On a Friday afternoon, cousins Lankston Lewis and Khera Lincoln, both 5, dipped their fingers in the black soil of a garden behind UT Physicians of Gladewater’s small wood-framed building to wiggle out two crooked carrots.
The girls are patients of Dr. Stephanie Tyo. They have an opportunity to plant, harvest and taste the offerings of earth. Along with the carrots, kale, sage, bell peppers, radishes, green beans and watermelons are sprouting from the tiny garden.
During lunch, it’s not unusual to see Dr. Tyo, 29, and her staff outside at a picnic table, adding kale leaves from the garden to their salads.
Kathy Cannon, a community health worker at the clinic, cares for the garden, along with help from her mother, and sometimes, Gladewater residents.
Lankston’s mother, Keshia Lewis, 34, said the girls enjoy visiting the garden.
“It brings the family together,” she said. “It kind of brought our whole street together because everybody comes out and helps Ms. Kathy with the garden. It’s making us more conscientious of eating healthy.”
A DIFFERENT KIND OF DOCTOR
Before the garden, Dr. Tyo, 29, gave seeds to patients to grow at their homes.
The family physician is more interested in preventive medicine, which includes good nutrition, than discussing illness and medication.
“It’s honestly more pleasurable for me,” she said. “I’d rather have a conversation about a garden with someone or have them interested in that.”
Dr. Tyo may be in a rare class. According to The Journal of the American College of Nutrition, the amount of nutrition education medical students receive is inadequate. In a 2010 study, only 25 percent of medical schools required a dedicated nutrition course. Overall, they received just more than 19 contact hours. However, the National Academy of Science has recommended since 1985 that medical students receive at least 25 hours of nutrition education.
A 2008 study, also published in the Journal of the American College of Nutrition, concluded that while 94 percent of doctors agreed they are obligated to discuss nutrition with patients, only 14 percent felt they were adequately trained to provide nutrition counseling.
“They don’t train us much on this stuff, and so on my own, I know the value of it and I sought out the education a little bit more,” Dr. Tyo said. “I just make it a part of everyone’s visit.
The correlation between diet and chronic disease has been examined for a long time.
“I definitely feel it’s the root of our chronic medical problems,” Dr. Tyo said. “I can just hand out medicines all day and get patients seen, but if you can change the lifestyle a little bit — and sometimes just the small changes build up — it’s way better for the patient.”
By “way better,” she means patients taking fewer drugs.
“We’ve had a lot of people lose weight, and once they’ve lost the weight, they need less of their medicines,” she said. “Overall, yes, that’s the goal.”
Dr. Tyo sees about 12 to 15 people each week at the rural clinic. Most of her patients have obesity-related conditions, from high blood pressure to type 2 diabetes.
They walk into a clinic where the staff approaches health holistically. There’s a counselor, community health worker and now a garden.
At the entrance, a display shows the amount of sugar in one can of soda.
“You wouldn’t sit and eat 10 packets of sugar so why would you drink it?” Dr. Tyo asked, referring to the display.
She’s also embarking on an experiment to see when and if a processed burger will decay.
At the front counter in a tiny waiting area, there is a glass window covered with adhesive letters that read: “The food you eat can be either the safest and most powerful form of medicine or the slowest form of poison,” quoting the late renowned holistic health practitioner, Ann Wigmore.
It’s reminiscent of Hippocrates’ adage, “let food be thy medicine and medicine be thy food.”
If patients are receptive, Dr. Tyo enthusiastically shares tips about eating well. If they push back, she makes the information available without putting pressure on them. One of her first goals is to persuade patients to give up soda.
“When you do take the time out, it works,” she said. “If someone is not receptive then we’ll just mention it a little bit at each visit. I won’t beat them in the face with it.”
Patients are flooded with information even if Dr. Tyo doesn’t say a word about nutrition. In each exam room, there are signup sheets for the garden club, health quotes are pasted to cabinets and there are sheets of paper with take home points from “Food Rules: An Eater’s Manual” by Michael Pollan.
As a community health worker, Ms. Cannon is at the center of the efforts. She educates patients, particularly those with diabetes, about making one or two healthy lifestyle changes at a time. She encourages them to cut back on white foods, such as bread, potatoes and rice, and opt for more vegetables.
She then follows up with a phone call or sometimes a home visit to see how they are adjusting and if they require additional support. The garden is a bonus.
“It’s literally picking your medicine from the vine,” Ms. Cannon said. “It has sparked more interest in eating healthier foods. We’re starting a recipe book for everybody so that our patients can take it and use two or three ingredients that will come from fresh vegetables.”
However, she understands that gardening and encouraging a healthy diet is easier said than done.
“It is a paradigm shift,” she said. “It’s just not to say, ‘Go and buy it and try it.’ It’s with a lot of support.”
The clinic’s attitude toward nutrition also has helped her make personal changes.
“When you provide coaching to people on making great choices, I think you should be the forerunner of doing it,” she said.
Dr. Tyo doesn’t expect to feed a community, but she does want the garden to grow. Her mission is to introduce — or reintroduce — people to the notion of eating whole foods that they’ve grown themselves.
As the community gets more involved, she aims to have grocery store tours, cooking classes and even a yoga class.
In the meantime, she hopes that more in the medical community will take an interest in healing with food.
“Other people can do this,” she said. “Schools can have gardens. What if every doctor’s office had a garden?”