Your Personal Health... with Jane Brody

GUEST: Jane Brody
AIR DATE: 02/06/10

I’m Richard Heffner, your host on The Open Mind.

And I admit I had one heck of a good time the other day looking back at Open Mind conversations I first conducted with today’s guest some three decades ago.

Of course, you can look at them, too – along with hundreds and hundreds of our other programs, some of which date back all the way to the 1950’s.

Just go to www.theopenmind.tv
and look for Jane Brody, my guest again today and the Personal Health columnist for the New York Times now as she was when we did our first Open Minds together in 1980 and 1981.

Her columns appear each Tuesday in the Times Science Section and are syndicated around the country.

Jane Brody’s Nutrition Book and her Good Food Book are both best sellers as well, and Random House has recently published Jane Brody’s Guide to The Great Beyond – showing, I guess, that my guest is keeping up to date … at least with my timely interests!

But, before we get to The Great Beyond … Jonathan Weintraub, our intrepid Rutgers researcher, has accessed and printed out for me the most recent two years of Jane Brody’s Personal Health columns.

And I was fascinated once again by the extraordinary range and scope of the information and insights she passes on to her readers … from items about dental implants instead of bridges, examples of invasive cardiology run amok, the potential for harm in dietary supplements, the importance for us of preserving a sense of balance, about eating less and better and exercising more, about keeping our brains busy and agile, and on and on.

But I want first to ask Jane Brody: in all these years of dealing with so many different matters of Personal Health – hers no less than ours – just what strikes her most forcefully, what’s stayed much the same, what’s changed the most? I guess I’m asking: what about the human condition?

BRODY: Well, the human condition is suffering at the moment because we are so dependant upon machines to get us from place to place to do our daily activities and yet we have not substituted regular physical activity for the activity that we used to get when we had to do all those jobs ourselves.

HEFFNER: How could that be, when you’re constantly “hocking” us about walking and exercising …

BRODY: Yes. I “hock” a lot. (Laughter) But not enough people listen. Or they listen, but they don’t do.

You see the problem is people try to make this a daily decision. “Should I do this today or should I not do this? Maybe I’m too busy today.”

I don’t make a daily decision. I get up … at 5 o’clock in the morning. I am out at 10 to six, I meet my friends, we walk around the park at 6 o’clock. I go from the park back home, put on my bathing suit, go right to the Y and swim. I don’t make this decision every day … am I going to do this? Am I not? I mean, you know, hell has to freeze over before I don’t do one of those activities.

HEFFNER: So why don’t the rest of us? What’s, what’s there peculiar about Jane Brody’s genes that enable her to do this?

BRODY: There’s nothing peculiar. It’s a mindset. It’s a mindset. You know, you eat, you sleep … every day. Right? You exercise every day. That is just a given, it should be a given and we have lost sight of that. And the importance of exercise cannot be emphasized strongly enough. Not only for preserving your heart and your respiratory system. But preserving your bones. It is the single most important thing. Weight bearing exercise … the single most important thing to keep your bones from fracturing as you get older.

HEFFNER: You modify it “weight bearing exercise” …

BRODY: That’s correct.

HEFFNER: What do you mean?

BRODY: Walking. All you have to do is walk. Walk 30 minutes a day. It, it’s not a challenge, everybody can do that. Anybody can do that. Instead of hopping in your car. I mean, we live in New York City. New York City is blessed by the fact that we, we have public … good public transportation. And we are a walking city. So more people walk in New York than any place else.

But you go out of New York City and people are in their vehicles from … they go from the bed to the kitchen to the garage and they get in their car and they park as close as humanly possible to their destination, God forbid they should walk a half a mile to where they’re going. But it really would make a huge difference.

HEFFNER: I know, I spend a lot of time in California and I’m aware that Californians are always in their car. I’ve got to go down to get a bottle of milk, I get in my car.

BRODY: Right. And one of my college roommates, who grew up in a walking city, the Bronx, moved to Virginia, where she has to drive five miles to get a newspaper. I mean it’s just … it makes no sense to me.

HEFFNER: I’m interested, you do emphasize this so thoroughly in your columns. Do people pick it up? Do them respond to you?

BRODY: Oh, absolutely. I get, I get thousands upon thousands of email messages all the time. And snail mail still … some people still write letters … talking about the column and telling me, for example, that I have saved their lives; that the diagnosis that their … that three doctors missed, I hit on. They read my column and they come into the doctor’s office waving the column, and said, “Could this be what I have?” and the doctor then does the test and says, “My golly, yes, that’s what you have.”

HEFFNER: And your friends in the medical profession … how do they …how well do they take to that phenomenon?

BRODY: Well, it’s very interesting. You know, I’ve been writing this column since 1976 … that’s a long time. (Laughter) And when I started I really believed that the doctors would have a fit. I thought that they would feel that I was impinging on their territory … who was I … you know, I wasn’t a nurse, I wasn’t even a chiropractor, who was I to be giving medical advice to the public?

But, in fact, what I have gotten from the doctors is quite the opposite. I have gotten kudos around the clock from doctors who say that I have greatly simplified their lives by explaining conditions that they had difficulty explaining to patients. But disabusing people of, of miscellaneous information they pick up on the television, in the newspaper, on the web, wherever, that is incorrect. And so they don’t have to bother explaining all of this to their patients. So it’s really been terrific.

HEFFNER: And what are the areas in which you think you lend your skills the most and the best … in the medical area.

BRODY: Well, I think it’s completely across the board. I mean I have not found anything where I, I feel like I’m a fish out of water. People seem to respond to everything from, from eye check ups to, to … oh, I got a gazillion messages about implants. And people who wrote to me and said, “You know you can get a lot cheaper implants if you go to Mexico, or if you go to some place in South America.” I mean it was very interesting. I had never even considered that.

But I think my impact is really across the board. And nutrition has been, of course, a big one. And now, with my new book and the columns that I’ve written in the recent years about death and dying issues that, that has become a very, very major source of information.

HEFFNER: Well, of course, it’s, it’s a major source of interest for me because, as I said, you’re getting to where I live … in terms of what I’m concerned about when I die.

BRODY: Well, you know, we should all be concerned about what happens when we come close to death no matter how old or young we are.

You know my mother died when I was 16 and she was 49. That’s a very young age. Most people don’t start thinking about dying when they’re 49. And yet in 1958 when this took place, we didn’t talk about death, we didn’t talk about cancer. We were totally unprepared to deal effectively with this situation. And as a result, my mother died without ever having the comfort of being told how much we loved her, how much we were going to miss her, without her being able to pass on a legacy that was meaningful, things that we would treasure long after she was gone.

HEFFNER: Well, when Diane Meier, Dr. Meier has been here and Kathy Foley, Dr. Foley …

BRODY: MmmHmm.

HEFFNER: … has been here and talking about death and dying in America … George Soro’s project, do you think we’ve made any, very much or very little progress along these lines?

BRODY: Well, it’s interesting. We’ve made two steps forward and one and a half steps back. You there are, I think, thousands of books have been written about death and dying since Jessica Mittford wrote …

HEFFNER: MmmHmm.

BRODY: … The American Way of Death, which was really about the funeral industry. And in that time we talk a lot about death, but we, we are not coming to grips with the facts of death and how to deal with them effectively.

And part of the problem is that we have a medical progress that has basically become a death denying kind of technology where you can do all these things to keep a body going … forget about the mind … the mind could be totally gone, but you can keep the body alive and so people say, “Well, the body is still alive, it’s on a respirator, it’s on a feeding tube”, but you know, is this person dead or is this person alive?

And we have not really dealt with that kind of issue. We have not come to grips with the fact that death is a part of life, that we are born, we live and we die and there is no cure for mortality. And that keeping people alive indefinitely on machines is meaningless.

HEFFNER: You say “meaningless”, why does it happen?

BRODY: Why? It, it happens because we can do it. And because people are in a state of denial. There could be some miracle down the road that, that suddenly this brain dead person is going to come back.

And it … you know, the Terry Schiavo case brought this home very, very clearly to, to … and it should have really informed the, the whole debate that is now going on in Congress with … quote/unquote “death panels”, which is total nonsense.

But Terry Schiavo was cognitively gone. She had no cognitive function. She was kept alive by a feeding tube for 15 years. And yet her, her husband went to court against her parents who fought him tooth and nail about disconnecting that feeding tube. And finally, once it go disconnected she died within a couple of weeks.

HEFFNER: But if we were to move away from pulling the plug in that kind of situation to the kind of much more difficult situation that you deal with here … what about the other manifestations of our failure to deal with the fact of death?

BRODY: I …

HEFFNER: The ones that come not when you’re comatose, but when you’re dying and the, the methods that are used to keep you going.

BRODY: Yes. That’s … it’s really interesting because I, I did a whole chapter on describing what active dying was all about, so that people will understand that when you are close to death, it is pointless to stuff food and liquids into that body, because the body can’t use it, the body is shutting down.

And I tried to explain to people that what is important is holding hands, gentle touch, maybe a massage if the person can handle it. Talking … because the last sense to leave the body is the sense of hearing. And so even if all you can do is say, you know, Daddy, I love you I’m so glad that you were for us for so long … or however long … and your, your presence in my life as been so meaningful and recount some of the meaningfulness of it.

This just happened to my brother-in-law. My brother-in-law just died this week and his granddaughter came to visit him the night before he died. And he, he was no longer able to speak and he was no longer able to communicate meaningful, except she brought a music box that she had given him as a gift. And he had played it many, many times … he was very familiar with the music. She brought the music box to the hospital and turned it on. And he started waving his hands to the music and then she started talking to him about her children and he squeezed her hand each time she said something meaningful about the child. That meant so much, not just to him, but to his granddaughter, you know, who had something to give to this man as he was dying.

HEFFNER: Well, it’s so interesting to me that one of your most poignant chapters has to do with what we have to give to those who come after us. And your advice to take note of what you’ve done in life and what you believe and what you want to communicate …

BRODY: Yes, I, I, call …

HEFFNER: … to the people who come after.

BRODY: … it leaving a lasting legacy. Leaving a lasting legacy can be anything from leaving behind your favorite recipes, to leaving behind life lessons, things that you accrued in the courts of living that were meaningful to you that you’d like to pass on to future generations.

My sister-in-law has been writing essays about her life growing up in rural America, when she had … they had no electricity …

HEFFNER: Sounded pretty grim.

BRODY: Yeah … but you know, they had a great time. My husband grew up reading via kerosene lamp. There was no electricity in the house. And, and …but she told these stories in very amusing ways and meaningful so that this history is likely to be lost when her generation is gone. I mean she’s in her eighties, there’s not too many people around who remember a life like that, and in such graphic terms because she remembers great details.

She remembers them ice skating across frozen lakes to go to school. It was a shortcut … when that lake froze over, it took them 15 minutes less to get to school and they just loved it.

HEFFNER: Well, are you talking in practical terms? Do you think many of us … I won’t even say most of us … can get ourselves to do something like that. To keep that record, to make that record, to leave … to have that legacy as you call it?

BRODY: Absolutely. And, and my advice would be, you know, get one of the younger generation to tape record whatever you want to say, to interview you.

I mean my, my sister-in-law … my other sister-in-law (laughter) has, had interviewed her grandmother before she died. And her grandmother lived in Nebraska in, in … also in a, in a rural setting … horse country. And she was just a fabulous woman and she went out to Nebraska and interviewed her and tape recorded all the information that now, the next generation and the generation thereafter can, can listen to. This is not complicated.

HEFFNER: Which makes me ask … I know that others of your books have been incredible best sellers … what’s the reaction to Jane Brody’s Guide to the Great Beyond?

BRODY: Well, it would have been nice if the publisher had done more to sell it. But it has …

HEFFNER: But we’ll do it right now.

BRODY: That’s great. (Laughter) I do appreciate it enormously. Once I set up a website, janebrody.net more and more organizations have come to me directly and had me come and speak and had book sales and signings and have bought hundreds of copies of the books outright.

So that, you know, 300 copies go to the Elder Law Institute of the Minnesota Bar Association, or to the American Society of Geriatric Medicine.

HEFFNER: Well, I’m interested that in the blurbs, and god knows we always need blurbs … Diane Meier … my great friend, Dr. Meier … “I didn’t think it could be done, but then Jane Brody has always accomplished the impossible. She has demystified and given us real control over the thing we fear the most … this book is a gift to all her fellow humans.” Demystification …

BRODY: Yes.

HEFFNER: … we are mystified by death, aren’t we?

BRODY: Yeah, well, it isn’t such a mystery when you realize that it is a continuum of life. And that we have to terms with that fact, that we do not live forever, we cannot live forever, we shouldn’t live forever.

Think about it. If Methusalah was real person what this world would be like with all these gazillion, millions of people … trillions of people that we can’t feed and we can’t house.

HEFFNER: Which leads me to ask the question about your own attitude toward “do not resusitate” …

BRODY: MmmHmm.

HEFFNER: And toward, more importantly, physician assisted death.

BRODY: MmmHmm.

HEFFNER: What are you … what’s your own fix?

BRODY: Well, my, my take on it is that this should be a personal decision and we should have that option. That when push comes to shove and there is really no hope for meaningful recovery, that we should be somehow able to come to terms with that and, and say “No” to any further treatment. And let nature take its course.

Whether physicians then give you a pill that will help speed things along is up for grabs. I mean some people would say that’s great and others would not. I think if you’re in … if you’re in intractable pain and that despite the incredible methods we now have for treating pain, sometimes it can’t be treated adequately.

I’m very well aware of what Diane Meier has done. I think she’s an absolutely fabulous physician and palliative care is critical. I think that when people go into hospice and receive palliative care that the end is so much easier and so much more pleasant … not just for the person who’s dying, but for the person’s loved ones, who can continue to communicate with the dying person, who can continue to see that person in comfort instead of in agony, tortured by all the tubes and bells and whistles that medicine offers.

HEFFNER: But we still, generally, in this country punish an effort that is met or my request …

BRODY: MmmHmm.

HEFFNER: … of my doctor …

BRODY: MmmHmm.

HEFFNER: … let it go, let me go already. If he does actively, he’s in trouble except in a couple places …

BRODY: Exactly.

HEFFNER: … in this country.

BRODY: Exactly. Except in a couple of places … in Oregon and the State of Washington, it is legal for the doctor to enable somebody to take his own life, if life becomes intolerable.

You have to make sure first that the person is not taking himself out because he’s depressed because he has a treatable condition. If the person has a treatable condition and that life would be a lot more pleasant if that condition were treated than it … then that shouldn’t be allowed. There have to be safeguards built into this. If it, if it’s allowed under the law.

HEFFNER: Understood. Safeguards. But if I make my choice, I don’t want treatment. What do you think about my right, my ability to have that wish met.

BRODY: I certainly think that denying treatment, if you … if that’s what you want and, and the cards have been laid out clearly on the table for you so you know what treatment would entail, what it … what it would be likely to accomplish and what it’s not likely to accomplish … even more important.

Then you have a … absolutely a right to refuse treatment. And if refusing, refusing treatment … interestingly for many, many people when they go into hospice care and I cannot emphasize the value of this strongly enough … when they go into hospice care, the desire to accelerate the time when they die often disappears. In fact almost always disappears. Because they’re comfortable, because they are able to, to sort of come to the close of their lives in a way that is acceptable to them.

HEFFNER: So you’re saying that discomfort and depression are the things that lead many people to say, “pull the plug”.

BRODY: That’s exactly right.

HEFFNER: And can we … you make much of the necessity of leaving instructions for the end, but you also point out how difficult it is to make your instructions precise enough.

BRODY: Exactly. And I have in the book a very detailed living will so that if you really want to go through every little step in the way and make it absolutely, crystal clear to the medical profession what it is you do want and don’t want under various circumstances, you would take that living will and complete it, just the way I wrote it.

But the important thing, the most important thing … living wills don’t come in to play until you cannot communicate on your own. If you’re unable to tell the physicians what it is you do and don’t want, that’s when you’re living will comes into play.

In New York State it’s not a legal document. The doctors are not obliged to follow it. But what doctors are obliged to follow, in nearly every state of the union, is a health care agent … a person … the, the person who stands up for you when you cannot speak for yourself.

And that person, called a Health Care Proxy or Health Care Agent, or someone who holds durable power of attorney for health care. That person represents you when you cannot communicate. And it is critically important for everyone to have such an individual.

And the other important thing about this individual is that regardless of what that person may want for himself or herself, they have to be willing to say what you would want under these various circumstances.

HEFFNER: That’s tough to find.

BRODY: Chutzpah … is what’s a critical ingredient in the Health Care Agent.

HEFFNER: Yeah, but too much chutzpah …

BRODY: You don’t want a wimp. You don’t want a wimp to represent you.

HEFFNER: Yeah, but you also don’t want someone who’s going to substitute his or her …

BRODY: Exactly.

HEFFNER: … conclusions. And, how do you find that?

BRODY: You have a conversation. It’s not so difficult. I mean if, if your spouse or significant other can’t handle it. If your child can’t handle it, then try a friend. There are people out there who, who are perfectly willing to say, “Okay, you know, I’m … I’ll be your Health Care Agent”.

HEFFNER: Well, if chutzpah’s what’s needed I’m thinking of maybe you and I should have a conversation …

BRODY: MmmHmm.

HEFFNER: … I’ll tell you what I want and don’t want.

BRODY: Okay.

HEFFNER: But what I do want is everybody to go out and buy and read Jane Brody’s Guide to the Great Beyond. And thank you so much for joining me again on The Open Mind.

BRODY: Thank you, Richard.

HEFFNER: And not another 30 years, please.

BRODY: (Laughter)

HEFFNER: And thanks, too, to you in the audience. I hope you join us again next time. Meanwhile, as an old friend used to say, “Good night and good luck.”

And do visit The Open Mind website at www.theopenmind.tv

N.B. Every effort has been made to ensure the accuracy of this transcript. It may not, however, be a verbatim copy of the program.

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