Sunday, May 15, 2011

Cleveland HO! Leaving

The day had warmed nicely, into the sixties, without a thundercloud in sight. I left the protection of wooded grounds and hit the streets, chilled by the light breeze. I wished for my running shoes for the four-mile walk back but my shorty-cowgirls were up to the task.
I noticed the plates of a parked car. Ohio’s bicentennial license plate proclaims: Birthplace of Aviation. Really? We’re a long way from Kitty Hawk Dorothy. As it turns out, Wilbur and Orville Wright were Buckeye’s. Not only born and raised, they designed and constructed their flying machine at their Dayton, OH bicycle shop. In 2003 Congress made it official, yes indeedy, by virtue of Wright’s birthplace, Ohio - not N. Carolina - IS the birthplace of aviation. The vote passed 378 to 3 with the Senators from – you guessed it – N. Carolina casting ‘Nay’ ballots.

I came across a rather new-ish out-door mall with European flair: cobbled streets, bright awnings, and ornate, wrought iron balustrades. Reminiscent of our newest mall, The Fountains in Roseville, it must represent the latest in mall-making fashions across the US. I wandered its storefronts and cobbled streets.

Ever notice that people who should not wear spandex in public – do? Enough said. More people: men, women, and children wear hats in Ohio, not baseball caps, rather cabby caps, Greek fisherman caps, porkpies, and fedoras. Perhaps I was observing a seasonal trend, that on the heels of winter, Clevelanders would not bare their heads until spring sprang.
Dress in California seems more flowing, airy, diaphanous, not necessarily loose but less constricting. Their clothing reminded me of… Nantucket. Nantucket? What is that? White collars, cuffs and cufflinks – I could stop right there; couldn’t I? But I’ll continue: striped cloth belts, khakis, geometric versus abstracts patterns, primary colors, high-heels, long and stylish overcoats. Young adults however, seemingly conform to a national dress code standardized by Abercrombie & Fitch.

The Legacy Village was organized around a central, grassy piazza and bandstand. Its marquee promised live music during summer. Part of its stubby, scrubby, brown lawn was cordoned off for reseeding. I was elated to see a CPK – California Pizza Kitchen – at one end of the piazza. I LOVE their salads though a single salad can be the caloric equivalent of two-full days. Grrr. At the opposite end of the piazza - the Brio Tuscan Grille.
I chose Brio and an eggplant-mushroom hors d'œuvre. Taking a corner table in the bar, opposite the entrance, I watched patrons come and go. The décor was ala Cheesecake Factory, walls colored in saffron, faux mortar and brick beneath crumbling lath and plaster, 20-foot ceilings with crown-molding and clerestory windows, all very faux Italiana – I liked it.
Not unlike the Cheesecake Factory, Brio’s portions are ridiculously large. My hors d'œuvre was served in a 12-inch boat of creamy, black-pepper sauce - spicy, delicious, if not a bit too salty – but you’ve heard that complaint repeatedly. I’ll save the diatribe.

There was a time in my life when I would forgo eating over dining in a restaurant alone. I’ve gotten over that but I must say, I do miss sharing food and breaking bread with others. It is perhaps this feeling of loss, so acute when publicly dining en solo, which has me wanting to avoid the situation entirely. Conversely, I am happy to eat what I want, when I want, and without a concern for the dietary preferences of another.

A very Morrie-looking man hobbled in on bilateral canes. His attendant, a young Polynesian woman, steadied him by his elbow. He was bent forward in back and knee, giving him the awkward gait of one inflicted by neuromuscular disease. Wispy, white hair stood straight up - for many inches - compensating for any loss in stature. An over-sized gray blazer, hinting of his former self, billowed loosely round his withering frame. Shape-ups? My mind did a back-flip and eyes a double-take. Is he wearing Shape-ups?
Skechers makes a line of sneakers promising weight-loss and gluteal tone to-die-for, and dog-gone if he wasn’t wearing a pair. You go-boyfriend! I suspected the rocking nature of their soles might aid in ‘push-off’ and thereby – ambulation. You know… like atrial-kick aids ventricular filling and blood pressure… just like that.

It was the early-dinner hour, that time when seniors are typically discounted. Morrie-like was seated immediately, he shuffled off, my study of him over before it began. While the bar filled for happy-hour, the elderly streamed into the dining room. People seemed shorter, dark-haired, olive-toned; I imagined them all Italian: little Italian men from the old country sporting thick-framed, Larry-King glasses under a cabby’s cap, their forearms coated in thick, black hair and belts deviating slightly south, who could say paesano with perfecto. And tiny – almost frail - Italian women with thin, gold-edged tri-focals and tailored pumps of maroquin, impeccably dressed for dining out. Notably absent were the willowy blonds of California and Stetsons.

People are not so obese here, I wrote. On the heels of The Longevity Project publication, one of the emerging observations was: thin people consort with thin people. No mention of casino buffets, the American diet, or super-sized portions; simply put: thin people consort with thin people. Hmmm – interesting.

My simple statement on a page, “People are not so obese here,” led my mind to The Longevity Project. Let me give you the backfill. The Longevity Project was published this year. It is the analysis of a study by the same name that followed 1500, San Franciscan, public school children continually since 1921 - from childhood to death. All remaining participants turn 100 this year.
Is longevity associated with being married, daily jogs, living with pets, or faith in God? “The Longevity Project uses one of the most famous studies in psychology to answer the question of who lives longest— and why. The answers will surprise you,” says Malcolm Gladwell.

The project examined other factors conferring not only longevity but also health and wellness. I examined my own group of friends. Do I consort with thin people? The answer is an unequivocal YES. And I admit, before completing the Wisdom Course, I had virtually no girlfriends who were not women athletes. All reasons point in a single direction: how I choose to spend my limited leisure time, nothing more.
I am intensely interested in wellness, my own and that of others. I am interested in healthcare models that not only manage disease but provide pathways to wellness. The Cleveland Clinic’s Wellness Program is one such model. The Longevity Project may provide guidance.

Outside, shadows lengthened and dissolved into dusk. I phoned my hotel and requested shuttle service. Their van was en route, for a deposit at the Apple Store, two doors up. “Look for a white, unmarked van. Our driver Jamal is wearing a hotel uniform.”
“Jamal?” I asked as I approached.
“Ms. Bacon?” We both smiled and I stepped into the van. Jamal made two additional stops, retrieving hotel guests along the way.
At the hotel, Jamal arranged for my 0430 pick-up for an 0600 flight due southwest connecting to long flight due northwest to Sacramento. I would be home by noon. I repeated the previous nights visits to gym, sauna, and hot tub before curling in bed with Morrie.

I returned to dog-eared page 126 and began reading. I turned into dog-eared page 127 where Morrie says, “Remember what I said about finding a meaningful life? Devote yourself to loving others, devote yourself to your community, devote yourself to something that gives you purpose and meaning. …Status will get you nowhere. Only an open heart will allow you to float equally between everyone.”
Most of you know I participate in on-going training and a body of teaching by Landmark Education. I would describe their teachings as philosophical in nature, an amalgam of great philosophical truths taught by all religions and practices coupled with communications, exercises and projects that internalize the lessons.
The entry course is called the Landmark Forum. Participation in their courses create a fundamental shift in one’s life from inward focus to outward focus, from me, to us, to all-of-us, to the open heart that Morrie describes. There are many bodies of work that espouse such theology and philosophy, however Landmark produces that result with reliability and velocity. Morrie woulda dug the Landmark Forum.

Dog-eared page 135: I believe in being fully present. That means you should be with the person you’re with. When I’m talking to you now, I try to keep focused only on what is going on between us. I am not thinking about something we said last week. I am not thinking of what’s coming up this Friday…”
Do you know there are exercises that teach presence? To really BE with the people you are with? Do you know that upset does not exist in the present? What if you could move with velocity through upset, anger, and suffering? Would that make room for more love? What would life be like with more present and presence in your present?

The hour was late as I flipped the final pages of Tuesdays with Morrie and dog-eared page 149 where he expounds on marriage. Happily, respectfully, and contentedly married for forty-four years gives Morrie license to pontificate, in my viewpoint.
There are a few rules I know to be true about love and marriage: If you don’t respect the other person, you’re gonna have a lot of trouble. If you don’t know how to compromise, you’re gonna have a lot of trouble. If you can’t talk openly about what goes on between you, you’re gonna have a lot of trouble. And if you don’t have a common set of values in life, you’re gonna have a lot of trouble. Your values must be alike. And the biggest one of those values… your belief in the importance of your marriage.

Morrie died on November 4, 1995. His respirations ceased just after his family slipped into the kitchen for a fresh pot of coffee. Ted Koppel recorded a final tribute that you can watch on youtube along with his Nightline exposés.
I wiped my tears, closed the book, and turned off the bedside lamp.

Four hours later I was airport bound. Let me just say that a window seat twelve inches from the turbine housing should not be billed as a window seat. The engine block consumes any view, the vibration loosens dental work, the sound deafens.

I sat with a young woman in jeans and a mohawk armed with a Kindle, a Shuffle, and earbuds. A chef of three-years, Amy was headed for the kitchen in Kings Canyon National Park. She planned to be there for dinner and the next several years. She was excited to see, in full-living-color, that which she had only seen in pictures. Amy described herself as a city-girl excited about the great outdoors.
We (of course) talked trails, and backpacking, and solo female trips, and on, and on, and on. She owned no backpacking gear and I assured her the REI in Fresno would not steer her wrong. At the end of the season, I encouraged her to get into Yosemite before snow made the roads impassable. She assured me she would. I loved her enthusiasm and tinkered with a trip to King’s Canyon to say, “Hey.”

During my second leg I was sandwiched between two large men, one whom overflowed the boundaries of his seat. A more than large woman ahead on the left, consumed 1.5 seats. Flight attendants relocated the person relegated to the 0.5 seat next to her. On a nearly full flight with few open seats, that was a task.
A little boy flying to California for the first time occupied the window seat and view of the engine housing. His grandparents begged to be re-seated, so he could see the earth passing beneath us. Flight attendants pulled another rabbit from their hat when a lady willingly relinquished her window seat.

Do you know that when the girth is sufficiently round, it moves one forward in the seat. And if one is sufficiently tall,  knees push into the seat ahead. After that, the only place for them to spread is out. I sat thigh-to-thigh with a very large man for several hours. Do you know how much I like thigh-to-thigh for several hours with a stranger? Not so much.
 I have more recently begun a regular practice of yoga in a studio. I don’t like strangers touching my mat or me. I am learning to deal with that. Sometimes the studio is crowded. I have learned that my practice is about my mat and me, nothing more.
My yoga practice was helpful in sitting thigh-to-thigh with this unknown man. I did not appreciate it but he did deplane without Monkey bites. (Y’all haven’t heard of Monkey for many, many moons. That is because I am involved in practices to tame Monkey – yoga is one. For those who are completely clueless, that which Freud called the id and Landmark calls the it, China calls the Monkey – that part of us more interested in survival and protection than love and connection.)  

Home again, home again, jiggety-jig. I returned home with fuel added to my fire. Renewed in my efforts to create a pathway to wellness for cardiac and diabetes patients interested in disease reversal. It’s not for everyone though clearly, it IS for some. I had put this project on hold until I could experience the program at Cleveland Clinic. I journeyed there for myself. There is no tax deduction, no continuing education credits, no Kaiser reimbursement. I went out of a commitment to health and wellness. I have been to Mecca, it is time to put structure to this idea and sell it to my director and chief. I’ll keep you posted.

I’ll close this with thoughts: first from Morrie.
Keep an open heart and open it up further and further and further until you encompass as much as you can with your love. Sounds kind of soppy but it’s not; it’s not.
Be compassionate to yourself and others.
Be involved.

Second from the Navajo nation: We are the ones we’ve been waiting for.

Third from Hillel the Elder – Jewish sage and scholar: If not me – who? If not now – when?

Lastly me: Be well and dare I say – thrive!

Thursday, May 5, 2011

Cleveland, OH-Ho! Day 2: Living Well & Thriving @ the Cleveland Clinic Wellness Center

 I arose at 0600 EST (0300 PST) and brewed coffee, fully nuked – caffeine is my friend. The excitement of spending time at the Cleveland Clinic Wellness Center all but mitigated my fatigue. Icy showers with temperatures in the forties were forecast. I dressed in layered business-casual in my belief the east is more formally attired and my consistent experience of freezing in climate-controlled buildings.

As an aside, when I first arrived at my new digs in Kaiser-Fair Oaks, my office was frigid while the rest of the building wanted for cooling. I telephoned engineers to inform them of the problem. I phoned again when no engineer seemed forthcoming. Finally I left this message, “The forecast in my office is for snow. There are icicles on my computer. Please help.” They did not find my message as amusing as I thought it was or they might. Given that we summon engineers only to fix the broken, I thought they might enjoy some humor. Not for the first time, I thought wrong. Nonetheless I DID get a response!
When they were unable to stop the arctic blast down my back and through my bones, I took matters into my own hands. Hmm… I recently relocated to Kaiser- Folsom (Sierra view, two miles from home, saves 90-minutes/day and $240/month in gasoline). I should perhaps telephone the new occupant of my old office and have him remove the heavy visqueen taped inside of the vent cover. :-D But I digress – as I am wont to do.

I stepped into the hall and eased my door shut. The doors of the Hilton are weighted such that, left to their own devices… I’d listened to numerous doors slam shut during the night.
The robust aroma of coffee wafted down the hall, tumbling through the Concierge Club’s door each time someone entered or departed. At 0730, breakfast was in full swing. Cleveland talking-heads delivered morning news on their large, flat-screen, HDTV. People sat in onesies or twosies holding quiet conversations, reading or watching the news.
Continental breakfast offerings were extensive: oatmeal, hardboiled eggs, pastries, bagels, toast, yogurt, freshly sliced fruit, cereals, juice, milk, tea, and coffee. I glanced at the USA Today while eating yogurt and fruit. I packed an apple for mid-morning, a bottle of water, and headed to the lobby for my shuttle.

Google Maps located Cleveland Clinic’s Wellness Center a straight shot and four miles north. We drove past brick colonials and wooden split-levels. The lots were large, the homes surrounded by spacious lawns and unfenced yards that flowed one into the other, in utter contrast to the fenced, postage-stamps of California.
No stucco and tile, the architectural theme was one of front gables and columns with decorative capitals, porticos and colonnades, corniced eaves and wide friezes, architectural features popularized during the Greek Revival and Italianate periods of colonial America.
My driver Martin said these were expensive neighborhoods but that a friend had recently purchased a three-bedroom, two-bath home for $115,000. He hoped to do the very same, very soon.
We passed entire city blocks of uncut forest, thickly wooded lands, their understory tangled with bramble and briar and no doubt, innumerous creatures therein.

Mid-block we turned left, west off the main thoroughfare. There was no signal, no fanfare, just a sign, an understated combination of stone and wood: The Cleveland Clinic Wellness Center. A long and winding road rambled over hill then through wooded dell, and the world of roads and malls and hotels and business became obscured and remote.
Wild geese paddled in a pond ringed by wooden benches. I imagined them pleasant perches in the verdant springtime sylvan. Under a gray sky, the sprawling lawns and scattered benches brought immediate peace and calm, reminiscent of the proverbial sanitarium, where peace and calm were thought to be requisite for wellness. Sanity – a clean and uncluttered mind. Maybe they were on to something.
The van labored up a steep hill that when crested, revealed a modern structure of glass, girders, and wood painted to blend with the forest. We circled the gravel drive that popped and crunched beneath the weight of the vehicle. I was let out in the roundabout, 45-minutes early.

The lobby was spectacular, like a Hyatt, with a soaring glass ceiling that fell at an acute angle from the third floor. The flagstone pond at my right funneled to an abrupt edge, sending water freefalling three stories below grade, to land yet again, in another flagstone pool. Flowing, falling water filled the lobby with music. Potted trees, and shrubs, and ferns encircled chairs arranged in conversational clusters.
I stopped at the security desk just inside the front door. They pointed across the sunlit lobby to a woman sitting alone at a four-top.
“Jackie is over there. She’ll check you in.”
I veered left, rounding the central stairwell as the ceiling plunged to touch down in the cafeteria’s dining area. Southern exposed, it was awash in early light. Gigantic, tubular, metallic mobiles hung overhead. I wondered if they would awaken, enliven, and animate as air warmed in the apex above.
A stone rimmed pond nestled against the building. Ducks floated on its glassy surface colored silver by the new day.

Jackie sat at the edge of this scenic, utilitarian space just beyond the sun’s reach. Her table was strewn with stacks of binders and folders and nametags. Jackie is Dr. Esselstyn’s secretary.
I exchanged numerous emails with Jackie prior to my arrival in Cleveland and it was nice to put a face to the gracious woman who responded to my requests.
 I'm glad you could come," she said, handing my materials over. "We are down the hall." She extended her left arm, gesturing toward the hall, its external wall of glass circumnavigating the duckpond. "The bathrooms are on the right. Dr. Esselstyn and Ann are already down there.”

I entered the room.
“Well hello young lady.” Dr. Esselstyn smiled, reaching to hug, pulling me into his crisp, starched, white, lab coat. “This is my wife Ann.”
“Wonderful to finally meet you,” I said, reaching for her hand and covering it with my own.

Dr. Esselstyn is an engaging, commanding figure, standing a full six-foot-two with a thick thatch of white hair. He is long, and lean, and authoritative - though warmly so.
I first met Dr. Esselstyn via videoconference from Kaiser Permanente (KP) -Santa Rosa, approximately eighteen months ago. He spoke of heart disease as a “reversible, food-borne illness and a toothless paper-tiger that never need happen.”
At that time, five of my patients had engaged their diabetes and diets such that, we had weaned them from insulin. I knew he spoke truth, evidenced-based truth. I spoke to patients about driving their disease into remission. Dr. Esselstyn spoke of driving disease into submission. That he had come all the way from Cleveland to stand in Dean Ornish country and espouse a plant-based diet was entertaining to me.

Let me give you the back-fill. Back in the early 90’s men like Esselstyn (Cleveland Clinic) and Ornish (Santa Rosa) began studying their patients with the hypothesis that heart disease was a lifestyle disease and thereby reversible. They were quickly labeled “quacks” until their research bore out their hypothesis. Men like Esselstyn and Ornish forever changed our paradigm of heart disease. It wasn’t long before that hypothesis - that many of our diseases (in fact, the top five killers) are brought on by lifestyle - was applied to other disease states. The ones of Essy’s focus include heart disease, it's cousin type-2 diabetes, and erectile dysfunction.
I conversed with Essy last fall at Kaiser’s annual COAST (Cardiovascular and Surgery) Conference. For a full accounting with backfill visit my blog at:

That conversation culminated in an invitation to Cleveland Clinic, to the induction day of his program.  Here’s how it works. Every patient that enters Cleveland Clinic for a heart problem: intervention (angioplasty, stents), surgery (valve repair/ replacement, coronary artery bypass grafting), acute myocardial infarction (heart attack), etc. is offered a complimentary, one-hour consultation with a representative of the Wellness Program. During that consultation they are introduced to the benefits of a plant-based diet and the program of support. For patients who choose participation, Essy holds a monthly workshop to deliver the “why”, while Ann delivers the “how”. It was for this induction day that I journeyed to Cleveland.

Ann is petite, with bright blue eyes, porcelain skin, straight, light hair, and blond brows, all the features - sans height, of them I’ve label “blond and blue from up there.”

“You mean northern Europeans?” My cardiology buddy teased, smiling through ruby lips and rosy cheeks against porcelain skin, his blue eyes laughing beneath light hair.
“Yea, like you,” I pointed, “Blond and blue from up there.” More specifically, blond and blue from up there refers to Scandinavians. Ann fit my picture of an elder Scandinavian beauty. She was trim and spry and full of vigor.

After greeting me Anne announced to the sparsely filled room, “This is Lorin, she came all the way from Sacramento.” I made the rounds, greeting participants. As each couple arrived, they did the same. Participants had come from as nearby as Chicago and as far away as Florida and Arizona. All in all there were nine patients, nine spouses, three health-care providers, and Essy’s team.
The patient demographics of this group included seven men and two women. The women exceeded 60 years of age; the men were under 55, some under 45. All the patients were lean, their spouses - not necessarily so. Every patient had experienced a catastrophic cardiac event that provoked seeking.

I visited with Joe and Nancy from West Palm Beach, Florida. He was long and lean with a cleanly shaven head and olive skin. Joe cycled 200-miles each week. Nancy and I were similar in size.
“Why are you here?” they asked. I told them of my work at Kaiser, of my patients who had weaned themselves from many of their medicines. I told them of my kidney failure and my improved tests and function after switching to a 99% vegetarian diet.

They told me their story. Joe’s bicuspid aortic valve failed – as they are wont to do. Bicuspid aortic valve disease affects only 2% of the population and is more prevalent in males than females. Present at birth, it is thought to be the symptom of an underlying connective tissue disease.
Normally, the aortic valve has three small flaps or leaflets that open and close securely to regulate blood flow, allowing blood to flow from the heart into the aorta and preventing backwash into the heart. (Remember forward-flow from Day-1 Getting There?)
Joe’s aortic valve had only two leaflets and was replaced last year. During the pre-surgical assessment he was found to have mild triple-vessel disease resulting in triple coronary artery bypass grafts. We call it the incidental bypass, not severe enough to crack a chest but since we’re there, chest already cracked… incidental bypass.
Post-operatively Joe and Nancy were perusing Borders bookstore, scanning the shelves, looking for answers.
“Essy’s book literally fell onto the floor in front of us. We picked it up to put it back, looked at the title and thought, maybe we should read this.” In retrospect, they felt the hand of God directed his book in falling to the floor. They contacted Essy through his website and within 24-hours he was on the phone hearing their tale.

Essy’s book, Prevent and Reverse Heart Disease is filled with recipes and reason. Joe and Nancy adopted the program and lost weight: 37 pounds for he, 32 pounds for she. They are lean and feel great – more energy, more stamina, more gusto, more vitality, more aliveness. It’s a good thing you know, being alive while you live.

We were assigned seats; I sat at the back table with Moira, a registered dietician and her mother Debra, a charge nurse for KP-Orthopedics.

Essy shrugged off his white coat, “Let me get out of this costume so we can begin.” He dove into a four-hour power-point presentation including the who: societies with a prevalence of heart disease and diabetes and those without.
The what:  the pathophysiology of endothelial (inner-most layer of blood vessels) disruption, cholesterol crystals, plaque formation, plaque rupture, cardiac ischemia (asphyxiation), pathogenicity (creating sorrow/tragedy) of the western diet, retrospective data/studies (i.e. decreased incidence of heart disease in Norway during WWII when all meat was consumed by the German army and Norwegian citizens were forced into plant-based diets and the subsequent rise of disease once dietary meat was reintroduced.)
The how: mechanisms that promote endothelial healing and disease reversal.

About halfway through, Moira, our in-situ registered dietician raised her hand. “What if you are vegetarian four-days a week and the other three…” her voice trailed off, her point made and question asked.
“Are you going to be a problem?” Essy asked with a wink and a smile. “Moderation kills,” he said. “Animal proteins ignite a state of inflammation in your body and in your endothelium. You restrict animal proteins and inflammation starts to subside, your body starts to heal. After a few days you re-introduce animal proteins and re-ignite the fire.” A picture of firemen pouring gasoline on a house-fire filled the screen at the front of the room.

He confirmed that which I have observed with my own patients: exercise is preferred but not requisite. Even the sedentary can extinguish their smoldering endothelium.

Then he said something that almost got past me. He mentioned autoimmune diseases and improved symptomatology with the introduction of a plant-based diet. He moved on and my brain hiccupped. Did he just say what I think he said? My hand shot into the air.
“Dr. Essy let me ask you to backtrack. You said something about plant-based diets and autoimmune diseases. I’ve heard you speak twice, this is the third time, and I have never heard you say anything like that. Can you say more?”

“Yes. Autoimmune diseases are those in which the body attacks itself. Remember macrophages and lymphocytes, the soldiers of the bloodstream? These soldier-cells misidentify a body protein as,” he raised his hands and pulsed pointer and middle fingers of each in quotation marks, “The enemy and attack. It likely started with eating an animal protein. There is a theory about gut-leak, whereby an unusually large protein molecule leaks from the digestive tract into the bloodstream. Macrophages and lymphocytes identify it as harmful and destroy it. Later, they encounter a similar but normal and useful body protein and attack.”
“In the case of rheumatoid arthritis, that body protein is the synovial fluid of the joints. There was a small but significant study involving patients with MS, multiple sclerosis, who experienced significant reversal of their symptoms once they began a plant-based diet.”
I drew a star in the margin of his syllabus, for future conversations with a few good men. Pictures of stars, keys, and the first letter of names are my recurrent marginalia. I constantly and consistently annotate for future conversations. This held more urgency for me than most.

“In the beginning,” Essy asserted, “They said a plant-based diet wouldn’t work. But there is good, hard science behind it now, this is evidenced-based medicine. Now they say, patients won’t do it. We haven’t found that to be true. There are many patients interested in disease reversal.”

We broke for lunch. I stood in line with a pasty and pockmarked, obese and elderly man in coveralls and flannel.
“My wife had a heart attack,” he said, “They put in some stents. But I don’t have any heart disease in my family,” he justified, “So I think I’m okay.”
Really? I wondered if his heart-healthy predecessors had sported an extra fifty pounds. “Based on the lecture this morning, I’d say if we are eating typical American fare, we are all in trouble.”
“Well, that might be true,” he acquiesced.
Denial is a powerful, albeit temporary, survival tool.

Our plant-based luncheon buffet was a delicious combination of: kale/humus/cilantro wraps, carrot/ginger soup, lentil chili, water chestnut/onion/cilantro/tofu pot-stickers, and decaf ice tea.

During the afternoon Ann taught shopping and food preparation: how to de-spine and use kale, reliable brands at Whole Foods, eating and travel, reading food labels, useful websites. I found her presentation extremely helpful because while many of us can agree with “the why”, “the how” stops us. There is little convenience in a plant-based diet.

Their son Rip is the national spokesman for Whole Foods. Ann held a copy of his book high for all to see, The Engine 2 Diet: The Texas Firefighter's 28-Day Save-Your-Life Plan that Lowers Cholesterol and Burns Away the Pounds. On the cover, Rip squatted in fireman fatigues. He was svelte and sported the familial thick thatch of white hair. Ann beamed, “He’s an awesome man; we’re proud of our son.”

“Let me wrap it up by saying this,” Essy said, “I’m 76 years old. I have no disease. I’m on no medication. I’ve been eating this way for 27 years. I hope to keep on going until one day I get pneumonia and die. But I don’t expect I’ll suffer with chronic disease. My wife and son are similarly healthy. As I said, much of chronic disease is a toothless paper-tiger that need not happen.”
A lengthy question and answer period ensued. We discussed heredity and children – some had very young children.
“Genes load the gun,” Essy said, “Lifestyle pulls the trigger.”
Lifestyle pulls the trigger...

Class ended all too soon. Our induction-day was over. Patients made arrangements for routine follow-up via email and forwarding lab results to Essy. He and Ann would be available via phone and email to offer dietary support and advice.
He signed books. People requested photos.
“Let me put my costume on.” Essy lifted his white coat and shrugged it into place. I waited until the paying public had their fill.

“Well young lady,” he turned his luminous smile on me, enveloping me in warmth and tenderness, “Was it worth the trip?”
“Absolutely! Thank you for the invitation.” I hugged them both.
“I will be speaking at the University of California Davis on June 22nd,” He said. “Let me check with my hosts but I’d like you to bring as many Kaiser people as you want.”
My mind whirred with the possibility.

I returned to the grotto in the lobby to reflect and plan my afternoon. The Rock and Roll Hall of Fame is in Cleveland and the late afternoon and evening were available for exploration. I sat in the sunlit cafeteria jotting notes into my tablet. I stared through the glass; the pond glimmered with afternoon sun, inviting me outdoors. I had to be honest with myself; I have little appetite for exploring a strange city alone.
I am a denizen of the suburbs, uneasy in cities, and more so in unfamiliar cities. In them I feel small and vulnerable and anxious. I would rather be alone in the wilderness with wild mountain goats than alone in a city. I would not venture into Cleveland city proper to seek out the Hall of Fame.

I stepped outside (my Heaven) and balancing stone to stone, circled the pond. I ducked beneath a branch where a single, curled, dried, brown leaf clung like a chrysalis, trembling in the light, warm breeze. At the tip of every twig, a tightly bound bundle of green was ready to explode.
While the rest of Cleveland wrestled with winter’s grip, the Eden-esque lands round the Wellness Center were well-groomed, well-nourished, and well-on-their-way to spring. Tall stands of stately trees, long and gracefully bent were bursting to bud. The grounds had the faintest patina, the promise of resurrection and life anew.
I shouldered my backpack and began walking.

You can visit Essy’s website at:
See Essy on utube with Wolf Blitzer, President Clinton, and Dr. Dean Ornish in the Situation Room at: