Seth's Blog

In a widely-emailed article about depression, Judith Warner, a former columnist at the New York Times, writes:

This is the big picture of mental health care in America: not perfectly healthy people popping pills for no reason, but people with real illnesses lacking access to care; facing barriers like ignorance, stigma and high prices; or finding care that is ineffective.

When Atul Gawande fails to mention prevention in a discussion of how to improve American health care . . . well, he’s a surgeon. Of course he has gatekeeper syndrome. What’s Judith Warner’s excuse? Judging from this article, the notion that depression might be prevented has not occurred to her.

There isn’t one fermented food on a list of “the 11 best foods you aren’t eating” compiled by Tara Parker-Pope, author of the world’s most visible health blog. Nor do any of the listed foods contain animal fat. One of them (sardines) is high in omega-3, so the list gets a D instead of an F. Fermented foods and animal fat (in sufficient quantity) have easily-noticed benefits, in contrast to every food on the list. Parker-Pope and the nutritionist she consulted (Jenny Bowden) have large gaps in their understanding of nutrition.

Two of my students took me here, which one list said is the best fish restaurant in Beijing. (Based on our meal, that’s plausible.) Its specialty is grilled fish “Wushan style”. Wushan is a mountain, not a province (like Sichuan or Hunan), so the restaurant may have invented the term. The menu is short. There are a bunch of cold dishes and the grilled fish, which comes in seven different flavors (hot & spicy, chinese sauerkraut, etc.). Unlike any other Beijing restaurant I’ve been to, you need a reservation. (Call a week ahead.) The restaurant, which wasn’t large, was packed. The walls were covered with Post-It notes. One said: “I wish I find my dream girl and me and my friend Bob have a safe life.” Another said: “Very spicy, very tasty, makes me feel very good.” A third said: “We had to wait a long time, so we ate a lot.” I wrote one saying what one of my students suggested: “We didn’t have to wait a long time but we ate a lot anyway.”

Of course I loved this comment on a recent post of mine about how to flavor stuff:

I made a vegetable soup today spiced by small amounts of vegetable stock, hoi sin sauce, angostura bitters, lea & perrins worcestershire sauce, kikkomann soy sauce, maggi würze, marmite, maille mustard. I can honestly say it was the best tasting soup I, or any of my guests, can remember having been served.

I routinely make soups that taste clearly better than any soup I had before I figured out the secret (thousands). There is no failure (I’ve done it 20-odd times), no worry about over- or under-cooking. Something else odd: There seems to be a ceiling effect. The texture could be better, the appearance could be much better, the creaminess could be better, sometimes the temperature could be better, the sourness could be better, but I can’t imagine it could be more delicious.
Why wasn’t this figured out earlier? I’ve looked at hundreds of cookbooks and thousands of recipes. I haven’t seen one that combines three or more sources of great complexity, as I do and the commenter did. There may be more trial and error surrounding cooking than anything else in human life. Billions of meals, day after day.

I think it goes back to my old comment (derived from Jane Jacobs) that farmers didn’t invent tractors. Some people claimed they did but I think we can all agree farmers didn’t invent the engine on which tractors are based. You can’t get to tractors from trial and error around pre-tractor farming methods. Even though farmers are expert at farming. I think that’s what happened here. I am not a food professional or even a skilled cook. My expertise is in psychology (especially psychology and food). Wondering why we like umami, sour, and complex flavors led me to a theory (the umami hypothesis) that led me to a new idea about how to cook.

And this goes back to what many people, including Atul Gawande, fail to understand about how to improve our healthcare system. The supposed experts, with their vast credentials, can’t fix it — just as farmers couldn’t invent tractors. Impossible. The experts (doctors, medical school professors, drug companies, alternative healers) have a serious case of gatekeeper syndrome. The really big improvements will come from outsiders. Outsiders who benefit from change. To fix our healthcare system, empower them.

In the latest episode of This American Life, devoted to 2010 predictions, a sixth-grade teacher says she would like one of her students to become a better writer. His essays are disorganized. “I would like Lewis to write two or three sentences that go together and make sense,” she said.

In the latest issue of The New Yorker, a profile of Supreme Court Justice Sonia Sotomayor by Lauren Collins contains this paragraph:

Perhaps in an effort to absorb quickly the mores of the Court, Sotomayor has hired experienced clerks, including one who spent the past year clerking for Justice Stevens and another who clerked for Justice Ginsburg. Near her desk is a framed cartoon by the Mexican-American illustrator Lalo Alcaraz. Against a lavender background, a girl with a pink bow in her dark hair sits at a desk, banging a gavel. A nameplate in front of her reads “Judge Lopez.” To her right is a makeshift witness box, inhabited by a Teddy bear. The jury box is full of stuffed animals. Taped to the wall behind her is a photograph of Justice Sonia Sotomayor.

The first sentence (“Perhaps in an effort . . . “) and the rest of the paragraph (“Near her desk . . . “) don’t go together. I suppose Collins or her editor liked the cartoon detail but didn’t have a good place to put it. So they put it here, at the end of a section.

The whole profile is more great work from Lauren Collins. The impressive thing about Sotomayor, someone tells Collins, isn’t that she’s the first Latina Justice, it’s that she’s the first Justice to grow up in a housing project. To good writing based on lots of work, Collins adds interesting observations:

In a profession that values the illusion of infallibility, Sotomayor has been unusually willing to acknowledge murky areas.

We want stories with heroes and villains. We want moralizing, in other words. In this sentence, Collins calls the legal profession bad and Sotomayor good.