The Summer of the OR Caveman

  • Chow, Harrison, MD
| Dec 10, 2012

Editor’s Note: As we go into the holiday season, Dr. Harrison Chow this week offers a unique perspective as to how we as physicians might stay healthy. Certainly the difficulty of finding healthy food choices in our health care facilities is a real one, especially this time of year. So read, enjoy and indulge, but not too much.

Some things change—and change fast—but some things really do stay the same. Not convinced? Just ask the caveman. The world I know is rapidly undergoing a digital transformation and nowhere has that change been more pronounced than in social media. So about three years ago, when LinkedIn (popular with many CSA members) suggested I might like to connect with my college girlfriend, “Nathalie,” I did so—after a couple of hours of thinking, over a total knee replacement—with trepidation.

How LinkedIn digitally traced her to me, I'll probably never know. We exchanged a few emails and a bit of text chitchat. It turns out that Nathalie had also gone to medical school and become an internist specializing in diet and nutrition now managing bariatric surgery patients. Recognizing that she had a specialty in an area where I had a need for advice, I pursued her counsel like the drunken uncle grilling you for medical advice over the Christmas holidays.

I explained how my own diet and nutrition plan was failing: my cholesterol, liver enzymes and blood sugar were in trouble, and I had kidney stones too. Sheepishly, I also confessed I had gained a few pounds since college. What she told me next probably changed my life (and likely extended it too) and health forever.

"I'm going to be honest," she said in a very serious tone. "I think you should go Paleolithic. You should be a caveman."

"A cave-what?" I was a modern, technology-loving physician. Medical professionals in this era do not often look to the Paleolithic period for advice. What was a caveman going to teach me?

Nathalie explained in detail, with lightness in her voice that gave away the true love of her field, a brief history of the human diet. How mankind had evolved from a scavenging, ape-like primate to a hunter-scavenger, and then into an agriculturally based diet. She noted how the human diet began to go wrong—with processed flour, turned into bread—about 2000 B.C. Her advice to me was simple: "Forget portion-control and counting calories…Just eat like a caveman. Go heavy on protein in the morning, so you can get through your first case and skip the OR junk. Get back to the ancient you."

That conversation opened my eyes up to a very disturbing and unhealthy lifestyle I had been living as a practicing OR anesthesiologist. Like so many physicians, caring for my own health was not a priority in the midst of a busy day caring for patients. I lived in a world of efficiency, quick OR turnarounds and packaged, processed foods…like the big box of donuts in every surgical lounge. After scarfing a morning donut (or two or three), washed down with a couple of cups of coffee, I'd be working in the OR for hours at a time, and then rushed through a 10-minute lunch of pasta or sandwiches with a diet soda. After my cases for the day, I might go half-heartedly to work out at the gym, then have some quick, convenient dinner like pizza or pot-stickers with the kids while watching TV.

This is most definitely not what a caveman would do.

So viewing my world wearing Paleolithic glasses, I figured the caveman in me was probably a hunter-scavenger, and at best, a whole food farmer. He had to physically work for his food, and the food would come in a “recognizable-as-food” form. Would ancient me recognize that box of donuts or bag of potato chips available for FREE to me in my OR every day?

So, I became the OR caveman that summer. I began physically working for my food. I went to the gym in the morning, stopped taking elevators and took any and every excuse to wander around the hospital or the OR rather than be sedentary. Surgeons wondered why I was standing or pacing in the OR. Well, cavemen had to physically work for food.

Sadly, (and I know most medical professionals would agree) the biggest challenge was the food available in my workplace. A place that provides top-notch heath care services, seems to be promoting job security by offering very little in the way of whole foods…you know, “primitive stuff” like meat, seafood, fruit, vegetables, nuts and whole grains.

I did prevail amidst the landmines of free hospital “food.” I drank lots of bottled water and ate lots of little meals. I envisioned caveman me on the run just like modern me, just eating eggs and blueberries in small amounts, instead of donuts.

In the fall of 2009, I saw my internist who was prepared to prescribe Lipitor for me to treat elevated cholesterol. He looked at me, looked at my new blood work chemistry panel in my chart and was quiet for a full minute.

"No I don't have cancer, and I feel great," I offered.

I had lost 45 pounds, lowered my resting blood pressure by 20 points, and improved my LDL and HDL cholesterol, fasting glucose and liver enzymes all to normal levels. My estimated body fat percentage from 35 percent to 11 percent. What to make of all this?

That's the story of the OR caveman—of Paleolithic me, now back at college weight in the year 2012. I like the new, old me, inside and out. The technology that connected me to Nathalie may have been a modern connection made via electronic bytes, but the real transformation in my life, came from converting to Paleolithic bites—of healthy, whole foods. I really don't look at our modern society or humanity the same anymore. Foraging, scavenging and hunting in my dark blue scrubs for the primitive food throughout my hospital every day. I keep protein bars in the OR bag for emergencies, and a bottle of water at all times. If it is difficult for physicians and the hospital staff to find healthy food options at the hospital, we can see how patients and their visitors will have little incentive to do better with their own food choices. I really would like to see our health care facilities proving more healthy food options—after all, its what we’re all about: helping patients and the physician-cavemen succeed.

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