All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the publisher, except in the case of brief quotations embodied in critical reviews and certain other noncommercial uses permitted by copyright law.

ISBN: 9781098311476

Dedicated to Dr. Bill Wallace (1944-2006)

Dr. Wallace was a microbiologist, who received his PhD at Harvard University. He spent his career helping students achieve their goals. He started at Harvard coordinating the Health Careers Summer Program from 1973-1979. He then became the Assistant Dean of Student Affairs at the University of Pittsburgh Medical School from 1979-1981. He came to the University of Illinois Medical School in Chicago to become the Dean of Students. As Class President at U of I, I had the opportunity to see how much time and energy Dr. Wallace devoted to his students. He became my mentor and friend. We collaborated on a book together, Flash Micro, a study guide of microbiology for medical students. I could hear his voice and lessons throughout my work on this book. I hope this book puts a smile on his face.

Special thank you

Dr. Barbie Jodoin Editor

Ken Brayden Matthews Cover and Photography

Dr. Melissa Toyos Support

Chris Caudy Trainer

To my mentors, Binnie Toyos, Prof. Francisco Batista, Prof. Howard Bern,

Prof. Bill Wallace, and Roger Parkin

Drs. Rolando and Melissa Toyos

Contents

Introduction

Chapter 1 - The Greeks

Chapter 2 - Spanish Flu

Chapter 3 - The Lab

Chapter 4 - Blue Zones and My Grandparents

Chapter 5 - Black Death

Chapter 6 - Dopamine

Chapter 7 - Motivation

Chapter 8 - Ebola

Chapter 9 - Air Travel

Chapter 10 - Exercise

Chapter 11 - Killer Mosquito

Chapter 12 - Good Food

Chapter 13 - Supplements

Chapter 14 - COVID-19

Chapter 15 - Conclusion

Appendix

Selected Sources

Introduction

“To every natural evil, Heaven has provided an antidote”

Dr. Benjamin Rush

Many Americans do not know that one of the signers of the Declaration of Independence was a doctor, Dr. Benjamin Rush. There is a medical school that bears his name in Chicago, Rush Medical College. He is better known for his work during a terrible yellow fever epidemic that killed 10 percent of the population of Philadelphia, our nation’s temporary capital, in the summer of 1793. There are many social, scientific, and political parallels between yellow fever and the current coronavirus pandemic. One similarity is a doctor is in the center of the political discourse concerning the disease: Dr. Rush for yellow fever and Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Disease and White House Corona Task Force, for the coronavirus. There are many other similarities that I will point out.

When someone becomes infected with yellow fever, they experience fever and chills. After several days, the skin turns yellow because of liver damage, and the patient will vomit blood hence the name of the disease in Spanish, vómito negro. Eventually, the patient becomes incontinent and wastes away. The disease is caused by a RNA virus that is transmitted by the bite of the Aedes Aegypti mosquito. The same mosquito that caused the recent Zika outbreak. The disease can be confirmed with a blood sample, but in 1793, no one knew what was causing this disease. As soon as people started dying in Philadelphia, a panic set in, and many affluent people escaped the city including several politicians like George Washington. It reminded me of the mass exodus of people from New York City to the Hamptons when the coronavirus pandemic started escalating. Dr. Rush did not leave the city because he wanted to help as many people as possible. He said, “I have resolved to stick to my principles, my practice, and my patients to the last extremity.” I could hear Dr. Fauci and most doctors I know saying the same thing.

There were many in Philadelphia that believed that a ship carrying refugees escaping the slave revolt in Saint-Domingue, now Haiti, brought the disease to the United States. It was thought that the disease could be transmitted from person to person. Dr. Rush believed that the disease was due to filthy conditions. The truth of the matter is that mosquitoes thrive in areas of shallow water and heat. In the summer of 1793, there were plenty of places for the mosquitoes to thrive including stored rainwater in barrels, shallow holes that dead animal bodies were thrown into, a sewage dumping ground, and the surrounding marshes and swamps.

The mosquito would bite an infected human or primate host, and when they would bite their next host, they transferred the virus. There is a vaccine now, but there are still outbreaks. Dr. Rush did not know the cause or how to treat patients but that did not stop him from adamantly stating that the way to cure these patients was bloodletting and large doses of mercury - bad ideas. Mercury is toxic. The Alice in Wonderland character, Mad Hatter, was based on the fact that people in the hat making industry were exposed to mercury and developed toxicity that caused emotional instability, tremors, hallucinations and speech problems. Bloodletting only weakened the patients and dropped their blood pressure, causing cardiac arrest. Some of the refugees, including West Indies doctors, through experience had a better way of treating patients. The “West India Cure” included a clean environment, drinking lots of lemonade, and wine. Many false theories did come out during this time including African Americans could not contract the disease, cleaning the house with vinegar, chewing garlic, and setting off guns in the streets (must be why so many people are buying ammunition now). African Americans supposedly could not be infected, so city officials called upon them to provide most of the city’s nursing care and manual labor. The coronavirus also had many myths that made the pandemic worse like: 1. Young people could not get terminally sick with the disease, giving them a false sense of security leading to flouting advised precautions. 2. Hand dryers kill coronavirus. 3. Rinsing the nose with saline protects against coronavirus. 4. The virus will die off when temperatures rise in the spring.

One interesting theory during the yellow fever was that smoking tobacco was a viable treatment. It turned out that people who were caring for the sick that smoked did not get the disease. The smoke from the tobacco would keep the mosquitoes away and decrease the chances of being bit. Doctors tried to tell Dr. Rush of their experiences, but he would not change his treatment regimen. One thing that I am seeing during the coronavirus pandemic is that the Chinese do have tips on the treatment of the disease that US is not using. Dr. Fauci has correctly stated that these protocols have not gone through vigorous scientific scrutiny so he is not currently recommending these protocols. Our society is more litigious which makes it difficult to try experimental treatments. I have talked to my colleagues in the Far East, and they have insights into the treatment of the disease that we should listen to and implement. For example, Favilavir (Avigan), an antiviral drug, was used successfully in the outbreak in Wuhan, and we have not heard a word about it in the US.

Dr. Toyos lecturing in China

Yellow fever eventually went away when the weather changed, and the mosquitoes died. Dr. Rush became a hero for his brave work in trying to help the sick during a crisis. It did not matter that he was wrong, but his thoughts on filth did ignite the city to establish the first municipal water system designed by Benjamin Latrobe. The water system decreased the amount of mosquitoes, decreasing the number of infections. I believe there will be unintended consequences from the coronavirus pandemic. Dr. Fauci will be a leading voice in the reform of our health care system. We will now realize that we are not equipped to handle an outbreak, and if we don’t make a change to our medical system, this will only be the first crisis of many that we will suffer in our lifetime. Looking on the positive side, the coronavirus infection curve will lower giving us time to develop treatments and vaccines to the virus. We will now understand the importance of washing our hands and universal health care precautions when people are sick. We have seen how patients who are unhealthy or have pre-existing medical conditions are at a higher mortality risk. Now, more than ever, it is important to adopt a healthy lifestyle. Wellness could save your life. I hope this book will get you in the best shape of your life.

Chapter 1

The Greeks

“The one exclusive sign of thorough knowledge is the power of teaching”

Aristotle Greek Philosopher

384BC – 322BC

The Greeks of the fourth century were the first to break with common beliefs that health and disease could be controlled by the supernatural. They believed that health and disease were influenced by several variables like environment, human behavior, and genetics. The Greeks reasoned that they could empower individuals with education to better their lives. Health promotion was a novel concept at the time that gave birth to modern medicine. As doctors, it is no mistake that we show deference to their wisdom by adopting the Hippocratic Oath. Hippocrates was a Greek Physician who lived from 460BC to 370BC and has been called the Father of Medicine. The Oath has taken on many changes over the years, while keeping some of the core values. One value that I try to practice every day is to educate my patients not only in disease treatment but health promotion. When people ask me why I write these books, my answer is simple: my job as a surgeon is to operate and educate!

Discussing Aristotle and Hippocrates with Father Nick

Teaching high school students in the clinic

Medicine has made incredible technological advances since the days of Hippocrates but has lost sight of how best to take care of people. The art of disease prevention has given way to the reliance on new drugs, techniques, and machines to treat disease instead of looking for ways to address health issues before they become problems. The Greeks adopted public policies to insure the health, spiritual, and mental wellbeing of their people. A famous quote by Plato (427 -347 B.C.) demonstrates their commitment to practice in a more holistic way.

“The cure of many diseases is unknown to the physicians of Hellas because they are ignorant of the whole, which ought to be studied also; for the part can never be well unless the whole is well …. This is the great error of our day in the treatment of the human body, that the physicians separate the soul from the body.”

The quote rings true today. We aren’t treating people, only disease. Healthcare has become big business, and people have relinquished their responsibility to change it for the better. A blockbuster drug can make billions of dollars, employ thousands, and bring huge economic impact to whatever society that is in the company’s sphere. A new piece of equipment can make surgery better more efficient for a common disease. Of course, society will pay good money for that technological advancement because it can solve an immediate problem. Drugs and surgery are much quicker ways to deal with the health issues of a huge diverse population. It is difficult and time consuming to educate patients, clean up an environment, change habits, and practice holistic medicine. We also have a population that has all but ignored their health responsibilities. Patients expect not to be bothered by adopting certain healthy lifestyle choices because they know they live in a technologically advanced society that can take care of any problem even those caused by poor choices.

Our environment and food have been compromised without our knowledge. A perfect example is Britain leaving the European Union, EU. Due to Brexit, the British government has been put in a situation where they have to negotiate new trade agreements. One trade agreement is the US exportation of chicken, and some people in Britain did not want the American chickens because of the US Pathogen Reduction Treatment, PRT. In the US, after chickens are slaughtered, their carcasses are washed with chlorine to kill pathogens like salmonella and E. Coli. The European Union does not allow producers to wash meat with any substance other than water. The EU believes that this leads to higher hygiene standards throughout the process. The European Food Safety Authority felt that PRT was a health concern. The Council of Europe felt that enough data supported the thought that the chlorine rinses could lead to the formation of carcinogenic compounds. They also felt that the chlorine could pose a risk to the aquatic environment, waste water systems, and sewerage systems. There is American data that counters this information, but a World Health Organization Study demonstrated that Salmonella was five times higher in North America than Europe. US consumers pay 21 cents less per kilogram of chicken because of chlorine washing. Is the reason we chose PRT a health or financial decision? I can’t tell you for sure because of the conflicting data, but before these reports came out, I didn’t know that Europe and US chicken standards were different. I use this as an example of something as simple as eating a chicken sandwich has to be examined and thought out by the consumer. When you gain knowledge, you can make better lifestyle decisions.

You may think it is overkill to examine what we eat, where we live, how we live, etc., but we should because the overall health results are negatively trending. In this day and age of incredible technological advances and breakthroughs, you would think that it is leading to improved life expectancy, but it is not. The US life expectancy is going down, not up. A study published in The British Medical Journal demonstrated that the USA now has the lowest life expectancy of high-income developed countries. We should be demanding that this trend be studied like a required post mortem. The four countries that have experienced an increase in life expectancy are Australia, Japan, Denmark, and Norway. You have respected professionals pointing these problems out, but their voices have not been amplified enough to drive people to act personally and politically.