Monthly Archives: June 2014

When Junk Science Meets Junk Food

Laurie and Debbie say:

eating in a settlement house kitchen

Scientists at the University of Toronto have released a report claiming that the very existence and availability of fast food somehow makes us be in a hurry. “Fast food represents a culture of time efficiency and instant gratification,” says Chen-Bo Zhong, who co-wrote the paper with colleague Sanford DeVoe to be published in a forthcoming issue of Psychological Science. “The problem is that the goal of saving time gets activated upon exposure to fast food regardless of whether time is a relevant factor in the context. For example, walking faster is time efficient when one is trying to make a meeting, but it’s a sign of impatience when one is going for a stroll in the park. We’re finding that the mere exposure to fast food is promoting a general sense of haste and impatience regardless of the context.” They did three experiments, each with less than sixty participants (less than thirty outside of the control groups), all of them University of Toronto students. So we already know we aren’t looking at real science. Their theory, which they “confirmed,” was that fast food logos, such as the ubiquitous Macdonalds’ golden arches, make people more impatient, and make them do tasks in more of a hurry. The experiments consisted of subliminal or peripheral vision flashes of fast food logos during other tasks. (We wonder if the control group got subliminal flashes of Alice Waters and the food at her restaurants.) While they don’t actually say in their paper that they are talking about why poor people make bad decisions, they do talk about “density” of fast-food restaurants, which we all know tends to happen in lower-income neighborhoods. (Fast food isn’t exclusively, or even perhaps mostly, the food of poor people. Know any white men in the tech industry? Any gamers?) Nonetheless, Kathryn Hughes, writing in the Guardian, has an excellent class-based critique: The panic around the moral and psychological damage of fast food … was always [fueled by] a much deeper suspicion of what it represented: ignorance, indifference, a wilful inability to imagine a better way of feeding the future. It’s for that reason that, back in the early 19th-century, moralists including William Cobbett churned out a whole array of “cottage economies” and “penny cookbooks” aimed at stopping the working classes from squandering money in the pie shop. These prim moral primers were full of bright suggestions for turning the scrag end of lamb and on-the-turn turnips into something that not only nourished body and soul but also saved pennies for a rainy day. … What all those Victorian moralists missed – just as the Toronto report ignores – is that fast food is the emblematic product of maturing and late capitalism. Urban workers, forced to work longer and longer hours, do not have the time to invest in cooking from scratch. Those who are obliged to live in shared accommodation and rented digs may not have the right equipment for making real food slowly (Agas don’t fit into bedsits; microwaves do). When you are exhausted after a 10-hour shift, then soup is fiddly to consume on the way home. Burgers and kebabs, by contrast, are easy to eat with one hand and require neither plates nor knives. Far from being the refuseniks of capitalism, unable to master its first principle of delayed gratification, the people who rely on fast food outlets are its honourable foot soldiers. We should salute them. Hughes is right on target for most of her essay, and is invoking a long and fascinating history of missionaries, settlement houses, and other do-gooder efforts aimed to make “the poor” eat “right,”  but we disagree with her that delayed gratification is a capitalist virtue, especially in 21st century capitalism. While she excoriates the study for ignoring how workers are pushed into fast food, she also ignores how consciously and carefully fast-food corporations engineer the attraction and desirability of fast food. Just to be clear, neither we nor Hughes are saying that fast food is a good thing, or good for us. Working through purchasable state legislatures, the corporations work hard to ensure ridiculous amounts of salt and sugar in every school cafeteria. Working with urban planners, they carefully calculate which street corners, neighborhoods, and strip malls will be most profitable for new locations. And working with food scientists, they carefully study exactly how much fat, salt, and sugar will make you reach for the next Dorito. So who exactly is into instant gratification? Who is trying to move fast, make immediate moves that might not be so sensible in the long term? Who is impatient? Well, fast food customers perhaps–but fast food owners, demonstrably. And no one is going to fund tiny, silly studies of what the owners do when their own logos flash subliminally onto a screen. Thanks to Annalee Newitz at i09 for the pointer.

At the Will of the Body, Part 2: (Becoming a Body)

Lisa Freitag says:

Dr. Lisa Freitag is a former pediatrician in Minneapolis, Minnesota. She wrote some guest posts for us in 2013, and we are delighted to have more of her insightful presence here. This is the second of three or four parts; the first is here. Watch for the others over the next month or so, between posts from Laurie and Debbie.

It was a fortunate coincidence that I found a copy of Arthur Frank’s 1991 book, At the Will of the Body, just a week or so before I fell and broke my arm at the shoulder and elbow. During the incoherent time that followed, I wasn’t able to read much, but I found Frank’s book surprisingly easy to read for an academic text. I had to reread it (several times, actually); its observations on what it means to be ill were close enough to my experience that much of it instantly resonated.

Frank has become, since writing At the Will of the Body, an acknowledged expert on the modern doctor-patient relationship and how it is failing both doctor and patient. This book has his very first observations on the subject, not yet fully developed, but all too clear to a reader of his later books and papers. I read the first chapter, ‘Becoming Ill,’ the night before going in for surgery. In it Frank describes the interaction between himself and his physician after he had a heart attack, He is surprised and dismayed at the clinical coolness with which his doctor relayed the diagnosis. The doctor speaks as though the body was nothing other than a thing, and its ills a mechanical breakdown which can be managed with no concern to the inhabitant of that body. Frank says, “Thus in disease talk my body, my ongoing experience of being alive, became the body, an object to be measured and thus objectified.”

This is perhaps not the wisest thing to read the night before surgery, particularly if one is already aware of, and resentful about, the distance which modern medicine has placed between itself and the people it purports to want to help. The next day I would have a first-hand experience of the objectifying process. Following the ways in which I lost my self to the practice of medicine at least gave me something to do while I was waiting. It was certainly better than giving way to the gnawing uncertainty and fear that comes before surgery.

The giving up of my self began, actually, in the parking lot. The hospital was under construction, and there were very strict signs conveying rules regarding who was allowed to drive where. When my husband dropped me off at the front door, an actual armed guard appeared, his duty clearly to make sure we were allowed to use the entrance. Only after assuring him that I was a patient were we allowed to stop there. Just to be allowed in the entrance, I had to change from person to patient.

Just inside that door, a brash woman demanded paperwork and answers to a bunch of questions that in other circumstances would have been grounds for invasion of privacy. She did not question her total right to answers, or her ability to keep them private, despite there being only a small padded partition between her and the coworker sharing the same desktop. At that stop, I gave up both privacy and identity. I was given a wristband proclaiming my new identity; Lisa,  open reduction of humerus and olecranon fractures, 01/05/56, no allergies.

I was a physician on staff at that hospital for almost ten years, yet the hallway down to the surgical waiting room was totally unfamiliar. Fifteen years ago, I used to walk these halls as though I owned the place, a fiction to which everyone else also ascribed. I was quite aware that as a lowly pediatrician, I did not own anything, but was still comfortable in belonging there. I saw no one I knew, and was relieved that no one who knew me had to see me in my new guise.

The surgical waiting room is like one of Dante’s levels of Hell. I am not entirely sure what I gave up there, but it was a loss worth grieving. Perhaps it was something like freedom. After turning over the evidence of my new identity to another woman at another desk, I was told to sit. And wait. My husband was with me, but neither of us knew how to act. Other family groups shared the room, but each group isolated ourselves in our own private knot of pain and worry. It seemed to be expected, and was surprisingly hard. We were all waiting to be admitted to the inner sanctum where, amid wonder and terror, we would be saved. Or cured. Or something. It was like waiting for Godot. The only appropriate response would have been to run away, but that was impossible. So we sat. Patiently. Patient. Waiting.

In a later chapter, that I had not read at the time, Frank talks about the body as territory, which medicine claims as its own by the combination of clinical distance and clinical expertise. Frank was given a new identity, as I was, as the cancer patient in a certain room. His doctors spoke to him about his disease in the passive voice, as though no actual person was involved. His body became the recipient of a treatment called chemotherapy. He says,

When a person becomes a patient, physicians take over her body, and their understanding of the body separates it from the rest of her life. . . Medicine cannot enter into the experience; it seeks only cure or management. It does offer relief to a body that is suffering, but in doing so it colonizes the body. This is the trade-off we make in seeking medical help.

He admits that, if the treatment works, as it did in his case, the colonization might be worth it.

By waiting in that room, I was allowing the colonization of my body. I had been identified. My elbow and shoulder had been mapped out for attention. Waiting was a form of consent, permission to be converted fully into a body.

In the next room, a small exam room, I lost my clothes. In a pretend effort to help me preserve something of myself, I was offered replacement clothes, an enormous blue thing with ties at the back and, amazingly, a pocket containing a small heater. That they had really no concern about my essential nakedness was demonstrated by leaving the door to the room open. My body sat in a huge recliner chair, in full view of everyone in the hall outside. No one passing by seemed to notice. I found that I really didn’t care much either.

The next room was a sort of surgical staging area. We bodies were lined up on gurneys, separated from each other by thin curtains. Here, I finally met a doctor. So did everyone else. At this point we were supposed to be sedated into incoherence. I was not, because I did not want narcotics. My punishment for this was a nerve block, a trivial procedure, at least for the anesthesiologist. Holding still for this, and not screaming, was like being complicit in my own torture. I do not recommend this route.

I was beginning to resent becoming a body, but then I had a pain-inspired revelation. Early in my training, I had seen operations similar to what was about to happen to me. I had two fractures, one in my elbow and one in my shoulder. A person I had met only once, an orthopedic surgeon, was about to cut ten-inch incisions over both joints in order to directly manipulate my bones into their proper position with his gloved hands. He was then going to keep the bits of bone where he put them by inserting metal strips held in place by screws. I had a vivid image of this, but could not apply it to myself. This is, after all, not something you do to a person. It can be done only to a body. And so, I submitted willingly to colonization. I became a body for them. And for me. It was much better that way. In the operating room, as the anesthesia hit my veins, I felt a surge of relief close to joy.

One week later, at my post-op appointment, I was still a body. The surgeon told me that most people want the metal removed from their elbow after it heals. I told him that it would take a massive amount of discomfort before I wanted anything like that operation to happen to me again. He seemed offended that I hadn’t appreciated the experience more. Maybe he was just disappointed that he would not get to cut me open again. Most surgeons are known to be massively disinterested in anything that doesn’t involve scalpels. He glanced at my two scars, assigned a nurse to remove the staples he’d put in a week ago, and left without a word.