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In Amish village, a rural doctor sees the rarest diseases on Earth

123 points| onetimemanytime | 6 years ago |usatoday.com | reply

69 comments

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[+] collsni|6 years ago|reply
This is my father's family doctor and was my doctor throughout my childhood.

He actually birthed me in Viroqua Wisconsin where he spends a few days a week. In the past few years (since they got a new Clinic in La Farge) his time has been pretty exclusive to La Farge and the Amish community. However he still sees my father multiple times a year, who is not Amish.

[+] cstross|6 years ago|reply
... Or the doctor in question could just have moved to Dewsbury, in West Yorkshire.

(n the mid-1980s I made an early career mistake and qualified as a pharmacist. I did my pre-registration work at the -- now closed -- district hospital in Dewsbury, a Yorkshire town of roughly 60,000 people. Dewsbury is in a steep valley and the working-class population tended not to travel: according to an older relative who worked there all his life, he knew co-workers who had been born, worked, lived, and retired in Dewsbury without ever travelling more than ten miles away from their birthplace. (Automobiles didn't really become a mass-cultural phenomenon there until the 1950s-1960s.) Cue lots of first-cousin marriages. During the 1970s, a Pakistani immigrant community arrived ... also from an isolated mountain valley town that didn't have much time for exogamy.

The hospital serving a city of 60,000 people shouldn't have a 30-bed cystic fibrosis ward (CF is an inborn error of metabolism) ... but Dewsbury needed one. (CF has a frequency of roughly 1 in 3000 in Northern Europe, so you'd expect 20 living cases in a town the size of Dewsbury: but they wouldn't need hospital beds simultaneously! The local frequency was much higher.) Nor should it have exotic conditions like familial hypobetalipoproteinaemia showing up in the population. Again, Dewsbury had that. In fact, Dewsbury was so notorious for genetic disorders that house officers and registrars training in the relevant fields got rotated there from the big teaching hospitals in Leeds (the nearest big city).

Upshot: if you get geographically isolated communities with religious cultures that discourage exogamy, you get really weird genetic disorders cropping up within surprisingly few generations.

[+] growlist|6 years ago|reply
Also in Surrey. A relative worked with visually impaired children, one of them of Pakistani heritage and having albinism, and this kid said one day "it's because we marry our cousins". This is one of those situations where the authorities etc. being all cringey and PC about things harms the very people they are trying to protect.
[+] beardedwizard|6 years ago|reply
This was a good story. I enjoyed the rural vibe and the simple mechanics: do it because you care, it's right, and it will still be hard.
[+] onetimemanytime|6 years ago|reply
I remember seeing a documentary--too lazy to look it up now--but it was about the Inuit (or a portion of them) that let a guest sleep with the woman /women in their igloo. At first look, this goes against Darwin, who wants to raise someone else's "bastard" but without it they'd be doomed. So the lesser of evils.
[+] selimthegrim|6 years ago|reply
Similarly such stories circulate about the Hutterites in Canada. I hear you’d better be white looking though
[+] Iv|6 years ago|reply
Evolution focuses on populations, not individuals. A lot of things make more sense if you consider that.
[+] red75prime|6 years ago|reply
I've heard that too. And it seems that something like that took place [0]. Not "a guest", but "close friend" though.

[0]: "American Anthropology, 1888-1920: Papers from the American Anthropologist" ISBN 0803280084 page 479

[+] Nasrudith|6 years ago|reply
Well it also depends on perceptions of relationships and monogamy. I don't know of their cultural ideal attitudes towards wives and agency (say she decides who she sleeps with period vs property to be shared spectrum) or actual for that matter but if it is a reciprocal norm it is likely a wash quantitatively. Not to mention survival concerns about having children to care for them in old age.

It reminds me of one joke about ancient Norsemen not caring about blatant signs of infidelity like the children having different skin and hair color so long as their sons were strong.

[+] throwawayhhakdl|6 years ago|reply
Monkeys and other animals that have strong social structures will do this for similar reasons.