health problems cannot be addressed without a radically new way
of thinking about health and the absence of health. A serious consideration
of this statement creates a new vision with strong innovative possibilities.
I offer my proposal with a thought experiment, for which I assume:
(1) There is no end in sight for the deepening health care crisis
with the prevailing medical model; (2) we Americans are a compassionate
and resourceful people who have resolved grave problems in our history
with massive citizens' efforts; and (3) the country has a sufficient
number of civic leaders, teachers, and integrative clinicians willing
and able to develop and implement an all-voluntary national "Health
Corps" – drawing on the experience of the Peace Corps
– but robustly protected from the corporate influences of
the American "medical-industrial complex."
As for the first assumption, in my book RDA:
Rats, Drugs, and Assumptions, I included a letter to the
US Congress that began with the following words:
Two elements characterize medicine in the
US today: The cost of health care continues to escalate, and the
health of Americans continues to deteriorate. If the two trends
were to hold, a time can be foreseen when the nation's total resources
will have to be committed to health care, and everyone will be
The US clearly continues on the disturbing
trajectory that I foresaw 15 years ago. The country spent $2.4 trillion
in 2008 on health care; and Americans, as I show later, continue
to get sicker. The incidence rates of most inflammatory and degenerative
disorders in the US are steadily rising.
My second assumption – compassion and resourcefulness of the
people – has become more compelling in recent months. As for
the third assumption of my thought experiment, I observed a most
impressive display of medical altruism at Capital University of
Integrative Medicine, Washington, DC, during a decade when I served
as its president, and again in the summer of 2008 with an all-volunteer
"Diabetes/Hypertension Initiative" organized and implemented
by noncommercial radio station WBAI (both described later).
Now to my thought experiment relating to a National Health Corps:
concerned citizens led by President Barack Obama and Congress pass
a "Health Corps Law" with the following three provisions:
1. Creation of a Health Corps (the "Corps") for a national
program of education, motivation, mentoring, and monitoring of all
schoolchildren and college students in the country (the "Plan")
to be developed and implemented by an all-volunteer board of trustees
(the "Board") and practitioners experienced in clinical
nutrition, environmental medicine, and chronic stress (the "Practitioners").
2. Funding of the Corps by Congress with legislative allocation
of $2 per $1,000 spent on health care by any and all health-care
entities in 2008. The Corps will receive $4.8 billion annually (0.2%
of $2.4 trillion spent in 2008).
3. Implementation of the Corps program of motivation, education,
and meals (breakfast, lunch, and afternoon snacks) for all students
in nation's schools and colleges. The curriculum will be established
by the Practitioners and taught in weekly classes by a cadre of
teachers using age-appropriate educational materials (booklets,
on-line materials, field programs, etc.).
Some elaboration of the three provisions of the Health Corps Law
First, the members of the Board will not have any commercial interests
in any businesses dealing with the Corps. Specifically, the Corps
will operate free of any interference from insurance and pharmaceutical
corporations. Second, the Practitioners will have a minimum of ten
years' experience in nondrug therapies and a documented professional
income of more than 50% from such activity. Specifically, clinicians
not well versed with clinical nutrition and environmental medicine
or otherwise opposed to these disciplines will not be invited to
advise the Corps. Third, the Corps will have a strong and enduring
focus on the teaching and training aspects of its Plan. Specifically,
it includes training teachers to instruct weekly classes on nutrition,
environment, and stress to all schoolchildren using age-appropriate
materials (booklets, on-line materials, field programs). Teachers
will be compensated fairly, both for training and teaching.
Our nation's hospitals, by and large, have outreach programs for
community health. Such programs can be harnessed to advance the
Corps's objectives. It is noteworthy that hospitals do not generate
revenues by preventing disease. So, the hospital staff doctors will
not be invited to develop any aspects of the Corps's academic curriculum
nor food choices unless they meet the above criteria.
Finally, the Corps will closely monitor the efficacy of the program
with comprehensive clinical outcome sheets designed by the practitioners
and completed by teachers during weekly classes. Congress and the
president will receive quarterly reports of the progress of the
Corps, and complete transparency will be assured with regular on-line
I return to my first assumption and ask: How dire is America's health
crisis? Consider the following:
· "Diabetes has already stricken
an estimated one of every eight adult New Yorkers, a rate nearly
one-third higher than in the nation as a whole. If unchecked, it
is expected to ensnare coming generations on an unheard-of scale:
One in every three Americans born five years ago; one in two Latinos."
(New York Times. January 9, 2006)
· Antidepressant and stimulant prevalence was three or more
times greater in the US than in the Netherlands and Germany, while
antipsychotic prevalence was 1.5 to 2.2 times greater.2
· The records of 14,187 children between the ages of 3 and
18 were reviewed. Of those children, 3.6% were found to have hypertension.
Regrettably, 376 (74%) were not diagnosed.3
· "Ninety percent [of Americans over sixty] is a staggering
statistic and cause for concern," said Health and Human Services
Secretary Tommy G. Thompson in a statement from the National Heart
Lung and Blood Institute (NHLBI) that supports the Framingham Heart
Study. "This finding should energize Americans to take steps
to protect themselves against high blood pressure."4
· The incidence rates of diabetes and cancer are nearly twice
as high among white 50- to 59-year-old American men as in British
white males of same age.5
Absence of Health
In RDA, I diagnosed the fundamental
nature of America's health crisis with the following words:
The two corps problems of American
medicine – in my view – are these: 1) We address the
21st-century problems of environment, nutrition and stress with
the 19th-century notions of disease and drugs, and 2) We have
raised generations of physicians who believe all nondrug, nonscalpel
therapies are quackery. Nutrients – not drugs – heal
injured tissues. Drug medicine is a medicine of blockage. Drugs
– essential as they are for acute, life-threatening diseases
– work by blocking essential physiologic processes, i.e.,
calcium channel blockers block cell membrane channels, ACE enzyme
inhibitors block enzymes that are necessary for the production
of certain essential hormones, beta blockers block beta receptors
on cell membranes, antidepressants block the uptake of some neurotransmitters.1
In chronic degenerative disorders, healthy
cells do not become sick overnight. I began my book Oxygen
and Aging with the following words:
Oxygen is the organizing influence
of human biology and governs the aging process. From that idea,
I develop two other dominant themes in this book. First, dysfunctional
oxygen metabolism (dysoxygenosis) is the primary mechanism of
cellular aging and will be the single most important threat to
the human life span in the coming decades. Second, a growing understanding
of relationships among man's internal and external environments
will govern all our plans for preserving health and reversing
Inflammation plays crucial roles in the
etiology of nearly all degenerative disorders. I address this subject
in my book Darwin, Dysox, and Disease as
Life is an unending injury-healing-injury
cycle. Injury is inevitable in an organism's struggle for survival.
Healing is the intrinsic capacity of the organism to repair damage
inflicted by that injury. Inflammation – in my view –
is one aspect of the energetic-molecular mosaic of that intrinsic
capacity. This view of inflammation – that it is a physiologic
component of the essential injury-healing-injury nature of life
– extends far beyond the classical and wholly inadequate
notion of it being a process characterized by edema, erythema,
tenderness, pain, and infiltrate of inflammatory cells.7
My Darwin and
Dysox trilogy is devoted to an in-depth treatment of the
subjects of oxygen homeostasis, inflammation, clinical nutrition,
environmentally induced illness, and the consequences of chronic
anger and stress.7-9 The trilogy includes a large number of long-term
clinical outcome studies documenting the efficacy of integrative
protocols for diverse clinical disorders.
Altruism in the
I developed a clear sense of the scope of clinical altruism among
practitioners of integrative medicine in the US during my 10-year
period of voluntary service as the president of Capital University
of Integrative Medicine (Washington, DC). All 58 members of the
university faculty also accepted full academic obligations pro bono
for that period as well. Most faculty members were busy practitioners
who traveled from various states to Washington, DC, one weekend
per month to teach. Additionally, they devoted considerable time
between those weekends to do curriculum work, evaluate academic
work of the students, and offer student-advisory functions.
In the summer of 2008, I observed an inspiring display of volunteerism
among the general public. Listener-supported WBAI radio (audible
on-line at www.wbai.org) developed and implemented the first phase
of its all-volunteer Diabetes/Hypertension Initiative, with the
following five goals:
1. a well-structured and ongoing radio
program of education for the general WBAI community;
2. development and implementation of a study protocol with well-defined
3. close monitoring of the study protocol and assessment of the
program outcome by a WBAI team composed of WBAI producers, staff,
4. collation, organization, and presentation of the study data to
the WBAI community and general academic community;
5. enhancement of the program for future community service and formal
My colleagues at WBAI and I presented the data collected during
the first phase on the air (now posted at www.majidali.com).
The second expanded phase of the program was launched in January
Diseases Do Not
Descend from Mountains
Nor do diseases emerge from the depth of oceans. So we are left
with the matters of nutrition, environment, and stress. The diagnostic
rubrics in the existing classifications of diseases do not take
into account the issues of contaminated foods, polluted environment,
and chronic anger and frustration. As for genetics, no gene therapies
are available at this time for common disorders. The central tragedy
of the prevailing dogma of medicine is that it has convinced the
public that diseases can only be treated with drugs and surgery,
and that disease prevention and reversal with nondrug natural measures
is not scientific.
The notion of organizing a Health Corps patterned after the Peace
Corps, of course, is not new. However, there is a world of difference
between a Health Corps of integrative physicians – total commitment
to clinical nutrition, environmental toxicities, and spiritual work
is their passion – and a Health Corps propounded by doctors
who earn their livelihood using drugs and scalpels. There is a wide
gulf between the ideologies and ethics of practitioners of natural
therapies and those practicing "preventive medicine" with
drugs, such as statins, proton pump inhibitors, and drugs that block
bone remodeling. This must be accepted as the core issue in all
deliberations of a national Health Corps.
What might be the results if the thought experiment presented here
were to be executed? I expect the following:
· The health of children and college students will improve
dramatically when the issues of dehydration and sugar-insulin-adrenaline
roller coasters are prevented with school meals designed specifically
to prevent these problems.
· The health of parents and grandparents will improve dramatically
when they learn the principles and practice of sound health in the
Corps classes, and then act on that knowledge to varying degrees
· The focus on environment and spiritual aspects of health
will usher in a new era of enlightenment, ethics, and compassion
for students, parents, and grandparents.
· There will be a national movement to counter the rising
tide of unethical and deceptive practices to market drugs with limited
short-term benefits and serious long-term consequences.
Rhythm of Compassion,
Ethics With Passion
It is my sense that the currency of compassion and ethics among
the peoples of the world is greater than at any other time in history.
Compassion, it seems to me, is seeing one's own self in others.
It is the ability to observe suffering of others and a capacity
to experience their anguish. Compassion is the faculty of obliterating
the distinction between peoples of different regions and ethnicities,
as well as between peoples and animals, and animals and plants.
Compassion is generosity of the spirit – the courage to act
to alleviate suffering. Ethics, simply stated, is the study of the
consequences of one's actions on others. Ethics is also the study
of the consequences of one's failure to take the needed action on
I consider the matters of compassion and ethics crucial in discussions
of national health, the roles of organized medicine, and the medical-industrial
complex in our age of spreading pandemics of developmental disorders
of childhood, asthma, obesity, diabetes, and hypertension. How ethical
is the use of drugs for such disorders before diligently considering
the issues of unhealthy foods, environmental toxins, and chronic
frustration and anger? In insulin disorders – obesity, insulin
resistance, and type 2 diabetes – the fundamental problem
is functional defect of insulin receptors embedded in the cell membranes
– the crank of insulin cannot turn the crankshaft of insulin
receptor, so to speak – and the proper treatment is to restore
the functionality of those receptors by addressing the relevant
issues of nutrition, ecology, and stress. Is it ethical for a doctor
to prescribe drugs to further increase insulin activity –
hyperinsulism substantially increases the risk of most metabolic
and degenerative disorders – without addressing the underlying
causes of insulin resistance? Can compassion find a new rhythm in
the world today? Can passion for ethics become clinical in our time?
Can such a rhythm of compassion and a passion for ethics be harnessed
for global health? Can the US be a beacon of hope in such a possibility?
These are the questions that seem important to me.
From a practical standpoint, the Health Corps model proposed in
the form of a thought experiment has other strengths. It can be
pursued parallel with other innovative ideas for the nation's health
crisis. It does not require dismantling of any existing health-care
structures. It can be a major component of voluntary citizens' efforts
to move our national agenda forward. For further reading on the
philosophy and practice of authentic integrative medicine relevant
to the Corps thought experiment, I refer the readers to www.healthcorps.us.
I close this column by reiterating that the success of any Health
Corps initiative will essentially depend upon the society's commitment
to protect the program from the nefarious influences of the medical-industrial
Majid Ali, MD, is president
of the Institute of Integrative Medicine in New York, NY, and Denville,
NJ. He is the author of the 12-volume series The
Principles and Practice of Integrative Medicine and editor
of the Journal of Integrative Medicine.
Dr. Ali was formerly associate professor of pathology at Columbia
University College of Physicians & Surgeons, New York, NY; president
and professor of medicine, Capital University of Integrative Medicine,
Washington, DC, and president and chief pathologist at Holy Name
Hospital, Teaneck, NJ.
1. Ali M. RDA: Rats, Drugs, and
Assumptions. Denville, NJ:
Life Span Books; 1995.
2. Zito JM, Safer DJ, de Jong-van den Berg LTW, et al. A three-country
comparison of psychotropic medication prevalence in youth. Child
Adolesc Psychiatry Ment Health.
3. Hansen ML, Gunn PW, Kaelber DC. Underdiagnosis of hypertension
in children and adolescents. JAMA.
4. Vasan RS, Beiser A, Seshadri S, et al. Residual lifetime risk
for developing hypertension in middle-aged women and men: The Framingham
Heart Study. JAMA 2002;
5. Banks J, Marmot M, Oldfield Z. Disease and disadvantage in the
United States and in England. JAMA.
6. Ali M. Oxygen and Aging.
New York: Canary 21 Press; 2000.
7. Ali M. Darwin, Dysox, and Disease.
Principles and Practice of Integrative Medicine 11.
3rd ed. New York: Institute of Integrative Medicine Press; 2008.
8. Ali M. Darwin, Darwin, Oxygen
Homeostasis, and Oxystatic Therapies.
Principles and Practice of Integrative
Medicine 10. 3rd ed. New
York: Institute of Integrative Medicine Press; 2008.
9. Ali M. Darwin, Darwin, Dysox,
and Integrative Protocols. Principles and Practice of Integrative
Medicine 12. New York: Institute
of Integrative Medicine Press; 2008.