Tuesday, November 24, 2009



"Daniel made up his mind he would not defile himself with the king's meat and wine... ‘Let us be given plant foods to eat, and water to drink’... At the end of ten days, their appearance was handsomer, and they were stronger, than all the youths who had been eating the king's food." 
- Daniel 1:12, 15, 17, 18

Timothy Bradley has been a regular at Nature’s Express in Rancho Mirage, California, coming in three to four times a week for a sandwich and a shot of wheat grass after working out. He has a comfortable and genuinely friendly manner with a smile that lights up the whole cafe. When he talks about wanting to be a good role model for kids, his face develops a missionary zeal. After spending a few minutes with Bradley, it becomes quite evident - he is the real thing.

On December 12th, Timothy defends his title as champion of the World Boxing Organization Junior Welterweight Division (140 pounds) against also undefeated Lamont Peterson. When Tim goes into the ring, he brings a controversy with him that will completely rock the sports world over the next few years.

Everything else being equal, since Timothy goes vegan during intensive training, is he destined to win?

ESPN recently had an informative article that discussed the pros and cons of a completely plant based diet, highlighting the records of some notable vegan athletes. Check it out; they seem to suggest that the vegan diet just might be an added edge for athletes that want to be their best.

In the animal world, there are records for both the carnivorous and herbivore contenders. The cheetah, with its digestive system designed for meat, is the fastest sprinter on earth, clocked at 70 miles per hour. But the elephant, eating the plant-based diet fitting its physiology, is the endurance runner king, able to run faster than the fastest human sprinter for 10 hours straight at 25 miles per hour.

The question is not whether the human design favors a plant-based diet, which it does, nor whether we can adapt to animal based products, which we do, but rather, does following a vegan diet give an athlete a significant edge?

Surveys show that only one per cent of Americans are vegan and so it is no surprise that most top athletes are meat-eaters. Carl Lewis and Edwin Moses are most often cited as the top vegan athletes. More recently Tony Gonzalez, Pro Bowl tight end, switched to a vegan diet in the middle of his 'hall of fame’ career without losing any of his endurance or strength. He even states that his energy and alertness in the fourth quarter far exceeds what it was in his younger, pre-vegan diet seasons.

There is a growing list of athletes that are choosing to be vegan for the same various reasons that others do - health, the environment, or animal welfare. But increasingly, some athletes are turning to a vegan diet because they believe it will give them the edge in performance that will take them to the top of their game.

One thing is certain, whether Bradley wins or loses on December 12th, the controversy over athletic performance and vegan diets will continue. After all, Edwin Moses won 122 consecutive 400-meter hurdles between 1977 and 1988 without convincing a world of carnivorous skeptics that the Book of Daniel has been right for a few thousand years.

Go Bradley!

Monday, November 23, 2009

Picture from 11/11/2009 blog

I was asked to put up this 1945 picture of my mom and grandfather that I talked about in my initial blog. My grandfather would never have guessed.

Expressly yours,

carl myers

Sunday, November 22, 2009

Healthcare Reform


A few evenings ago I listened to a thoughtful National Public Radio guest who suggested “inappropriate healthcare” as a place to save dollars. I believe such efforts are worthy, certainly not new, and unlikely to significantly change healthcare cost trends.

Yet the words “inappropriate healthcare” struck me. Have I been part of the “inappropriate healthcare” that he referred to? Every day in my medical practice I would see at least one cancer patient whose disease had not been significantly helped by the chemotherapy drugs that I had prescribed. Every day I would also see at least one patient who had been cured by their chemotherapy. We often celebrated with patients who had been helped by chemotherapy despite poor odds.

Even in hindsight, I have difficulty defining when I rendered inappropriate care. A few times in my career a patient or their family sought a new physician because I had stressed (as compassionately as I could) that in my opinion chemotherapy treatment in their situation would likely cause more harm than good. What if this patient was one whose cancer would have responded against great odds? Did this make my advice inappropriate? What if the next physician decided to treat them and the patient was just made sicker by tens of thousands of dollars of drugs that did not work?

By addressing these complex aspects of care I do not mean to say that efforts to evaluate the appropriateness of care should not continue. However, I doubt that these are the most germane questions to ask.

The succinct adage - ‘garbage in, garbage out’ - quickly reminds one that a computer does not fix faulty data. Such a reminder helps focus efforts where they really count, since even the most elegant analysis of bogus data is a waste of time.

Our current medical model could use such a pithy slogan to focus our efforts more effectively.

Billions of dollars of junk food in, trillions of dollars of pills and surgery to chronically maintain the junk out’ is hardly pithy, but it accurately fits our healthcare reality. And like ‘garbage in, garbage out’, it should focus our efforts where they belong - avoiding the ‘garbage in’ in the first place.

Hypertension, heart disease, and diabetes are only a few of the ‘junk in, disease out’ illnesses that plague us. More studies won’t make it any more obvious that our high fat, high salt, high sugar, and non-nutritious diets make us obese and then kill us. Largely ignoring junk food in the healthcare equation has resulted in millions of Americans dying prematurely and trillions of wasted healthcare dollars.

I sometimes quiz audiences about this ‘junk in, illness out’ perspective. I’ll ask them to raise their hands if they think they eat more junk food than they should. Most people giggle a bit and then sheepishly raise their hands.  I then follow this question by asking them if they also put diesel fuel in the tank of their gasoline-powered car.

In an instant the audience gets a glimpse of the depth of the delusion supporting our junk food habit. It becomes clear, if we were as smart with our bodies as we are with our cars, we could be much healthier.

To paraphrase Clinton’s message on the economy - as far as spiraling healthcare costs are concerned, - ‘it’s the food, stupid’.

Thursday, November 19, 2009

Healthcare Reform


America is dying of healthcare costs.

We spend twice as much on healthcare per person as other developed countries. Despite the higher costs, we ranked dead last in a study of quality adjusted life expectancy. Widespread concerns about the costs and effectiveness of healthcare have been a national focus for over thirty years and our inability to address these trends is well documented.

Both the healthcare reform movement and the free enterprise proponents have their vocal advocates. However, each also has a long track record of being inadequate to overcome the lobbies that benefit from the status quo.

Since the problem is not improving, many blame our leaders in traditional fashion - the Democrats are the problem if one is a Republican, and vice versa. This is politics as usual and may get someone elected, but will not solve the problem.

However, in this instance, our leaders are not the cause of the problem - we are. American’s fundamental attitudes concerning health underlie both the costs and the reasons we cannot reach effective reform.

In War and Peace, Tolstoy posits that the major shifts in world history are not initiated by great leaders, but by a tectonic shift in the attitude of the masses. He points out that great leaders seem to lead, but in reality just skillfully execute the changing direction arising from the mega-shift in perspective.   

Tolstoy’s assessment doesn’t fully explore the nuances of leadership, but it does point out a key limitation of leadership. Leaders can lead only so far ahead of the curve or they will be replaced - no matter how eloquent they may be.

The result of the current healthcare reform battle is irrelevant; the status quo will be served. Real reform - significantly better health for significantly less cost - requires a sea change in the way we approach our health. True patriotism is not just waving the flag faster. In healthcare reform, patriotism requires a fundamental reassessment of our thinking.

To be continued…

Expressly yours,

carl myers

Wednesday, November 18, 2009

CHANGE - 11/18/2009

My own conversion from the typical Western diet was neither quick nor relapse free. Twenty-five years ago, no one would have predicted my destiny as a zealot for healthy food. I had every intention of remaining a lifelong meat-lover - - giving up cheese was not an option.

As a kid, cheeseburgers were always my first choice. When I started oncology practice and could finally afford steak, I knew the long years of medical school and residency had been worth it. I considered the addition of lobster, shrimp, and scallops as the just desserts for long hours of training and middle of the night phone calls. I still have happy memories of Saturday morning jaunts with the kids to McDonald’s for pancakes and sausage patties.

So in 1984 when Jean read Diet for a Small Planet and became vegetarian, I was less than pleased. Suddenly, after setting up my life perfectly, I was married to a lunatic. I found restaurant questions about beef broth and vegetable soup particularly jarring to my concept of a romantic night out.

However, our world did not stop with her becoming vegetarian, and I gradually developed tolerance to her peculiar food choices. By 1986, as concerns about red meat became more prevalent, I noted the hypocrisy of advising patients to cut back on their red meat intake while daily treating myself to a burger or steak. I switched to more chicken and fish as a concession to consistency.

In 1992, both Jean and I began a meditation practice. As a result, I also became vegetarian and widened my goal from ‘be a caring physician’ to ‘embody compassion for all creatures’.

Once I adopted a vegetarian diet, I read the medical literature differently. While still eating meat, I had minimized the statistics that implicated meat as causing cancer. After becoming vegetarian, the same scientific data now represented largely ignored and unnecessary deaths.

Since I continued to consume dairy products, I was a somewhat lukewarm disciple to healthy eating. However, the handwriting was already on the wall once I learned that dairy products were also neither healthy, nor kind, nor necessary. In 1998, I finally decided to give up dairy products. However, that decision turned out to be a struggle, and it was not until 2001 that I finally gave up cheese.

Occasionally I remind myself of my own slow, seventeen-year change process as I encourage other people to move toward healthier eating. Expecting dramatic changes from the cultural status quo defies logic. However, as the Bob Dylan song goes, ‘The Times They Are A-Changin’.

Jean realizes that the quote is over forty years old and advises me to be content planting seeds.

Expressly yours,

carl myers

Wednesday, November 11, 2009


As I started this restaurant blog, I glanced up from my writing desk and saw the high school graduation picture of my mom with her father. She was pretty with the short, tight curls that marked the end of World War II. Looking back at her life, I saw a derailed determinism in her eyes and nuanced smile. Her father, a judge in rimless eyeglasses, was handsomely austere. It goes without saying; both were thin.

My mom, forty years before the fashion, became obese in 1957, following a twice daily routine of Ovaltine and whole milk to an early diabetic grave. Grandpa, in the tradition of his time, ruined his lungs with Camel cigarettes and died at age 62.

I would like to dedicate this blog to them and what I learned from watching their addictions morph, almost imperceptibly, from pleasurable routines to severe disabilities and early deaths.

May we profit from their legacy as we seek wiser decisions.

Expressly yours,

carl myers