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cussion, and that’s where Cape can provide solid information, and often counter the worst-case scenarios the patients have found on the Internet. A small percentage of patients may de- cide to terminate the pregnancy, but most embrace the situa- tion with a determination to help their children live to their fullest potential.


Those with a poor prognosis can work with a palliative care team that Cape serves on, in order to make a birth plan—do they want to hold the baby? do they want any intervention for it?—so everything’s in place at the delivery. “It’s really hard for them,” she says, “but I think this helps a lot.” One thing Cape will not give is advice on what the expec- tant parents should do. “My opinion is never important,” she says. Of course, they do ask. But she replies, “I’m not you. I want you to have all the information so you can make the best decision for you and your family.” And most of the time, even when patients are considered


high-risk, there’s no problem with the baby. “It’s what we try to reassure patients: most babies are born healthy,” she says. —KG


YOU ARE WHAT YOU EAT


A licensed, registered dietitian and certified diabetes educator, Jean Strathearn-Daniello ’76 has her finger on the pulse of American wellness. And it’s pretty thready.


NUTRITIONIST JEAN STRATHEARN-DANIELLO ’76 SAYS TOO MANY AMERICANS ARE SIMULTANE- OUSLY OBESE AND MALNOURISHED.


Starting her career in the USDA’s Women, Infants, and Children pro- gram in Mary- land, she has also worked with aging popula- tions, in group homes for people with disabilities, and at the Joslin Diabetes Center. Today she serves a broad spectrum of outpatients at Carroll Hospital Center in West- minster, Md. She first stud- ied diabetes be- cause she en- countered more patients suffering from it—even be-


fore type 2 diabetes became quite the epidemic it is now—and saw an opportunity to help them through dietary reform. She views the explosive growth of the disease as a logical outcome of a larger sociopolitical situation. She says, “The big agribusi - nesses are subsidized to grow crops such as corn, soy, and


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wheat,” much of them used in making high-fructose corn syrup, processed foods, and carbohydrate-heavy snacks. It’s not just that the government is underwriting the pro- duction of unhealthy food. The subsidies, she adds, also make it less profitable to grow produce in the US. “We import a lot of our ‘healthy’ foods such as fruits and vegetables from Latin America.” She argues that the American industrialization of food is strictly about profit, not health. Every taxpayer subsi- dizes high-fructose syrup production on the front end, then pays for spiraling health-care costs on the back end. With that kind of agricultural economy, “for the past 30 years our diet has been going in the wrong direction,” she says. Strathearn-Daniello recalls a poignant moment when she was working with preschool children who weren’t participating in the National School Lunch Program. “It wasn’t uncommon to see kids bringing in a lunch that consisted solely of a pouch of Doritos chips (basically carbs, sodium, and preservatives) and a juice box (full of high-fructose corn syrup).” Particularly heartbreaking is the preponderance of severe obesity in the lower income strata, she says. She calls it a “malnourished obe- sity”—brought on not just by overconsumption, but more specifically by overconsumption of empty calories from junk food and soda-pop. “There’s such an imbalance between nutri- tive and non-nutritive foods available in certain neighbor- hoods, which makes it hard for those residents to find or select healthy food.” She says that, as a society, and particularly in poorer or less educated communities, we need to educate peo- ple about healthy eating: “real fruits and vegetables, whole grains, and lean sources of protein.” While the scales are still tipping ominously, Strathearn- Daniello has been particularly pleased with First Lady Michelle Obama’s crusade to combat childhood obesity. She was also surprised and delighted that New York City’s mayor Michael Bloomberg proposed a ban on “super-sized” sodas. And she does have patients who have taken ownership of their diets and are now making healthy choices. From her perspective, “Diet isn’t a cure-all, but eating poorly is a sure way to get sick.” —Jon Wurtmann ’78


BODYWORKER


Carl Rabke ’94 got a painful wake-up call in college. A herni - ated disk in his spine—from years of lacrosse and basketball, and from too much sitting—was so severe that he had to write his thesis while lying on his stomach. Shortly after graduation he opted for surgery. It relieved the pain, but Rabke says he re- alized, “I had to change my relationship with my body, or I’d be back in the same situation.”


In Utah he began practicing tai chi and yoga and studied


with a Tibetan Buddhist who focused on “embodiment.” The more Rabke learned, the more he saw how disconnected he was from his body’s “wisdom and intelligence.” He enrolled in massage school, then studied Structural Integration (also called Rolfing, created by American biochemist Ida Rolf) and the Feldenkrais Method (developed by Russian-born Israeli physi-


LISA HELFERT


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