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Tuesday, June 19, 2018

The Art of Not Eating

A few years ago, my good friend Kevin started a cleanse. He bought a cleansing kit. He took the cleansing pills and fiber for ten days. He refined his diet. For breakfast, he ate berries. For lunch, he ate salad. For dinner, he ate baked salmon and steamed broccoli. More importantly (for him at least), he did not drink his micro-brews, and he did not eat his favored hard pretzels.

Kevin felt light and optimistic. He also felt insatiably hungry. So he called me.

"I need to eat more food," he said.

"So eat more food," I said.

"Like what?"

"A sweet potato?"

"But that sounds good."

"So?"

"Shouldn't I be suffering?"

The Faces of Fasting: Kevin
Kevin's attitude is not unique. Most people, I believe, equate cleansing and fasting with suffering. We look at a cleanse as a Great Giving Up. We give up our favored foods and drinks, our preferred ways of eating. Why do we do  perform this fanatical act? We think it will make us feel better.

"That's it," we say, "I'm never eating wheat again."

Then we wake up, have a bagel.

Sometimes, though, we just stop eating.

If you're like my friend Kevin, though, you go out and buy a cleansing kit. You give up carbohydrates. You give up bread, ice cream, red meat, beer--everything you love. You willfully suffer.

To many, this is a cleanse: Suffering. To many, a cleanse is penance. For eating too much. For drinking too much.

***

One might fast by eating nothing, or eating only one type of food, or simply eliminating a few foods from the diet. A fast can last several days to several weeks.

"Cleansing" is a relative term; it generally means the purging of excess toxins and residues--a view  not supported by medical science. According to the alternative health community, cleansing can be achieved in many ways; a fast is one method of cleansing.

Others might include: enemas, cleansing kits, or extreme flushes.

Medical science and alternative medicine speak about cleansing and fasting in dramatically different terms. In fact, medical science believes "cleansing" is a misnomer, and has has all but denied its value. As Christopher Wanjeck writes on Live Science:

"Most doctors consider detox therapies to be pseudoscience, based on a misunderstanding of basic biology. Moreover, mainstream doctors view detox products as either a waste of money or potentially harmful."

Additionally, medical science has long debated the value of fasting, and although clear benefits have been observed in animals, the value of  fasting, or calorie restriction (CR), for humans is still unclear.

In their review of the literature on calorie restriction, Leonie K Heilbronn and Eric Ravussin, writing in The American Journal of Clinical Nutrition, say:

"CR reduces metabolic rate and oxidative stress, improves insulin sensitivity, and alters neuroendocrine and sympathetic nervous system function in animals. Whether prolonged CR increases life span (or improves biomarkers of aging) in humans is unknown."

Although the value of CR is unclear, the new research on intermittent fasting is promising. As David Stipp notes in Scientific American, for example, intermittent fasting "revs up cellular defenses against molecular damage" and increases insulin sensitivity.

And last year, a study from Harvard revealed that "fasting can increase lifespan, slow aging and improve health by altering the activity of mitochondrial networks inside our cells" (Source).

Alternative health practitioners might urge you to expel mucoid plague. For medical science, though, the value of fasting is not detoxification, but cellular renewal and increased insulin sensitivity.

If anything, the two agree on one simple fact: the digestive system requires a great deal of energy. Depending on your view, then, you might believe that when not digesting food our body works to detoxify or, as Stipp, writes "rev up cellular defenses against molecular damage."

***

I started fasting at twenty-one, when home from Italy in June 1998, I discovered my father’s water-stained copy of Fit for Life, a book that theorized that eating fruit, in the morning, on an empty stomach, to the exclusion of other foods, inspires exuberant energy.

I call that summer “The Fruit Summer.” Each night, I feel asleep in faded Levis, and each morning, I leapt from bed, already dressed, primed for another day of fruit. Blueberries, cherries, and watermelon, and later peaches, plums, and nectarines: the evolving summer bounty.

With a few exceptions, I managed to avoid full-time employment until the age of twenty-eight. That summer, with little else to do, I devoted my life to “health.”

In my father’s basement, in flood-damaged cardboard boxes, I soon discovered other books: Back to Eden by Jethro Kloss, Arnold Ehret’s Muculess Diet Healing System, and Fresh Vegetable and Fruit Juices: What’s Missing in Your Body?

The latter, written by a fanatic’s fanatic, Dr. Norman Walker, a full-time juicer who lived to 107, claims that carrot juice is the most efficient food on the planet. Walker soberly explains the phenomena of orange skin, a symptom of dissolved waste passing through the epidermis. Like sweat. I underlined the following:

"In any case, is it not better to have a healthy satin-like skin, even though it may be slightly on the carrot shade, than to have the pasty complexion that publicizes the unhealthy condition of the body?"

Motivated by this sort of talk, and my new fruit-inspired energy, my fanaticism evolved. I pledged my body to juicing and cleansing. I did, in fact, develop a "healthy satin-like skin...slightly on the carrot shade."

Throughout my early twenties, I explored cleansing more deeply. I practiced food combining.  For three years, I followed the illustrious Master Cleanse in the fall and spring, for ten days at a time. Fruit, especially, began to inhabit a special presence in my life. For each fruit, I had a story. I've recounted this time in my memoir:

"There was my first mango, shared one summer morning with Karen after a horrid fight. Later, whenever I ate mango, alone or shared, the grassy notes tasted of absence, her absence, which I could never bear, even when she left the room for a moment, so that I found myself, against my better judgement, blaming her for wanting to always leave.

Then there was the watermelon. It was a midsummer night, and I'd cut a ten pound watermelon in half. Standing on my father’s back stoop, wearing only Levis, I plunged my face into the red pulp and sucked—a Titan, I imagined, devouring a lycopene-rich planet.

Karen sat next to me, in perfect silence, reading for the first time my copy of Leaves of Grass. Twice she paused to look at me. Twice I lifted my head, and spit a seed at the sky. When she paused a third time, with a bold laugh, I was surprised to see tears in her eyes.

"Listen," she said, and she recited:

This day before dawn I ascended a hill and look’d at the crowded heaven,
And I said to my spirit, 


When we become the enfolders of those
orbs,
and the pleasure and knowledge of everything in
them,
shall we be fill’d and satisfied then?

And my spirit said,
No, we but level that lift to pass and
continue beyond.

My wife, Karen, on the final day of a 10-day fast in 2008
My good friend, Steve Pyle, a former champion wrestler who has practiced some form of fasting or cleansing for his entire life speaks about fasting quite eloquently on our food blog, FoodVibe

So much of what he says rings true for me I'd like to quote his post, "On Cleansing and Fasting," in its entirety, but I'll limit myself to this:

"I find something so attractive in the idea of the cleanse. As if, through fasting, we can correct everything wrong with our bodies and ourselves. It’s the ultimate romantic notion—that by simply cleansing ourselves we can seemingly fix our past, or even repair the broken relationships in our lives.

The Internet is rife with websites devoted to fasting, cleansing and natural healing remedies. Some sites have shocking photos of mucoid plaque, gall stones, kidney stones, and other physical monstrosities expelled from peoples’ bodies during a cleanse. Page after page offers ecstatic testimony: "Fasting saved my life!" "Fasting cleared my acne!" "Fasting cured my cancer."

Many of these testimonies delve deeply into the idealism and mysticism of self-purification—that you can fast and cleanse yourself to a perfect body and soul.

While I do believe several of those testimonies, the idea of cleansing this way comes very close to the misguided idea that one can get something for 'nothing,' that one can reap maximum benefits from a minimum effort or sacrifice...

Yet isn’t that what repentance is all about? That we can somehow fix ourselves? That it can happen in a moment or quicker? Isn’t fasting a sort of atonement?

I think life is much harder. Life requires more work.

While fasting has many untold healing and spiritual benefits, there seems to be also a sort of delusion involved for the many dilettantes who swear by it. It can all get out of hand. Approached incorrectly, fasting can be dangerous. One can become carried away with the idea of self-righteousness and purification, to the point where you end up like the kid in Into The Wild. Tragic and pointless."
The Faces of Fasting: Steve
In his book Healing with Whole Foods, Paul Pritchford writes about the Eastern philosophy of yin-yang:

"Yin and yang, in essence, describe all phenomena. Some people may claim not to believe in yin-yang philosophy, yet these terms are merely descriptions of easily observed processes—day changing into night, youth into age, one season into the next:

Among its myriad possibilities, the philosophy of yin-yang is used in Eastern medicine to diagnosis and treat medical conditions; yet, even without specialized knowledge, a Westerner can apply the philosophy to his/her own health.

Essentially, yin-yang describes a duality, yet at that bottom of this duality, as Pritchford notes, is an unchanging source:

"Even though yin and yang specify change and separation, their source is permanent: 'The Great Ultimate is Unmoved,' according to Shao Yung, the 11th-century Chinese philosopher. The Bible expresses this idea in the phrase, 'I am the Lord; I do not change.' (Malachi: 3:6)"

This unchanging source can be likened to the human body: by nature, our body has a capacity for what Dr. Weil, in Spontaneous Healing, calls the "innate, intrinsic nature of the healing process."

Our health might manifest as "good" or "bad", but our bodies, at their very core, offer the possibility of unified, solid health: "The word healing," Dr. Weil notes, "means 'making whole'—that is, restoring integrity and balance."

In terms of cleansing, those words—integrity and balance—feel especially instructive to me. To the point: I often wonder whether my early cleansing contributed to my later illnesses. In any case, once ill, my fanaticism for cleansing and fasting transformed into something altogether destructive.

As I wrote last week:

"When I experienced my first symptoms of autoimmune illness, my obsession evolved, into what I now view as an eating disorder. My early symptoms were vague: moving pain, crushing fatigue, listlessness, depression. Blaming certain foods, I refined my diet. For months, I refused to touch anything but organic greens, sprouted grains, wild salmon, brown rice, and tempeh. I drank green drinks. I refused wine. I did not eat one ounce of cheese or bread. I avoided all night-shade vegetables. I never, ever combined proteins and carbohydrates at the same meal."

Blame. It seems ridiculous to blame food, but I believe this is the impulse behind so much of the fasting and cleansing practiced in America today. It is, at its root, extremism.

So why, exactly, do we fast? For that matter, why do we eat? Why do develop cravings for a certain thing? It isn't always food, this thing. Actually, it's never food. What is it then?

The Faces of Fasting: Emo Edition
I took the above "celf portrait" in the midst of my final fast, in the summer if 2006. And yet, even though I no longer practice fasting or cleansing, I still practice the sort of extreme penance I came to associate with the practice. Attempting to recover from a party, for example, I get on the treadmill and run until my heart nearly explodes.

But is running to exhaustion the cure for partying to exhaustion? Or is it, in a way, the same thing?

I believe fasting can be beneficial--if practiced in the right way, with the right spirit. My experience might be a cautionary tale. Steve's experience, though, offers a different view:

"Even as I write this, I've just finished my second cleansing fast, and am still thinking about it. I’m thinking what people who know have told me—that the most important part of any fast is what comes after. That is, how the fast has changed your perceptions about health and wellness to the point that it has permanently changed your habits.

Because your body exists in such a delicate stasis while on an extended fast, you really see how the things you put into your body affect your energy level, mental acuity, and spirituality. As a result, I have made some drastic lifestyle and wellness changes that I can see lasting for a long time, hopefully forever. So in that sense, the fast was a success.

But on a more important level, fasting has made me realize a few other things. First, I noticed how much time we spend preparing food, eating food, or thinking about what to eat next. The entire day opens up when you are not concerned with these things. This feeling is similar to the one I had when I swore off television—you realize how much time you have wasted. I experienced the same thing when I gave up smoking as well. Even with all of this new found time while fasting, it still seems that I spend most of it just sitting around, waiting for my water to filter.

There is a metaphor in there somewhere. Continuing on the subject of time, it is just exactly that which fasting has taught me the most—that time is indeed precious and scarce. Fasting forces us to think about how we fill the empty spaces, the silence. It all comes down to how we have used our time. That has been and always will be how we assess the success of life. There is no quick fix. You can't get something for nothing. It all comes down to how we fill the seconds, the moments, the hours. These are the things that ultimately make up all of our days. And we live them."

Tuesday, June 12, 2018

Trust Thy Gut: Healing in the Age of the Microbiome

I was diagnosed with ulcerative colitis in May, 2002. On the day of my diagnosis, I refused my doctor's prognosis, as well as the drugs, and commenced a journey to heal—a twelve-month experiment, absent any conventional medical guidance whatsoever, that ended midway through my honeymoon, when my new wife admitted me to the ER.

For twelve months, I devoted my life to an obsessive and fastidious investigation. Hunched over my desk, I spent day after day Googling. For a phrase like “ulcerative colitis natural cure,” I'd click twenty pages deep, reading every word on every site—every blog, every forum. Certain opportune comments led to new searches in new windows, fresh rounds of clicking.

When I risked leaving the house, I’d visit the book store, where I’d scan the indexes of books, seeking the slightest reference to "colitis," or "autoimmune." Inevitably, though, turning from my screen, or trudging from the store briefly lifted by some tidbit, I’d come to think of the only definitive cure: death.

I do not believe my obsessive investigation, nor my despair, were unique. In my experience, most people who experience illness--from colds to colitis--engage in some form of this fanaticism. And many, discovering confusing or contradictory advice, have yielded to despair. My search led to life.

I've learned to heal my symptoms--without drugs.

And yet, each year for many years, around March or April, just as the weather warms, I would suffer a relapse, or "flair." The severity of these flairs varied--yet I knew how to recover.

In May 2013, however, I suffered a particularly bad flair. My go-to remedies--a horridly wine-free lifestyle, VSL#3, and Metagenics--seemed to fail. Worse, the severity of the symptoms transported me back in time, to 2002, when I felt my despair most acutely.

My wife, who witnessed my behavior over the years, acclimated herself to my eccentricities. But even she was startled, that year, when I walked into our infant daughter's nursery, and pointed to the dirty diaper laying on the changing table.

"Save that," I said.

"What?" she asked.

"Save that," I said, and to state the case plainly, I added, with conviction, "I'm doing a fecal transplant enema."

Nearly all DNA in our bodies belongs to microorganisms: they outnumber our cells nine to one.

- Burkhard Bilger, writing in The New Yorker 
Fecal Transplant Enemas: A Brief History

Although the provenance seems to be disputed--by this guy, for example--the fecal transplant enema is generally accepted (by the folks at Wikipedia, and elsewhere, at least) to have been first described in 1958, when the Chief of Surgery at Denver Hospital, Dr. Ben Eisman, reported in the Journal of Clinical Gastroenterology, on four patients who had been cured of pseudomembranous colitis (commonly known as C. difficile colitis or C. diff).

Eisman described a novel treatment: Enemas containing feces from healthy colons had been transplanted into the patient's colons, and had successfully replenished the patient's bacterial ecosystems, effectively curing the patients.

The next documented success occurred in the mid-1980s, when an Australian gastroenterologist, Dr. Thomas Borody, was faced with a particularly challenging case. A traveler, recently home from Fiji, had contracted an especially pernicious form of colitis. Searching the medical literature for a potential cure, Borody discovered Eisman's article, and decided to give it a try.

Writing in The Scientist, Cristina Luiggi explained Eisman's procedure quite candidly in her article "Same Poop, Different Gut":

"He collected stool from the woman's brother, and after screening it for known pathogens, he stuck it in a blender, added some brine, and filtered it to get rid of any undigested material. The stool, now turned into slush, was administered to the patient—who had her gastrointestinal tract previously flushed—via two enemas over the course of two days. The results were nothing short of surprising, Borody said. Within days her colitis was gone, never to return."

This is the method I'd considered in the spring of 2013. Obviously, like any reasonable human, I would've preferred to administer this treatment with a doctor.

Unfortunately, despite the mounting evidence of the treatment's success--including the first randomized control study--the FDA had made the procedure essentially untenable for any liability-minded doctor. Even though some doctors believed the regulations had become too strict., it was nearly impossible to find a reliable source of treatment.

(Happily, updated guidelines recommend the treatment for C. diff.)

Faced with this climate in 2013, but suffering acutely, I found myself standing in my daughter's room pointing at her diaper, envisioning my own guerrilla campaign.

All I'd need, I told my wife, was a "dedicated" blender and a little poop.


Michael Pollan's 2013 lead article for The New York Times Magazine, introduced the microbiome to many readers:  "To the extent that we are bearers of genetic information, " Pollan wrote, "more than 99 percent of it is microbial. And it appears increasingly likely that this 'second genome'...exerts an influence on our health as great and possibly even greater than the genes we inherit from our parents."


Sterility, Cleanliness, & Purity

I believe the FDA's regulations mirror a cultural obsession with sterility--and as Kathleen Barnes, a Johns Hopkins Medical School researcher, said in a Science Talk podcast on the "hygiene hypotheses," this obsession may be harming our health:

"The hypothesis is that as we make the shift from dirt to sterile that you are changing the direction of your immune response. And so in the context of asthma, and frankly in other autoimmune diseases and diseases of inflammation, it's this imbalance from that side of our immune response that we believe evolved to protect us against things like bacteria and viruses and malarial parasites to the other side of our immune system that, frankly, when it's revved up causes diseases like allergies and some of these other diseases of inflammation."

For me, this obsession with sterility--and by way of sterility, cleanliness and purity--touches the most intimate part of my life: my relationship with food.

For my entire adult life, I’ve been a staunch "health-food" enthusiast. At the age of twenty-one, while traveling in Italy, I became a vegetarian. But even before my trip to Italy, I'd experienced a lifetime of brown rice and Moosewood Cookbook recipes, organic broccoli and honey-sweetened treats. My mother raised me with a special attention to my diet; she also sent me to a school--the Waldorf school--that favored whole food cooking.

I lost touch with this impulse throughout my teenage years. Then, when I was twenty, in college, in the midst a dismal semester eating in the student cafeteria, I came across a surprising image in the cafeteria kitchen: a box of hamburger patties stamped Grade F, But Edible.

Within a week, I was a vegetarian.

For me, vegetarianism, and later veganism, morphed in my twenties into obsession with purity. When I experienced my first symptoms of autoimmune illness, my obsession evolved into what I now view as an eating disorder.

My early symptoms were vague: moving pain, crushing fatigue, listlessness, depression. Blaming certain foods, I refined my diet. For months, I refused to touch anything but organic greens, sprouted grains, wild salmon, brown rice, and tempeh. I drank green drinks. I refused wine. I did not eat one ounce of cheese or bread. I avoided all night-shade vegetables. I never, ever combined proteins and carbohydrates at the same meal.

By the time I received my ulcerative colitis diagnosis my diet was already remarkably limited. The new diagnosis, however, thrust me into a new realm.

At the time, my relationship with food, ritualistic and minutely precise, alienated me from others. When eating lunch, specifically, I simply could not bear company. I dined under strict conditions: on the zero or five, at say, 12:00, 12:05 12:10, and so on, exactly four hours after my last bite of food—a bite I might’ve detained in my mouth, for minutes, if the time did not match my zero/five requirement. For fifteen months, from my ulcerative colitis diagnosis to my wedding day, I never once finished eating on the one, two, three, or four.

For reasons I have yet to entirely fathom, this rigor did not survive dusk. Dinner absolved me—and Karen, from her patient allegiance to my eccentricities. We’d invite others to share the weirdness—to share our chilled Chianti and buttery Castelvetrano olives, our pan-roasted wild salmon and spice-grilled mini sweet potatoes. Easing into these dinners, I eased back to myself—my pre-illness self: the gallant host, the ecstatic narrator.

Today I live for dinner’s absolution, but I am still haunted by my daytime exactitude. My timing is more fluid, but I can only bear company to a point—as long as I’m free to sit in complete silence, and slurp my 1¼ cup seasonal soup, and dip each of my twelve tempeh squares into a tiny ramekin of portioned extra virgin olive oil, and eat my seasonal salad without once glancing to my left or right, but down, to the latest New Yorker.

My Lunch: Every Single Day
My obsession with purity nearly killed me. Refining my diet to an impossible degree, I distorted my relationship with my body and food and those around me. Worse, I'd tricked myself into believing that this diet was the only diet for my symptoms.

Even then, I felt shameful of my illness; shameful of the person I'd become, this ill person with this horridly embarrassing disease. Yet I felt powerless to change. I could hardly utter the word, "colitis," in private, let alone write about it on a public forum.

In a sense, I was guilty of "kitsch," as Milan Kundera defines it:

"The absolute denial of shit, in both the literal and figurative senses of the word; kitsch excludes everything from its purview which is essentially unacceptable in human existence."

My recovery was occasioned by the opposite: an embrace of the chaotic and messy in my life and writing, the literal ingestion of dirt, and an entirely new diet typified by my first bite of meat after eight years of vegetarianism: a juicy, blood red hunk of lamb, cooked rare.

I'd ordered the lamb, spontaneously, with the sort of nervous enthusiasm a person might reserve for a wedding proposal. It was this enthusiasm, this new sense of goofy caprice, that also typified the attitude that inspired me to walk into my infant daughter's room seeking poop.

Not to say that I hadn't researched the topic with my typical compulsive energy. I had.

By "goofy caprice," I simply mean to say that in learning to recover from illness, I've opened myself to change, and that in doing so, I've also learned to see humor in my vehemence.

For me, humor provides confidence even in the darkest hours. This is something I try to express in my writing. I often write about illness, about how I feel as if I’ve been slapped by life. In part, I want to express an honesty about my feelings of woundedness. However, I don’t want this sense to drive my writing into dour seriousness, but rather give me range to be, at times, slightly goofy, as all celebration is.

In the end, after a series of tedious conversations with my wife, I did not administer a fecal transplant enema. I'll spare you the details. Instead, as a compromise, I tried the probiotic enema suggested on the website Listen to Your Gut.

This video, specifically, convinced me as well as the raw testimony of the video's star, Crohns Boy:

"So to tell you the truth it sucked being sick for the last 2 weeks especially while I was in Hawaii. When I look back at it now I am almost grateful for being sick as it has taught me a lot in the process. I have learned that when I feel awesome and other people are doing shitty I really have to remember how I felt when I was in their shoes-feeling depressed, hopeless, insecure etc and I have to be able to communicate effectively that they will overcome this and that stuff will be lost in the process. I also realized life has a great way of humbling you from time to time even if it came in the form of a flare lol I realize you really have to soak up the GOOD TIMES and enjoy them!! Sunshine is always awesome and appreciated the day after the storm.....simply said."

"Gut bacteria may be the key to preventing or treating some diseases," says The Harvard Medical School, which recommends fermented foods or probiotics as a healthy option for "good bacteria." [Photo Source]

Fermented Foods and Probiotics

I am a passionate proselytizer of bugs--specifically the beneficial bacteria found in fermented foods. In my former position at Whole Foods Market, I spoke to hundreds of people over ten years who offered testimony after testimony to the effectiveness of probiotics. And finally, it seems, the idea of "beneficial" bacteria has entered the cultural conversation under the meme of "the microbiome."

Although the microbiome is meant to describe our entire bodies’ bacterial ecosystem, much of the current talk focuses on the gut, and the profound influence the gut has on our health. Many scientists studying the microbiome are hesitant to make recommendations. In his groundbreaking article, however, Michael Pollan teased enough information out of his sources to discover “the outlines of a new diet.”

Near the end of the article, Pollan writes, “one of the keys to good health may turn out to involve managing our internal fermentation.”

How is this done? If you’re interested in trying a probiotic, I suggest inner-ēco™ Coconut Kefir--a food-based probiotic that follows Pollan’s advice of tending to “internal fermentation.” Another option is eating small amounts of fermented foods, like miso, tempeh, or pickled vegetables.

Recently, I have also tried a relatively new product, Restore. I cannot recommend this product enough. The effects have astonished me. My digestion has improved appreciably, and I am sleeping better. This is a simple addition to any diet.

Five Years: Symptom Free

"I have learned that when I feel awesome and other people are doing shitty I really have to remember how I felt when I was in their shoes-feeling depressed, hopeless, insecure etc and I have to be able to communicate effectively that they will overcome this and that stuff will be lost in the process." Crohns Boy

By the time I'd read this quote from "Crohns Boy," in mid-April, 2013, I'd already suffered two months of symptoms. I'd been to my doctor three times, and had, for the first time in my life, considered taking the potent anti-inflammatory drugs. I'd lost ten pounds, and had acquired the paperwork to take a LOA from work. Inspired by Crohn's Boy, I tried the probiotic enema on a memorable date, April 15, 2013: the day of the Boston Marathon Bombings.

That was Monday. By Wednesday, I was completely symptom-free.

I've remained symptom-free since then. (Update: As of August, 2018-five years later, I am still symptom-free).

I understand that the very nature of my illness might ensure a relapse--perhaps maybe even next spring. With each flare, and each recovery, however, I do believe I've learned to become a bit more human.

For me this means, specifically, an acceptance of that which I cannot control.

Each year, I learn to cede a bit more control to life as it is: radically imprecise, often downright messy. Bacteria, and by extension, probiotics and poop, have become metaphors for my growth.

That I can now talk about this so openly seems to prove the point--for me at least. 

Monday, June 4, 2018

The Art of Eating

"Tell me what you eat," Brillat-Savarin wrote, "and I will tell you what you are."

You might know this quote from the Japanese Iron Chef, where it appears in the opening sequence of each episode, accompanied by a solemn overture from Hans Zimmer's "The Arsonist's Waltz," which quickly cuts to the show's brash theme song, another Hans Zimmer song, "Show Me Your Firetruck." Both songs originally appeared in the 1991 film, Backdraft--an odd choice for Iron Chef, if you ask me, but also complementary to the odd spirit of the show.

(If you're interested, here's an a cappella version of "Show Me Your Firetruck.")

After the opening bombast, any viewer of the Japanese Iron Chef will quickly see: the tone of the show is bombastic, too. The show's most famous image occurs at the end of the opening sequence, when the host, Chairman Kaga, bites a pepper. From his quizzical expression, it's hard to say, exactly, what Chairman Kaga is thinking or feeling. In any case, it's a distinctly Japanese moment: to a Westerner's sensibility, bizarre and inexplicable.

Although the Brillat-Savarin quote feels apt for the show, the opening sequence, with its bravado and flaming torches, does not offer an entirely accurate association for Brillat-Savarin, let alone the tone of his masterwork, The Physiology of Taste.

In fact, Brillat-Savarin's work is equal parts bravado and self-parody--a fitting combination, I think, for any discussion of food and eating.

Thursday, October 19, 2017

Ella Loves Kindergarten

Ella has no talent for evasion. She reveals her emotions without the slightest artifice. Her happiness is so obvious, so transparent. She smiles, laughs, and skips--actually skips--across the room. When she is angry, the emotion is no less obvious, and the source is unmistakable. Often, I catch her glaring, with hooded eyes, at Owen. When angry with her parents, she retreats to the corner and pouts, her anger determining our mood like a bad weather pattern.

Since starting Kindergarten, in September, she has revealed new emotions, most notably a strong sense of self-esteem, obvious in her posture, how she straightens her back and tilts her chin upward when speaking about her lessons: counting and writing and coloring in the lines--oh, the profound importance of coloring in the lines!

I love it. I love everything about her school. I love the principal, Mr. Mac, who visited our house in August to read Ella a story. I love her classroom, with its primary colors, the gleaming metal pegs where she hangs her backpack, the low chairs, the smell of crayons and pencil shavings and books. I love picking her up after school, at late care, when we walk the corridors, poking our heads into classrooms, or the library, or the gym, which smells of decades of sweat. (The school was built in 1969, the year my brother Scott was born).

Ella loves it, too, though she spent the entire summer dreading it. One night in late July, before Mr. Mac had come over and after we had watched Spider-Man 3, she woke around 5:00 AM and padded into our room, crying.

"Mommy," she said, half asleep, "I dreamt of Venom. It was almost as scary as the principal coming to our house!"
But he came. And she survived. And now whenever Mr. Mac sees her, he shouts out, "Ella!"

Recently, when I picked her up on a Friday, after Mr. Mac had shouted across a hallway crowded with kids, "Have a good weekend, Ella," I stopped in my tracks to stare at Ella. She was shaking her head and smiling as she tightened her backpack straps to her chest.

My God, I thought. She is so proud.

I loved it. I loved her. It felt like the best moment of my life.

She looked up at me. "Daddy," she said. "STOP."

She knew what I was thinking--for I have no talent for evasion. In the hallway, surrounded by children, she was embarrassed by her father. And I loved that, too.


Originally posted on Facebook.

Monday, July 3, 2017

Thirteen-years Married

Thirteen-years-ago I married my high school sweetheart. Unreliable online data suggests high school sweethearts account for only 2% of all marriages. And less than 2% of people who marry their high school sweetheart earn a college degree.

That last statistic is significant (to me) for a simple reason: After I graduated high school (a year before Karen), we survived a five-year long-distance relationship. I lived in Bloomsburg. Karen lived in D.C. In a box in our bedroom closet, we keep a testament to this time: hundreds of hand-written letters.

The most difficult period, by far, was our first separation, during the summer of 1995, when Karen traveled to Mexico for six weeks and I entered Bloomsburg's "summer freshman" program. I dormed with Anthony, a football player, a truly unintelligent person, who had yet to discover the bacchanalian freedom most summer freshmen had abused for entire high school careers. Making up for lost time, he boozed nightly and rarely slept. Sleepless and depressed, I abused Tylenol P.M. I drank too much bad beer. I found sleep, though not of the restorative sort. Even then, no torment equaled my summer-long paroxysm of lovesickness.

Jerry Garcia died that summer: August 9. That night, when Jerry’s noodling droned in countless iterations from a hundred dorm room windows, the sound was indistinguishable from the mountain-rich blur of bugs, yet I recall walking across campus, from Shroomin's room to my own, excited for my appointed call to Karen’s host family’s place, and catching a snippet of “Box of Rain.”

Oh, how I hated the Grateful Dead. My feeling was: Good, stay dead. But Karen loved "Box of Rain."

Hearing the snippet was enough: I burst into tears. On the phone, minutes later, we cried together, not for Jerry, but for ourselves, for the lonesomeness of our long-distance call—one of many despairing, lovesick calls which reduced both of us, on any number of humid summer nights, to sobbing.

And that was just the first summer. Anyways: Here's to high school sweethearts! This image was taken last week in New Orleans, at the back of a streetcar. We were on our way to the Garden District to get drunk and eat tacos.


Originally posted on Facebook.

Wednesday, May 3, 2017

On the GOP's New "Healthcare" Plan

Of my various pre-existing conditions, type-1 diabetes is the most cost-intensive. In the GOP's new plan, my state can either continue the Obama-era protections for pre-existing conditions or place me (and others like me) into a "high-risk pool," as a way to separate me from healthy people, who can then enjoy lower premiums.

Here's what Andrew Gurman, the president of the American Medical Association, has to say about high-risk pools:

"Prior to the enactment of the Affordable Care Act, 35 states operated high-risk pools, and they were not a panacea for Americans with pre-existing medical conditions. The history of high-risk pools demonstrates that Americans with pre-existing conditions will be stuck in second-class health care coverage -- if they are able to obtain coverage at all."

Without coverage, I will pay out-of-pocket at least $500 per month in insulin and testing supplies alone. With insurance, under the new plan, my costs may be--what?

Trump said on Monday: "It will be every bit as good on pre-existing conditions as Obamacare."

Yet nearly every publication I have read, with the exception of The Wall Street Journal, disputes this fact. The Journal's opinion, contrary to the president of the American Medical Association, is that "high-risk pools are a fairer and more equitable solution."

Yet The Journal's editorial misstates the amount of money available to states for these pools as a "$100 billion." The real number is $8 billion, which is woefully inadequate according to nearly every healthcare expert. (Please correct me if I'm misreading this).

Implicit (to me) in so much of the debate about healthcare is that there must be "winners and losers," as if the health of other human beings is a game.

Also implicit is the notion that sick people do not "deserve" to pay the same premiums as healthy people--after all, why are we sick? I've actually seen this argument made against people with diabetes. What can I say? If you know me, you know I fight every single day to be healthy. And yet, I have several chronic illnesses--so, inevitably, on any given day, I lose my fight. That is the nature of chronic illness.

So what do I deserve as human being who requires care? Do I deserve the label (and attendant costs) of "high risk"? Or do I deserve to pay the same premium as my "healthy" friends?

Health care is not political. We all deserve health care. When we create distinctions between the sick and the healthy, we fail to recognize each other's humanity.

And just to say: I am not posting this picture of my infant son and me to be gratuitous or attract undue attention to my post. The point of the picture, to me, is simple: Healthcare is about caring for those who need it. And some require more care than others.


Originally posted on Facebook.

Monday, January 23, 2017

Invisible Illness

I talk and write about illness often, so I'm hesitant to say--with the lingo--that I have an "invisible" illness. And frankly, I'm not one to hide my illness. I lance my finger in front of friends and colleagues. I jab a needle into my gut wherever: a restaurant, a crowded street.

What I do hide is my day-to-day symptoms. At any hour, on any day, I might feel vertigo, bewildering fatigue, pain. I often have a headache. I rarely feel balanced. My symptoms stand opposed to the person I want to be, so I try to appear healthy, for hours each day, until I return home, when Karen, just home herself after a long day, suffers the burden of my efforts. I can be silent, mean. She's receptive, but not sympathetic. After all, she too suffers an "invisible" illness.

So we have an implicit understanding. We move on, ignoring our symptoms for days, weeks, months. We attend all the events. We host countless dinners. We welcome the world to our home. We do this, we tell ourselves, for life, for our children. We go on and on—until life makes us stop.

Two weeks ago, I woke with a pain in my chest. I thought of Uncle Dean, whose own heart troubles began in a similar way: one morning, a pain in the chest. The feeling, and the thought, were impossible to ignore. I could not take a deep breath. I tried, but some mechanism blocked me.

Already anxious, it was impossible for me to respond reasonably. I plunged into the woes: frustration, sadness, worry. For a few hours on a Tuesday, I was dying. I now admit I was suffering an “anxiety attack,” as my doctor called it—a diagnosis I had, at first, denied. I was certain I was experiencing Dean’s illness. Over fifteen years, I had learned to manage my chronic illnesses, yet these symptoms felt acute, and somehow the opposite of “invisible.” As I went about my life, I thought everyone could see—or worse, feel—my anxiety.

Oh, I thought, this is not the person I want to be. But since everyone could see, I thought, I might as well speak. So I started talking to people—at the grocery store; at the Y. One morning, some self-interested impulse made me confess my anxiety on Twitter. Friends responded with encouraging words. One friend wrote in a message: “Seth, I have suffered anxiety for years. My suggestion: find a picture of Owen and Ella. Look at it until the darkness passes.” And so I did exactly that. Whenever I felt anxious, I looked at this picture of Owen and Ella.

What I learned from talking and sharing, I think, is that many people suffer from “invisible” woes—and many, like me, do not share for fear of seeming vulnerable or self-interested. Oh, but how sharing healed! Even the simplest of words helped me feel less desolate, less afraid. Since then, the pain has subsided, my breathing has calmed. The darkness has passed. Be well, friends. If you feel a need to share, I'm here with open ears.


Originally posted on Facebook