SEVEN CANARIES

Following are seven true-to-life case studies, each illustrating one or more essential issues in the diagnosis and management of chronic fatigue states. Six of these are my patients, but names have been changed for obvious reasons. The seventh case history is that of an engineer whose story was published in the Wall Street Journal.

These case histories demonstrate that these individuals were set up for later events — they were carrying biological burdens in the form of allergies, chemical sensitivities, viral and bacterial infections, sugar and adrenaline roller coasters, battered bowel ecology states, and toxic metal overloads. One other factor distinguishes them from others: These persons developed chronic fatigue in circumstances in which others would not have. They are human canaries. What turned them into canaries? I address this issue at length in the chapters: Pasteur's Sheep and My Canaries, What Is Chronic Fatigue? and Where Does It All Begin?

LITTLE JOE: THE FIRST CANARY

Little Joe's mom consulted me because he was "always tired." Little Joe had been a colicky baby and had "bad diaper rash all the time." His mother didn't know he was allergic. He frequently suffered from sore throats and ear infections, and required antibiotic therapy to control such infections. Little Joe finally had tubes put into his ears. The tubes reduced the frequency of ear infections but didn't save him from yet more courses of antibiotics. When he was just an infant, his mother had asked his pediatrician if he needed allergy tests. The pediatrician told her he was too young for allergy tests. When Choua heard about this, he chuckled, "Too young for allergy tests but not too young for antibiotics." I asked Little Joe's mother if she had sometimes noticed mood swings or if he had ever thrown temper tantrums after eating ice cream and candy. The answer was a resounding "yes."

ZENA: THE SECOND CANARY

Zena was, as Victor Hugo would say, in the youth of her old age. Fiftysomething, she lived a quiet and contented life with her husband, except when her daughter visited with her two grandsons, which didn't happen too often. There hadn't been any surprises at the office for years. The people at work, it seemed to her, had changed even less than the red bricks on the front wall of the company building. Democrats hadn't begun to like Clinton yet. Nobody liked Bush. Perot still hadn't pulled out, and Quayle was still into Murphy Brown. Then everything changed.

Zena suffered a cold. Her doctor prescribed antibiotics. Days went by but her cold symptoms didn't clear up. Antibiotics followed more and different antibiotics, and CAT scans followed chest X-rays. Her dry hacking cough persisted, and she felt very tired. Then she switched doctors. She had several blood tests done and yet more antibiotics were prescribed. The Lyme disease test was negative but one for Epstein-Barr virus turned out to be weakly positive. She became progressively lethargic and irritable, developed muscle and joint aches, and grew anxious and depressed. Days turned into weeks. She suffered from recurrent episodes of lightheadedness and numbness in her limbs. Her husband noticed she didn't remember things that had happened just hours before. She consulted still more doctors who suspected chronic fatigue syndrome but thought she needed to see a psychiatrist before they could give her gamma globulin shots and Zovirax for the viral infection. It didn't really surprise Zena. She herself had begun to wonder if the whole thing were all in her head. Zena wondered if she would ever get better or if this was to be the story of her golden years.

FATHER THOMAS: THE THIRD CANARY

Father Thomas looked his part. He was tall, broad-shouldered and soft-spoken. Listening came to him naturally and effortlessly, virtues that resulted from years of long professional training. I got the sense he wanted me to succeed, not because he consulted me for relief of his chronic fatigue, but because he felt I deserved to succeed. His fatigue, he confided, was not really disabling. It was just that he was tired all the time and knew that was not right. Sometimes he wondered if he was harboring a killer cancer somewhere in his body that was silently eating at his innards, causing fatigue.

LUCIA: THE FOURTH CANARY

During her initial consultation with me, Lucia, a 39-year-old housewife, smiled and said,

"Dr. Ali, I'm afraid my husband might divorce me if I don't get my energy level up and don't lose some weight. God knows I have tried, but I haven't succeeded."

Patients often make such comments with smiles that do little to hide serious inner concerns. I returned her smile.

Lucia looked like a strong woman, and her interest in body sculpting work showed in her bearing. She did not recall any specific illness that was followed by problems of impaired general health. Rather, she had slowly lost her energy level over several months. This change in energy level was associated with a host of other symptoms that seemed to follow one after another, including muscle aches, undue sensitivity to cold, abdominal bloating and cramps, severe PMS, headache, mood swings, short-term memory loss and depression. She knew she was allergic but her allergies had never been diagnosed and never managed.

BRUCE: THE FIFTH CANARY

Bruce, a young man in his forties, walked in for a consultation carrying a thick bundle of previous medical records. His shirt was obviously too large for him, and it was equally obvious that he had lost a lot of weight. He looked exhausted as many chronic fatiguers do. His skin was dry and his eyelids swollen. He sat down on the chair and looked at me with deeply doubtful eyes as I studied his history questionnaire.

During the visit, he pulled out from his thick pile of papers a typed summary of his symptoms that I reproduce on the following pages.

* Birth to three years

Received prolonged antibiotics at age 6 months for pneumonia More antibiotics for pneumonia at age 2

* 3-6 years

Physically very active More antibiotics for recurrent tonsillitis followed by tonsillectomy Extended antibiotic therapy for rheumatic fever

* 6-12 years

Physically very active More antibiotics during dental work Multiple mercury fillings

* 13-21 years

Still physically active but with diminishing energy Weighed 130 pounds at age 21 More antibiotics for acne and for dental work Started some herbs for health

* 22-23 years

Physically inactive Weight 142 Antibiotics continued for dental work

* 24-29 years

Very busy with work as financial analyst Physically active, running 20-45 miles per week Antibiotics continued for dental work

* 30-35 years

Knee surgery at 30 that followed forced running Nasal polyp surgery at 31 Physically inactive, weight steadily rising to 152 pounds Began losing weight and energy at 35 years Developed food intolerance and chemical sensitivities Started elimination/rotation diet and homeopathic remedies. Symptoms progressively worsened despite therapy

* 35-37 years

Took nystatin continuously, "Life became tolerable, by far the best I felt in years, but four months after stopping nystatin, chemical sensitivity became so strong I had to stop working. Was easy to identify problem substances. Occasional good days, but produced lots of lifestyle constraints."

* 37-41 years

Physically inactive, progressive weight loss (from 152 to 117) Digestive aids helped. Internal cleansing: No matter what, the same pattern occurred: A brief period of improvement, a slow, steady increase in symptom severity that continued until the method was stopped.

* Long-term symptoms

Occasional age 14-19 Frequent age 20-29 Constant age 30 to present

* Digestive and other problems

Excessive gas Always hungry Always underweight Bloated Food intolerance Leaky gut Cold hands and feet Sensitive to heat/cold/weather Hair loss Poor posture Depression Hyperactive Apprehensiveness/anxiety/shoulder and chest pain Mood swings Difficulty staying focused Sensory perception problems (primarily vision, smell) Physical balance problems Time/space perception problems Coordination, motor skill problems Chemical sensitivity Heavy metal toxicity Fatigue Hypoglycemia Pancreas/liver stressed Degree of problems varies with the degree of food/chemical exposure

I'M AFRAID OF HOPE

"I'm afraid of hope." Bruce spoke those words during his initial consultation with me. The words have stuck in my mind ever since. He was very eager for me to study his whole case — as most chronic fatiguers are, months and sometimes after years of hope roller coasters. Hope, I found out early in my work with chronic fatiguers, is easy to create. It requires much patience and long hours of work to sustain. I know of many sad stories of chronic fatiguers — people whose hopes were raised by the promise of seeing some great fatigue researcher at some great out-of-state fatigue center. Those hopes came crashing down when — after spending thousands of dollars on sophisticated tests — they were rewarded with a prescription for some antidepressant.

The subject of hope creates a dilemma for me in my clinical work. Hope is essential for healing. Yet, hope that does not bring relief is devastating. Then there are those frivolous people around who sit in judgment of the work of holistic physicians and who equate hope with deception, duping, and outright fraud. And finally, there are malpractice attorneys who blatantly advise you against holding out hope for anyone. Hope, they counsel you, is the fuel for malpractice actions.

I told Bruce that I couldn't work without hope. Hope is what sustains my patients — sometimes for those interminable months when relief from symptoms escapes them. Hope is what sustains me — sometimes during months of strong doubt and a punishing sense of personal inadequacy. And — I told Bruce not knowing how he would take it — I truly do not know where true hope ends and false hope begins. Indeed, I do not know if hope is ever truly false. Some attorneys know better. Editors of our prestigious medical journals know better. Some folks who sit on state licensing boards know better. But I don't. Next, I told Bruce that if he wanted me to work with him, we were going to begin with hope. And that it was okay with me that he was afraid of hope.

JOHN: THE SIXTH CANARY

John was a financial analyst before he became a full-time chronic fatiguer. That happened four years before I first saw him in the conference room, slumped in a chair during a workshop. I was speaking about how some liver enzymes detoxify environmental pollutants in the body. "Speak for yourself," he muttered to himself, but loud enough to be heard by others. When I turned my head to see where the words might have come from, John became flustered. John, I learned later, knows more about chronic fatigue than most people, including most physicians I know. He told me to speak for myself because he knew his detoxification enzymes were not working, and that was his main problem.

Unfortunately for John, long before he educated himself intensively about the impact of his environment upon his genetic makeup, he had been prescribed extensive broad- spectrum antibiotics for recurrent infections and other drugs for symptom suppression during his childhood and teen years, and then again during the early years of chronic fatigue. John developed severe, unrelenting fatigue, muscle aches, and a diffuse, dry, red rash all over his body that sometimes cracked and oozed. He rapidly developed multiple food allergies and chemical sensitivities, lost weight and became emaciated. By the time he learned the true nature of his suffering, he was seriously ill most of the time in spite of the care given him by some knowledgeable holistic New York physicians.

THOMAS LATIMER: THE SEVENTH CANARY

Mr. Latimer is not my patient. I choose his story as told by the Wall Street Journal to illustrate some other aspects of the chronic fatigue pandemic.

Thomas Latimer used to be a vigorous, athletic man, a successful petroleum engineer with a bright future. Then he mowed his lawn. On a summer Saturday in 1985, Mr. Latimer spent an hour or so cutting the grass, picking up the clippings and edging the walkway around his modest two-bedroom home. Soon, something was

terribly wrong. He felt dizzy and nauseated. His nose was running, and his chest was tight. He had a pounding headache. Ten days later, he was still sick.

The Wall Street Journal October 14, 1991.

This is not an unusual beginning of what, sadly and only too frequently, turns out to be a horror story. The essential clues in such stories stare physicians in their faces but are seldom heeded.

The man in the Wall Street Journal story was "a vigorous, athletic man" who was in perfect health and then became suddenly ill after mowing his lawn. Dizziness, nausea, headache, tightness in the chest and runny nose are symptoms that cry out for recognition as a severe systemic reaction to an environmental poison. Was it recognized? The Journal continues:

Now six years and 20 doctors later —after liver biopsies, spinal-fluid taps, CAT scans, radioactive brain flow studies, sleep studies and many other tests — Mr. L, 36, accepts the diagnosis of doctors: that he was poisoned by an organophosphate pesticide used to treat his yard.

Why did it take 20 doctors six years to diagnose pesticide poisoning? Because this type of illness does not fit into our blessed double-blind, cross-over model of disease classification in the prevailing drug medicine. It is far more convenient for us physicians to deny such illness. The Journal continues:

A toxicologist, three neurologists and two neuro-ophthalmologists who examined him all concluded independently that the Tagamet suppressed the normal role of his liver in metabolizing the poison and expelling it.

How did these specialists arrive at that conclusion? I wondered about this question. After all, that is the precise reason why physicians who practice environmental medicine have been crucified for some decades. What has been the sin of practitioners of environmental medicine? They searched for the cause of illness in their patients in environmental pollutants? When a clinical ecologist suspects that formaldehyde exposure causes headache, or trichloroethylene (dry cleaning solution) causes skin bruising, the drug doctors jump at him and threaten his license because he is not "scientific" enough. When three neurologists and two neuro-ophthalmologists conclude that Tagamet suppressed the normal role of his liver, no one asks how did they support their conclusion? Did they study the cytochrome P-450 enzyme levels in the liver cells in Mr. Latimer? They didn't. Even if they had, how could they prove that liver enzymes were injured several years previously on that fateful day when he mowed his lawn? How can anyone conclude something like that after years of exposure.

The real answer is that practitioners of environmental medicine make clinical judgments based on repeated patterns of symptomatology that follow exposure to environmental agents. Then they exclude those pollutants and manage other related burdens on detoxification enzymes and clinically observe the outcome. This is as good a science as any other in medicine.

The canary in Mr. Latimer carries some important message:

First,

seemingly innocent drugs such as Tagamet used for stomach ulcers by millions of people can slowly but relentlessly injure energy and detoxification enzymes and lead to serious chemical consequences.

Second,

drug therapies administered to "treat" such illnesses only compound the problem — they turn easily manageable clinical problems into irreversible immune disorders.

Third,

the practitioners of drug medicine can accept the precepts of clinical ecology only after prolonged drug therapies have inflicted substantial additional damage.

Fourth,

in environmental medicine, we see cases such as that of Mr. Latimer almost every week — most of them recover relatively early with nondrug therapies. When the drug doctors are stuck with such cases, they become media events. What surprised me was not that an organophosphate in pesticide had poisoned an engineer, but that the Wall Street Journal was so impressed by the case history that it put the story on the front page.

GENES AND CANARIES

Little Joe, Zena, Father Thomas, Lucia, Bruce, John and Mr. Latimer are human canaries. Their genes set them up for chronic fatigue states — to render them vulnerable to life in a highly polluted and toxic environment. They become chemically-sensitive and tolerate our miracle drugs poorly. They benefit little from our Star Wars medicine.

"DNA legislates life, Environment interprets the laws,"

Choua once told me. " You physicians seem to understand that in theory," he continued, "but in clinical practice, it is a different matter. You ignore both essentials. Drugs and knives are the tools of your trade, and there are no drugs nor surgical procedures to cope with either. Chronic fatiguers suffer needlessly because environmental and nutritional medicine have been declared quackery by the high priests of Star Wars medicine. The champions of N2D2 medicine believe such therapies are treating diseases that really do not exist. Their injured enzymes are ignored because Star Wars medicine has no drugs that can undamage’ the damaged energy enzymes — unoxidize’ the oxidized and denatured enzymes. Women and men who bow at the altar of the gods of the double-blind, cross-over and scientific vigor have pronounced that all methods of treatment except those that use drugs and scalpels are unproven and unconventional. I have no trouble with the unconventional part, but unproven is simply not true. They are proven for those who use them every day and see their clinical benefits, clearly and unequivocally." "Choua, you have a one track mind. You can't help yourself. Everything has to end with an indictment of the medical profession," I complained. "In the old days, miners carried canaries deep into their mine shafts," Choua continued darkly, "so the birds could warn them of poisonous gases. The canaries died, but the men lived. Chronic fatiguers are the canaries that tell us something about the shape of things to come. Are the high priests of your Star Wars medicine listening? Do they see the havoc our technology has wrought upon our environment? Do they see the chemical avalanches we have unleashed upon our planet Earth? Do they recognize the impact upon human and animal biology of environmental pollutants? Do they understand what polluted air, contaminated water and toxic foods do to living things? Do they realize how the delicate gut ecology of babies is destroyed with indiscriminate use of antibiotics?" "Choua, it's changing. Even the New York Times knows antioxidants are good for preventive medicine." I tried to ameliorate the situation. "Yes, the Times has finally learned that! But do you think those men of scientific vigor on the editorial boards of medical journals know that?"

Choua now referred to an editorial I had written for the Life Spanner in which I commented on two studies published by the New England Journal of Medicine. These two large multimillion dollar studies clearly showed the protective value of vitamin E against coronary heart disease. Yet, the Journal concluded both articles with the recommendation that the use of vitamin E beyond the RDA value of 30 units should await further studies. This was a stunning conclusion for practitioners of nutritional medicine, who have safely used 400 to 800 units of this vitamin for years. I said so in my editorial.

"All you think of is drugs," Choua resumed. "Drugs for chemical sensitivity, drugs for immune disorders, drugs for degenerative diseases, and, of course, drugs for chronic fatigue." "It's changing," I said lamely. "Changing? Changing, my foot! You have some sense of humor. Don't you? They are revoking Levin's license and you think things are changing. What are the awful things Levin did that he deserves to lose his license and livelihood? He prescribed vitamins! That's the punishable offense! Isn't it?" "Levin hasn't lost his license yet. With luck, the Board of Regents will see the truth and will rule in his favor," I said hopefully. "Luck! Aha! Waiting for luck. Waiting for Godot!"

MOST PEOPLE WHO SUFFER FROM CHRONIC FATIGUE DO GET BETTER

Little Joe was doing well at my last visit with him two years later. Micro-elisa blood allergy tests for mold and pollen allergy and electrodermal conductance tests for food incompatibilities revealed allergy and incompatibility to numerous agents. It usually takes children a while to see the relationship between what they eat and how they feel. Joe was no exception. Initially, he resented changes in his diet and bitterly fought with his parents. In a few months, he gradually relented and accepted new foods. Sugar was finally and completely eliminated. Once, when he felt very well, Halloween's arrival made him very sick. That did it. He began to link the way he ate and the way he felt. He has not required antibiotics in several months now. His parents have been satisfied with the clinical results. This turned out to be a simple case of accelerated oxidative injury caused by sugar roller coasters and food allergy. The case management was simple, outcome satisfactory.

Zena made dramatic initial improvement. Her fatigue cleared up almost completely with intravenous (IV) nutrient therapy, oral vitamin and mineral therapy, allergy immunotherapy injections and stress control. "It's hard to believe this problem could have been solved so quickly and without any drugs," she told me after a few weeks. Relapses of fatigue after initial recovery are not uncommon. Indeed this happened to Zena. She returned for some more IV therapy. Her fatigue cleared again and didn't return. This was a case of accelerated oxidative molecular injury triggered by a viral infection and compounded by multiple courses of antibiotics, stress and fear of an unknown, disabling disease.

Father Thomas proved to be allergic to multiple molds and pollen with the micro- elisa blood test and had multiple food incompatibilities. With allergy treatment, some nutrient therapies, food rotation and some autoregulation, his fatigue cleared up within several weeks. I didn't think he needed IV therapy. I saw him recently about three years after the first visit. Now his energy level is high. He continues his nutrient therapy and now takes an immunotherapy injection once every four weeks. Again, this case turned out to be a simple case of chronic fatigue caused by allergy and functional nutrient inadequacies that was successfully reversed with simple nondrug therapies.

Lucia got her energy back, but with some ups and downs. Initially, she responded only minimally to my initial nutritional, environmental and self-regulatory protocols (immunotherapy for IgE-mediated allergy always takes weeks to months to produce clinical result). My advice not to undertake any strenuous body sculpting work went unheeded. I then decided to administer intravenous nutrient protocols. She responded rather dramatically to four infusions. Then I didn't see her for about six months. She returned with the following story:

"I was well for several weeks after I stopped your therapies. Then slowly — just as I had before I saw you — fatigue returned along with all the other symptoms. My husband became very frustrated. He took me to this specialist at a New York university hospital who ordered a bunch of tests for which we paid over $1,300. His professional fee came to $560. Then he told us that I needed to see a psychiatrist. I was so mad at my husband. I wanted to come here because I got better here the first time, but he insisted I must see a New York City specialist."

I reviewed the records again and decided to follow exactly the same management program that had worked so well the first time. As she was leaving my office, she turned back and spoke,

"Dr. Ali, if your fatigue book is not finished yet, please write about me. Maybe it will save other patients a lot of aggravation and a lot of money. When you suffer from chronic fatigue, and many other problems, it really hurts when a doctor tells you to consult a psychiatrist."

Bruce's progress notes in his own clinical chart written after I started my environmental, nutritional, self-regulatory and fitness protocols include the following:

Seven weeks later

Very concerned about continuing weight loss. Mild improvement in food choices based on food sensitivity profile. Fresh vegetable juices okay. Squashes give a clear mind — then it crashes. Soreness in ileocecal region. Primer I, II and III intravenous infusions prescribed. (In the chapter Intravenous Nutrient Therapies for Chronic Fatigue States, I give my reasons why I defer such therapies for some time after the initial consultation.)

14 weeks later

First IV (Primer I intravenous Protocol) brought relief for two to three days. Primer II and III brought relief for four to seven days. "IVs really good results if there is no exposure". Overall improvement 2+ (scale 0 to 4+); Fatigue 1.5+ (scale 0 to 4+)

19 weeks later

IV therapy with autoregulation much more helpful than without it. Now, with permission of the other patient receiving IV therapy in my room, I turn down the lights and we do autoreg. My initial reactions to IV have almost disappeared. I feel I am stepping into a transition. Overall improvement score 2+; fatigue score 2+.

27 weeks later

"Dr. Ali, I can't believe it happened. I drove my car for five hours at a stretch. And that's some thing for me. I have been so sensitive to car exhaust I couldn't drive for more than half an hour at a time." I told him not to test his limits that way that soon, but he seemed too elated with his achievement to pay attention to what I tried to impress on him.

John and I came to know each other well. When I first met him several years ago, I had no plans for writing this book. He was among the first people who felt my work had relevance for a much larger audience than I could possibly manage myself. "Doc, you are the most underutilized resource there is in preventive medicine. And I have been around," he told me once.

John is highly allergic. We achieved only minimal success with allergy immunotherapy injections. Those were the days that I was just beginning my research with intravenous nutrient protocols. One day he dragged himself to the office. He looked very pale and sick, and was obviously in a lot of pain. He had been mugged a few days earlier, he told me. Some of the wounds got infected. Then he developed multiple abscesses under the skin of his legs and abdomen. He wanted me to treat those abscesses with IV nutrient therapy. I thought he was frightened, in pain and irrational. It is one thing to try to manage severe viral infection with intravenous nutrient infusions and altogether different to try to cope with multiple bacterial infections with such therapy. Antibiotics, it is well-known, do not work against viruses. Antiviral drugs such as AZT for AIDS are too toxic to be lightly used for nonlethal viral infections. It is different with bacterial infections that can almost always be controlled with appropriate antibiotic therapies. I told John I could not agree with his request.

"Doc, you don't know my body. Antibiotics will kill me. Please do an IV for me, will you?" John pleaded.

I repeated my detailed explanation all over again. Then I said, "John, I do not have as much freedom as you might think I have. There are such things as malpractice insurance carriers and state licensing boards." "Give me more credit than that, Doc. I will sign a consent form that you are giving me this therapy purely on a compassionate basis. I will sign papers that you advised antibiotic therapy but that I refused, and that you do not really think that IV therapy can do anything for such large abscesses."

There was no problem with John's thinking, I realized. He had thought the whole thing through — the compassionate use of IV and the consent and release letter. I wondered whether the insurance carriers and folks who sit on the state licensing boards ever learn about such matters.

I relented, and John received his first Infection Control Protocol IV that evening and a second one two days later. There was no sign of abscesses when I saw him a week later. Perhaps he would have healed his abscesses anyway without my IV nutrient protocol. After all, human beings used to heal abscesses before Fleming discovered penicillin.

John was trapped in some drawn-out family legal matters. Neither he nor his sick mother was up to that demanding task. I didn't see him for several months. He returned one day and asked if I could certify his illness. He could not get disability benefits, largely because the disability folks could not understand why he had not applied for such benefits some years earlier. I asked him why he hadn't. "Doc, because I kept thinking it was just a matter of some weeks before I'd get better and resume my work in finance. It never occurred to me that after all these years, my intentions to get back to my work would keep me from getting disability. Ironic, isn't it?" John spoke with a sad smile.

Now I see John occasionally when he totally collapses and requires some urgent medical attention. He suffers from severe and persistent skin rashes, for which he uses sauna therapy. Sometimes I see him when he wants me to write a medical note so that the folks at his sauna do not keep him out because of his skin rash. Sauna is a therapy without which John cannot catch the three to four hours of sleep he does manage to get. John's suffering continues — a victim of his genes, of his environment, of unrelenting fatigue, of universal reactivity, of ever-present muscle pains, of total body skin scaling, oozing and itching and of recurrent abdominal cramps.

"Now I am frightened the way I have never been frightened before. Doc, I can't think now. Now I don't know where this thing is leading me. Where am I going? Doc, do you know?" he asked me the last time I saw him several months ago.

John, above all, is a victim of Star Wars medicine that excels only when people are near death, and it has little to offer in preventing environmental diseases. The irony is that our Star Wars medicine has nothing to offer to people like John even when they stare into the face of death.

Could John's unending miseries have been prevented? I have often marveled at the astounding feats of Star Wars medicine when it deals with people in near-death situations. I have also wondered how utterly ineffective this medicine is in helping people as they begin to get ill. Could John's untold suffering have been prevented? Probably — if his genetic handicap had been managed optimally and if his environmental burdens had been alleviated — at least in part, and if he had been nutritionally supported well. Instead, what N2D2 medicine offered was more and more powerful (and toxic) antibiotics, and other drugs. Whatever damage N2D2 medicine spared him if any, the politics of disability medicine completed it. John continues to suffer.

Mr. Latimer can no longer ride a bike, the Wall Street Journal story continued. He has difficulty walking. At night, to combat seizures and nightmares, he takes an anti- epileptic medication. Until recently, he could sleep for only about an hour at a time. The Journal continues,

The makers of the pesticide Diazinon, and of Tagamet firmly deny that their products had anything to do with Mr. Latimer's condition. ... . When they (Mr. Latimer and his wife) discovered Mr. Latimer's cancer, they accelerated their plans for starting a family, even creating their own sperm bank.

(parenthesis added)

Could Mr. Latimer's prolonged enzyme damage have been prevented? My answer: The overwhelming probability is that it could have been if he had been managed properly with holistic nondrug therapies. I do not make this statement lightly. It is based on considerable personal experience with such environmentally-induced illnesses. I have had the opportunity of caring for many patients who became suddenly ill after a major chemical exposure. I managed all such cases with intravenous nutrient infusions and carefully looked into all the factors that render persons like Mr. Latimer so vulnerable to chemical exposures, including a focus on stress reduction with effective self-regulatory methods. None of these patients followed the same course as Mr. Latimer. His was the common tragedy of environmental illness that is either denied completely — the old all-in- the-head story — or worse, treated with multiple drug therapies that further damage the patient's energy and detoxification enzymes.

I end this chapter with a letter I received from one of my patients.

"I am encouraged and hopeful beyond words. The paths that once seemed closed now are wide open and beckoning to me. I am coming! The sun is brighter, the music more beautiful, the flowers sweeter — all this because I feel my health returning to me. A gift and a miracle I only imagined a year or more ago. Something I prayed for, cried over, pined for, is at last palpable and real to me. The smallest task accomplished, the most momentary burst of energy — however brief — the unspeakable feeling when I can sing a song — a whole recital — with focus and strength; all these things and many more sit upon me like gold and linger in dark moments. Each day is a new opportunity, a new adventure and a new chance for fulfillment. I am glad, proud, thrilled to be here to experience this growth and transformation.

The slow, often painful movement from sickness to health is full of challenge and is ultimately more profound, more resonant and more satisfying than any other

I've experienced. I am witness to the undeniable fact that God lives in me — in my body — and he is working with me all the time and guiding me towards that perfection which is my birthright.

I let go of the belief in limitation and restriction and instead embrace the faith in the boundless possibility that resides, undaunted, within the human spirit.

Amen!!

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Dear Dr. Ali,
This is the little piece I wrote for our newsletter here at work. (I mailed it to you weeks ago, but apparently it was lost in transit.) I was feeling particularly well that day and felt the urge to express it...

I continue to improve all the time, and I am very grateful for it. Thank you for all your work for the sick.

Your patient, LN