The Ministry of Rural Medicine

PINE APPLE – The town of Pine Apple lies about 20 minutes off I-65 South tucked in the southeast corner of Wilcox County along Alabama’s Black Belt. Driving through this farming community, you quickly notice the picturesque countryside dotted with the occasional farm house and antebellum home. This is an old and settled community with a population of around 150 residents.

However, Pine Apple is nestled into one of the poorest counties in the country with a population of about 12,000 residents and few physicians to make the rounds. Roseanne Cook, M.D., is one of a handful of physicians serving the county. The Pine Apple Clinic is a community health center with its business center in Selma. The clinic receives some federal funding, and Dr. Cook has taken care of patients there since 1986. The clinic isn’t the average medical clinic, and Dr. Cook isn’t the average rural physician.

Dr. Cook is a Roman Catholic nun, a sister of St. Joseph out of St. Louis, MO.

In 1979 working as a biology professor, Dr. Cook said she felt her life had another mission. So, at age 40, she entered medical school, and her life’s work was about to fully take shape with the intent of delving even deeper into her ability to help our country’s poor residents.

“I loved teaching, but I knew the Lord wanted me to do more. When I first went to my major superior about going to medical school, I wasn’t sure what that answer would be!” she laughed. “The answer was if it’s the Lord’s inspiration, you’ll get in, if not, you won’t get in. And, I got in at age 40…the age of most of my student colleagues’ mothers.”

After medical school, Dr. Cook had planned to follow her order to Peru, but the nurse practitioner from her order was already in Pine Apple and convinced her to come to Wilcox County instead to join the practice.

Now as a family physician serving many counties, not just her own due to a shortage of family physicians in rural areas, she has more than her hands full of patients. But, she and her staff always make the best of the situation.

“I’ve been in this area since 1986, and it’s poverty stricken…actually it’s beyond poverty stricken,” Dr. Cook said. “These residents work hard, and because they work, they don’t qualify for Medicaid or subsidies, so we do everything we can to make their lives a little better.”

Wilcox County has a recorded median income for a household in the county is around $16,646, and the median income for a family is about $22,200. According to the last census, about 36 percent of families and 39 percent of the population were below the poverty line, including 32 percent of those age 65 or over.

Dr. Cook’s clinic is a small community unto itself and eagerly accepts donations to continue some of the services the surrounding residents have come to depend upon. The medical clinic building is flanked by an adult care building and learning center building. At the end of the square lies a thrift store-style facility. Unfortunately, due to lack of funding, the adult care and learning center has closed. Yet, the medical clinic building almost doubled in size due to a private donation in 1991.

“We do the best we can with what we have,” Dr. Cook said. “Sometimes we have more. Sometimes less. But we always make it work here.”

Working in a rural setting presents unique challenges for any physician. But in 2001, Dr. Cook was faced with one of her most challenging moments when she stopped to help a vehicle of stranded motorists just outside of town.

She was on her way to the clinic when she spotted the car on the side of the road. It needed a jump, so she pulled up and got out of her vehicle with her jumper cables. Ready to deliver roadside aide, Dr. Cook wasn’t prepared for what happened next.

She was knocked unconscious and tossed into the trunk of her vehicle. Driven down a desolate road deep into the county and only partially conscious, she wasn’t sure what was happening until shots were fired into the trunk. Five shots rang out. Four missed. One grazed her cheek.

“God didn’t want me to die that day,” she said. Today, she can look back on the incident with an ease that she surely didn’t have 15 years ago. It’s part of Dr. Cook’s character, woven into every fiber of her soul that keeps her soldiering on every day to treat the patients she’s grown to call members of her extended family.

And…she still makes the occasional house call.

The Science of Food

Vestavia Hills – Luis Pineda, M.D., MSHA, has been a practicing oncologist/hematologist for about 38 years. Like many in his field, he longed for a way to make the treatments for cancer easier for his patients.

His life’s work took an interesting turn in 2003 during rounds as he began to notice the cans of liquid supplements on the nightstands of his patients. Each day, there were more cans, and his patients continued to suffer the lingering effects of chemotherapy and radiation. Loss of appetite, nausea, vomiting, and other symptoms robbed Dr. Pineda’s patients from the simple act of eating a meal to regain the nutrients they needed to fight the cancer he was helping their bodies to overcome.

“I realized I needed to help my patients in a different way, by combining my knowledge of medicine with the science of food,” Dr. Pineda said. “This led me to Culinard where I could experiment with medicine and the art of cooking. I needed to find ways to stimulate their taste buds after their chemo and radiation. There truly is a science to food.”

For two years of eight-hour Saturdays, Dr. Pineda traded his physician’s jacket for a chef’s coat as he became a student again – this time at the Culinary Institute at Virginia College. His mission was different from the other chefs-in-training, but the outcome would be the same – to give others pleasure through food.

As a student, his instructors noticed some of Dr. Pineda’s culinary combinations were a bit unorthodox, yet they served a purpose. He began to craft dishes that used ingredients intended to stimulate taste, aid in digestion, ease mouth inflammation, and even detoxify the body. His concoctions are quite tasty as well!

“It’s easy to use simple, everyday inexpensive ingredients to bring good things back to the body,” Dr. Pineda said. “Our cultures center around the kitchen. It’s where we gather and make memories that last a lifetime. When something happens to take that away from us, it takes more than just food from us. It takes those good memories away from us.”

While Dr. Pineda’s recipes have not been scientifically tested by the traditional standards of medical research, they are based upon his knowledge as a trained physician and chef. Each recipe is created for a specific reason, highlighting ingredients that are known to be cathartic in some way. For example, many of Dr. Pineda’s recipes rely on chili peppers due to their levels of capsaicin, which can stimulate a cancer patient’s taste buds as well as ease symptoms of nausea.

Dr. Pineda’s mission to help those with cancer enjoy a better quality of life through good food culminated in the creation of Cooking with Cancer, Inc., a non-profit organization with the ultimate goal to provide better understanding of how food can be a healing factor in cancer patients. Cooking with Cancer, Inc., operates on donations and by the sale of Dr. Pineda’s cookbook, Prescription to Taste, A Cooking Guide for Cancer Patients. The cookbook and companion DVD have sold more than 30,000 copies nationally and internationally.

For Dr. Pineda, there is no standing still. He continues to push forward in educating his patients toward new eating habits, by guest lecturing on cancer prevention and community outreach, and with cooking demonstrations, but there is always more to learn.

“There’s always something new to learn in cooking and in medicine,” Dr. Pineda said. “There’s always someone we can help. My dream is that every patient diagnosed with cancer receives a copy of this book for free.”

To learn more about Cooking with Cancer, Inc., to order a cookbook or make a donation, visit the website at www.cookingwithcancer.org.