Prose Poetry from a Doctoring Life

by Lawrence Power, M.D.

 

Self-cleaning Arteries Posted on by Lawrence Power

“Astonishing,” muttered the pathologist to no one in particular. “They’re clean as whistles.” What prompted his surprise lay in the body of a 54-year-old man, a patient of the two physicians watching silently across his autopsy table. They had labored hard for several desperate hours to keep the man alive. “Look at those arteries,” bubbled the pathologist, pointing at several already scissored open. “Clean as a newborn babe’s.”

The patient had been a Memorial Day weekend visitor to the lake and Cedar Beach, at the cottage of relatives. He was visiting to ‘rest and recover his nerves’ after two years of self-treatment, thinking he had a nervous condition. Alarmed relatives took one look and insisted he see a local doctor. The Junior Partner recognized thyroid storm . . . an excessive overactivity of the thyroid gland. Its high production of hormone had burned off all the man’s body fat and much muscle, and made him wildly restless. The Junior Partner called in Old Doc Mac, and they admitted him to hospital for urgent treatment.

None of their frantic interventions were of more than transient benefit. They could not slow his trip-hammer heart, his rapid breathing, restless limbs or lower his mild fever; and he died in 12 hours. Regulations mandated an autopsy, and the pathologist had come down from Toledo. Neither knew the fellow, and they were attending in a somber, chastened mood. It was rare, the patient came in late, but they had failed.

“No atheroma anywhere,” continued the pathologist, astonishment still in his voice. Quentin Kubler was a teacher at the medical school, and he read their puzzled expressions correctly. “No porridge tumors in any artery,” he expanded, a twinkle in his eye. A barrel-chested fellow, he was in his middle years and heavily jowled. “Let me take you back a century,” he continued professorially, “to our predecessors who first put arterial hardening on the map. Indeed, back two thousand years to Hippocrates who first observed how ‘diseases of repletion — diseases of excess in today’s tongue — were best managed with restriction.’

“Anyway, a hundred years ago a German pathologist first documented small clumps of grayish fatty material just under the lining of the arteries in well-nourished individuals coming to him at autopsy. It put him in mind of breakfast porridge so he chose the Greek word for gruel to name it, atheros, and because the deposits bulked up into the tunnel of the artery like little tumors, he added the suffix oma, thus atheroma.” Kubler’s audience nodded their understanding. “Larger and older deposits eventually become fibrous to create atherosclerosis.”

“Not arteriosclerosis?” queried Mac.

“Same thing,” continued Kubler. “But permit me to tidy up here, gentlemen. I’ll only be a few minutes and we can chat about this more comfortably.” Out in the doctor’s lounge, their visitor rejoined them, settled back, sipped some coffee and continued. “Later pathologists noted that the largest deposits were in the arteries of better-fed autopsy subjects, and that wasted individuals coming to autopsy had fewer and smaller deposits. They reasoned that the process was reversible. That was a hundred years ago.

“Cancer first kills the appetite and weight is lost. Without food coming in, tissues are burned for energy. Fat is mobilized and arteries are cleaned out too. I wager that patient of yours recently had loaded arteries, like the rest of us, but two years of wasting from thyroid excess washed it away . . . just as starvation does in other wasting conditions.

“A few decades ago,” reflected Old Mac, “ there was a time we used thyroid hormone to lower the blood cholesterol, but soon abandoned it . . . too toxic on the heart.”

“He arrived at your doorstep, sadly too late to be kept alive but his arteries quite tidy.”

Vis Medicatrix Naturae,” intoned Mac, then he translated, “the Healing Power of Nature, but we failed him,” he added solemnly. The Junior Partner nodded.

“Take heart,” comforted Kubler, “he may have been too late, but as a profession we learn from such failures to help other patients. Those ‘clean artery benefits’ could be achieved in the rest of your practice without anyone dying, but by dieting.” He traced a fond hand across his bubble mid-rift. “I’ve begun to address a ‘repletion excess’ of my own . . . down 22 pounds and counting,” he grinned into his cup. “ I hope there’s enough left of me for you to recognize at our next encounter.”

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