What I'm Reading (Sept. 23)

Social workers, forgotten members of the care team. Can music really soothe us physiologically? A pill that results in 15% weight loss, and what we eat has more to do with our values than nutrition.

A lot of digital ink is being directed at the socioeconomic factors that impact our health. In fact, Kaiser Health News reports that lawyers are being added to primary care clinics to help sort out housing issues. But for all those words, we often overlook a vital member of any hospital care team, the social worker. 

“The social work craft is invisible on Chicago Med. It’s invisible on most television shows and most of our popular culture. When social workers are shown, they’re often depicted in cardboard ways: As naïve secular saints. Or as overworked, well-meaning, but incompetent bunglers. Or as malevolent bureaucrats who take children away.”

From the wonderful Incidental Economist, Where are the social workers on network TV dramas?

“Music has charms to soothe a savage breast.” As a physician fascinated by the connection of our body and mind, those words have a certain resonance. Perhaps that is why this piece from Stat caught my eye.

“In 1993, researchers reported that after college students listened to a particular Mozart piano sonata for 10 minutes, they showed better spatial reasoning skills than they did after listening to relaxation instructions designed to lower blood pressure — or to nothing at all. And their IQ scores jumped by 8 or 9 points in what became known as the Mozart effect. Even though the benefits were hard to reproduce (and wore off within minutes), the fad of Mozart for babies’ brain development was born.

In that early research, scientists also said listening to Mozart’s “Sonata for Two Pianos in D Major” (K448), helped patients with epilepsy by reducing spikes in neuron activity that can lead to seizures. Again, the results were not consistent enough for other scientists to replicate them. But now, 28 years later, newer methods are reviving the possibility that music can be the calm that prevents the brain’s electrical storm.”

From Stat, New study revives a Mozart sonata as a potential epilepsy therapy

Being overweight, I have more than a passing interest in weight reduction. Despite, or because of being a surgeon, bariatric surgery, the currently most effective option, is not a consideration. But consider this, medications are catching up with bariatric surgery, and they are not the problematic drugs of the past.

“The history of medicine is littered with failed weight loss pills. One of the first popular weight loss drugs was 2,4-dinitrophenol, a high explosive used in munitions in World War I. When ingested, it has effects that are equally incendiary: it causes the little power plants in our cells to waste calories as heat, which increases metabolic rate by 30–50% at a commonly prescribed dose. The largest study of the drug, published in 1935 by an enthusiastic team of doctors in the prestigious Journal of the American Medical Association, reported that it caused an average of 17 pounds of weight loss over three months. However, 2,4-dinitrophenol is hard to dose correctly and happens to occasionally cook people from the inside out when they take too much, among other serious side effects. Its use in humans was banned in the US in 1938 under the Food, Drug, and Cosmetic Act, although a few people still use it illegally.”

That interesting sidebar aside, consider this fascinating article on treating obesity from Works in Progress, The future of weight loss

One more food piece, and then I will stop.

“Aaron Carroll, a physician in Indiana and a columnist at The New York Times, argues that people spend far too much time worrying about eating the wrong things. ‘The “dangers” from these things are so very small that, if they bring you enough happiness, that likely outweighs the downsides,’ he said in 2018. ‘So much of our food discussions are moralizing and fear-inducing. Food isn’t poison, and this is pretty much the healthiest people have ever been in the history of mankind. Food isn’t killing us.’”

From Aeon, an article on essentialism and nutritionism, and how our views of what is right and wrong to eat are more often about our values than science. The Food Wars