Spent yesterday's austere training session working on something called a 'jump spin back kick,' a strange gyration that involves spinning in the air as you jump, ultimately kicking into a direction that you cannot actually see.

Interesting how easy something like this appears to a twelve year old, versus, say, a forty-eight year old. A kid just jumps, much like a cat, knowing that he is springy enough to get up and around, and flexible enough to not be troubled by the thought of a posterior landing. By the time you get to my age, you start to ponder the osseous consequences of this sort an action, which is why you hesitate and fail.

Napoleon once said that it was amazing what you could get an eighteen year old to do for a piece of ribbon.

The immortality thing.

The forty-eight year old is more likely to say 'Uh, no thanks. I have enough ribbon right now.'

Last night my sister in law Rita, an nurse with an extensive background in research, sent me an abstract from the Journal of Clinical Oncology, titled 'Herbal Remedies in the United States: Potential Adverse Interactions With Anticancer Agents' (J Clin Oncol 2004;22 2489-2503). The crux of the article being the potential threat to chemotherapy drug effectiveness posed by such botanicals as garlic and echinacea, which may influence the body's ability to metabolize chemotherapy drugs, and compromise their effectiveness. She asked me what I thought about the article.

When I finally got a full version, two things stuck out immediately. One, this was a review article, meaning that there was no proof of any such activity being presented, but rather a tenuous connection between the known, but rather modest, effects of certain herbs on the cytochrome p450 system (drug detoxification) and the p-glycoprotein levels (drug delivery).

More accurately an editorial, it provided absolutely no evidence to back up any of its assertions. C'mon guys, talking about garlic interfering with p-glycoprotein and blocking a drug like taxol is like saying that a paper bag containing your lunch has the 'hidden potential' to derail an Amtrak train. Hey, if garlic or herbal antioxidants and p-450 modulators were all that effective at blocking cell damage (chemically programmed or not), there wouldn't be any need for oncologists and oncology journals in the first place.

Amazingly, the article then goes on to advise physicians to look into herbal use in non-responding cancer patients as a rationale for treatment failure, a rather cruel balm to the fact that greater than 99% of those non-responders are simply not going to be cured by chemotherapy, herbal medicine or no herbal medicine.

An article published in the Archives of Internal Medicine (Archive Int Med; 1998;20: 2187-2191) may help explain why medical academics spend their time worrying about garlic blocking chemotherapy. It looked at conventional attitudes toward supplementation. Their conclusions: Throughout 20th century American academic medicine has resisted the concept that supplementation with micronutrients might have health benefits.

According to the authors, this resistance is evident in several ways:

(1) by the uncritical acceptance of news of toxicity, such as the belief that vitamin C supplements cause kidney stones;

(2) by the angry, scornful tone used in discussions of micronutrient supplementation in the leading textbooks of medicine; and

(3) by ignoring evidence for possible efficacy of a micronutrient supplement, such as the use of vitamin E for intermittent claudication.

Part of the resistance stems from the fact that the potential benefits of micronutrients were advanced by outsiders, who took their message directly to the public, and part from the fact that the concept of a deficiency disease did not fit in well with prevailing biomedical paradigms, particularly the germ theory. Similar factors might be expected to color the response of academic medicine to any alternative treatment.

I boldfaced the line about 'outsiders' as I can relate to that one personally, since I am a naturopathic physician (strike one!) posit a diet theory that does not fit in well with the prevailing paradigm (strike two!) and wrote a book on the subject for the public (yer out!)

Instead of wasting time looking for herbal inactivators of chemotherapy these folks should look at ABO polymorphism to help explain cancer treatment variation. Type A individuals may have as much as seven fold higher levels of p-glycoprotein, 30% higher levels of von Willebrand Factor and significantly higher levels of e-selectin and ICAM --all know modifiers of metastasis, drug delivery or resistance.

There is a certain lack of candor in a medical community that rebukes supplements as weak and ineffective medicines, yet warns that these same supplements are dangerously blocking chemotherapy drugs.

Reminds me of the joke about the two oldtimers at the early bird special:

The first one turns to the other and says 'The food here is terrible.'

The second oldtimer turns to the first and says 'Yeah, and the portions are small, too.'

Have been furiously designing and programming the IfHI 2005 conference website.

I happen to like programming in a furious manner. For example, I have developed the ability (at the expense of creeping myopia) to read code very fast, usually accomplished by holding down 'down arrow' on the scroll bar and letting the program just roll the code faster and faster until I find something I'm looking for.

This also works for screening research on MEDLINE. Set the results to say, 200 titles per page, then just scroll and scroll, faster and faster. I read somewhere that the mind is better able to 'see' things in movement, perhaps a leftover from when seeing moving things was a survival advantage. I also think it is a bit easier on the eye muscles to let the type move, rather than keep scanning back and forth with my increasingly senescent occulii.

The social downside of all this is that after a while you can get a bit trite with people, but that is another blog.

Went with Martha to a 'sparring clinic' last night. Well over 150 people of all belt ranks.

Guess who didn't pack his belt?

Anyway, since it wasn't a formal class, they let me stay, but strangely enough, not having that belt on left a weird 'open' feeling, sort of like my pants kept wanting to fall down, although they had their own draw-strings. Learned a few cool things.

Working on IfHI 2005 is getting me back into almost daily contact with Laura Mittman, IfHI's executive director, which is always a pleasure. Laura and Paul Mittman are two of our closest 'naturopathic type' friends, and as the years progress, they've just become great friends. Memories of the great IfHI 2003 conference are making me nostalgic for the future.

Paul, as the president of Southwest Naturopathic College, has given the Blood Type Diet a true home, unlike my alma mater Bastyr College, which has clearly lost its way.

Bastyr is locked in the one-size fits all, whole-grain/Ornish world that didn't work when I was a student there twenty years ago. Sadly, as they have become more 'accepted' (aka 'scientific') they have become less naturopathic, although there is certainly no reason why the two cannot coexist. They did there once a very long time ago.

Well, off the the cottage. Winter frost blew out an outdown water spigot I want to replace, and my daughter Emily, who apparently has no temperature receptors in her skin, wants to jump in the lake.

Guess who didn't turn off the inside valve to the outside water spigot?

Yesterday I went through with what I call ‘weather head,' a fullness that I occasionally feel when the outside barometer goes up while the inside barometer in my head is still heading down, or vice versa. Better this morning.

Great day in the office. Eight office calls, several featuring favorite patients who I have tended to for literally decades. What a delight it is to grow old with a good patient! To see their children mature and develop; to see the lines and wrinkles and gray hairs develop on their faces and they on mine.

Dinner tonight will be at my brother's place. He and his wife have a delightful little one-year-old son, Alex.

Ally-Boy, as his proud godfather prefers to call him (as opposed to Andy-Boy, a brand of broccoli) is a true child of the ‘info-toy' generation. By this I mean the battery-operated, push-button, stimulus-response and ‘educational' device toys everybody gives kids nowadays.

Now at age one, Alex thinks everything that looks like a button should produce some sort of computer voice, light or music tone when he pushes it. How insulted he gets when his best effort to twiddle a knob or dial on an unplugged radio or push a knot or whirl pattern in a piece of furniture is repaid with stony indifference!

On my way out to my office (which sits behind my garage) Martha passed me a news article from the NY Times about a man who is suing the estate of Robert Atkins and the company that promotes his dietary products.

A group with the improbably highfalutin name ‘Physicians Committee for Responsible Medicine' (PCRM) but who are actually a veganism and animal rights support group is actively assisting the plaintiff. The lawsuit seems more of a publicity stunt and is not surprising, since the PCRM has maintained an ‘Atkins-watch' website for several years now, where people can report adverse reactions to the use of animal products in their diet.

Apparently Mr. Jody Gorran, a wealthy manufacturer of solar panels and swimming pools, and who ate quite a bit of cheese and cheesecake while on the Atkins Diet, had his cholesterol increase from a rather low 146 to a potentially hazardous 230. This resulted, he claims, in a 99% blockage in one of his coronary arteries, requiring angioplasty.

From what the article said, most law experts do not believe the lawsuit would get anywhere, and even the plaintiff said he contacted the PCRM ‘because they are familiar with publicity.'

So I guess this is where the Great American Diet Debate eventually winds up.

In court.

Not that I believe for a second that this will end matters. In fact, I'm certain that the heavy-handed manner of the PCRM will eventually boomerang badly, since they in turn leave themselves open to litigation from any ex-vegan who goes on to develop cancer or some other ailment supposedly prevented by their vegan diet.

Blades cut in two directions.

But who knows? If one-year-olds can eventually adjust to their lack of results in expert knob twiddling and button-pushing, then perhaps there is hope for Mr. Gorran and the PCRM.

Music: 'String Quartet in Four Parts: Nearly Stationary' by John Cage

Yesterday was full of extremes, mostly emotional.

The morning featured its regulation dose of austere training; the almost standard hodge-podge of line drills, forms, kicks, stretches and chi-qong like breathing exercises. What makes the particular instructor that I train with so unique is how he weaves the disparate elements into a greater realization, which then becomes the lesson for that class.

In today's class we used the most basic form* taught to all white belts, then removed all the 'hardness' from it. Blocks and punches became open-handed, almost Tai-Chi like apparitions; stiff forward movements and stances became sinuous, each flowing from the hip and into the next.

One of the newer white belts is my friend and patient Michael, AKA 'Gerard' in ER4YT. 'Gerard' was the fellow headed for the liver transplant who never actually went down that path. 'Mikey' continues to do phenomenally well, so well in fact that here he is, grunting and sweating with the rest of us.

My time in the office went well. One returning patient was a gentleman with throat cancer who is almost ready to get his trach tube removed, as they no longer see any signs of disease. Another new patient was a young women with strange skin rashes that nobody can figure out the cause of. Not too surprisingly a type O who eats a lot of wheat and dairy.

Then had to bolt down a bowl of lentil soup and head over to my daughter's school for their choral performance. Both of our children have gone through the local Montessori school to the 6th grade, and if nothing else, these kids can sing! Cute little songs about 'painting with the wind' and other similiarly happy motifs.

Being around an event full of Montessori parents (at least in Connecticut) is sort of like discovering that the Soviet Politburo has suddenly moved to Esalen. In the old days, nobody wanted to be the first person to stop clapping after one of Stalin's speeches, so they installed a bell and rang it so everyone could stop at once.

We needed a bell --Not that the kids didn't deserve it.

The event was actually a part of the school's 40th aniversary celebrations, which takes place all this week, so the songs were interweaved with little speeches by past and present luminaries, one of who gestured backwards with her hand and used the phrase: 'look at your beautiful children, these children are the society of the future.'

I found this statement rather depressing, considering the screwed up world these children are destined to inherit. Some society. Can we possibly mess it up any further for them? At some point in time, in their new society, when the grown-up version of these kids write their history, how will it read?

Here is my guess:

The Second Thirty Years War, variously referred to by some authors as the 'SUV War,' 'The Well-Poisoners War,' 'The Land For Dead War' or 'Liberty/Terrorist Victim War', was waged by ideologic extremists of all varieties and cultures, in a vacuum created by inequitable wealth distribution, lack of individual expression and environmental deterioration.

But hey, I'm just an aging hippie.

* A form [or 'hyung' in Korean, 'kata' in Japanese] is a series of programmed moves along a pattern. It's goal is to develop one's technique and refine their nomindedness, i.e. relying on the innate rather than the conscious.

Good for martial artists, bad for political leaders.

Well here I am at the computer again. I'm supposed to be working on the Allergy book, but the weather can't seem to make up its mind, which I prefer to think is the reason for my writer's block.

This morning featured its usual dose of austere training, centered around the simple act of moving foward and backward, delivering either a block or a punch. Sounds easy, but it's not. You have to deliver the technique in a tensed, extended position but move in a relaxed fashion (tension/ relaxation). One author writes that you should "move along the floor as if your feet are separated from the floor by a sheet of tissue paper, but deliver the technique as if you are suction-cupped to the floor." You must also move in a linear manner, not bobbing the head up and down.

Easier done than said.

The concept was to 'flat line' the concentration; do the technique but not bother it with too much thinking. I'm sure the instructor meant flat-lining my EEG, but after 15 minutes of this he could just a soon been referring to my EKG instead.

This weekend Martha and I attended a class in Escrima or Kali, a Phillipine martial art technique that uses short rattan sticks or bastones. It uses complicated footwork as you weave the bastones into an electron flurry (sinawalli). Done with a partner it is quite hypnotizing.

The class was taught by Grandmaster 'Nene' Tortal, a 69 year old, five foot one ball of energy. Not only was this guy quite obviously deadly, he was gentle and helpful as well. Several times that afternoon all twenty of us had to have a go at him one at a time in a series of drills that left each of us panting for air, while GM Nene just went on to the next student and started all over again. He would guide you through the drills by yelling 'get out' while lunging at you. After you finally started doing the drill correctly, he would then just start chanting 'maintain! maintain!'

Maybe that should be a bye word for doing the diet: get it right, then maintain.

This weekend we had a visit from my sister in law Marge and her husband Jim. Jim is one of those people I could listen to for a long time. In one of his prior lives Jim, a West Point graduate, was a battalion commander in Vietnam. The exposure to defoliants like dioxin (Agent Orange) was probably the reason Jim can down with Non-Hodgkins Lymphoma and Hodgkin's Disease at the same time a few years ago, apparently a very rare occurence. He was given several months to live, even with chemotherapy, but has amazed his oncologists by living with the illness now for something like six years, using conventional and alternative medicines.

Maintain Jim. Maintain.