As I celebrate my 43rd birthday, I am filled with gratitude. COVID-19 has created an opportunity for us to focus on our home and family. While this may be a negative for some (hopefully very few) and is frustrating to those whose loved ones are too far away to see with a reasonable car trip, it can still be a positive opportunity.

I wrote the above, as I later learned, about the time that my colleague was at work and suddenly stopped being able to talk. Thirty-six years old and a runner, father of three, working as the only doctor on site. How cruel can reality sometimes be? With that said, I took the next blog I was writing and meshed the two together as the themes are the same. From last week I wrote:
I had a conversation this week with a friend from Ohio as he sat in a hospital room recovering from multiple injuries from a fall. He is a man who looked after me in the fire department in Canton, where I volunteered (yes, I was a firefighter; most people who worked with me knew that medicine was my true calling). A big man with an even bigger heart who fell from a height while at work at his regular job of 23 years. The fall resulted in multiple fractures. He cannot walk, is understandably in pain, and requires his wife for assistance with the basics of daily functions. These are unfortunate accidents that can happen to any of us. And while we talked about his anticipated recovery and the challenges that come with it, it was other aspects we discussed that I felt more poignant.

At over 400 pounds, the weight loss took time and dedication. No, my friend is not a plant-based eater, and until the time of this phone call, he did not know I was. The specifics of what he ate he did not tell, but exercise by walking up to eight miles a day became a routine for him, which helped him lose 150 pounds! His weight alone is challenging enough, but he had dropped more than 150 pounds while better understanding his depression. Depression, he knows, contributed to his obesity. Because of the pain he was experiencing at the time, we did not extend our conversation into the details of the topic mentioned above. We instead discussed how his wife and family were doing in recent months, as well as reminiscing about the strength of our firefighter community.

He is no longer an active volunteer firefighter; thus, the exertion and stress that come with that profession have not been present in recent years. But it was two familiar faces on the ambulance who took care of him from scene to hospital. The community of people within the fire service has already built a ramp at his house to aid him when he gets home.  While I know there is research to support plant-based eating helping with mental health issues, obesity, and other diseases; I do not pretend that it is the be-all treatment of all things. The support of the people around you, those that matter most, are often the driving force. Community is a huge factor in our life. The more we engage our community, the better off we all are.

For firefighters, every third day of their life, they are away from their own families and spend time instead with their professional families. Firehouses are often sensationalized on TV or mocked by others for sitting around the firehouse and washing the apparatuses. But make no mistake, there is camaraderie. You spend a third of your life with people who know you as well as your own family does. For volunteers, it is not much different, though the hours may not be as consistent. I enjoyed sitting and talking with someone I call a friend from my firefighter days after much time between conversations; it was good to pick up where we left off years ago.

And so I return to the present, to my 36-year-old physician colleague who, three days ago, could not speak. When he arrived to work, our co-worker recognized he was showing symptoms of a stroke. He received clot-busting medicine (called “TPA”) with no improvement and was transferred to the large academic center in town. He had a subsequent seizure, needed to be intubated (to be put to sleep and put on a ventilator machine to breath for him). After a few days, he recovered (only complaining of a headache). Our community of doctors, physician assistants, nurse practitioners, nurses, and medical techs have formed a meal schedule for his nuclear and extended family. I was fortunate enough to be the first person to deliver food to the family. He was kind in his text in thanks for bringing a “healthy dinner” to his family. Yes, it was vegan and I apologized that my supply of brisket had been exhausted years ago.

The point of all this is another example of the hospital community coming together in short order to look after his nuclear and extended family as they look after him. The world is not fair. What is happening to my friends is not fair. The injustice that has existed for those of color and is now dominating the press is not fair. But the hope of our communities coming together and looking after one another is the positive light in this seemingly dark abyss. I implore us all to be better human beings to each other, starting with our communities.
​
As I continue the journey into engaging this community with plant-based eating guidance, I hope I will learn more about you as we build our community together.

My mother-in-law lives one hour from Canton, Ohio. Her house sits on a corner of a rural highway, a mile and a half from where she grew up. She has neighbors that are either farmers or Amish. The small town’s grocery store closed about six years ago and basic staples can be obtained at the “Drug Mart” and “Dollar General” that is driving distance to the small town. Her other option is to drive to Canton or another town 45 minutes away to go to a traditional grocery store.

Access to food is one of many systemic problems for our country. While this rural example is but one, food discrimination is just as prominent in urban environments. A common term used is “food deserts” to describe neighborhoods that lack any sort of grocery access (defined as more than 1 mile to food access in urban areas and more than 10 miles in rural areas).
One or ten miles respectively may not seem like much, but for many, the distance is even greater. Whether it is lack of access to transportation, financial means, local mass transit or infirm from age or disease, food deserts exist in most metropolitan areas.

Often in areas of low socioeconomic neighborhoods, food deserts make it challenging for families to prepare quality meals and more often have to rely on options such as fast food or boxed/processed foods. As most of my Emergency Medicine work is in a city hospital, I see the complications of this every day. These foods are inexpensive and quick to make, but they are low in nutritional value, low in fiber and typically high in salt, fat and cholesterol. When these are a family’s best options, it proves my point: there is a problem.

There are multiple solutions to this problem. While moving is one option, it is not realistic for most. Instacart.com, Amazon Prime for Whole Foods or other food delivery services are good options, but they come with several barriers. Subscription services have an annual fee and grocery deliveries are often more expensive. Also, rural access, such as with my mother-in-law, is not offered by most of these delivery services.

Food pantries or food banks are places for those with a tight budget (or sometimes no budget at all). While, traditionally, canned goods and other nonperishable items were what mainly existed at these places, a shift towards healthier options has taken place and more and more fruits and vegetables are available. There is always a strain on inventory for these places, but if this is your best option, that is what they are there for. If you have the means to donate to local food pantries that can in turn dispense to those in need, thank you.

Community gardens are one answer which, when there are enough volunteers, shows a lot of promise, This is especially helpful regarding older populations such as those that rely on Meals-on-Wheels. I recall being a young idealistic Family Medicine doctor delivering these meals to see where my patients lived and do home visits, as well. It never dawned on me that these meals, while important for sustenance, probably was not the most healthy of food options.

Community gardens have so many benefits.

Typically, they are started by either donations from nurseries or by community members wanting to help themselves and those around them. Some of these gardens sell plots at minimal cost for individuals to do their own gardening. Often times, surplus food is donated or dispensed in the area to neighbors. Volunteerism, social engagement, physical activity, mental wellness: these are good things that can come from this concept.
​
In Dr. Musa’s area of Canton, Ohio is www.cantonfarmersmarkert.com/garden

Here in Richmond, Va. there are multiple options: www.richmondgov.com/CommunityGarden/index.aspx

And then there is taking matters in your own hands at home. Make your own food. Below is a picture of my raised bed. I am fortunate to have a few 4 feet by 4 feet raised beds with irrigation. But you do not need all of this. A large pot will do. A big planter is even better. After you buy that, you can buy a big bag of potting soil for less than 10 dollars. What you see before you is a row of carrots sprouting ($1.82 for the pack of seeds….and still plenty of seeds to spare) with a tomato root that came up from last year's planting. The rest is all lettuce ($1.82 for a pack of seeds, also with more seeds to spare). Lettuce itself typically costs anywhere from $1.50-3.50 per head at most stores. If you can grow even a quarter of this lettuce and cut the leaves (if you do not pull the roots it will keep growing during the season) you will get a HUGE return on your investment. You do have to water it and occasionally pull some weeds. But after the initial time of planting, this is low maintenance.

One comment on grocery stores regarding more whole food plant-based options is that we can vote with our mouths. Because I occasionally travel to rural areas or other states where doctors are needed temporarily, I go food shopping in a variety of stores. Options can be limited for my needs simply because that is what is shipped to the area. The more we demand with our purchases, the more will become available. We are all consumers to one degree or another, but the more we take control with our purchases and manage the things we buy, the more we will get the things we need and ultimately it will lead to better health.
​
This is taking control of your health. Happy eating!