The most devalued persons in our society often have medical conditions that are only superficially a part of typical medical training....
The middle-aged man had shown up with bleeding gums, unexplained swelling, bruises, and fatigue. His team of internists suspected a skin infection, but every bacterial test came up negative. They were stumped until, Churchill recalls, “someone eventually thought to ask about this person's diet.”
It turns out the man, who was mentally ill and lived alone in one of the city’s poorest neighborhoods, had eaten nothing but white bread and American cheese … for years. “And this had led to these very severe nutritional deficiencies,” Churchill says.
The man’s vitamin C levels were so low, he qualified for a disease Churchill hadn’t thought about since medical school: scurvy. The same scurvy made famous by pirates and British sailors from the 1700s, who would go for months or years at sea without fresh produce, experiencing symptoms from rashes to hemorrhaging. Back then, scurvy killed more seafarers than storms and shipwrecks combined.
Over the next five years, the Springfield doctors measured vitamin C levels in about 120 patients who came in with a range of mysterious symptoms, such as fatigue, mood changes, rashes, headaches, or joint pain.
Twenty-nine had vitamin C deficiencies severe enough to qualify for scurvy—more than had been found in any other recent study. (The closest was a study from the Mayo Clinic that found 11 cases between 1976 and 2002.)
The results were especially surprising, Churchill says, because the nutritional bar for preventing scurvy is so low. “You can have a handful of McDonald’s ketchup packets a day, and that’ll give you enough vitamin C to keep you from contracting scurvy,” he says.
That meant these patients were eating virtually no fruits or vegetables. And since their general fitness was poor, their symptoms had been attributed to other conditions. This was the first time, for any of the patients, that a doctor had mentioned scurvy.