We all have a few patients who have not only done very well by our care, but also have made us remember why we decided to become doctors. These folks would hardly change the graphs in double-blind studies and probably wouldn't convince a skeptical medical board. Still, there is something to be said about the patient who not only does well with alternative medicine but also lives a life that proves it.

My patient is Joe Kimm, Sr. He will turn 97 this summer. Joe told me that winter was tough this year because he was not able to snow-ski – his love for the last 40 years was skiing at Washington State's Stevens Pass. He gave up skiing when he turned 94. He looks forward to the spring because he is able to get back to his golf game. Several years ago, he studied new golf techniques, and he proudly informed me that his golf game improved immeasurably. Given the fact that he has been golfing for over four decades, Joe's comment gives one pause over the maxim that "you can't teach an old dog new tricks." Joe tells me that he doesn't have much to do at 96, but he still delivers "meals-on-wheels," to deserving seniors, and he is the active treasurer for his retirement community. He is in charge of keeping the books, itemizing the accounts, and making the deposits for the community's four shops and clubs.

Joe started flying in the late 1920s for an infant airline industry. In the old days, flight school was pretty primitive. There were no computers or electronics – you kept the plane afloat and on course by pulling on the yoke and manually raising and lowering elevator levers. Joe's career with Northwest Airlines had its close calls. He learned a lot from looking over the mistakes of many of his friends who didn't fare so well piloting. At 60, he was looking forward to learning the ins-and-outs of the Boeing 747, but the airline didn't want to fund expensive training for an older pilot. So Joe retired and took up skiing, scuba diving, and golfing.

Joe was not a health nut. He smoked two-and-a-half packs of cigarettes daily for nearly 30 years, and he liked to cap his non-working nights with several drinks. He realized at 48 years old that if he wanted to retire healthy, he needed to clean up his act. It took him five tries, but he finally quit smoking. He cut down and eventually quit his drinking. He began to trim down his weight from 190, losing 20 pounds. And he started taking vitamins – and not just a few vitamins – about 50 years ago. He also took up yoga and developed a routine of stretching and exercising each morning for 20 minutes. His lifestyle change gave him the stamina and flexibility to scuba dive through his 70s in the cold waters of the Puget Sound. His biggest dive to 100 feet was challenging, but Joe likes the stimulation of doing new activities and keeping physical.

At 81 years of age, Joe suffered his first major heart problem. He developed shortness of breath, and on examination, he was found to have 90% blockage in the major coronary artery, the left anterior descending. He had an angioplasty, a dilation of the blood vessel, but without a stent. Joe elected to come see me a short time after this, wanting to look into chelation. He was on his own making this decision – his MDs were not open to using chelation for circulatory problems. Joe did receive 30 chelations during the first year I saw him and remarked about his improved stamina, overall vitality, and ability to engage in all his activities, including his beloved skiing, which had been sidetracked when he first developed coronary artery ischemia. His follow-up cardiac exams did not show any significant improvement in the first year after having chelation. But in the second year after having chelation, Joe's cardiac reserves, heart muscle function, and coronary artery status had improved.

Some patients undergo the chelation process, do well or do not-so-well, and move on. There's a protocol that suggests that 20-30 chelations are necessary to remove toxic elements and improve circulation blood flow. The protocol is not clear about what should be done after those first 30 treatments are done. As a rule, most patients come in periodically for "booster" chelation to maintain the benefits of the initial chelation series. Joe elected to come in for maintenance chelation and to continue having chelation on an extended basis. After it became clear that his cardiac status was improving based not only on his symptom response but also on the results of cardiac studies, Joe decided that long-term chelation maintenance would be incorporated into his health strategy. He continued to follow a prudent diet, exercise, actively ski, and consume many herbal and vitamin/mineral supplements.

Joe has continued seeing me and having chelation throughout his 80s and 90s. He has had a few rough spells in the last three years. Each time, he has come in for an intensive chelation series of ten or so chelation treatments given over a short time period. His primary care physician has changed his viewpoint over the years regarding the chelation process. Initially disbelieving its value, Joe's physician, "Hank," is now convinced that it has been extremely helpful for Joe.

And perhaps this is the lesson for chelation and alternative medicine: some treatments work awfully well for certain patients. Despite the fact that some smaller studies did not find good results for chelation, there are always a number of patients who not only respond well, they usually respond spectacularly. How does medicine deal with a treatment that yields mediocre and spectacular results? It would be terrible to dismiss the treatment process because we don't have a therapy that offers a typical bell-curve result pattern. Medicine needs to acknowledge that alternative medicine works on patients very differently from the dose/benefit pattern of a drug. Alternative therapies appear to work on patients who are "conducive" to responding to such treatments – this is not a placebo. This is a patient engaging in a healing process and the healing process engaging the patient. When there is a "marriage" between a patient and healing process, it works; when there is no "marriage," it doesn't. Hence, the absurdity that alternative medicine must be reduced to "evidence-based" medicine. Alternative medicine will always be the medicine that "matches" what is right for the particular patient.

Joe recently returned to see me, because he suffered from a difficult flu bug and he had become quite short of breath. He resumed having chelation and is no longer suffering with the infection or breathing difficulties. He looks forward to getting back on the golf course this spring.

In this month's issue of the Townsend Letter, Robert Crayhon interviews Dr. John Abramson, MD, who discusses "The Overselling of 'Statins.'" Crayhon's radio show "Nutritional Medicine Update" focuses on interviewing the "big minds" in nutrition and integrative medicine. His conversation with Dr. Abramson tackles a serious topic: how effective are pharmaceutical drugs in preventing progressive deterioration in heart disease? Over the past two years, the medical profession has taken the unseemly position that elevated low density lipoprotein (LDL) cholesterol scores require drug therapy until proven otherwise. For the non-diabetic, an LDL score exceeding 100 mg% is considered high; for the diabetic, an LDL reading of more than 70 mg% demands treatment. The quickest and most efficient prescription dispensed in the clinic is a "statin." Until the Vytorin quagmire earlier this year, one had little argument against the prescribing of Lipitor or Zocor. Or so it would seem. Dr. Abramson argues that the evidence on LDL cholesterol treatments reveals statins may be useful in lowering cholesterol but are of little benefit in reducing cardiac disease or mortality. Abramson posits that diet and exercise remain the best treatment strategies for preventing heart attack and that the evidence that statins "work" are misinterpretations of the data.

Brian Peskin, with Dr. David Sim, examines the Vytorin failure and presents a compelling argument to reconsider LDL's role in the development of cardiac disease. Peskin, an electrical engineer, and Dr. Sim, a cardiologist, theorized in a paper published in the August/September 2007 Townsend Letter that essential fatty acids play a fundamental role in preventing cancer. Peskin's theory argued that the dietary consumption of esterified and adulterated fats obstructs the effective oxygenation of cells, facilitating cancer metabolism. In their article in this issue, Peskin and Sim worry that the statin degradation of LDL cholesterol interferes with the body's innate mechanisms to remove esterified fats and diminishes the productions of prostaglandins necessary to prevent abnormal clotting. Peskin also worries that our excess consumption of essential fatty acid derivatives found in fish oil supplements disrupts the normal balance of "parent" "omega-6" to "omega-3" essential oils. Peskin's work is controversial but deserves study and consideration.

On the political side of things – no, I don't mean the debate over Clinton and Obama – read Dr. Julian Whitaker, MD's guest editorial on the misconduct of state medical boards. Whitaker takes the position that medical boards have unbridled powers and their investigations violate due process, pose conflicts of interest, and breach privacy. He discusses a lawsuit against the Texas Medical Board and encourages readership support.

Jonathan Collin, MD