Welcome to CeliacUniverse
It has been ten years, and my story and travels have been told in pieces along six continents. To pay homage to another Douglas1, this is my guide to the galaxy of celiac disease and the world of gluten-free living (to some a mythical “restaurant at the end of the universe”) 2. Credentials are one thing (check), life experience another (check), but the benefit of sharing this space I hope will be a story in itself. I look forward to navigating the amazing Celiac Universe together, to share stories, experiences, new medical literature, and other health related information.
Accepted fellowship to Harvard Combined Program in Pediatric Gastroenterology and Nutrition.
I was entering my final year of pediatric residency at Washington University and St. Louis Children’s Hospital. I grew up in St. Louis, and after stops in Austin and Tel Aviv, was enjoying the land of Ted Drewes, the St. Louis Cardinals, and my family.
But, after milling several opportunities in the spring, I was excited about the new adventure I was about to embark upon in Boston. As a pediatric gastroenterologist, I hoped to become a master endoscopist, study biliary atresia http://www.childrennetwork.org, (a life-threatening disorder, the leading cause for liver transplant in children), and perhaps diagnose celiac disease. Even in 2002, celiac disease was still considered rare by some. Just three years earlier, at an interview for a pediatric residency in New York, as part of the standard, “So tell me why you want to become a pediatrician”, I was presented with the first challenge of my young career in medicine. I outlined my treatise (see above) on why I should be part of their program and highlighted interests in a littany of things, already narrowed to a career in pediatric GI. And then it happened….. a direct challenge and likely “mythbuster”.
For every patient I see, physician phone call I take, gluten-free meal I prepare in 2011, these words from the interviewer still resonate……. “We just don’t see it very often” (celiac disease), you won’t see it.” Although there was some sarcasm in his voice, how could that be I privately thought (sitting in front of a respected pediatric GI physician, a potential future mentor), that in New York, a city of nearly 2 million Jews, that celiac disease wasn’t common. We all know how that story goes as Fasano et al. in 2003, reported 1:133 individuals in the United States had celiac disease. MYTH-BUSTED!
Summer 2002 (St. Louis, Missouri)
I was fortunate to have amazing mentors that were knowledgeable about and had lived the evolution of pediatric GI disorders. And like every medical student who thinks they have a disease, (http://en.wikipedia.org/wiki/Medical_students’_disease) medical residents might have it worse. They actually know what tests to order and how to follow-through. And so there I was, rotating in a clinic, whose mission was to coordinate complex diagnostic care for pediatric patients and in my eyes, to solve clinical conundrums, challenging cases, and learn from master diagnosticians, an opportunity that continues to serve invaluable. One test, the tTG or tissue trans-glutaminase, a serologic marker for celiac disease, was frequently ordered. So, I became more acquainted with the various results, interpretations and more curious.
To be continued……..(Are you curious too?)
1 The Hitchhikers Guide to the Galaxy. Douglas Adams, 1978.
2 The Restaurant at the End of the Universe. Douglas Adams, 1980.