One early spring morning in 2009, Helen set off from the starting line of Boston’s Run to Remember, an annual half-marathon held each year. She jogged alongside the Charles River, through the public gardens, across the bridge into the city of Cambridge. The weather was cool and serene, the oaks had burst into an early green, and she felt her body working in synchrony. But soon after getting home, her runner’s high was overcome by a dull ache that flared deep in her legs. At first, she was sure the pain came from shin splints. But when it refused to abate, she consulted with her doctor who saw that her blood counts had plummeted. After visiting a hematologist, the doctors put a needle through her skin and pierced the hard shell of her hip to collect the soft marrow underneath. A few days later, the results came back. “I had multiple myeloma,” she whispered to me, as though still in shock, when we met this past fall.

As a doctor—though not her doctor—I could understand why she might still be shocked. Multiple myeloma is an uncommon cancer that usually afflicts elderly Americans, but Helen* was a cruel statistical exception: She was only 38 at the time of diagnosis, giving her a life expectancy of only about six years. Facing that grim prognosis, Helen began to wonder if this was her fault—if she had done something wrong. Still a young woman, married, employed, with two children at home, she exercised regularly, never smoked, rarely drank, and hardly ever got a cold. What in my life, she wondered, was to blame?

Helen’s doctors encouraged her to look forward. Her hematologist, at Massachusetts General Hospital in Boston, explained that her bone marrow had become overgrown by cancerous immune cells, and that the treatment required high doses of chemotherapy. The doctor described the litany of consequences from the powerful medications: hair loss, infections, and a probable bone marrow transplantation. Helen sat in the clinic of the busy Boston hospital, surrounded by expert oncologists with their novel clinical trials in dismay. She faced either the threat of a serious, potentially life-limiting disease or a heavy-duty regimen of drugs that she felt would similarly poison her body. “There had to be another way,” she said. “I didn’t want chemotherapy.”

Helen did choose another way, based on her suspicion about why she had fallen sick in the first place. “It had to be my diet,” she told me. So, against all professional medical advice, she started an experiment on herself.

Nutrition has a role in today’s medicine, but it’s nothing compared to pharmaceutical therapy’s. Doctors favor drugs over everything else. The average older adult in this country is on four medications a day, which helps explain why, in the past few years, companies like Pfizer, Eli Lilly, and GlaxoSmithKline have enjoyed profit margins of 20 percent or more. But the never-ending rise of drug costs is shaking our already buckling healthcare system. A year of cancer drug therapy, for example, costs more than $100,000 per patient. Yet the case for prescribing drugs remains strong, mostly because they work: HIV has become a chronic illness rather than a death sentence in the U.S., some cancers shrink away in response to targeted therapies, and, in a recent example, the recent Ebola outbreak led to the swift development of vaccines and therapies that may assuage future epidemics.