The Doctor's Opinion
"We doctors have realized for a long time that some form of moral psychology was of urgent importance to [compulsive overeaters], but its application presented difficulties beyond our conception. What with our ultra-modern standards, our scientific approach to everything, we are perhaps not well equipped to apply the powers of good that lie outside our synthetic knowledge." - xxvii
Had you asked me ten years ago if there were problems of health that medical science could not resolve, I would have said "no." Even psychological problems could be solved through medication - or so I thought. And I considered psychiatric treatment to be within the scope of medical science. I figured that if there was something medical science couldn't cure today, that we would eventually find a way to cure it in the future. And it is true there is a possibility that food addiction will be curable later on. They are already making vaccines against nicotine and methamphetamine, maybe they will create a vaccine against whatever goes on with our brains as well. But right now, this problem is not something that medicine can address - not that they haven't tried.
I remember the first thing my doctor did was try increasing my thyroid levels up slightly above the normal range. When that didn't work, they tried giving me tablets that would curb my appetite. Eventually when that didn't work, they gave me tablets that would bind to fat molecules and help me not absorb everything I was eating. When that made me sick, they sent me to a nutritionist who gave me an insanely detailed diet involving weighing and measuring every bite of food - when that didn't work for the high school student I was at the time, they then tried signing me up for a personal trainer and exercise program. Again that didn't work. I have tried everything from a measured carbohydrate diet, to a no carbohydrate diet, to a low fat diet, to Jenny Craig and Weight Watchers, and even a liquid diet. When nothing could help and I just got worse and worse, the doctor told me that I needed bariatric surgery. I was reactive hypoglycemic and developing insulin resistance. I was told that if I didn't get that surgery I'd be dead by thirty. So I got the surgery and it didn't help. Well, it didn't help much. I was able to keep off a whopping thirty pounds. That's it. Of the over 100 pounds I needed to lose I was able to keep off thirty.
But I find the phrasing to be the most interesting part of this quote: "moral psychology" and "synthetic knowledge." Saying that the psychology involved in finding abstinence is "moral" in nature bothers me. It suggests that there is something amoral about people who have addiction problems, and that just isn't the case. We may have moral issues, but not by virtue of having an addiction! Again it goes back to the nature of the malady being both physical and spiritual in nature. If it were a purely physical or purely psychological or even purely spiritual problem, a solution would be far easier to find. Referring to the medical science as "synthetic knowledge" is also fascinating.
The practice of medicine is called a practice because it is more of an art than a science. We test our medicines on people in a vacuum. At least, as much of one as we can create. There are always those people who are more sensitive or less sensitive than others. And while there is a range of "normal" for locations of anatomy, not everyones heart is in the precise same location as everyone elses heart. Sure the general location is correct, but it is the details that differ. So anything we say we "know" about the body really is this artificial notion based on statistics and averages, as opposed to specifics. The phrase "synthetic knowledge" seems to address both the imperfections of our medical knowledge - and imperfections of our ability to actually apply that knowledge to individual cases - and the fact that most of our remedies involve putting a foreign substance into our bodies.
"Of course [a compulsive overeater] ought to be freed from his physical craving for [food], and this often requires a definite hospital procedure, before psychological measures can be of maximum benefit." - xxvii - xxviii
Again it is the notion of mixing medicine and spiritual healing. But I read this and wondered what exactly this would involve for a compulsive overeater. There are bariatric surgeries, but that isn't exactly necessary. Would this "definite hospital procedure" be the equivalent of our food plans? Or are they referring more to the detoxification portion of weaning an alcoholic off of alcohol. Considering that this was written in the 1930s, I'd be curious to learn what kind of hospital treatment that alcoholics received.
------------------
Normally I should do five pages, but there is so much that called to me that I'd be up all night if I tried, so I'll return tomorrow for more!
