Dr Jeremiah Stamler has a little problem at work.
You know the kind: that checklist item that you cant quite seem to check, the one part of the big project that you havent yet nailed down.
You cant slam the door shut on the work until you get answers.
He knows the problem is out there, just waiting for him. And frankly, thats just the kind of thing he thrives on.
Dr Stamler is a professor emeritus and active researcher at the Northwestern University Feinberg School of Medicine in the United States, who recently turned 100 years old.
His problem is cheese.
Dr Stamlers speciality is preventive medicine in fact, he helped invent the field.
He did pioneering research into the causes of heart disease and coined the term risk factors to describe circumstantial and genetic contributors that increase the risk of cardiovascular disease.
While working for Chicagos Public Health Department in the 1960s, he developed the Heart Disease Control Program, aimed at educating the public and bringing focus to issues the city still grapples with, such as the availability of healthy food in poor neighbourhoods.
Hes an early adopter of whats known today as the Mediterranean diet and his own best advertisement, a long-living testament to the lifestyle changes he advocates.
Currently, hes one of only a tiny handful of scientists over age 90 to have an active US National Institutes of Health grant for research.
We have immense amounts of things we should be grateful to Dr Stamler for, says Dr Donald Lloyd-Jones, chair of Northwesterns Department of Preventive Medicine, because hes improved our health as a nation and a world, but hes also affected our society.
He points out that Dr Stamler, who founded the Department of Preventive Medicine, has retained 110% of his mental acuity. Hes forgotten more than I will ever know, and I dont think hes forgotten very much.
But aside from being an obvious outlier in the healthy-habits-plus-great-genes department, the record of Dr Stamlers life reveals another core characteristic that clearly fuels him.
Hes charming and smart, but he wont back down.
Not for anything. Not for big food companies or basic human intransigence, or even the US Congress. Not for the toll age takes, not even for time.
He has made standing up for things his stock-in-trade.
I think its a measure of his character, says Dr Lloyd-Jones. Its remarkable. Hes my hero.
A life in research
Dr Stamler was born in Brooklyn, New York, in 1919, and grew up in West Orange, New Jersey, the child of Russian immigrants.
From an early age, he was suspicious of mass-market food.
The loaf of white bread is anathema, he says. My father got to this country, saw the white bread and was ready to get back on the boat and go home!
Instead, he grew up with hearty rye breads and got an early start eating whole grains.
Other healthy habits came easy, he says: I never liked butter. I dont know why. It mustve been something in the blood intuitive.
After medical school, he did what most of his contemporaries were doing and entered the US Army.
Near the end of World War II, he was sent overseas. To Bermuda, he says. So I spent a lovely year in Bermuda, my wife came with me, and it was very nice.
Shortly thereafter, the war ended, and like thousands of other GIs, he headed home to launch the next phase of his life.
He knew he wanted that life to be in research, and in 1947, found a place to pursue that work, taking a position at Michael Reese Hospital in Bronzeville, Chicago, under pioneering cardiology researcher Dr Louis Katz.
Dr Katz told me, Why the hell do you want to go into research? says Dr Stamler.
You never win. When you first discover something, people will say I dont believe it.
Then you do more research and verify it, and theyll say, Yes, but...
Then you do more research, verify it further and theyll say, I knew it all the time.
And he was right.
Undeterred, Dr Stamler and his first wife Rose, who trained as a sociologist, but went on to become a major researcher in the fields of cardiovascular disease and hypertension in her own right, moved to Chicago in 1947.
They offered me a US$200-a-month fellowship, he says. In those days, that was a fortune.
His research involved examining the effects of cholesterol and other factors suspected as drivers of cardiovascular disease.
I was always interested in the heart artery problem. Why did human beings with diabetes get more heart artery disease?
Whats the relation of habitual lifestyle, fat intake, saturated fat intake, cholesterol intake, salt intake, with cardiovascular disease? The interplay between multiple factors.
And of course, we were all interested in tobacco even way back then.
He studied his theories on animals.
I was feeding cholesterol to chickens, he says. We could test everything that we suspected might have an impact, except smoking.
And over time, he helped discover and confirm many of the things we now take for granted: High cholesterol and high blood pressure are linked to cardiovascular disease.
Into public health
Dr Stamlers interest in these issues didnt stop at the merely scientific, however.
He had long been interested in social causes he and Rose had met at student meetings during World War II, while he was still in college, and her work leaned strongly into social justice.
He realised that his work had vast implications in the world outside the laboratory.
From 1948 on, as our work accelerated, he says, we were more inclined to translate our findings into recommendations for the public.
That approach began to earn him a few enemies.
Here in Chicago, we had the North American Meat Institute, they were barking at me all the time.
They had a very simple view: Why dont you do research, write papers, publish them and shut up?
We didnt feel that was an appropriate posture for people doing research on a scientific problem of great public health importance to do the research and then bury it. What the hell is the point?
Big tobacco, big food companies and other interest groups werent too happy about Dr Stamlers findings either.
He didnt care. I began to find the best ways to express all this to the public, and we decided that the best way is the risk factor concept, he says.
A set of well-defined traits, easily measured, frequently occurring, which when pre-sent, particularly in combination, are greatly associated with increased risk.
Risk factors, which represented something the public could understand and act to change, changed the face of how Americans thought about cardiovascular health.
The question was, what happens when you modify them, control them, lower them? Dr Stamler says.
Does the cigarette smoker at age 60, after more than 40 years of smoking, benefit from quitting smoking and lowering cholesterol?
The answer is, it isnt too late.
Dr Stamler was driven by a desire to see that knowledge put into practice by the public.
Its a very important message, he says. From a practical point of view, its the only message.
In 1958, he brought that activist approach to public health to city government, taking a position in Chicagos Department of Public Health.
I rolled up my sleeves and went formally to work, he says. A different kind of work. Quite different from feeding cholesterol to chickens.
Reluctantly, he gave up animal research and turned his attention to the pressing concerns of the citys health.
We started with rheumatic fever prevention in kids, he says.
We developed a hypertension control programme, coronary prevention evaluation programme, all right there in (then Chicago Mayor Richard J) Daleys Health Department.
He actually used a picture of me with one of the participants in the programmes in one of his political campaigns, to show how up-to-date and modern his administration was.
Dr Stamler also looked to tackle Chicagos diet: First and foremost, we worked to improve the mix of foods that were readily available in the supermarket.
We encouraged broiling rather than frying, roasting on a rotisserie rather than frying, modest portion sizes.
Chicagos legendary steakhouses? They didnt exactly fit Dr Stamlers programme.
It may be OK to victimise a tourist by selling him a 16-ounce (455g) steak, he says, but for the natives, lets make it a 4- or 5-ounce (113g or 142g) steak.
Lets encourage fish and seafood, vegetables and fruits, whole grains.
Not that were indifferent to the outside, but we feel a first responsibility to locals.
The question of the role cheese, as seen in this filepic, plays in heart disease is what currently occupies centenarian researcher Dr Stamlers thoughts.
An un-American accusation
But it wasnt steakhouses or even food lobbyists who posed Stamlers next challenge.
In 1965, he was called before the US House Un-American Activities Committee (HUAC), a congressional committee aimed at ferreting out suspected communist sympathisers in America.
The committee was known for subpoenaing a range of people, from the entertainment industry, academia and other spheres of public life.
They had informants who told them who to call, says Tom Sullivan, an attorney who worked on Dr Stamlers HUAC case, and the people took the Fifth Amendment (to the US Constitution, invoking a right against self-incrimination) and that was the end of it.
It ruined many lives and employment and wreaked havoc.
The consequences for refusing to answer the committees questions was blacklisting, and in Dr Stamlers case, Sullivan says, Mayor Daley would have fired him immediately.
Dr Stamler chose not to exercise a right against self-incrimination, instead choosing not to answer the committees questions to him by challenging its constitutional right to do so.
Sullivan and his team filed suit against the committee on behalf of Dr Stamler and his colleague Yolanda Hall, who worked as a nutritionist in his department and was also an outspoken activist on issues such as fair housing and civil rights.
The committee found the pair in contempt of the US Congress.
The clients were facing years in jail for contempt of Congress, says Sullivan, and Jerry Stamler decided he was willing to take that chance, to make this a test case.
Litigation followed for eight-and-half years, during which Dr Stamler continued to champion public health, but rarely spoke publicly about the court battle.
In late 1973, the case settled, with the committee, which had begun to lose steam, backing down and Dr Stamlers side agreeing to withdraw its complaint.
In 1975, HUAC was disbanded. The case, says Sullivan, was the decisive factor in ending it.
Those who know Dr Stamler best say the story isnt out of character.
He has a mantra, says Dr Lloyd-Jones, just apply firm, steady pressure.
When his scientific discoveries or medical recommendations meet resistance, Dr Lloyd-Jones says, his response is always the same: Keep smiling. But dont back down.
He knows that if you apply firm, steady pressure over time, the data will win the day.
If we make sure our assertions are grounded in the very best science, the truth will out.
Confronting cheese
In 1972, Dr Stamler was appointed as the founding director of the Department of Community Health and Preventive Medicine at Northwestern, where his research continued and he took on the role of mentor to a stream of new cardiologists and researchers.
The work has never let up, though Dr Stamler has decided where to draw the line in one arena.
He sort of stopped advancing in his tech use at fax machines, says Dr Lloyd-Jones, so when we send him papers to read, we email them to his assistant, they print them out, he takes the hard copy, he marks them up extensively in pen, and he faxes them back.
Currently, Dr Stamlers working with a team on metabolomics, the study of products created by the bodys metabolic processes.
Those faxed notes, Dr Lloyd-Jones says, are sharp as ever.
Hes really at his core a scientist. Hes always about taking the data and what it is giving you, and not over-interpreting it.
Dr Stamler sticks to his guns at home as well.
Read the original post:
Father of preventive medicine, Dr Jeremiah Stamler, turns 100 - The Star Online