When we come to the Beach Boys, there is that old favorite, “Wouldn’t It Be Nice”—Maybe if we think and wish and hope and pray, it might come true.
That brings us to Larry Kushi. There is a saying that the apple does not fall far from the tree. I do not know if one can say that this expression applies or not to Michio Kushi and Larry Kushi, his son.
Michio Kushi studied law at the University of Tokyo but came to the U.S. after World War II where he continued his studies at Columbia. In Japan he had studied the macrobiotic diet. This is a concept that is hundreds of years old, based on Zen Buddhism, which attempts to balance the yin and the yang in our diets. Operationally, this means that there are reduced animal products, locally grown natural foods, and eating in moderation. It puts an emphasis on whole grains, beans, fish, etc.
Michio Kushi became the leading proponent of the macrobiotic movement in the U.S. He founded a center for its practice, wrote many books, and provided educational programs on it. He argued that it could prevent cancer, though there was not a shred of scientific or experimental evidence to support that claim. Ironically, he, his wife and his daughter all died from cancer.
The Kushi Center was located in Brookline, Massachusetts, where he and his wife raised their children, among them Haruo (or Lawrence [Larry]) Kushi, who did not go to Maimonides. There can be little doubt that his father influenced Larry’s choice of career. He studied at Amherst College before earning his doctorate in epidemiology at the Harvard School of Public Health. His first faculty position was at the University of Minnesota, and he later joined the faculty at Columbia, but has been the director of research at Kaiser Permanente in Northern California for many years.
Kaiser-Permanente was the first health maintenance organization in the U.S. It started on a small scale in the post-Depression era, but in its modern form began after World War II. It is as close as we have in the United States to a nationalized health care system, though other health maintenance organizations have emulated its prepaid model of health care financing around the country. Such organizations provide a particularly attractive locus in which to conduct research on quality of care, especially prevention and similar types of studies.
Because the Kaiser-Permanente system is the largest HMO in the country, it is particularly useful for studies. Lawrence Kushi, ScD, has made it a heavily used database for such studies on breast cancer etiology, screening, and prevention, and also for colorectal cancer, and other cancers.
Interestingly, he has written to urge restraint in adopting the macrobiotic diet as either a method to prevent or to treat cancer. He recognizes the dearth of scientific evidence that can establish a role for this diet. Even so, he mostly does adhere to that diet himself.
Lawrence Kushi made a particular contribution to the study of the etiology and survival of breast cancer. He created a large cohort of breast cancer patients called the Pathways Study, which generated many discoveries in this area. Central to these studies was the ability of the Kaiser Permanente data to provide outstanding data for the research scientist and his colleagues to do their research work. Much was especially learned about nutrition and breast cancer. As we have learned previously, there is not all that much to know about nutrition and breast cancer. Calories are important for sure, though and so did Lawrence Kushi find.
He has made his biggest contribution in nutritional policy, serving as chair of the American Cancer Society Committee on Guidelines for the Dietary Prevention and Management of Cancer, as well as chair of the Food and Nutrition Section of the American Public Health Association.
Parenthetically, long-time readers of this column will recall an article from more than a year ago on the Jewish Chronic Disease Hospital scandal in which I recounted how three courageous Jewish internal medicine residents at that hospital refused to administer injections of tumor cells to elderly patients at that hospital in the 1950s without informed consents and were consequently fired. I noted that I could not find any follow-up on them, but would come back with info as I obtained it. For one of the residents, Avir Kagan, his daughter recently contacted me and was kind enough to tell me that her father was subsequently reinstated and went on to complete his internal medicine residency. During a rewarding career, he served as medical director of Coney Island Hospital in Brooklyn. Her brothers, both physicians themselves, were particularly gratified to hear the scandal and its ramifications and the role their father played recounted and discussed in their own ethics courses in medical school, just as he had told the story at home.
Alfred I. Neugut, MD, PhD, is a medical oncologist and cancer epidemiologist at Columbia University Irving Medical Center/New York Presbyterian and Mailman School of Public Health in New York. Email: [email protected].
This article is for educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and does not constitute medical or other professional advice. Always seek the advice of your qualified health provider with any questions you may have regarding a medical condition or treatment.
