There’s an old Chinese Proverb that I like to roll out as a kind of epitaph whenever I find myself being asked to explain my life. Translations vary from source to source, but the gist of it goes something like this:
“Don’t listen to what they say. Go see.”
During my winter & spring breaks in medical school, I volunteered to provide medical relief in rural Africa, and had the opportunity to see a wide variety of health challenges. However, I noticed something odd about the collective sum of the cases I was seeing, something missing…
While learning about asthma, eczema, and allergies back home – members of the so-called Western diseases – I was struck by their near absence in the populations I was working with in rural Africa. Especially noticeable was the conspicuous absence of autoimmune disease.
Impossible as it might seem, I didn’t encounter a single case of autoimmune disease in the 1,200 or so people I treated. When I checked the medical records from village clinics, again not a single autoimmune diagnosis. In rural Africa, it seems, no one aches from rheumatic arthritis.
I have a particular and personal interest in autoimmune disease. When I was ten, my sister was diagnosed with autoimmune hypothyroidism. A year later, my father developed a baffling hybrid of type 1 (autoimmune) and type 2 (non-autoimmune) diabetes. Later that same year, my brother was diagnosed with inflammatory bowel disease. A close cousin of mine was diagnosed with multiple sclerosis just as I started medical school. And my mother has been a lifelong allergy-sufferer and asthmatic. When it came to autoimmune & allergic disease, my family had won the lottery.
While I was puzzling over what I found in rural Africa, or – more accurately – didn’t find in rural Africa, epidemiologists gave it a name: the African Enigma.
My family history made me wonder: what were these rural Africans doing to protect themselves from autoimmune disease? Autoimmune disease is fairly new to the human race, but the rural Africans were living more or less the way they always had. How could they develop a protection to a new disease so quickly?
As it turns out, it was us in the West who were doing something new; something that made us more susceptible to autoimmune disease; something that the rural Africans weren’t doing. And that something was widespread disinfection.
Research has caught up with the theory in recent years, and now we know that bringing back the beneficial bacteria and our other “old friends” can treat or prevent some types of autoimmune and allergic diseases,
In my clinical work, I’ve made a marriage between my volunteer experiences in rural Africa and the insights I’ve gained from living alongside family members rife with autoimmunity.
My clinical work at the Interactive Health Clinic is only the latest example of a sterling & heartfelt effort to live a life consistent with my values: to coordinate compassion, service, and patient education with expert medical care. These basic principles inform my approach with each and every patient who seeks my medical expertise.