Hunting for Tiramisu

16 Oct

I am a professional young woman, highly educated, quite self-sufficient, and even cried at the end of “The Note-Book.”

On a daily basis, my job in the hospital gives me the opportunity to interact with people of varied ages, backgrounds, and socioeconomic groups. Yes, even Republicans.

Being a medical resident is like being at a cocktail party. You’re always meeting and interacting with new people, running into people you’ve known for years. And, then, there are those, few, that quickly after 2 seconds of reconnecting—you are quickly reminded of why the two of you are only Facebook friends. I’m finding that, like a cocktail party, there’s one other thing in common among all my interactions in the hospital. And, no it’s not Sick people.

Cakes are Nice Too

Everybody always makes the following statement to me: “…so, you’re single.” This comment is always said in a very nice and respectable way. Kind of in such a manner as not to offend me or others around me. I excitedly wait to hear: “…so, I know this young chap that I’d like you to meet.” This, of course, never happens! And, I’ve come to realize, alas, that such an interaction will never happen at the hospital.

The women’s liberation movement has, indeed made many great strides. And, at a workplace, where pride is taken in professionalism, such conversations would not end well, I suppose. So, I am not entirely sure where Grey’s Anatomy gets their weekly inspiration for their racey story lines. Since, I am a self-sufficient woman, I’ve read the works of Virginia Wolf and NY Times’ fiery redhead, Maureen Dowd. I’ve decided to act in a very proactive, self-sufficient manner. After all, my medical specialty of Family Medicine is all about being proactive. We try to prevent chronic diseases such as Type II Diabetes, High Blood Pressure, and Obesity by focusing on preventative measures that a patient can take to improve their health outcomes.

With a professional mindset, previously described, I boldly treaded forward to bring a proactively directed method to the matters of the heart. I can accomplish such a mission through the only one possible vehicle known to generation Y and Z—it’s online dating.

In theory, it is such a proactive and sound concept. There could be no flaws. You put up a picture of yourself, write a few paragraphs about yourself, what you like to do, and whom you’d like to meet. It seems analogous to a social “Resume” or a professional Curriculum Vitae. It makes so much logical sense, that I have high-fived myself.

As a physician, we are ingrained to look for patterns in most everything we observe. Diseases, people I meet, and even the clouds in the sky—all have patterns. My first few blind dates were rather nice and cordial. The men looked quite dapper in their corduroy pants. Yes, I like the preppy look. Most of my dates seem to be follow the following pattern:

I spoke about myself, the young gentleman spoke about himself. I usually ordered a Pinot, sometimes a dirty-martini depending on how big or late lunch I had earlier in the day. And, then we ordered dinner. Or, at least, “talked” about ordering dinner. It generally takes me 10 seconds to figure out what I wanted to order. Come on, I am a girl; I know what I want. Of course, I don’t tell the date that I already checked the dinner menu on-line before joining my date for dinner. And, it’s not because I hate spontaneity or am a control freak.

To my surprise, each gentleman would before ordering dinner spend a lot of time trying to “problem solve” my diet restrictions secondary to Celiac Disease. Some would go through the entire menu: naming each entrée and understanding why I could not eat it. I was always a little uncomfortable asking the managers and chefs; and, some of my dates preferred to do that on my behalf! Some chefs would come to our table and wanted to learn more about the specifics of my dietary restrictions. But, only after they found out I was a physician. Prior to knowing that I was a physician, I got the sense that I was viewed as “the high- maintenance ” date who was a rather picky eater

Once they realized I’m not snobby snot, I was made to feel special by the wait staff, my dates, and the general public around me. I was not made to feel apologetic for causing a disruption. In medicine, you decide how to get tasks done

Very Nice!

quickly and then, do not reinvent the wheel. Thus, my decision to pre call the restaurants. But, medicine also forces you to change in the face of new evidence.

I came to accept the attention as endearing. Most of my dates would ask questions about my life-style. They asked questions about Lipstick to toothpaste. After all, I couldn’t simply pluck off the bread accidentally placed on my meal, and, then call it a gluten free meal. So, no harm in not sharing this part of my life with my dates.

As time went on, though, I started to get a little annoyed. The spark wasn’t there for me. I kind of want to talk about me, my quirks and not just my disdain for bread. I was more than my disease process. I am not defined by having celiac disease. In my clinics, I usually tell my patients, that they are not defined by the disease. It could be, or share a part of your identity; but, never serve as the foundation of it.

But, my dates remained enthralled! Piercing eye-contact was maintained the entire time. Which slowly lead to the usual courtship ritual seen among the human “mating dance.” Men display certain patterns, here, too. Self grooming gestures were being thrown my direction—left and right, fixing of their hair, adjusting of ties, shoulder brushes, and eventually the gaze of “Come Hither” was flashed towards me. It was GAME-ON!

I would always get a little tired by dessert time. I caught myself numerous times politely, repeatedly having to say “No” to dessert. I forgot to read the dessert menu before hand. Thus, I was always blind sided by bready deliciousness.

Since, dessert is a must in our dating culture. I didn’t have time to completely prep for my entire meal. I have other obligations in my life–like the responsibilities of a resident at a hospital. Yes, this being-a-doctor thing is quite time consuming But, after a while, all hunting for the right desert started getting cute. I liked observing the hunter-gather instinct kicking in. My dates were hunting or at least trying to hunt and spear for some gluten free Tiramisu. So chivalrous!

As, I began to express my choice of foods to my blind dates, most were really excited to learn about the details of celiac disease and the gluten free lifestyle: from the diagnosis to the parts per million (ppm) guidelines the FDA has set on foods so that they can be classified as GF. Their interest wasn’t just about the current task at hand: dinner. I found myself talking about the non-GI symptoms of Celiac disease. No, not all of us “poop” a lot. Some of us can actually get cancer, infertility, anemia, and balance problems because of Celiac Disease.

My dates were finally turning into the cocktail parties I knew at the hospital. I felt like myself, and felt free to share myself. I could kid around, be goofy, and just talk about normal blind date things. They say you don’t find soul-mates, but you learn to become each other’s soul-mates. I even talked about some of my feelings and fears about having Celiac Disease, these dates were now full of emotion and feelings for me. Now, it was GAME-ON for me!

Then came John. And a few other non-corduroy wearing, non tiramisu-hunting men. John was a young physician as well. We never professionally worked together. He was an orthopedic surgeon, who personally thought that he was the grand-son of the first dude to have ever eaten an organic vegetable. And, probably—John also, owned a lot of stock in the Organic Food Stock Market. Okay, that maybe a bit of a little lie. There’s no such thing as the Organic Stock Market.

Things NOT always Equal

John was exceptionally Zealous of the Organics food lifestyle. He felt, I could immediately relate to his food habits because I’m GF. I, too, am a believer, though a cautious believer. I think it’s wise to know what goes into our bodies. As someone with Celiac Disease, you don’t always need to focus on what comes out of your body!

As a physician, and with the latest landmark Stanford meta-analysis study: I tell all my patients that Organic foods are not safer or healthier. They have not shown to reduce certain types of cancer. The only things that we can conclude about organic foods is: they have less pesticides, organic chicken and pork have less exposure to antibiotic resistant bacteria, they taste better, and they generally are kinder to the animals and help local farmers. This is what we know right now. That may change tomorrow.

Many years ago, we didn’t believe that Wheat, the staple of most of the entire world could cause disease. And, now we’re finding that dogs also have Celiac Disease! CD among humans was first described by Samuel Gee in 1888 in a report entitled “On the Coeliac Affection“, a similar description of a chronic, malabsorptive disorder by Aretaeus from Cappadocia (now Turkey) is traced as far back as 2nd century AD.

The specific cause of celiac disease was unexplained until the Dutch pediatrician Willem K Dicke recognized an association between the consumption of bread and cereals and relapsing diarrhea. This observation was corroborated, when, during periods of food shortage, during the Second World War, there would be a normalization of diarrhea symptoms. We are still learning about the specific genetic dance that must be orchestrated in order for a patient to develop such auto-immune diseases.

An essential tenant of clinical medicine, and the fundamental nature of science is that medical recommendations change in the face of new evidence. What’s constant is our analytical framework and the ability change in the face of new evidence.

After the Stanford study came out, I still saw many of my patients continue to eat Organic Foods. They saw it as a form of exercise in power, which transitioned from “it’s healthier” to “it’s environmentally friendlier, to, it is better for the farming community, and it just tastes better.” As, I sometime force my patients not to identify themselves with disease, I see many patients who form their identity with health.

Change Happens

It’s a choice. America is based on choice, given that one’s choice does not harm others. My patients that eat Organic Foods don’t harm anyone. Rather, they take great pride in their bodies. Their choice is a stark comparison to the majority of my patients who are morbidly obese and crippled with chronic life-style diseases such as high blood pressure, high cholesterol, and diabetes. As a family medicine physician, I am happy when someone CHOOSES to take an active role in their health. Specifically, in their eating choices.

My colleagues and I spend countless hours teaching patients about the perils of foods with a high glycemic index. Foods that are scientifically proven to cause heart attacks, liver disease, and
cancer. There are times that I imagine myself wearing amazing shoulder pads, as I punt my patents’ sprinkled doughnut into the ground, which obviously would then be followed by me doing a little victory dance at the goal post. That would be my super-bowl victory.

Speaking of football, my date, John played college football. That’s what he said, at least. If you ask me, his shoulders were kinda tiny. No, I did not see the size of his feet.

No, as a doctor, I do not have a medical opinion if a man’s shoe size accurately correlated to the size of his you know what. Our dinner progressed along. I enjoyed his company over hot sake and sushi rolls. The conversation drifted with a natural ebb and flow. I smiled, I laughed, and was totally captivated. I was having a great time. Then, John said something really stupid. “Don’t you think black pepper can replace a rescue inhaler when someone is having an asthma attack. You know, because black pepper naturally has amazing anti-inflammatory properties?”

For those of you not in the medical field: Orthopedic Surgeons are victims to a stereotype that precedes them. How do I say this nicely, they are known as the Jocks of our profession. Not the brightest, nor the most articulate. Shear brute strength which obviously is necessary to manually correct a dislocated bone. That’s a stereotype, kind of like a pattern.

Though to be fair: I have friends that are orthopods. I like orthopods. If an orthopedic surgeon ran for president, I would vote for him or her.

But poor John was just plain stupid. He took an amazing leap of faith with me. He whispered this correlation to me, knowing that if he raised this question in the hospital, or in a louder voice he might be ridiculed. I am surprised that I did not ridicule him. But, this did result in John not getting date #2. He, like millions of Americans was making an innumeric conclusion. John’s question is perfect in theory, similar to my acceptance and excitement of the theory of on-line dating. Both make perfect logical sense. Though, both fall apart because in real there are always exceptions. There are always Johns.

There’s a stereotype of people with Celiac Disease, too. A pattern that’s beginning to develop in mainstream America. I am not shy to call it out. It sort of goes like this: We inherently believe that a gluten free diet can cure many diseases: Multiple Sclerosis, Autism, and World Hunger. A gluten free can even cure the stupid out of Snookie and Kim Kardashian. Those are the imagined powers of a gluten free diet. Nothing more.

Some Disclaimers:

  1. Yes. In our present day society: hunting and gathering are not gender specific tasks. No, I do not know if females or males are the better hunter.
  2. No. No, animals were hurt in the process of hunting for tiramisu.
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5 Responses to “Hunting for Tiramisu”

  1. Donna November 1, 2012 at 4:16 pm #

    Thoroughly enjoyed the post!!!! ESPECIALLY the curing the stupid out of Snooki and Kim Kardashian!!!! Ha, ha, ha!!!!! The hype that non Celiacs eating gluten free to lose weight is totally ticking me off so thanks!

  2. Puja Blogs November 3, 2012 at 3:23 pm #

    i’m glad you’re reading! It’s a tough world out there: dealing with the disease and then the posers who wish to use it as a platform to get famous.

    • Donna November 3, 2012 at 4:20 pm #

      Not only posers but people that belittle and ridicule Celiac. It’s not real, it’s not as bad as cancer, you can’t die from it etc.

      • Puja Blogs November 3, 2012 at 5:13 pm #

        That’s a really good point. I try to be positive and stay positive. I surround myself with people that want to learn and grow. I have meet so many specialists such as Obstetrics, Neurologists, and Psychiatrists that are excited to learn about how celiac can also effect their specific patient population.

        Then there are others. Some medical professionals and patients always compare celiac to other diseases to help see the silver lining. That’s so frustrating. You would never hear someone compare a mentally handicapped person to a physically handicapped person, and say one is easier than the other.

  3. Donna November 5, 2012 at 9:26 am #

    Keep up the good work in educating people Puja!!!! I will be following your blog now!!!! Thanks!

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