At a rural Albemarle clinic, two doctors are teaching patients that health is in their heads

Dr. Zachary Bush, right, opened alternative clinic Revolution Health Center in Scottsville. Dr. Martin Katz was a partner there, and both told their patients: “You have the power to heal yourself.”

John Robinson Dr. Zachary Bush, right, opened alternative clinic Revolution Health Center in Scottsville. Dr. Martin Katz was a partner there, and both told their patients: “You have the power to heal yourself.” John Robinson

When UVA-trained endocrinologist Zachary Bush decided to start his own alternative practice devoted to helping patients lead healthy lifestyles, stubbornness played a big role in where he decided to put it.

“I was told it wouldn’t work in rural Virginia,” he said. “People told me, ‘You could start a plant-based diet program in Charlottesville or Boulder, Colorado. But you’re not going to do it in Buckingham.’”

He opened Revolution Health Center in Scottsville, he said, to show that everybody can be taught to change their attitudes and behavior—and their health.

Bush came to Charlottesville in the early 2000s for his internship and residency in internal medicine at UVA after medical school at the University of Colorado. He excelled, becoming Chief Resident in 2005, was offered a prestigious endocrinology fellowship, and did pioneering work in the lab studying the role of a vitamin A compound in cancer signalling.

He also developed a strong and ultimately life-changing skepticism of the medical establishment he’d come up in. Whatever he and his colleagues were throwing at the rising tide of deadly lifestyle diseases he saw in clinical rotations—diabetes, heart disease, thyroid disorders, high blood pressure—it wasn’t fixing the problem.

“We had 10 years of data saying, ‘Whoa, the drugs aren’t working,’” he said. “So the alternative is—what?”

Bush became convinced of a theory that’s still fairly far outside the norm in modern medicine: that all our ills are caused by inflammation, the body’s immune response to stress of any kind. Lose the stress—hormonal, dietary, psychological—and you remove the root cause of illness, the thinking goes.

“As a physician, it simplified what seemed like a really complex situation,” he said. No more prescribing statins for high cholesterol, beta blockers for hypertension, and thiazolidinediones for diabetes. Instead, start from the ground up with a total lifestyle overhaul: plant-based diet, exercise, and the belief that given the right inputs, our bodies can largely take care of themselves.

It made him reshape his entire view of medicine, from the disease-centric treatment of a vast array of symptoms to a patient-centered approach. It also shunted him from the world of mainstream medicine to that of the alternative.

Two years later, Revolution Health Center has another partnering physician, sports medicine specialist Dr. Martin Katz, and several consultants who offer nutritional expertise and more alternative treatments. They also have a steady stream of patients.

Their emphasis on a vegan diet makes them unusual; Bush said he couldn’t generate enough support for a clinic based around the concept at UVA. But he said the most fundamental part of their approach is an effort to shift patents’ thinking: They’re responsible, and they can be well.

“I was taught that it was rude to say that,” Bush said. “That you shouldn’t blame the patient for their disease problems. That’s too intense. Don’t tell them that they could have avoided their diabetes.”

But he said pulling the curtain back on diseases that are largely caused by lifestyle choices—especially diabetes—is empowering.

“These patients walk in feeling doomed,” said Bush. “They watched their mother die with amputations and complications from diabetes at 53, and they’re 38, and they already have severe diabetes, and they’re scared because they already have ulcers on their feet.”

Telling them they can reverse the course of their disease “isn’t damning a patient at all,” he said. “It’s empowering them. You can escape your own genome, your own predispositions, and heal.”

Chris Curtis was one of those patients when he walked into Revolution a year ago this month. At 350 pounds and with full-blown Type II diabetes, “I just knew that I was dying, literally,” he said. He couldn’t work. His medications filled a gallon Ziploc bag, he said, but they weren’t helping. “My body was shutting down. I felt totally helpless.”

Curtis, who lives in Ruckersville with his wife and one of his grown sons, was steered to the clinic by his endocrinologist, who thought Bush’s approach could help him. After three weeks on a vegan diet, Bush took him off his insulin and, eventually, most of his other medications.

A year after he started going to Revolution, he’s 110 pounds lighter and full of energy, and his diabetes is under control. Finally changing his diet and introducing exercise—advice he’d received before—have made him vastly more healthy. So why did it stick this time?

“What blew me away was that they taught me what was going on in my body,” Curtis said. “And as they worked with me, it wasn’t just telling me to do this and do that. Take this drug. Badda bing, badda boom. They helped me understand why this is the way.”

Bush and Katz said they understand why such an approach isn’t widely used.

“Doctors are busy,” Katz said. “You’re spending more time with your patient, not just giving them a drug or a referral. This approach, it’s just not aligned with the current model of care.”

But mainstream medicine may be catching on. Dr. Daniel Cox, a psychiatrist and neurobehavioral scientist at UVA, is partnering with a medical team to study the effectiveness of just such an approach. Of a group of 50 newly diagnosed diabetes patients, half will get traditional treatment—drugs and the usual doctors visits—and half will get no meds, but will receive intensive instruction in disease management.

Cox said he’s hopeful the study will shed some light on the importance of using systematic, patient-empowering methods to change behavior.

“The reality is there isn’t anything new in the content,” he said of his study. The dietary and exercise science is there when it comes to diabetes and other lifestyle diseases. “It’s the package that’s important. It’s working with the person.”

Chris Curtis said for him, that distinction was the difference between living and dying. He believes if he hadn’t shifted course, he wouldn’t have made it to 2013. “Dealing with just somebody’s attitude alone can save their life,” he said.

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