[Article Writing Competition] #1 From Roseto,With Love

 From Roseto, With Love

            100 miles southeast of Rome, lies a medieval township. Faithful to it's Roman heritage, the town was built around a large, central square. Directly facing the square, was houses belonging to the city's nobles. There was a middle-aged archway on one side, that will bring visitors to the town's church, Madonna del Carmine -Our Lady of Mount Carmine-. The town was actually established upon the foothills of Apenine near rural Italy in a province named Foggia. For those who were accustomed to the area, they will find the town's pavement arranged in the form of narrow stone steps that run up to the hill side. Flanked in between, was 2-storey stone houses with a red-tiled roof, sheltering visitors from the gentle warmth of sunny Foggia. The town's name was Roseto.

            Life in Roseto was harsh. The peasants there commonly worked near the marble quarries around the foothill. Some went to the terrace valley below, ploughing farm for crops. Each day, they have to walk 6 to 8 kilometres down the hill in the morning and back up to the mountain by dusk. Economic betterment was foreign to them. Even, literacy among the townsfolk was scarce. It was not until 19^th century that  words reached Roseto, that across the ocean, a land of opportunity was found.; the Land of America.

            January, 1882. 11 Rosetans set to sail to New York. That following year, 15 more followed suit. Words started to become promises. Before long, some twelve hundred Rosetans migrated to America and headed to Pennsylvania, leaving the old town of Roseto empty.

            The 'new' Rosetans in America quickly bought lands near the rocky hillside of Bangor, Pennsylvania. They started to build the closely clustered 2-storey houses, complete with the slated, red-tiled roof. They set up a church and called it Our Lady of Mount Carmine. They farm crops of beans, potatoes and melon in their backyard. They grow grapes for their homemade wine. They raised pigs and cattles as nutriment. They  organized festivals and celebrations. You can see that the Rosetans were trying hard to stay true to their culture. In fact, if you were to stay there in the early 1990's, not only will you hear pure Italian being spoken, but in precise, the southern and rich Foggian dialect of Roseto. To an observer, the Rosetans intention was clear; They are going to build back their home. They are bringing back Roseto. As inclusive as they can. But not until Stewart Wolf came there and discovered a peculiar miracle.

            Stewart Wolf was a physician. He was a lecturer, teaching at the medical faculty of Oklahoma University. It was summer when Wolf was spending his time in a farm right beside Roseto in Pennsylvania. "I was invited to give a talk at the local medical society," Wolf said. After the talk was over, he joined the local doctors for a drink. It was there that he heard the story of Roseto from one of the doctors; "You know, I've been practicing for 17 years. I get patients from all over, and I rarely find anyone from Roseto under the age of sixty-five with heart disease". Stewart Wolf was shocked.

            Wolf's scene of suprise needed to be put in a context first. This was 1950's. Years before statins, bile acid sequestrants, or nicotinic acid agents was introduced. Years before people even realize the importance of leading a healthy life. No cholesterol-lowering drugs coupled with the absence of concrete measures to promote robust lifestyle can only meant one thing; fatal heart disease. Seeing the statistic, it was hard to guess the other way around. In 1950, nearly half of the causes of death in America was a direct call from heart disease cases. Common sense dictates that for a doctor to work in America without bumping into any heart-disease related patients was effectively zero. To put it in our language, it's like a doctor working in Kelantan without hearing about any "kencing manis" case. It just doesn't make any sense.

            Stewart Wolf was determined. He gathered support from his students and colleagues around Oklahoma. They packed and went to Roseto. The mayor provided the town council room for the purpose. It was 1961 when they started. "We decided to do preliminary study" Wolf plans. Their investigation stretched from death certificates, physician's records, medical histories, and up to a complete family trees. They took samples of blood and EKG readings from a small pool of the townsfolk. It wasn't enough. After four weeks, the team moved from the town's council room to the town's school. Only this time, their sample pools were bigger; The entire population of Roseto.

            The result was astounding. None of the Rosetans under the age of 55, has ever died from heart attack. They don't even show any signs of one. Wolf was intrigued. He was challenged, to be exact . He just couldn't find any explanation. In a nation where heart disease was -and still is- a serial killer, Roseto seemed immune from it. He grabbed a phone and call his friend, John Bruhn, a sociologist from Oklahoma. They decided to change their method of approach."I hired medical students and sociology grad students as interviewers, and in Roseto we went house to house and talked to every person aged twenty-one and over," Bruhn recalls a scene which belongs some 50 years ago. "There was no suicide, no alcoholism, no drug addiction, and very little crime." Bruhn couldn't hide his amazement. Rosetans didn't have any other cause of death. They died only because of old age. That's it.

            How you choose your food, the amount of calories in the food, the nutrients in store, all these are the official guide of How to Treat Your Heart Disease for Dummies. But to say that the Rosetans followed a strict diet originating since from Roman age, would be preposterous. For one thing, the Rosetans foods were cooked with the cheap and richly-saturated pig fat of lard. Heavily in contrast to the more expensive but healthier olive oil they used for cooking back in Italy. In Italy, the Rosetans baked pizza with thin crusts, some onion and anchovies. In Pennsylvania, their pizza was bread dough plus pepperoni plus ham plus sausage plus salami. Italian sweets as biscotti, canestrelli and taralli were exclusive to Christmas and certain festivals back in Italy. While in Roseto, they were eaten the whole year round. Wolf had once asked dieticians to analyze the eating habits of Rosetans. They found out that an unbelievable amount of 41% in their diet was purely fat. If you are what you eat, surely Rosetan didn't seem like it.

            Wolf started to consider hereditary factor. Genetic similarity or maybe some particular nuclear arrangement. The Rosetans are basically a self-sufficient group coming from a similar region in Italy. Maybe they have something in common with the other Southern Italian. A particular gene perhaps which give them such resilient breed of stock. Wolf began tracking down the relatives of Rosetan's scattered across America. He was searching for the invisible ink which may connect the visible dots from Roseto. Some remarkable attributes of health that they may share with their cousin. He combed through the list. He calls and send letters to them asking for their health condition, any form of tangible link that they could recall. Then Wolf suddenly stops. He cannot find any.

            Wolf's team list of options were narrowing. It wasn't diet, and it was't genetic factor. To credit the Rosetans habit of exercising would be laughable. Roseto in Foggia and Roseto in Pennsylvania was different in terms of geography. Here in America, they doesn't have the same routine of going down and up the mountain for a total of 15 kilometer per day for the obvious reason that they didn't have to. Nor was them the type of people which rise up early in the morning for yoga or jogging. In fact, many of them were struggling with obesity. They also smoked heavily. Again and again, Wolf's chase seemed like a hopeless case.

            Wolf held on to what perhaps maybe his last card. The region of Pennsylvania. What if there was something special about the foothills here? Something or anything that correlate directly to the benevolence of Rosetan's health. As a starter, there were only 2 towns closest to Roseto; Bangor and Nazareth. He noticed that both of them  have the same span as Roseto, with the almost same kind of community that Roseto had. A community of hardworking European immigrants. Wolf just maybe have found his lucky break. Wolf started scouring down on the medical records of both town. He then compared them to Roseto's. Bangor and Nazareth death rates were 3 times that of Roseto. Period. Dead end.

            It wasn't too long however, before Wolf and Bruhn began to realize that they had been looking at the wrong place from the start. "I remember going to Roseto for the first time, and you'd see three-generational family meals, all the bakeries, the people walking up and down the street, sitting on their porches talking to each other, the blouse mills where the women worked during the day, while the men worked in the slate quarries. It was magical" Bruhn remembers. It wasn't magic that made the death rates in Roseto were 35 percent lower than expected. It wasn't magic that made Rosetans lived twice longer than the national average. It was just Rosetans being Rosetans.

            Such abstract concept was really alien to the medical society. You can already guess the wave of cynicals that Wolf and Bruhn met when they presented their findings to the scientific community. Imagine; here they are, standing in a conference, where their colleagues bring forth incoherent datas and statistics, trivial findings of biomarkers, test results of a new pharmaceutical drugs; while Wolf and Bruhn talking instead about the benefits of a close-knit community, of people stopping and talking with each other around the corner, of families of three generations living under one roof caring one another. But no one seems to giva a damn at that time. Because no one ever saw health in terms of community.

            "People are nourished by other people," said Wolf. This was a peculiar statement coming out from the mouth of a physician. People's life depends on their heart. And heart was nourished by capillary beds, by good circulation of blood., which then extends to our eating habit, our choice of food, our lifestyle attitude. But Roseto defies logic. They went a step further. They  function as a whole. Instead of putting their elderly ones "on the shelf", they were hailed "to the Supreme Court". The young ones who are in need of guidance, were thus free to express themselves to their elders at home. They externalized their stress, sharing the weight of their burden with the people who care them the most; their family. "(They) radiated a kind of joyous team spirit as they celebrated religious festivals and family landmarks", Wolf noted. Then, he ends; "In those communities, each person has a clearly defined role in the social scheme -- toward a common goal--a better life for their children". Roseto doesn't need good food or new drugs or strict diet to live longer. Roseto only need Rosetans to be Rosetans.

            What Wolf saw there in Roseto was definitely beyond the lens of microscope. It wasn't anything new, though. Nothing revolutionary. It was just a community functioning as a community. It was just care and affection between members of family. In Roseto, what Wolf saw was true love in practice. As simple and as effortless as it can be.

written by:

Ahmad bin Abdul Rahim

Second Year Malaysian Student

Faculty of Medicine, Cairo University