Alternative Cancer Treatment Researcher Lothar Hirneise Interviews Dr Johanna Budwig
Extract from Dr. Johanna Budwig’s book “Cancer - The Problem and The Solution”, published in autumn 2005.
What is the fundamental concept of your therapy?
Dr Johanna Budwig:
I was senior expert for pharmaceuticals and fats in the Federal Health Office; this was the highest authority in our country responsible for deciding on approvals for medication. At this time, 1951, many applications had been submitted to me for approval, or to be more precise, these were medications for cancer therapy with the sulfhydryl group (sulfur-containing protein compounds). Everywhere I saw that fats played a role, also in expert reports provided by well-known professors like Prof. Nonnenbruch.
Unfortunately, we could only detect fats in the late stage, and there were no chemical values to detect fats chemically at all. By this time, 1951, I had already developed the first chemical verifications for fat, jointly with Professor Kaufmann, the director of the German Federal Institute for Research on Grain, Potatoes and Fat, and my former doctoral advisor, who was also director of the Pharmaceutical Institute. This was published in 1950 in Neue Wege in der Fettforschung (New Directions in Fat Research).
Using the method of paper chromatography, which I had developed, I could analyze 0.1 mg of fat, and characterize it as highly unsaturated or unsaturated. We then published this extensively.
These were the first studies that made it even possible to detect linoleic acid or linolenic acid. Due to the importance of this work, 16 doctoral candidates were assigned to support my efforts. In this situation I noticed the sulfhydryl groups in my appraisal of the medications for cancer therapy. Through official channels I had the right to ask the companies questions relative to how they wanted to substantiate how this substance (sulfhydryl group) could help with cancer. The companies e.g. the company Knoll, which wanted to use these types of medications as cancer therapy were prepared to send all the copies of the created file, on my request.
Consequently, in early 1951, I got a very fast overview of where the problems were in this issue. That was the same year that B. Flaschenträger’s manual appeared: Physiologische Chemie (Physiological Chemistry). The problem of automatic oxygen absorption for the living substrate is one of the most elementary questions in all of physiology, and it is one of the darkest. Everybody knows the sulfur-containing protein compound of the sulfhydryl group can be detected in all breathing tissues.
However another partner must be present in the interplay with this sulfhydryl group, because the self-active oxygen consumption in the living system is executed in a zig zag curve. Strictly speaking, it is manifest that oxygen consumption does not produce a reaction product; rather it occurs in an interplay between the positive electrically-charged sulphur compounds in the protein, and some kind of fatty substance that we cannot detect, because no verifications for it are available. This fatty substance however plays a major role in the Warburg’s respiratory enzyme.
Warburg recognized that with the Warburg respiratory enzyme or the cytochrome oxydase, fats play a role in the lack of oxygen consumption and oxygen utilization (utilization in the living substrate). He wanted to overcome this blockade in the experiment with butyric acid. This attempt was a failure.
Does this mean that Warburg was the first who attempted to introduce more oxygen into the cell with butyric acid?
Dr Johanna Budwig:
No, von Helmholtz [...] had attempted to get more oxygen into the cell. He showed that when we treat doves who have become asphyctic (i.e. doves that have been fed in such a manner that oxygen absorption is blocked), with increased ozone or oxygen, they then die more quickly – and this is still the case today. If the “oxygen bomb” is set up in the hospital for a person with oxygen deficiency, then the sick person dies more quickly.
If animals can be made asphyctic through a certain diet, e.g. bleached rice, then they suffocate and neither increased introduction of oxygen nor activation with any other possible substance will help. At this time we already knew vitamin A, B, C, D, and E, but this did not help. Prof. Linus Pauling for example had been involved with animal experiments and knew precisely that it had been published in 1951 that all vitamins had been investigated in searching for the respiratory activator for Warburg’s respiratory enzyme, but this had produced absolutely nothing, not even vitamin C. By the way Professor Pauling, who had requested all my books from me personally, and who also received them from me, never referred to my work later.
And then the idea occurred to Warburg in 1926 that fats play a role. However he did not know which ones, and experimented with butyric acid. By the way, [Albert] Scent-György also experimented with fats and wrote as early as 1952 that the substances are too easily oxidized and we cannot detect them. In this situation I then published my new ways of fat analysis, namely to introduce sensitive and specific verifications, nice stains. I was able to analyze fats precisely and break them down into the individual fatty acid components.
What effects do these fatty acids have?
Dr Johanna Budwig:
They form the opposite electrical pole to the positively charged protein in the cell nucleus. They are located in the cell membrane and have been known for a long time as lipoids (fatty substances). In the case of tumor formation it was not known why cells in division are present in such great quantities. The wrong concept is still being pursued in medicine today; the tumor is associated with too much growth. This is incorrect. In 1956, I had published that with the tumor many cells in division are present, and amitosis has already started (see Fig.).
However in the case of tumor formation, cleavage of the daughter cell is lacking, which then results in rejection of the aging cells. When a leaf falls from a tree, a skin has formed over it and this vital function for [the normal] growth process is interrupted if the electrically charged fatty acids are lacking.
How are fatty acids charged electronically?
Dr Johanna Budwig:
An important physicist, Kenneth Ford, said in 1966 that the elementary function of the electron exchange with the photons of solar energy is so intense, that one gets the impression the electrical energy stored in the electrons of seed oils, for example, still recognizes the relationship to its forbears in the photons of solar energy. Physically this has been strictly proven. And this absorption of solar energy in seeds is already adjusted in the green leaf to certain very specific wavelengths; science refers to this via the quantosomes. The quanta of physics, of the wave movement are adjusted to the photons of solar energy. This means that they do not even absorb other rays, and if other radiation such as with the transport of nuclear waste (1998) influences human functions, the elementary function between fats and proteins for oxygen absorption, then the radiation from the ashes of the atom bomb work so radically that this dipolarity which must remain in interplay in movement for the life process, is torn apart and the life function is destroyed. In physics these products in physical processes that disturb (i.e. pull apart) the dipolarity in the life process, which really should be banned, have been called radicals for a long time.
Now if you expose a normal life function, regardless of whether it is a seed or a person, to these rays, then intervention in the life function is so radical that in these experiments with quanta biology with the wrong rays even rats and mice jump around until they fall to the floor dead. The term radical comes from physics and was later used as camouflage for the highly heated oils, which we do not want to name by name, but that work exactly the same way.
The base reaction of oxygen consumption and energy extraction from food is executed in the interplay of positive sulfur-containing protein, electronically highly charged with the photons that are suitable in terms of solar energy quanta, stored in seed oils of various quality. This dipolarity differs in quality and it is crucial for the function of the fatty acids that are recognized as vital. Other fatty acids that have a shorter fatty acid chain, e.g. 4, 6, or 8 links, are also utilized under other conditions in the life process.
Here however we are only referring to the fatty acids that are recognized as vital with 18 links in the hydrogen chains (chain with 18 links) and with high electronic enhancement. It is scientifically known that the electronic energy, e.g. in the linoleic fatty acids, is so high-grade that this energy lifts off of the heavy mass and moves as an electron cloud. You must start with the idea that heavy matter, charged positively, pulls down, the electrons pull upwards. In this dipolarity man can stand up, and in this dipolarity man has more capacity to store solar photons than does any other form of life, as demonstrated in the quantum biology of Professor Dessauer in 1954. It is particularly in the brain that these electrons are highly enhanced.
What is an electron cloud?
Dr Johanna Budwig:
If the enhancement of electronic energy is always higher through absorption of photons in the electron compounds of the fats, then the power of the electrons is so high in the dipolarity in between gravity and electrons, that they move from the fatty acid (which also contains hydrogen compounds, and which is heavy matter), over the chain with electrons.
What is the significance of the cloud?
Dr. Johanna Budwig:
No life form has as much energy to store the electrons and photons in depots as does man. This electronic energy, stored in the electronic substrate of the human being, stored particularly in the vital, highly unsaturated fatty acids, is such a strong life element for man, that it was correctly said previously that these are certain fatty acids that have been recognized as vital foodstuffs. Man cannot live without them.
For instance, chemists measure the iodine value of fats and say that if oils have a certain iodine value, then these oils are unsaturated. If oils, regardless of whether sunflower oil or flax oil, are treated with overheated steam then these oils can indeed give a positive iodine value, but they are not the vital fats with 18 links, but rather they form cross-links between the fatty acids like a large net, and are highly detrimental to metabolism of the fats, and with protein they act like radicals.
I repeat because it is so important: I have detected particles in oils treated with steam, which indeed have a positive iodine value, but which are highly toxic for man.
And you attempt to avoid this toxin when treating people who are sick?
Dr. Johanna Budwig
In my nutrition therapy I expressly switch off these fats. By the way the discovery of switching-off these toxic oils, has been recognized as nationally worthwhile since 1971. In the oil and fat industry production has not been changed to this day, because they say these products are billion-dollar items, and nobody will give the industry money to establish something new. That is understandable. The representatives of chemotherapy pose another problem. Our chemotherapy is aimed at destruction of the tumor, and it is recognized that chemotherapies destroy many living cells, and the entire person. Anything that disturbs growth is fatal because growth, as elementary life function, is part of the life process of man. We cannot achieve something good with bad tools.
Can you tell us something more about the unsaturated fatty acids and their net-like connections?
Dr. Johanna Budwig:
For a moment try to forget everything that you have read previously. In butter the fatty acids consist of 4 carbon compounds, in coconut fat, goat fat, and sheep fat the fatty acids consist of 6, 8, 10, or 12 carbon compounds respectively. The unsaturated vital fatty acids really start in the chain with 18 carbon compounds. For example, in olive oil there is only one unsaturated bond in the fatty acid. A person who has a deficiency of vital fats does not absorb it. Thus today’s publicity concerning olive oil does not help at all. The fatty acid chains are primarily saturated in the lower area of the carbon chain links, butyric acid, coconut fat, and palm fat, primarily saturated, however they are more easily co-combustible for people if the essential fatty acids are present. The fatty acids with 18 links are the most important essential fatty acids. There are also fatty acids with up to 30 links.
Fatty acids with 18 links, like in sunflower oil or in flax oil with the higher level of unsaturation, are more important for people, particularly for the brain functions of man.
The carbon compounds are heavy matter, even in the fatty acid. If two people reach out to each other with two arms, then they are more strongly bound to each than if they only extend one arm. It is precisely the same for carbon. The fatty acid in olive oil is not considered to be a vital fatty acid; it can only be co-combusted in the organism if essential fatty acids are also present. Linoleic acid rich in electrons is considered vital. There is a particularly high amount of energy in this double double bond of the linoleic acid. This energy wanders and is not fixed in place as it is with a chemical compound, such as with table salt. This energy, wandering between electrons and the positively charged protein with sulfhydryl groups is an alternating association process in the electromagnetic field. This is very important. Perhaps you are familiar with the painting of Michelangelo, where God creates Adam (two fingers pointing to each other, however they do not touch). This is quantum physics, the fingers do not touch. The physicists who I know, Max Planck, or Albert Einstein, or Professor Dessauer all represent the view that man is created by God in His image. You see in being together as human beings there is certainly also a connection without directly touching the other person. People who maintain that they only believe what they can touch are wrong.
The dipolarity with a simple double bond in olive oil is weaker than it is in sunflower seed oil, which is bonded twice. This double double bond is considered to be vital for man. However if the same chain length of 18 carbons has three unsaturated fatty acid compounds, then the electrical energy is as strong as a magnet, depending on the position of the double bond. If double combinations are now closer together, then the energy is greater. All electrical energy that is in movement produces a current that flows and spreads a magnetic field. These electrons also have a magnetic field. You can see this on the window when it rains, for instance. When one drop comes down, it attracts another drop and becomes a larger drop. Precisely the same principle applies with electrons.
This electronic energy is negatively charged. The positively charged sulfhydryl groups of the protein adhere in the unsaturated bonds where the electrons are and that is where they insert their sulphur-containing compounds.
This produces the lipoproteins. The life process is sustained in the interplay between the positively-charged particles and negatively-charged particles. In this process there is no connection, and this is our life element. If a radical break occurs at this point through fatty acids that no longer give off electronic energy, but rather are cross-linked like a net, then the dipolarity can no longer work actively in this net. This is the deadly effect of radicals, because instead of the chains with the electron clouds they interlace a net without electron clouds, indeed with unsaturated bonds, but without dipolarity.
I quickly knew that the triple unsaturated fatty acids, which were called linolenic acid, and which no one had isolated before me, had 18 links and that they did not always carry their double bonds at the same point. They have such a strong electronic energy compared to the heavier matter in the 18-link fatty acid chains, that biologically this energy is far greater than it is with the next arachidon acid with 20 links. The highest electron collection is with the combination of linoleic-linolenic fatty acids in flax oil. The linolenic acid as conjugated (interaction of neighboring double bonds in the molecule that are separated by a single bond) fatty acid is even more effective and is even more strongly effective in interplay with linoleic acid as it is present in the flax oil chain as essential fatty acids for oxygen absorption. This was relatively easy for me to verify in my experiments. I would like to emphasize this. The combination of double unsaturated linoleic acid with triple unsaturated linolenic acid is particularly well-combined in flaxseed. Naturally the quality of flaxseed differs greatly. Naturally red flowering flaxseed and blue flowering flaxseed are naturally different; there is also a difference depending on whether flaxseed is harvested in the cold like in Siberia, or in Africa.
Is it this energy that heals cancer?
Dr. Johanna Budwig:
Yes, this energy is now movable and it is easily released. It is precisely this energy that heals cancer, or does not even allow it to occur. If this vital element is present then no tumor can occur. This vital element is a deciding factor in the immune system. There is a lot of talk these days about immune defense. There is no effective factor in the immune system other than the essential fatty acids. Let’s take for example a patient with a breast tumor. I do not radiate the woman directly on the tumor with my laser, rather I soak the surrounding tissue with fat and protein through the diet, use my oils, e.g. ELDI oils for external application, and radiate the healthy tissue.
Another case. For example I had a child here with a sarcoma in the bone. The child repeatedly claimed that somebody pushed him in kindergarten and he fell on a sharp rock. Since then I have had this. The doctors say, that’s nonsense, falling on a sharp rock does not cause a sarcoma. But I say, if the child’s immune system is weak, and the child is injured, then this can be a trigger.
But shouldn’t all those people who eat these heated oils get cancer?
Dr. Johanna Budwig:
It is very important to view the person as a unit consisting of body, soul, and psyche. However, the factor that is primarily effective at the moment can be quite different. I am still convinced today that if a woman has a very poor marriage, and has to deal with suppression and taunts from her husband day in and day out, then I cannot help her with quark-flax oil. All three factors belong together in a human person. Here is another example. It is very cold here in November. Let’s assume that several people must spend the night outdoors. One takes a hot bath and everything is fine. Another gets lymphogranulomatosis, and another gets pneumonia. They do not all get sick in the same way. The life function of the person always plays a very significant role.
Or let’s look at another case. I have a patient with lung metastases. Her doctor from Ulm came along as well. I counseled her first to change the diet, and then use the oil pack with ELDI oils, to more quickly dissolve the metastasis. The patient was rubbed with oils over the entire body, but naturally in determining the diet and the environment, the whole person must be taken into consideration. This patient knew that she had been given up on. I set up the diet in different steps. Now the patient lives in Ulm and against my advice, she is involved with yoga. In this case I counselled against yoga, and recommended autogenic training, so that her body is pacified and her body is balanced and calm. Sometimes* yoga or sport is very important, but sometimes the patient should not do this.** Guiding the sick person is very important. There is no one treatment that applies for everyone. The patient must also feel for himself what is good for him. Yoga alone cannot replace the healthy basis of nutrition.
Does this mean that generally you do not recommend physical training [exercise]?
Dr. Johanna Budwig:
Correct, it must always be viewed individually. I would never allow a cancer patient with metastases to jog, ride a bicycle, or to practice yoga. His body must relax. I am more an adherent of Zen philosophy in this area. It is based very much on the factor: Let it come. Do not be inactive, rather be very active. I (advise) in my consulting, the patient should not stay in bed, stretch out and let others act. That is incorrect. The patient must work as well. On the other hand, unfortunately I have often experienced what it means when family members do not participate, for example if food is prepared without love, and if the family member basically rejects the treatment. The whole subject of sport must be treated on a very individual basis.
Do you think that a large tumor must be operated on?
Dr. Johanna Budwig:
I can’t make a general statement here. I totally reject radiation and chemo; I also reject hormonal treatment for abdominal cancer. However, operations must be considered very individually. This also applies for tumors in the intestine. I am not a proponent of quickly creating an artificial anus. The ubiquitous technocracy no longer does justice to people.
How did you get your naturopathic license?
Dr. Johanna Budwig:
I acquired my insights in the area of natural science as a well trained expert for fats and pharmaceuticals in a responsible position. Then I tried to make my findings known regarding the significance of the highly unsaturated fats and the damage caused by denatured fats. Naturally this is not necessarily connected with the practice of naturopathy.
However as the number of sick people who sought and received help from me increased, the number of attacks from the medical fraternity who viewed my nutritional advice as an encroachment on their area also increased. Up to 1968, these attacks from doctors were unsuccessful. In 1968, I realized that the use of laser radiation is only possible if the resonance capability is provided in the biological area based on my quantum biological findings. In the USA it was published at that time that the absorption capacity in the living substrate must still be verified.
In this regard, I created the so-called ELDI oils (Electron Differentiation oils) through exact spectroscopic measurements via the absorption of light in different oils. This enabled me to immediately switch the metabolism to positive using the ruby laser that I had chosen. The success was surprising, even to me. These ELDI oils, which are used externally, have a very favorable retuning effect on the metabolism for people who are ill. With my knowledge of the borderline situation concerning the practice of alternative medicine, I said to myself, if I now treat with laser beams, then that constitutes treatment of sick people. Consequently, I obtained the additional permission to practice as a non-medical [naturopathic] practitioner.
But then you also studied medicine.
Dr. Johanna Budwig:
That’s right, in 1955 and in the following years, I also studied medicine, totally real with anatomy and everything that goes along with it. Through the illness of Ms. Martius (wife of the well-known Professor Martius in Göttingen, I am not revealing any unauthorized secret, because this was carried in all the press releases), where I was called on for advice, I was able to use my therapy in various clinics in Göttingen. This was very successful, as is documented in my book Der Tod des Tumors Bd. II (The Death of the Tumor Vol. II). Then, however, I reached a limit as industrial groups and also professors became involved.
Since the people who were opposed to what I was doing always said that I had not studied medicine, I took the time in Göttingen to study medicine. I still remember the time I was working late one night in Göttingen, a woman came to me, with her small child whose arm was supposed to be amputated due to a tumor (sarcoma). I told her what she should do and soon thereafter the subject of amputation was dismissed and the child quickly did very well.
Because I was still a medical student at this time, I was summoned to appear before the Municipal Court due to a petition that I should be prohibited from studying medicine. I was accused of walking through surgery clinics, looking for patients and pulling them out of the clinic. Then I said: “I have never been in the surgery clinic, I do not even know where it is,” I explained that the mother sought me out; I did not seek her out. I then asked what I should do. Shouldn’t I help the child? Because I demonstrably helped a patient successfully (documented in the book Der Tod des Tumors Bd. II (The Death of the Tumor Vol. II), there was a petition to bar me from studying medicine. But the director of the court and counsel for the university, Dr. Henze, rejected this and said: “You have nothing to fear. In my area of jurisdiction nothing will happen to you. If it does there will be a scandal in the scientific community.”
Nevertheless, I concluded that I could better deal with the opponents to my direction as a university graduate and no longer as student. And I still believe today that this decision was right.
Where have you had the opportunity of presenting your position at congresses and presentations?
Dr. Johanna Budwig:
A very important presentation was held in 1964 in the Hilton Hotel in Chicago, at the invitation of the American Oil Chemists Society. Before Professor Kaufmann and I published the validity of my finding concerning the significance of the highly unsaturated fats for the vital function of the human being, Dr. Kaufmann wanted to be sure, and he ordered cytochrome dyed yellow-green in vials from the company Mack in Illertissen. This is considered to be the preliminary stage for hemoglobin, the blood pigment that cancer patients do not produce adequately.
He gave me the yellow-green cytochrome on paper and said: “Touch this and see if it turns red.” I touched it and it turned red, then Prof Kaufmann asked; “Do you have red paint on your finger?” I laughed and said, “No Professor, you can do the same thing as well. Touch it with your fingers.” It turned red, and I said: “I know that you have now started eating flax oil, too.” Then the audience stood up and applauded me. This presentation is in my book Kosmische Kräfte gegen Krebs (Cosmic Powers Against Cancer). Another important presentation was given in Tokyo, where I was the first woman allowed to speak at a congress. At night in my hotel then several women requested that I should give a presentation on the role of women in the world because the newspapers were devoting a lot of attention to the fact that I was the first woman who had been allowed to speak at a conference.
That’s why I was no longer impressed that German doctors who knew too little of real science criticized my work as all philosophy and not science, which is still going on to this day. However I have the impression that the public trend, recognizing the importance of the natural basis for the vital function of the human being, has also become so strong, even in Germany, that pure medical doctrine must join it. The German physician Dr. Roehm who immigrated to the USA published an article in the USA in favor of my work: Who are we, we doctors? In this article he takes the position that it is beneath the dignity of physicians to exclude the natural basis of the life function, as is still attempted in Germany to a great extent. By the way, on the advice of friends in Innsbruck I have put all my scientific work together in a well organized manner (see Presentations at congresses, see Appendix….).
Does a cell become malignant if it does not get enough oxygen?
Dr. Johanna Budwig:
There is an error in your question, because your question reduces the human being to a cell, that is not possible. In humans the lymph system plays a very significant role in the metabolism of fats. When discussing this holistic medical issue you should not localize on the cell, but to return to my previous example – when this child falls on a sharp stone in kindergarten then the important thing is which immune forces are active in the body and which are not.
You see, a doctor comes to me with his 12-year-old child. As I said previously, I always let the sick person speak for himself, this applies to children as well. The boy was happy that he was now allowed [to] speak and said: “OK, now I am going to tell you something. The man who is sitting over there is my father. But the woman sitting next to him is not my mother, that is his secretary, and my mother does not live with us. When my mother lives with us then the muesli tastes good. And when this woman makes the muesli, it doesn’t taste good at all.”
The father turned very red indeed. You see, these things are very important. You cannot reduce the illness to the cells. When people learn that they have been given up on by allopathy then I ask whether the patient is Catholic or Lutheran. And often the patients proceed to tell me for instance how much they are troubled by the fact that they have not been to confession for some time.
Then I tell the patients that before they return in 4 weeks, they should go to confession, and speak openly with their priest. I am Lutheran myself. I always take the whole person very seriously.
What do you recommend when people do not want to eat quark for ideological reasons or because it does not agree with them?
Dr. Johanna Budwig:
A well-known professor from Sweden who is director of a sanatorium for biological therapies, and who knows my treatment very well, called me because he had been called in to treat President Bill Clinton and, according to his information, unfortunately President Clinton cannot eat quark. I did not give him any advice. But I can tell you the following. I have never had a patient who was not able to eat quark in combination with my oil-protein diet.
What do you recommend to people as a preventative measure so that they don’t get cancer at all?
Dr. Johanna Budwig:
Only flax oil as oil. I reject all meat that is in the stores. Fresh meat is OK. Nothing from the frozen food section. You should bake your bread yourself. Oleolux, for example, is something that lasts longer than flaxseed that you can spread on bread or add to vegetables (see the instructions on the next page). You should also prepare your fruit juices yourself. Potatoes are OK, so is cheese.
Also the electromagnetic environment in which we live is very important. Also the textiles that we wear are not insignificant. I reject synthetic materials because they consume too many forces.
I dislike modern foam mattresses because they rob too much energy from you when you sleep. A lot of wood is important in home construction. Carpets are also important so that radiation remains as biological as possible. Gemstones and semi-gem stones are also important because they have good biological radiation and thereby they influence the environment. Books could be written about the favorable effects of gem stones. The environment and living conditions must be as biological [organic & natural] as possible. The lifestyle, e.g. regular sleep is very important. Many cancer patients stay up too late at night and sleep too long in the morning. There is often incorrect or misleading advertising on the labels of our grocery products.
There are hundreds of such aspects that must be taken into consideration. I would never maintain that I heal patients with tumors with the oil-protein diet, on the other hand I get a steady stream of confirmations of my work from recognized experts, that in the surgery clinic in Helsinki they have experienced a success rate of 90% and more, when using the findings of Dr. Budwig, and this success was achieved in cases where allopathy failed. This was submitted by Professor Halme.
[How] do you work with patients?
Dr. Johanna Budwig:
When patients come, I generally schedule two hours for the initial discussion; this is usually between 3:00 and 5:00 in the afternoon. Usually I let the patient report first – about his difficulties, treatments, diagnoses that he is aware of, the medical history, which therapeutic measures have been already employed, etc. In this report, I also learn about the patient’s environment, the workplace, what kind of work the patient has done, and I also learn about the living conditions, e.g. condition of the marriage, and the diet.