Lesson from Dr. Mcdougall

When Dr. John McDougall finished his formal medical education, he set up a practice on the Hawaiian island of Oahu. He began writing books about nutrition and health and established a national reputation. In the mid-1980s John was contacted by St. Helena Hospital in Napa Valle, California, and asked if he would accept a position running its health center. The hospital was a Seventh-day Adventist Hospital; the Seventh-day Adventists encourage followers to eat a vegetarian diet ( even though they consume higher-than-average amounts of dairy products). It was an opportunity too good to pass up, and John left Hawaii and headed for California.

John had a good home at St. Helena for a number of years. He taught nutrition and used nutrition to treat sick patients, which he did with fantastic success. He treated over 2,000 very sick patients, and over the course of sixteen years, he has never been sued or even had a letter of complaint. Perhaps more importantly, John saw these patients get well. Throughout this time, he continued his publishing activity maintaining a national reputation. But as time passed, he realized that things weren’t quite the same as when first arrived. His discontent was growing. Of those later years he says “I just didn’t think I was going anyplace. The program had 150 or 170 people a year and that was it. Never grew. Wasn’t getting any support from the hospital and we had gone through a lot of administrators.”

He had small clashes with the other doctors at the hospital. At one point, the heart department objected to what John was doing with heart patients. John told them, “I’ll tell you what, I’ll send every one of my heart patients to you for a second opinion if you’ll send yours to me.”  It was quite an offer, but they didn’t accept it. On another occasion John had referred a patient to a cardiologist and the cardiologist incorrectly told the patient that he needed to have bypass surgery. After a couple of these incidents, John had reached the limit of his patience. Finally, after the cardiologist recommended surgery for another one of John’s patients, John called him and said, “I want to talk with you and the patient about this. I would like to discuss the scientific literature that causes you to make this recommendation.” The cardiologist said that he wouldn’t do that, to which John responded, Why not?  You just recommended that this guy have his heart opened! And you’re going to charge him 50,000 or 100,000 bucks for it. Why don’t we discuss it? Don’t you think that is fair to the patient?” The cardiologist declined, saying tha it would just confuse the patient.” That was the last time he recommended heart surgery for one of John’s patients.

Meanwhile, none of the other physicians in the hospital had ever referred a patient to John. Not once. Other physicians would send their own wives and children to see him but they would never refer a patient. The reason, according to John:

They were worried [about what would happen when] their patients would come to see me, and it happened all the time when patients would come on their own. They’d come to me with heart disease or high blood pressure or diabetes. I’d put them on the diet and they’d go back off all their pills and soon their numbers would be normal. They’s go to their doctor and say, “Why the hell didn’t you tell me about this before? Why did you let me suffer, spend all this money, almost die, when all I had to do was eat oatmeal?” The doctors didn’t want to hear this.

There were other moments of friction between John and the hospital, but the last straw involved the Dr. Roy Swank multiple sclerosis program mentioned in chapter nine.

John had contacted Dr. Swank when he learned that Swank was about to retire. John had known and respected Dr. Roy Swank for a long time, and he offered to take over the Swant multiple sclerosis program and merge it with his health clinic at St. Helena Hospital, preserving it in honor of Dr. Swank. Dr. Swank agreed, much to John’s excitement. As John said, there were four reasons that this would be a perfect fit for St. Helena’s:

  • It fit in with the philosophy of the Adventists: dietary treatment of disease
  • They would be helping people who desperately needed their help
  • It would double their patient census, helping to grow the program
  • It would cost almost nothing

In thinking back on it, John said, “Could you think of any reason not to do this? It [was] obvious! So he took the proposal to the head of his department. After listening, she said that she didn’t think the hospital wanted to do this. She said, “ Well, I don’t think we really want to introduce any new programs right now.” John, dumbfounded asked her, “Please tell me why. What does it mean to be a hospital? Why are we here? I thought we were here to take care of sick people.”

Her response was a doozy: “ Well, you know we are, but you know, MS patients are not really desirable patients. You told me yourself that most neurologists don’t like to take care of MS patients.” John could not believe what he had just heard. In a very tense moment, he said:

Wait a minute. I’m a doctor. This is a hospital. As far as I know our job is to relieve the suffering of the sick. These are sick people. Just because other doctors can’t help them in their suffering doesn’t mean that we can’t. here’s the evidence that says we can. I have an effective treatment for people who need my care and this is a hospital. Will you explain to me why we don’t want to take care of those kinds of patients?

He continued:

I want to talk to thee head of the hospital. I want to explain to her why I need this program and why the  hospital needs this program and why the patients need this program. I want you to get me an appointment.

Ultimately, though, the head of the hospital proved to be just as difficult. John reflected on the situation with his wife. He was supposed to renew his contract with the hospital in a couple of weeks, and he decided not to do it. He left on cordial terms, and to this day he does not hold personal grudges. He just explains it by saying that their directions in life were different. John would prefer to remember St. Helena for what it was: a good home to him for sixteen years, but a place nonetheless that was “just into that whole drug money thing.”

Now John runs a highly successful “lifestyle medicine” program with his family’s help, writes a popular newsletter that he makes freely available, organizes group trips with past patients and new friends and has more time to go windsurfing when the wind picks up on Bodega Bay. This is a man with a wealth of knowledge and qualifications, who could benefit the health of millions of Americans. He has never challenged by any of his colleagues for physician “misbehavior,” and yet the medical establishment does not want his services. He is reminded of this fact all the time:

Patients will come in with rheumatoid arthritis. They’ll be in wheelchairs, they can’t even turn the key on their car. And I’ll take care of them and three or four weeks later, they’ll go back to see their doctor. They’ll walk up to their doctor, grab their hand and shake it hard, Doctor will say “wonderful”. The patient all excited, will say, “Well, I want to tell you what I did. I went to see this Dr. McDougall, I changed my diet and now my arthritis is gone.” Their doctor simply responds, “Oh my goodness. That’s great. Whatever you are doing, just keep doing it. I’ll see you later.” That’s always the response. It’s not, “Please, my god, tell me what you did so I can tell the next patient.” It’s, “Whatever you’re doing that’s just great.” If the patient starts to tell them they changed to a vegetarian diet, the doctor will cut in with, “Yeah okay, fine, you’re really a strong person. Thanks a lot. See you later.” Get them out of the office as quickly as they can. It’s very threatening…. Very threatening.   

- from the book "The China Study", p 335-338

The China Study: The Most Comprehensive Study of Nutrition Ever Conducted And the Startling Implications for Diet, Weight Loss, And Long-term Health by T. Colin Campbell, Thomas M. Campbell II, Howard Lyman and John Robbins

"[These] findings from the most comprehensive large study ever undertaken of the relationship between diet and the risk of developing disease are challenging much of American dietary dogma."  —The New York Times