand years ago that human beings living somewhere in England developed the capacity to tolerate lactose in adulthood. According to mappings of the human genome in 2002, scientists were able to trace lactose tolerance to a mutation in regulatory DNA that controls the lactase gene. Lactase, an enzyme in the intestines, allows infants and children, and now a sizable minority of adults, to digest a complex sugar in the form of lactose.
With this evolutionary development, people were able to move further and further north, from England on to the rest of northern Europe and to Scandinavia and even Iceland, where there were no greens, edible vegetables, or fruits for at least nine to ten months each year. Dairy was a lifesaver, the salvation for those migrating north. The herding of milk-producing animals became a way of life.
Likewise, in parts of East Africa and Saudi Arabia, where people traditionally herd milk-producing animals, a different mutation affecting the same gene developed to help herders and their families tolerate lactose. Culture can indeed reinforce the forces of evolution.
So, I began to create my own culture, my own evolutionary forces. I mutated from someone who combined the worst of the Swiss and Scandinavian and American diets into someone who now has forsaken everything related to land animals. I forsake the milk from their breasts; I forsake the flesh from their corpses.
In the 1990s a report came out in the New England Journal of Medicine indicating that a substance called oleo-linoleic acid is a crucial factor in the development of aggressive prostate cancer. This form of linoleic acid is found only in . . . land animals. So what if the report was premature, and the findings did not pan out. My religion of one did not allow for doubt.
Some new mantras were forming: I have gleaned enough to be weaned; I am keen to be clean of land animals; I will no longer allow myself to be seen as a conventional “milkman.” Screw those old dietary conventions.
Then George Sheehan came along to reinforce my new belief system. A runner and a cardiologist and a writer, he had just been diagnosed with prostate cancer—and later died of it in 1993. He similarly had changed his diet, not so much to prevent the prostate cancer from becoming more aggressive, but to prevent his dying from some other more acute disease. No heart attacks, no strokes, or CVAs (cerebral vascular accidents), no adult-onset diabetes for him, thank you very much.
Another mantra: I want to live long enough to die of prostate cancer, not with prostate cancer. I want to die via a slow boil, a death indeed on the installment plan. No quick untimely death allowed.
Yes, the horses have already escaped from the barn; the disease was already in full flower. Was there any logic in closing the barn door at this point? Perhaps fatty acids from land animals might be instrumental in making the disease more aggressive and invasive, I thought. I had nothing to lose in trying to rein in those horses and those fatty acids.
This was my first test after the diagnosis of prostate cancer. Could I evolve? Could I mutate in response to these new cultural and medical demands? Could my mind have a mind of its own? I had some newfound missionary zeal. But my custom-made religion of one and by one and for one was not a fundamentalist creed: I encouraged my family, my disciples, to eat plenty of cheese and other dairy products in their younger years, and unsuccessfully tried to convince my daughters that a childhood and adolescence without a few corned beef sandwiches is a hopelessly deprived one. They could cut back on dairy and meat later in their adult lives.
This religion now has its own slogans and rallying cries. “No ice cream parfaits, no MIs no CVAs, no crème brulée—cheese nachos, stay away.”
I have my own prayer or vow, bizarre and paradoxical as any prayer can be: “Let me die of prostate cancer, and do not let me die of some other more acute disease, or any disease associated with the typical American diet. As a mere mortal I wish to live long enough to have prostate cancer kill me.”
I had the symbols of my faith: olive oil and peanut oil, potato chips and French fries, with more than a little broccoli and other cruciferous vegetables thrown in for good measure.
I can think of worse things to worship.
CHAPTER 9
Oxygen—and A Cannot-Do Philosophy
“. . . there are places in this world where the safety net they (Westerners) have spent so much of their lives erecting is suddenly whipped away, where the right accent, education, health insurance and a foreign passport. . . no longer apply, and their well-being depends on the condescension of strangers.”
Michela Wrong, In the Footsteps of Mr. Kurtz: Living on the Brink of Disaster in the Congo
It pays to be deluded.
As a psychiatrist I am well aware of the fact that people who are depressed have a better handle on reality than people who are not depressed. The depressed person has a fuller grasp of his own mortality, of the morbidities of life, of the futility and fruitlessness of existence, of the wisdom of John Maynard Keynes’s line that in the long run we are all dead.
At the same time, I grew up in 1950s America, with a can-do philosophy that for every problem there is a solution. We had the buoyancy from the war, and our self-assuredness from having beaten the Nazis and the militaristic Japanese, and we had by far the best educational system in the world that excluded no one. We had the rags-to-riches stories of Horatio Alger to inspire us in this optimistic and empowering view of life.
It pays to believe fancifully that obstacles are opportunities, to forget that obstacles are truly obstacles.
But it also pays to be aware of our screwups, to accommodate the yin and the yang, to allow for doubts and misgivings along with answers and fixes. Often the fixes come only through screwups, particularly when it comes to potential antidotes and fixes for the effects of radiation treatment.
So, praise the old Soviets. The Soviet Union unwittingly provided the experimental subjects for radiation meltdowns, radiation accidents, radiation explosions—all leading to radiation sickness and to thyroid diseases and to blood dyscrasias and to radiation deaths. Praise to the old Soviets for insisting on keeping these meltdowns and explosions secret so that the experiences could be repeated over and over and over again. When scientific journal articles suggest in their conclusions that some of the data and findings may need to be replicated, they were preaching to the choir in the Soviet Union. The Soviet findings invariably got replicated—and confirmed.
So, by early 1985 when I was going through thirty or more days of radiation to the prostate bed, I was aware of a growing body of knowledge coming out in bits and pieces from Russia. Chernobyl in April 1986, was the most publicized radiation event in the Soviet bloc and forced the Soviet Union to abandon its secrecy—but that event was thirteen months after the end of my radiation. A major accident occurred in 1957 in the east Urals in the development and use of plutonium for bomb development. But this event—despite its widespread dest
ruction and devastation—was kept secret for thirty years. In the 1980s, at the time of my exposure to radiation, news was dribbling out about smaller events near the Poland-Russia border—accidents that affected radiation plant workers but not local civilians.
Sigmund Freud once noted that he learned the most about psychiatric treatment when he lost a patient who left therapy abruptly because of a mistake he had made. If we never screw up, we then never develop new skills or new ways of understanding the world.
The Soviet radiation workers gave us some wonderful gifts in the midst of their suffering and dying. They taught us how radiation kills living cells. And the Soviet government, desperate to keep these disasters secret, looked urgently for antidotes to radiation exposure—better to keep the masses quiet.
The yin needs the yang, the can-dos need the cannot-dos, the maturing fragrant flowers need the reeking manure, matter needs antimatter, the facile need the screwups. And the capitalists need the communists.
The Russians confirmed that radiation takes its destructive action in a variety of ways. First photons—elementary particles that have characteristics of both particles and waves and are a “unit” of light—penetrate the protoplasm of one’s living cells. These photons interact with the protoplasm to create ion pairs, which in turn react radiochemically with water (H20) to produce hydroxyl (OH) and hydrogen (H) free radicals. These free radicals produce a further chain of reactions, creating new reactive forms, lasting only millionths of a second, like hydrogen peroxide (H2O2) and hydrogen dioxide (HO2) and trihydrogen oxide (H3O)—weird stuff instead of water. In rapid succession these odd and contrived products react with critical protoplasmic molecules in DNA and in enzymes. Cells either die precipitously, or at best they are unable to divide and proliferate in their normal fashion. Approximately two-thirds of the radiation damage to DNA in mammalian cells is caused by hydroxyl (OH) radicals.
Some other less understood degenerative processes may occur in brain and neural tissue. Radiation may cause a demyelination of the nerve fibers. In a process not unlike that which occurs in multiple sclerosis, the fibers lose their myelin sheaths—sheaths that are essential for the conduction of electrical charges and signals.
Hyperbaric oxygen, the Russians discovered, is an antidote to many of these radiation phenomena. The inhalation of oxygen at high pressure forces oxygen into tissues and cells, which, after exposure to radiation, are starving for oxygen and its life-giving power. This heavy infusion of oxygen may reverse the processes unleashed by radiation and may allow barely viable cells—cells dormant and on the verge of a final death—to come back to life.
Hyperbaric oxygen was well-known for years as a singular and necessary treatment for decompression sickness. If a diver is decompressing too abruptly during a deep-sea dive, in his rising too quickly to the surface, the blood vessels become permeated with nitrogen bubbles that interfere with the natural perfusion of oxygen into cells and tissue. Just as oxygen delivered at high atmospheric pressure rids the body of these nitrogen-bubble toxins, this same oxygen, the Russians discovered, may push out the toxic effects of radiation.
As I was going through my own exposure to toxic amounts of radiation, word was coming out that the Russians had some impressive results in using hyperbaric oxygen chambers for their exposed radiation workers.
I filed this information away and jumped into action during the summer. I had my mantra of doing everything I could to restore my sexual health, my new way of eating, and my own surprise and encouragement that I had been able to abide by it. I also had intense motivation, fueled by desolation and despair.
I called around the Washington, DC, area to find out who was offering hyperbaric oxygen treatments. One large chamber at a university hospital in Baltimore was too cumbersome a drive for daily treatments for four weeks. Another program was in a small community hospital in northern Virginia, in Mount Vernon near George Washington’s home and close to what is now called Reagan National Airport. The two glass-enclosed chambers in a tiny room catered to divers with the bends, who were flown up to National Airport from naval stations in Portsmouth and Newport News, Virginia, and occasional recreational divers fresh from calamities in the Caribbean, with a few rare gas-gangrene cases and suicidal patients poisoned by carbon monoxide through a car exhaust thrown in.
The medical director of this small unit was itching for some new targets for his interventions. A 1960s Marlboro man now in his fifties—fortunately he snuffed out his cigarettes before going anywhere near the oxygen chambers—he was intrigued by my idea that high concentrations of oxygen would be the ideal antidote for my sexual wreckage. He seemed to feel my pain and identify with the horror of losing one’s sexual capacities at age thirty-six. Not unlike me he had read the literature describing what the Russians had been doing to assist their wounded workers. My being a physician seemed to help my case. He perceived me as a reasonable guy, not a quack. Looks can deceive.
A man of few words, the Marlboro man said, “Let’s give it a try. We have nothing to lose.”
It pays to be lucky. My health insurance fully covered this treatment. Long before the advent of managed care in the early nineties, we were living in the mid-eighties, when physician recommendations ruled. My Marlboro man told the insurance company I would benefit from this treatment, and the insurance company went along with it.
Ah, the good old days. Days when the psychiatrist and Washington Post columnist Charles Krauthammer received extensive long-term treatment and support for his quadriplegia, suffered after a ruinous swimming pool accident while in medical school. The hospital care and institutional support allowed him to complete medical school, a psychiatry residency, a National Institutes of Health (NIH) fellowship, and move on to his life as a writer.
I was merely looking to get erect.
The hyperbaric oxygen treatments worked—at least temporarily. I went through twenty consecutive treatments, five to six each week, two hours each. After about thirteen or fourteen treatments, I felt some stirrings in my pelvis. Nothing grand, nothing dramatic, but some miniscule partial erections in the mornings. I was ecstatic. Some cells were still alive. Not all the tissue in the pelvis had become necrotic and scarred; some dormant cells on the verge of dying were perhaps being brought back to life.
By the twentieth and final treatment, what was miniscule was now more erect—not a full erection but at least workable. Helen and I were able to have sex, not great sex, but immeasurably better than nothing. Yes, the joy, the over-joy, of sex. When we lose something essential and then regain it—oh man, what a joy, not to be taken for granted ever again.
This vow, this mantra was already paying dividends. This effort was easier and the rewards faster than anyone could have predicted.
Ah, not so fast: The outcome did not last. I lost my erections. A week or two after the conclusion of the twenty treatments, the gains dissolved. A psychic deflation following my erectile inflation.
“How ’bout we try it again, doc?”
“Sure, why not?” the doc muttered with a cigarette hanging from his lips.
Twenty more treatments—the same result. Initial inflation followed by debilitating deflation. Modest erections, then nada. Twenty more treatments, then twenty more. This guy at Mount Vernon Hospital truly felt my pain. Short-term gains, no long-term ones, though.
Eighty treatments in, we gave up. I could not spend the rest of my life in a hyperbaric chamber.
My spin: My efforts could be rewarded. Keep pushing, keep trying. Not too picturesque, but it was picaresque, nevertheless. A new kind of quest, an inner pursuit—no traveling the Mississippi in a raft, no traveling through a heart of darkness in the Congo—instead a penile and mental and emotional quest, a quest of the inner life with every neuron in my body engaged, especially every neuron in my brain and my pelvis.
The salamander had not quite regenerated its tail, but oxygen had brought new life, temporarily, and renewed hope to my own tail.
CHAPTER 10
The Infertile Road to Chinese Medicine: A Better Life Through Electricity, Not Chemistry
“The art of healing is thousands of years old. The science of healing is still in the process of being born.”
David Eisenberg, Encounters with Qi
“The methods used by one man may be faulty; the methods used by two men will be better.”
Chinese Proverb
“Illness is comparable to the root . . . If the root is not reached, the evil influences cannot be subjugated.”
Traditional Chinese Medicine Texts
“Haughtiness invites ruin; humility receives benefits.”
The Chinese Book of Changes
Libido, yes; potency, no. And fertility? None. What is going on here? In a biblical sense, what is the point of fucking?
I was dry humping as best I could. Dry, no ejaculant, but my testicles were producing sperm. No one cut into or cut off my balls. I was thirty-six years old, Helen was thirty-five—right in the heart of her reproductive years. We always wanted a third child and now this was thwarted.
A lack of fertility cuts right into our basic raison d’etre. It is automatic, it is instinctual, it is reflexive, it is unconscious and unmeditated. Our instincts tell us: reproduce, breed and spawn and regenerate; ensure the survival of our species, of our people, of each and every one of our genes. Our texts tell us: be fruitful and multiply.
Yet childless couples are more contented and happier in their fifties and sixties than couples with children in the same cohort. So much for reflexes and instincts.
And yet . . . the term “maternal instincts” may have been coined with Helen in mind. At his primate lab at the National Institutes of Health in Poolesville, Maryland, Stephen Suomi has described some primate mothers as being “super-mothers.” They have just the right touch; they are rarely punitive with their offspring. Even when matched with baby monkeys who are skittish and sensitive by temperament, these super-mothers provide a loving and caring environment that allows these babies and youngsters to explore their world in bold and courageous ways.
A Salamander's Tale Page 6