Seth's Blog

Yesterday was really windy. Lots of bikes fell over, including mine. I thought my sheets, hung to dry outside my apartment window, had blown away. I searched for them around the building. I eventually found them — in my closet. I got a piece of dirt in my eye that I noticed for several hours. It was my first significant bad encounter with Beijing air this time around (since August). I was in Beijing last fall, too, and then the dirty air really bothered me. I felt better after I got an air filter for my apartment.

When I was a freshman at Caltech, Richard Feynman came to our dorm for dinner. I asked the first question: “What do you think of the air?” He looked at me as if it was a stupid question. I think his answer was, “You get used to it.” After living in Beijing last year, I said over and over I liked everything except the air. Now I find it hard to complain about the air. In my apartment I have one big air filter per room that runs constantly; they are quiet and turn red if the air is dirty. They hardly ever turn red. Last year, after a week without dusting, you could write “lung cancer” in the fine black dust that had accumulated. Now it isn’t there. Through my window the visibility is usually pretty good; I can see the lights of buildings in the distance.

Yesterday someone told me Beijing air has gotten much much better. “Ten years ago your hair would get filthy” from coal dust, he said. The hutongs had coal-burning heaters. Now they are gone. Measures of air quality have even improved since last year, I think he said. I met someone recently arrived who was bothered by the air but she felt much better after I gave her an air filter.

Overall, I think four things have changed: 1. The air in my apartment, where I spend most of my time, is much better (compared to unfiltered). 2. Outside air is somewhat better. 3. Due to fermented foods, my overall health is better. 4. Due to learning about hormesis, I don’t worry about a small amount of air pollution.

James Fallows on How I Survived China. The bottled water at a Buddhist restaurant came from a garden hose.

A few years ago, a Berkeley surgeon named Eileen Consorti, to whom I was referred by my primary-care doctor, recommended that I have an operation to repair a hernia so small I couldn’t detect it. I have already written about how she kept saying there was evidence such operations were beneficial but as far as I can tell no such evidence exists. (Dr. Consorti has yet to provide the evidence she still seems to think exists.) Okay, she overstated benefits. What about costs?

During a conversation about whether the operation was a good idea, I said operations are dangerous. I didn’t want to have one unless there was a clear benefit. She replied that nobody had died from anesthesia during one of her operations. But of course death is only one of the things that can go wrong. It turns out the general category of bad things happening during anesthesia is called undesirable events and the rate of undesirable events has been measured. In this study, the rate was 100-150 undesirable events per 1000 hours of anesthesia. My operation was simple; I estimate it would have taken one hour. So my chances of having something bad happening to me as a result of an operation without any clear benefit to me — but considerable financial benefit to Dr. Consorti — was about 10%!

In a discussion of the costs and benefits of the operation, she didn’t tell me this.

A friend with bipolar disorder writes:

When I wrote in your blog that I use your discovery daily, it means that every day I look in a mirror for an hour, starting at approximately 6:30 a.m. I have the mirror about 20 inches from my face because I have read that a mirror image is half the size of the object reflected. [Life-size faces appear to work best. Using a mirror means the face you see is perfectly life-size, allowing for distance. TV faces can be larger or smaller than life-size.] To keep from being bored while looking at my face in the mirror, I mostly listen to tapes of C-SPAN programs. Sometimes I listen to music. Once or twice a week I may just think, or plan my day. That does get boring after about 30 minutes.

Sorry, I definitely was exaggerating when I wrote “doctors are amazed”. “My doctors” refers only to my psychiatrist and psychotherapist; at best, they seem “impressed” by my condition. My therapist regularly says that I’m doing “great”(variously referring to social relations, self-awareness, and general functioning) — “especially considering my situation“ and my psychiatrist once exclaimed that my bipolar disorder was in “complete remission”, albeit when we were composing an online personal ad. I do think both of them are at least mildly surprised that I seem to be doing alright on half the standard therapeutic dose of Depakote, and a low dose of Prozac.

There was an actual experience that weakly supports my claim about practitioners having no interest in utilizing your idea. I once asked my therapist to suspend his disbelief, and just imagine that your treatment does work as a strong antidepressant. Then would he mention the treatment to his other patients, or give a talk at a conference, or write up a report, or tell his colleagues? In all cases, he said “no”. Although he agreed that ideas for clinical trials have to come from somewhere, evidently that somewhere was not part of his concern.

I stress that my therapist is compassionate and reasonably intelligent, and he has helped me deal with many important practical problems. And of course in your blog even you have admitted that your idea, on the face of it, sounds way too crazy. It’s to my therapist’s credit that he claims to believe your treatment works to some degree — adding positively, “whatever works for you”. Unfortunately, that addition implies that your treatment is somehow working “psychologically” for me (e.g., as a kind of meditation) rather than working “biologically” in a way that, presumably, would work for most people.

If my doctors were following my particular case as closely as they pretend to, then they ought to be amazed. Instead, my sense is that they see me through the lens of their diagnosis. Without actually dismissing the sheer statistical improbability of my having been off of drugs and without a hospitalization for four years, they do seem to forget that fact when we discuss drug therapy. When I mention those four years, they sometimes play the skeptic, offering up alternative possibilities: it was a fluke, or I was in remission anyway, or something else. I don’t try anymore to persuade anyone, not even family, about the treatment — it’s not worth the effort.

I suppose the bigger picture is that there is little credibility to the testimony of a bipolar person who has experienced psychosis. (Perhaps my case is not helped by dramatic pronouncements of mine such as, “History will judge you. People will wonder, “why didn’t they listen to him?”) Too, I’m not paying my doctors enough to get lengthy consultations. If I were paying enough, and if I made the case with details to my psychiatrist, she might be persuaded that there is a big effect. She has a high opinion of you; in fact, she’s the person who told me of the report in The SF Chronicle (5/30/06) about the SLD diet. And, she gives some credence to Dr. Stoll’s results with omega-3 for treating bipolar. Nevertheless, for what it’s worth, I would stand by my original opinion about her not changing her practice.

Here is a long list of reasons, by Steve Dworman, who makes them for a living, why infomercials are the way they are. One big reason is data: you can easily do an experiment that compares two different versions of the same commercial. It is much harder to measure the effectiveness of other forms of advertising. (The lack of data involved in most advertising choices is easy to see on Mad Men.) Self-experimentation has the same advantage: It’s so much easier to test an idea.

One of his points is about the use of celebrities: It must work, or else they wouldn’t do it. (Because there is data behind how things are done.) I think this points to something hard-wired: We want to learn from other people. That’s the default. If we have a question, we search for someone who will answer it. Learning from our own experience — such as self-experimentation — is a last resort. It feels wrong, we don’t like it. I remember feeling this way when I bought a camera. Sure, I could do extensive research about which camera is best. But that would be hard. Better to ask a friend. And then the purchase would be a link between us.

A brief summary of my previous post is all I needed to do to cure/prevent a skin infection was buy more socks. Instead of buying 5 pairs every 6 months, buy 20 pairs every two years. That’s all. Costs nothing. No drugs. No special treatment of the socks. No special cycle on the washing machine. No following a hundred (or ten) instructions about how to avoid infection. Like my depressed friend, I had the reaction: Why didn’t my doctor tell me this? He didn’t tell me because he didn’t know, I realize. Why he didn’t know . . . is a harder question.

The whole practice of health care is called medicine, so focused is it on cure rather than prevention. There are medical schools, which turn out doctors. Schools of public health are the closest thing we have to schools based on prevention but they don’t even train nutritionists. Nor do they do experiments, in most cases. (They do little data collection besides epidemiology.) And they get much less money than medical schools. Scurvy and Vitamin C are the first examples of the new way of dealing with illness I’m talking about — finding the environmental deficiency and fixing that, which is inevitably extremely safe and extremely cheap. After the discovery of Vitamin C, similar examples were discovered and the broader term vitamin was coined. But I think there is a need for a similar term that includes non-vitamins. It would mean aspects of everyday life, food and non-food, that we need to be healthy.

Like Vitamin C, my discovery that more socks eliminates skin infection points to a cure/prevention agent that is perfectly safe and extremely cheap. So do all my posts about fermented foods. It costs basically nothing to let food ferment. You lose nothing and gain a lot. Yet bacteria are not vitamins — and it isn’t all bacteria we need, just the 99.999% that are harmless. (And other foreign stuff, like bee venom, can substitute for bacteria.) I began thinking there are non-food vitamin-like things (things we need to be healthy) when I discovered the effects of standing on sleep and morning faces on mood. So we need several things to sleep well, including morning light, and at least one thing for proper mood regulation. Insomnia and depression are non-infectious problems, like scurvy. We think of vitamins as preventing/curing non-infectious problems, so the analogy was obvious. And these examples (sleep and mood) involved the brain. So there were vitamins for the brain, you could say. But the socks/foot infection example and the fermented foods/many illnesses example both do not involve the brain and do involve infectious diseases and auto-immune diseases (which, although non-infectious, are quite different from scurvy). So the idea that there are bunch of extremely cheap, perfectly safe things we need to be healthy expands to cover more of health.

Vast amounts of money are spent on health research, much much more on the consequences of poor health, and truly incalculable suffering comes about because we don’t know what these things are. (Depression alone causes vast suffering. Now add to that poor sleep, autoimmune problems, much infectious disease . . . ) Yet because studying these things (a) will make money for no one, (b) won’t produce a steady stream of published papers and (c) is useful (= low status), they are nearly impossible to study.