Monday, January 21, 2013

RETIREMENT Dr. Shoemaker


Dr. Shoemaker is retiring due to his pulmonary hypertension effective 1/28/2013. This illness is progressive and has a predictable outcome despite availability of multiple medications. His focus in retirement is (1) to certify physicians as experts and (2) to expand use of the genomic aspects of biotoxin illness.
He writes on his 36-year career ("Looking back") as follows:

The number one question for the website is, "Who can help me without traveling to Maryland?" We are now going to be able to list physicians (if the physician chooses) who know the Shoemaker Protocol adequately to pass a certification exam. Patients can then access contact information for expert physicians posted on the www.survivingmold website.

Be sure to follow developments on regarding physicians' certification. Please stress the importance to your physician of adding her/him to our list of providers. Also, for all physicians, if you know people who are completely well (we call them controls), who would like to know their genomic make-up, please let the website know so we can send you a PAXgene tube (special blood tube) to draw for genomics testing. For every control we receive, we will run a sample from a "case" in your practice at no charge.

Once I receive the legal "go-forward," I can now be allowed to help people over the phone but, of course, without ever prescribing medications or ordering tests. I will continue to speak with physicians as they request. Keep monitoring the website for details as this consultative practice develops.


Looking back:

So my career seeing patients is now over. Maybe I could have bargained better with the Grim Reaper to try to stay in active practice. I tried. I could have given him more, maybe a few toes or an ear or all my grey hair (that's all I have any more) in an effort to avoid saying "no" to seeing new patients. But he wasn't interested in negotiations. I couldn't bargain with the Reaper; I knew beforehand that those who do always lose.

He wanted my lungs and heart and whatever else was connected. There is no appeasing that guy. And he is relentless. He's going to get what he wants from me. It is just a matter of time.

So I am left to reflect on 36 years of working 80 hours (plus!) a week doing what I love (medicine and research) almost as I love my wife, JoAnn, and daughter, Sally. They always came first in my thoughts and now will in my actions. I can hear them yesterday, expecting me to say no. Did I want to go to see Spamelot? When is it? Early in February. Yes, I want to go. Last year I would have said "No, I have too much work to do."

Now I have all the time in the world.

That 36-year work load was real. What am I going to do without finishing patient charts and writing affidavits until midnight? Time off for R and R? Goodness, just last month taking a day or so off for a conference meant a week or so of digging out from underneath faxes, emails, phone calls and the US mail. Lucky for me I have worked with some great people like Debbie Waidner and Debra Bell. Debbie starting working with me on October 4, 1982, the day I first set up my private practice in Pocomoke. That is over 30 years ago. Thirty years! Debra herself has worked tirelessly in my specialty practice for many of the years since 2002. Good help is hard to find you know. I have been blessed with the best.

I still remember my attempt at dedication to patient care in 1977 in Delphi, tucked away in the mountains of Greece. I had finished medical school at Duke a month early. I didn't really want to wait around to attend the Oath of Hippocrates ceremony in Duke Chapel. I mean, the Oath is said to Apollo, and last I saw, he wasn't sitting in a Methodist chapel in North Carolina. No: I would say my Oath to Apollo in his chapel, in his Temple, in Delphi. Duke officials were a bit annoyed as I think I was the only person in the medical school graduating class listed as absent. But it was my Oath, not theirs, so what right did they have to argue with my personal decision?

The day was chilly and overcast in Delphi. The bumpy bus ride up from Athens was enough to shake up even a flask of cholestyramine. I was pleased to be on the right bus as just about the only words I knew in Greek were Plaka, Parthenon, Mykonos, agora, Plato, Delphi, phi, beta, kappa, souvlaki, retsina and ouzo.

The Temple was plain yet elegant; simple but extraordinarily complex. I looked to the skies and saw grey clouds. No sun, no sign. Wasn't that just something? Here I had traveled thousands of miles for a cloudy day. Maybe I should have stayed in Durham. Somehow though, I knew Apollo would honor my wishes.

There had to be a sign for me; I wanted so much to say my precious words at just the right time, when Apollo said, "do it." So I looked around, waiting for the right moment for the Oath. The ruins were awesome though the Oracle was less of a big deal. "Hey, Mr. Oracle, I see the Yanks over the Dodgers in six in October with Reggie hitting all kinds of homers." No sign, but no disagreement either.

But then, just as the bus was loading for the return trip to Athens, I walked down the hill one more time to stand in Apollo's Temple. The clouds suddenly cleared and a shaft of light struck me straight in the eyes. I said my Oath, goose bumps and all. Then the clouds closed into grey all over again.

Patient care it would be.

Maybe a theme was being established back then. If what was expected of me by the Establishment didn't make sense to me (or wasn't true), who in the world would expect anyone to knuckle under to someone else's opinions, however flimsy, anyway? What would Apollo do?

Still, who did I love, the CDC, EPA or the AMA? Or my patients? That was easy. Patient care was like my Anteus, the mythological beast who drew strength from the Earth. Hercules defeated him only after lifting Anteus off the soil; thereby taking away the source of his strength and then strangling him like a wet kitten (I don't condone strangling kittens, and never would agree to seeing Anteus strangled for that matter).

The Greeks simply said, "Be true to thine own self." And I have done that. Yes, I have taken some "flak," but I learned long ago when working on the highway crew in the 1960's, that "One should take no more flak than what one puts forth." Maybe the boys dressing up the highway shoulders and teaching me about living in the real world used words different from these, but you know what I am saying. They would be proud of me that I never took much flak but I certainly identified flak when I heard it. OK, it is true; tact hasn't been much of a part of my vocabulary. Flak is.

My interest in research was dominant by the time I got to undergraduate years at Duke in 1969. There Dr. Montrose Moses took a liking to me and let me work with his electron microscope at his Duke lab. Oh my, we could control DNA replication in Tetrahymena organisms! Here were the pictures! And that meant a cure for controlling cell replication, i.e. a cancer cure was just around the corner! Very cool.

Maybe my enthusiasm left out a few steps in curing cancer. As it turned out, I was drawn to the newly minted Family Practice movement. Researching cell physiology was so much fun, but just look; in primary care I could work designing patient-driven access to care systems, add in longitudinal care, provide comprehensive care and more. Man that was it. I had to do it and I did.

I worked my way through Duke as an undergraduate but Med School cost way too much money. The National Health Service Corps (NHSC) scholarships looked pretty good. They would pay my way and give me some money every month (oh my, that cash brought home a used British racing green MGB GT- my favorite car ever). All I had to do in return was to work in an under-served area. Great, that was what I wanted to do anyway.

After Family Practice residency in Williamsport, Pennsylvania (where I bet it is still snowing), I waited at the NHSC site in Pocomoke, Maryland for JoAnn to finally say yes to my requests for marriage. I don't know how anyone could be happier than I was when she said yes.

Thirty one years later, JoAnn is still here with me in Pocomoke, still supportive and still magnificent. And I love her with all my heart. And now we have all the time in the world.

I look back on my medical career with joy. There are literally 300,000 patient visits and countless advances in diagnosis and treatment of biotoxin illnesses. I had a dream that the Reaper was asking what had I done on Earth.

"Well, just look at widespread use of CSM, VCS, MARCoNS, HLA, VEGF, C4a, C3a, MMP9, MSH, VIP, TGF beta-1, T reg assays, MRS, NeuroQuant, SAIIE, HERTSMI-2 and more. Not to mention my sequential treatment protocols and the genomics patent."

He said, "So what."

"Wait, you don't understand, Mr. Reaper, each of these tests were remarkable advances defining aspects of inflammation in biotoxin illness. The research of our team brought them to clinical use. Look at the countless docs who use these tests every day."

He said, "So what. Do you think that every trivial advance, and all tests, and most ideas, are always trivial, in diagnosis and treatment of a pervasive societal problem of biotoxin illness will stop abuses of both a basic human right to a safe place to live/work and convey dignity from the doctors about their chronic illnesses?"

"Mr. Reaper, the process of doing what is right matters in the end. The process is additive; there is no advance that opens insight that is trivial. It is the tiny advances that create the platform for the leap of thought that others call a wild-eyed leap. The process is science at its most pure. Bringing hard data to the bedside gives dignity, gives validation to the masses of mold and Lyme and CFS patients. Truth matters. These illnesses are not rare or unusual. People deserve to know what is wrong. They deserve a chance at healing. My goal with all these protocols is to heal a life that your buddy, inflammation, took away. Just look at how these illnesses have fulfilled the concept of application of Th17/Treg imbalance to countless other diseases."

Even more important, now we can identify what is wrong in affected patients by use of genomics (everyone should have a PAXgene tube run. Everyone). We can now answer what is wrong with cognition and central nervous system problems using NeuroQuant. And with VIP replacement we can restore life to dead regulatory pathways. We can restore shattered lives. Data and science lead the way. We don't have to give way to the bully boy abusers of human rights and dignity.

Unfortunately, I can't do the good fight any more. In a way it is ironic that just as I have arrived at the mountaintop of successful diagnosis and treatment I am told to leave the mountain. The Reaper will show me the way down the hill. Others will have to do what is needed for the next step. I will do my best to show them what I know. Dr. Laura Mark said simply, "You can't die without leaving us what is in your brain." I will try.

I will be working to educate and certify physicians in my protocols. I will be working to publish all the goodies I have stored in countless datasets. I will live on in this fight to give rights and dignity to those who are denied. And justice? Surely, logic will prevail.

As far as unveiling the complexity of chronic inflammatory response syndromes goes, I will keep looking for a cure.

Even if it kills me.

Ritchie C. Shoemaker, MD

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