It’s in the Genes

Ruminating on all the minutiae of my move and wondering how a home office for my medical practice will work out, I have been thinking lately about how and why I was drawn to the medical profession in the first place.

My mom was a registered nurse, my father a medic in the army, my grandmother a licensed practical nurse, and my grandfather a general practitioner. Maybe it’s in the genes?

I don’t know that I inherited any medical DNA, nurture vs nature and all, but I did inherit my grandfather’s old desk that he used in his office. Ironically, he practiced out of his home too.

I can see plain as day my grandparents’ sprawling ranch house, complete with a screened in porch and an in ground pool. The property’s expansive yards backed up to a deep, wide ravine on Sylvania Avenue at the outskirts of Toledo, Ohio. The red brick house had two doors off its front porch entrance, the north facing grander door for the main house, and the more modest door to the east for Grandpa Doc’s office. It must have been a bedroom, repurposed, now that I really think about it; but at the time it seemed built in, natural, like it never was any other way. “Doc” as he was affectionately named, accepted chickens and tomatoes and beans as payment from his loyal patients. And conveniently, Grandma served as his nurse.

Grandma and Grandpa were the epitome of “opposites attract.” Reserved and unassuming, Grandpa mostly stayed in the background, listening from afar. He always wore a starched white shirt, pressed black trousers, and grey leisure shoes. Maybe he only had one set of clothes. Grandma, quite distinctly, was flamboyant, even eccentric. With her bright red lipstick, costume jewelry, and bellowing singing voice, she created a party (or a commotion) everywhere she went.

We spent lots of time at that Sylvania house, baking huge sugar cookies the size of saucers, swinging on a myriad of plastic swings hanging from towering oak trees in the grand yard and then climbing all over them like monkeys. And that’s what Grandma called us, her “little monkeys.” We piled in her white Cadillac convertible with its red leather interior (in our pajamas no less and as late as 8pm!) for a trip to McDonalds (the first one in Toledo I am sure), then choked down cod liver oil the next morning. Grandpa did not join in that fun, but he was there, and his presence was felt. He never denied us a ride on the old orange tractor. I can still smell the damp, musty mix of gasoline and dried grass wafting from the tool shed where he parked the old workhorse after mowing the back forty.

Grandpa died when I was seven years old. I remember driving past his childhood home, a tradition in the Jewish faith I am told, before laying him to rest. Grandma soldiered on, but she was never the same. She took us “Termites” on her travels to the Smokey Mountains. She stayed at our house for a week, sometimes two, darning socks, making Favorite Casserole and bolagna sandwiches with butter and mayonnaise, and played Kings on the Corner, Crazy Rummy or Euchre with us till the wee hours of the morning. We accompanied her on visits to her five sisters and their kids. TheToledo Zoo, Cedar Point, a local fishing hole, and Frischs’ Big Boy became our stomping grounds. Sometimes she would take us to the Holiday Inn down the road for the weekend just so we could swim in the pool.

Grandma spoiled us with love and laughter, but her “fun tank” could run dry. Or so it seems when you are a kid. There were times where we stood knocking at her door for an eternity, begging her to come out and play. But she stayed hidden in the safety of her home, lights off, blinds pulled low, and doors locked tight. Many years later I learned she suffered deep, prolonged bouts of depression and agorophobia.

Grandma was of Polish descent. A tall woman with a larger frame, she had curves in all the right places and carried her weight well. But during these bouts of depression, when she turned to the all the latest fast and highly processed food for emotional support, the inevitable happened. She gained weight and developed multiple chronic diseases including endometrial cancer which ultimately led to her demise. Her genes were like a loaded gun as far as energy storage was concerned, and the food environment as well as the medications she was taking pulled the trigger. Even though I was completing my residency in Family Medicine at the time, I had no knowledge of epigenetics, insulin resistance, or binge eating disorder. Not even a clue.

Now I understand that weight regulation is genetic. There are over 200 genes that we know of today that tell our bodies when to store, how much to store, and where to store energy. We come in all shapes and sizes and that’s in our genes. Unlike the genes that tell our eyes to be blue or green or black, these weight regulation genes are modifiable by our environment. Changes in our environment affect the expression of these genes beginning with our formation in our mother’s womb. Things like illness, injury, antibiotics, surgery, allergy, emotional trauma, medications, can all effect how these genes are expressed. And just like a rheostat where gene expression for energy storage can be turned up, it can also be turned down. Environment plays a crucial role.

So how do we set our genes up for healthy expression. At the risk of sounding like a broken record: Eat real food. Go to bed. Get moving. Manage stress with strategies that don’t involve food.  Eat to feel well, not to be good. These are the lifestyle pillars that set you up for healthy gene expression and healthy weight regulation, that decrease the risk of the diseases you inherited from your parents, like type 2 diabetes and certain cancers and heart disease that you don’t have to get.

These are the habits that we want to help you build and pass on to your children and grandchildren. It’s what we do at Oregon Weight and Wellness. And its how we live. And now we are doing it from home.