Interview with Staton L. Awtrey, MD
Staton Awtrey, MD
Cardiothoracic surgeon with Premier Physicians of Midland Memorial Hospital in Midland, Texas
Q: Why did you become a physician, and what led to you embracing food as medicine?
A: My father was an ear, nose and throat surgeon in Corsicana, Texas. He had a massive heart attack at the age of 43, and, although he survived, he sustained severe brain damage from which he never recovered. He died three years later.
His father, my grandfather, was also a doctor—a family doc who had graduated in 1920 from Tulane University and had a medical practice in Alabama. Like my dad, he died at a young age in the 1940s, the result of hypertension.
I used to go to hospital with my dad. While this would never happen today, back in the 1960’s, when I was around 9 or 10 years old, I’d scrub in with my dad and assist him in surgery—probably more observing than assisting. I suppose you could say that the practice of medicine was my legacy, although my hope was that my father and grandfather’s chronic disease that cut both of their lives short would not be my legacy.
I grew up in Corsicana, TX, graduated from the University of the South in Sewanee, TN and then headed to medical school at the University of Texas Southwestern in Dallas. I finished my training in general surgery at the University of Arizona in Tucson, and completed my thoracic surgery residency at the University of Missouri. After school, I practiced with a group of thoracic surgeons in West Virginia, then in Austin, TX, before heading five and a half years ago to Midland, TX, which is now home.
I have my wife, Blythe, a registered nurse, to thank for sparking my paradigm shift regarding using food as medicine. Blythe had always been interested in nutrition and wellness. We thought we were doing pretty well up until the spring of 2012 when someone suggested to Blythe that we see the documentary Forks Over Knives. Seeing that film was nothing short of an epiphany—we knew at that moment that we could do so much better where dietary lifestyle was concerned, for ourselves, for our family and for our patients.
Like the vast majority of my fellow physicians, I had virtually no nutritional education in medical school. While it seems absurd to me now, until a few years ago all the nutritional advice I could offer my patients was to eat less fat and avoid too much salt. I was completely ignorant. I had no expectation at the time that diet could predictably prevent and even reverse and cure common chronic diseases. I am so grateful to those that have taught me otherwise.
Once we embraced a low-fat, whole food, plant-based diet, the changes were drastic. Blythe went through our kitchen and got rid of everything that was inconsistent with the optimal dietary lifestyle recommendation. You could say that we went ‘cold turkey’ and completely changed our diet to one that was whole food, plant-based. Our personal experience has been wonderful, and we began sharing information with family and friends. One of our friends experienced dramatic results—a reversal of chronic disease and a nothing short of remarkable transformation in overall health and quality of life.
The husband of this couple had suffered from GERD—he was morbidly obese, hypertensive, pre-diabetic, suffering from sleep apnea and migraine headaches. He would come home completely wiped out from working in the oil field and collapse on the couch. His wife resigned herself to this being their way of life as they were getting older.
This couple used food as medicine. They were receptive and ready to make changes. The result: all of his biometrics stabilized. He had been on four hypertensive meds and is now down to two, hoping to soon be off of all. He’s lost 60 pounds and no longer has GERD. He hasn’t had a migraine headache for 18 months, and is no longer pre-diabetic. He comes home after a long day’s work and is active and energetic. It has changed his life and radically changed his marriage. His whole being is tremendously improved from nothing more than changing what he eats.
Another glowing example is my childhood best friend. When I first shared the message with him, his response was, “I’m good; my doc says I’m fine. I’m on Crestor.”
He had no interest of eating a plant-based diet. Then…last year, he had a heart attack, a helicopter ride to the hospital, and a stent placed. At that point, he was ready to listen. Rather than going ahead with what his cardiologist was recommending, I urged to my friend to reach out to Dr. Caldwell Esselstyn, author of Prevent and Reverse Heart Disease. He did, and immediately switched to a plant-based diet. That was a year ago, and he now says that he’s never been healthier. His angina is gone. His hypertension gone. His mild arthritis is gone, as is his sleep apnea. He’s still on a trace of statins; otherwise, he’s medication free. He says he’s a new man—scuba diving, hiking, exercising and feeling great. It’s amazing to see.
One of my patients is a West Texas cattle rancher who has shifted to a plant-based diet—doing so as an alternative to having open heart surgery. If a Texas cattle rancher can do this, anyone can!
Q: How have you incorporated using food as medicine into your medical practice?
A: At first, I wasn’t sure how to integrate this into my practice. The first people we shared this ‘good news’ with were family and friends. The information was met with resistance by some people, some had no interest, and some embraced it.
Blythe earned her Certificate in Plant-based Nutrition through the T. Colin Campbell Center for Nutrition Studies and she now counsels my patients.
In my office waiting room, there’s a TV that used to play whatever happened to be on that time of day. No more! We now play loops of Forks Over Knives. I look out in the waiting and see my patients taking notes. I’ve found it to be a great conversation starter. I bring the topic of whole food, plant-based nutrition up with each and every one of my patients and frequently offer it as alternative to coronary bypass surgery, and as long as their cardiologists are on board. Even if surgery is elected, I encourage plant-based nutrition as an adjunct to surgery. Needless to say, I make a lot of calls to cardiologists and am finding that more and more are supportive. Patients are electing to embrace dietary modification instead of having surgery. I keep myself busy with unstable hospitalized patients and with my valve practice.
I don’t have a great way of tracking adoption or compliance as of yet, although I estimate that about 25 of my patients have followed my lead in adopting this dietary lifestyle—with many of their family members doing so, as well. Some patients have done so instead of surgery and some as an adjunct following surgery. As I get better at counseling, and as cardiologists become more comfortable and informed, then I hope that the only coronary patients I’ll be operating on are too unstable or unwilling to make these changes.
Interestingly, I find that some patients simply can’t believe that disease reversal is possible simply through changing what they eat—they aren’t comfortable with a low tech alternative and opt for surgery.
I present my patients with a brief presentation on using food as medicine and then either loan them a copy of Forks Over Knives or urge them to rent a copy. If the message resonates, I then arrange for them to contact Blythe who provides more detailed information and assists with access to online resources. She goes to the grocery store with patients to teach about label reading and how to shop to support a predominantly plant-based diet—complete with a pantry makeover.
I’m excited that the Plantrician Project will soon be releasing Culinary Rx and the Plant-based Nutrition Quick Start Guide. Both will be invaluable educational tools that I can prescribe to my patients.
Q: I understand that your efforts are helping to spark a bit of a healthcare revolution in Midland, TX; would you mind sharing the details?
A: While Blythe was enrolled in the T. Colin Campbell’s nutrition certification course, she came across information about the CME accredited International Plant-based Nutrition Healthcare Conference that was held in Naples, FL in the fall of 2013. We registered and were excited to be part of the inaugural event. It was an amazing conference and was when I first had the opportunity to meet its co-founder, Dr. Scott Stoll.
It was exhilarating to talk with Scott and the other physicians who were in attendance, all of whom were passionate about the subject matter. Blythe and I attended the 2rd annual conference in San Diego last fall and are already registered for the 3rd annual event which will be held in Anaheim, CA the end of this September.
Scott shared about the success he’s had in helping people in his own practice; he has an infectious optimism and positive outlook on how to practice medicine using whole food, plant-based nutrition.
Based on the interactions I had with Scott, and from hearing all the other featured speakers at both conferences, I got excited about trying to influence my fellow physicians in Midland. I asked Scott if he would come out to Texas and be a featured speaker at our hospital Grand Rounds, also staying an extra day to conduct a seminar at our church.
There was incredible interest from both the hospital and church leadership, so we scheduled both events for early 2015. The response far exceeded our expectations.
Twice as many physicians as had ever attended before turned out for the Grand Rounds where Scott presented on nutrition and diabetes. Typically, the doctors will pop in, listen, eat and bolt. For Scott’s talk, it was different: Most of those in attendance stayed for about 45 minutes after the talk to ask questions. These docs had never heard anything like this before—they had no idea that physicians were actually curing people of their chronic disease using diet alone.
I think we all went into medicine to help people, although it’s difficult not to become cynical over time. Patients come in, we prescribe meds, they come back in complaining of side effects that beg for additional meds. Some do benefit, but they’re not cured. It’s disheartening.
For a doctor to hear you can cure hypertension; that you don’t have to treat diabetes—you can cure it; that you can prevent heart disease and reverse coronary disease; that even if you don’t reverse disease, you don’t have to have stents; you can halt the progression with food. The message of a physician being able to cure, rather than just treating symptoms and putting Band-Aids on disease is radical. Needless to say, the group we had assembled at the Grand Rounds was blown away by this message.
The feedback I received from those in attendance was extremely positive. Even members of the hospital administration were excited, because the hospital has a mandate help the people of Midland to be healthy. We used to think this was about getting patients into a clinic to do screenings, often referred to as ‘prevention.’ We now have the opportunity to promote true prevention and provide real ‘health’ care to the population we serve, as we educate them about the power of their food choices. One of the things I told our hospital administrators is that people are hungry for this message—they simply aren’t getting it from their physicians.
Many changes are now in the works at Midland Memorial Hospital—all sparked as a result of the Grand Rounds talk given by Scott earlier this year. A wellness committee has been formed, comprised of our chief medical officer, a nutritionist, a primary care doc, an OBGYN, a couple other members and myself. When we have meetings, there is tremendous enthusiasm. We’re preparing to launch a wellness clinic that incorporates whole food, plant-based nutrition. We’re also planning to provide whole food, plant-based options for patients while they’re in our hospital. And…we’re working on providing scholarships for medical residents, enabling us to send several of our primary care residents to the Int’l Plant-based Nutrition Healthcare Conference, along with at least one of our dietitians, so they’re able to come back and teach the other members of our nutrition department.
Our hospital has decided to sponsor an annual ‘nutrition conference.’ Dr. Stoll has agreed to return, and Dr. Michael Greger of NutritionFacts.org has also agreed to come. We want to showcase practicing physicians who have experienced the efficacy of plant-based nutrition, providing ongoing education to medical professionals in this community. The hospital has embraced this, viewing it as ideally aligned with its role in the community. It’s remarkable to see these things coming to pass.
Witnessing the impact on the hospital has been tremendous. The same can be said for the impact of Dr. Stoll’s visit on our church. Nearly 150 people came to hear Scott speak. He was offering hope—so much more than they were getting from their very well meaning primary care docs who simply don’t know about the impact of nutrition on health.
Since Scott’s presentation at our church, we’ve continued to have monthly pot-luck get-togethers where everyone brings their favorite plant-based dish, shares recipes, and has the opportunity to offer community support. This is important, because it isn’t always easy to make healthy food choices. Too often there are few healthful options when dining out, and our grocery stores are filled with unhealthy foods. Getting people together to encourage one another is powerful. Individuals are inspired by the dramatic changes they see and hear about in each other’s lives—hearing testimonials of those who are experiencing restored health and no longer taking meds is a strong motivator.
Q: As we’re seeing a continued rise in chronic disease trends and are bearing the burden of the associated costs—costs that are unsustainable, how do you see the “food as medicine” message as part of the solution?
A: It’s far less expensive for society to stay healthy than to try and restore health. I envision doctors and healthcare providers being advocates for health instead of being pill pushers and technicians in the operating room. My hope is that patients will receive meaningful nutrition counseling as part of routine medical visits. If we can do this, we’ll have a tremendous impact on patients and families for generations to come. The outcome will be health, rather than the management of chronic disease. Not the alleviation of symptoms, but the prevention and curing of chronic disease. It is our ONLY way out of the path that we’ve taken. With two-thirds of Americans now being overweight or obese, the trends will overwhelm us if we keep doing the same thing. We must do something differently. The only thing that’s been shown to be effective is dietary lifestyle.
In May, I had the opportunity to attend your inaugural Int’l Cardiovascular Nutrition Summit in Chicago—another outstanding CME event. One of the speakers cited an analogy about our chronic disease epidemic, saying that people are falling off the cliff, and we’re building hospitals at the bottom of the cliff to treat their injuries. This is, of course, absurd and expensive. The reasonable alternative is to build a fence at the top of the cliff to keep people from falling! Whole food, plant-based nutrition is this fence. It’s a simple, affordable and effective solution. Nothing else can reverse the direction of the unsustainable course on which we now find ourselves. The only thing that will do this is lifestyle change—dietary lifestyle. It works!