Wednesday, March 17, 2004
SURGERY AS PLACEBO
Salon has an article on gastric bypass surgery in adolescents. I admit my background on gastric surgery is pretty limited, but all accounts seem to emphasize, over and over, the incredibly restrictive diet patients must follow for the rest of their lives.
Now, granted, the surgery ensures that if post-ops deviate from that diet they will become violently ill. But it seems likely to me that following the same diet in the absence of surgery would also result in dramatic weight loss. Is it simply that the nausea and misery that result from post-operative indulgence are sufficient deterrant to enable patients to restrict their eating? Or that the expense, risk, and pain of surgery are inspirational--essentially, patients have invested so much that they can't let it be a failure?
I don't know how you could ethically do a controlled trial of this--randomly assigning gastric bypass patients to be operated on, or just to be cut open, resealed, and told they've undergone the surgery, is obviously not an option. But I would like to see more attention paid to the possibility that the surgery is not the direct cause of the weight loss.
Monday, March 15, 2004
Today is a very special day--not only is it the Ides of March, but it's the second anniversary of my college graduation.
I'm trying to come up with some deep insights I've gained in my post-collegiate life, but there ain't much. The year and a half interval between college and grad school was quite eventful, but not necessarily productive of enlightenment. So, in lieu of providing my own thoughts, I'll quote Bertrand Russell, whose autobiography I read recently. Russell spent one year at the University of Chicago, teaching an invited seminar. He mentions that President Hutchins didn't like him, and that he was impressed with the students, but sums up the experience thus:
"The town is beastly, and the weather was vile."