The Lion, the Shirt, and the Rune Stones

As a boy, I loved to wear a special shirt my dad presented me when I was 4.  He commissioned the unique shirt for me and only me. It was the early 80’s, and it was short-sleeved navy blue and had red letters pressed vertically from top to bottom on the left chest (those felt letters that you iron on).  The letters spelled “ru ruoth e miyone,” an aphorism my Kenyan dad would jovially utter from time to time.  It was his nature to tell jokes and speak in proverbs and other curious maxims.

For many years I did not know what those red letters said or meant.  I finally came to learn their meaning in 2002 when my dad suddenly died. He was only 58. My dad, who was not only a paragon of health but also an expert anatomic pathologist, was found to have atherosclerosis in his coronary arteries that nobody knew about.  

During his Promotion to Glory, we formally celebrated his life in Nairobi’s Anglican Cathedral. The Anglican Cathedral with its many-colored stained-glass windows reminded all the unstoppable passage of a lifetime.  Seated in the front pew, I listened to those whose lives he touched give vibrant tributes.  At the very end my Uncle Peter rose to the pulpit.  In the middle of his tremulous eulogy Uncle Peter turned, looked at me and thundered “Ru Ruoth E Miyone! A Bull is Only as Strong as it Lives as Long as Possible in Life.”

It was another day at the office in December 2025.  In the decades since, I had become a pediatric ophthalmologist and adult eye alignment surgeon.  Between busy days treating patients, developing a new technology to combat amblyopia (lazy eye) and more, I had also become a dad and kept a strict pescatarian diet. I had ventured to apply for life insurance.  These days the wager for life insurance is the approval of an underwriter, who just like an undertaker, takes vials and vials of blood drained with rigor from an artery by a large gauge needle.  And so, the insurance company’s efficient phlebotomist drew, packaged up and mailed my blood. 

Two weeks later I popped open a nondescript email to read test results which had come back “abnormal, high cholesterol!” blaring across my screen in red bar graphs.  I wiped my glasses and squinted again.  Then I scratched my head.  “Did I eat too much just the day before? but I did starve as they told me too”; “Is something off with their test?”

So, I walked over to my colleague Dr. Alan Gianotti asking him what to make of this result.  Dr. Gianotti’s office was next door, and I noted that he read many different medical books including a particularly thick one titled ‘Longevity'.   Reading my printed report, Dr. Gianotti asked about my family, “who else has cholesterol or coronary disease?”  I paused… I had heard family rumors my older brothers had higher cholesterol.  Then, the remembrance of how I lost my father resurfaced.  As Dr. Gianotti peered at me above his reading glasses, my mind swept back to ‘that day’, through the grave, chaotic circumstances of my father’s sudden death.  While I recollected medical reports which I had forgotten across the turning hands of so much time, Dr. Gianotti chronicled on his notepad.  Resurfacing, he had reconstructed my family tree and began to decipher the rune stones of my lineage.  

It helps to connect where one has come from to where one is now, to know where one is going.  To grasp where I was going, I asked Dr. Gianotti, and he agreed, to take me on officially as a patient.  Moving from denial to another vial, Dr. Gianotti and his nurse re-tested my blood with advanced Boston Heart genomics, pinpointing an inherited gene producing excess cholesterol (the nurse thankfully used a smaller needle).  More cross-checks with anatomic and functional studies plus specialized chest imaging.  A longevity team springing into action.  A few weeks later the full picture emerged: I had a genetic form of clogged artery-causing cholesterol inherited from my dad.  The cholesterol had already gathered into plaque, consuming precious lumen space in my heart’s main anterior descending artery.  This vessel descends vertically across the heart in the left chest, vitally supplying blood to the heart muscle itself.  It is termed the ‘widow-maker’ because if growing plaque is not halted, catastrophic, lethal heart attack ensues. 

One thing many people don’t know about pediatric ophthalmologists is that we prescribe medications sparingly.  The eyes of children are small and sensitive, and we must titrate use of any eye drug to shield growing eyes from side effects.  We must balance things so that drug benefits are sufficiently large.  Because of this, and because I have never needed any long-term medicine myself, I was quite hesitant to begin a recommended pill that can reverse the excess cholesterol my body was overproducing.  When I insisted how I did not want to be on a life-long medication, joining forces Dr. Gianotti and Dr. Erik Schraga brought me around to rightly see it not as a life-long, but as a long-life medication.  Choices often depend on one’s perspective, and a team approach can create conviction. 

With a fast-beating heart and a deliberate hand I took my first new daily cholesterol-combating medication 6 months ago.  As I watch for my cholesterol to drop, my confidence in a stronger, longer, life, increases.  

It increases especially because my own daughter turns 4 in just under two weeks.  It is August and in a twist of fate, she arrived early and ended up being born the very last day of Leo.  Noting her nature, I will therefore write in icing on her birthday cake, “You will always be as bold as a lion.”  She is precocious, strong in head and heart.  And it turns out that unlike humans, her totemic lions do not get any coronary heart disease despite a meat diet brimming in cholesterol.

Every parent wants the best for their children. The doctors I have known want doubly the best for their patients. I want my daughter to leap into her life with a heart as strong as a lion’s.  My dad lived wanting the many patients he touched, and his children he clutched, to live as strong and as long as possible in life.  And to be sure, my dad would have wanted me to trade the inheritance of a sentinel event for Sentinel doctors like Drs. Gianotti and Schraga whose hearts are big enough to spot and stop the dangers of diseases of the past, in the present and for the future.

Dr. Omondi Nyong'o is a concierge physician at Crescendo MD in Portola Valley, California, and a board-certified pediatric ophthalmologist and adult strabismologist (FAAO). He specializes in diagnosing and treating vision disorders in children and adults with strabismus, bringing 15 years of experience as the inaugural Chair of Ophthalmology at the Palo Alto Medical Foundation and his current role as Adjunct Professor at Stanford University's Department of Ophthalmology, serving families across Portola Valley, Atherton, Woodside, Menlo Park, Palo Alto, and the greater San Francisco Peninsula and Bay Area.