Since When Is Sugar A Vitamin?

When a woman becomes a surgeon, she doesn’t necessarily have to give up her femininity – but she often has to make sacrifices.

I enjoy nail polish, but that’s not the reason I switched specialties from neurosurgery to psychiatry. The upside is that I can now indulge myself and my nails.

At first, when I was still in residency, I would sometimes sit on and hide my nails when I was around someone who had a good a professional salon nail-do.  Now I do not much care, as I am more mature and more self-confident.  My nails are polished with some generic enamel from a discount store in a single color, and I apply the lacquer myself. If you inspect them at any random time, you will probably find them plenty chipped. If someone ever noticed — and critical women patients occasionally do — I remind them that those nails were attached to the hands that wrote the prescriptions, so they were good enough for now. The answers didn’t matter.  Mostly there is none.  Sometimes a woman would say, as this one did, “You are nice looking for a doctor, so I thought I should remind you…” “Feh,” I thought but did not say.  I refocused on the job at hand. Nails are more important to some other people.  Sometimes more important than health.

That was the case of this 24-year-old young lady who came to see me.  Not only were her nails done better than mine but she had blond hair of a type not seen in nature.

She also had two children that she had to leave with her mom for the appointment, ages two and five.  They were her reason for seeing me, indirectly.  Her complaint was an uncomplicated postpartum depression according to the chart, and she was doing as well as could have been expected.  Not suicidal, no signs of depression.  

Because of her financial condition – she had no finances – the clinic was able to pry free antidepressants from a drug company with a crowbar (known as a “compassionate care program”) and it was working just fine — no side effects.

Under most normal conditions (meaning with a “normal” psychiatrist) her visit would simply be a quick renewal and on her way.  But I always try to connect personally, help with life.

Like everyone else, pretty much, at that county clinic, she had told me she was struggling for money, trying to make do. In her case she was lucky, getting some help from mom.  But she and mom did not exactly agree on everything.  I offered a therapist. “Mom will never change,” she responded. She showed me that she had in her hand a bottle of “Vitamin water.”  I had seen it on the shelf at some supermarket or even convenience store, and had passed it by, never even read the label.  I take lots of vitamins and supplements.  It would never ever occur to me to get some in water???  I take a lot of water, of course, but even bottled water seems an extravagance since I purchased a couple of filtering-pitchers to process tap water. “At least I eat healthy,” she said as she held her bottle up to me, as if to toast me with it. I resisted a powerful instinct to chastise her on her use — or abuse — of money. If I hadn’t, I would have lost those few precious moments of contact when I could, perhaps, have actually gotten her to listen to something I said.  I had to be gentle. “I’m not sure that is the best way to eat healthy; I mean, there is lots of other stuff…” She looked shocked. I have since learned a bunch about vitamin water. Now unless the FDA has received some kind of wild money infusion, they probably don’t have enough personnel to follow prescription drugs post marketing in as much detail as would make me kvell with joy, so we have to thank these people from the Consumer League, since I had absolutely never heard of before this one, with coming up with this information, although I have always been interested in consumers’ points of view from anyplace.

I didn’t know then about the slogan “flu shots are so last year,” nor the advertising implications that this could have been immune-stimulating.  I mean, I have purchased supplements at places ranging from actual pharmacies that the ever popular 99-cent store, things that actually could have been stimulants to the immune system. But even the best of them had disclaimers as long as the book of Psalms.

I will never know what words, what slogans, what suggestions, made this young woman buy her vitamin water.  I suppose it was an impulse buy at the checkout or something similar. I know she did not read labels.  I mean, like a lot of the patients at the poor county clinic where I was consulting, she had no particular talent for, let alone inclination for reading.  I would have estimated her intelligence at the lower end of average. I suppose the argument could have been made that these sorts of assertions were meant to be humorous.  I mean the slogan, “flu shots are so last year,” sounds like the utterances of one of the Valley Girls who has made Southern California the delightful bed of anti-intellectualism we all know and love. I suppose it could actually dissuade someone from getting flu shots. What I don’t think it could do is actually make anyone laugh or even snicker. I am a student of humor.  Not just cramming in comedy writing, but even having trained, even performed (albeit briefly) in stand-up comedy. Done workshops and improv workshops with my husband. Now, I am considered a “hoot” by clever people.  But I could never work clubs where people were drunk, or for that matter anything other than college students on Coca-cola. Humor, which Freud thought was the defense mechanism for the psyche that was at the highest level of function (He had a great joke collection which nobody could actually find terribly laughable today) seems the province of smarter folk. My husband, only a bit less formally trained in being funny than I am, is constantly joking with supermarket checkers who take him all too seriously, and I am constantly giving him either an elbow in the ribs or a squeeze of the hand or later, when we have left the puzzled clerks behind, remind him that these people do not have humor to see the world. Back to Vitamin Water. There is one thing it has absolutely got. Yessirree Bob. Sugar. The home page of Glaceau  is as artistic a website as I have seen for anything. Obviously, it was not this that had influenced my young patient, as I asked her about internet access and she told me she did not get into that sort of thing. Glaceau offers no obvious link to a page about ingredients.  

Of course, this young lady could even have thought “smart water” makes you smart, or been blinded by the classy French brand name. I admit that even I did not know this was a Coca-cola brand.  At any rate, you can tell that these people moved their main page to Facebook. Why do I have a feeling they are more interested in fans than science?  At any rate, when I look for the contents, criticism is what comes up — 32 grams of sugar in a bottle. 4 grams of sugar in a “regular” sugar cube and 39 grams of sugar in a “regular” can of – you guessed it — Coca cola. Now sugar addiction may not fit the criteria for addiction in the same way most substances do that the alleged experts had in mind when they wrote the DSM IV classification of mental illnesses, but enough people complain of it that there is definitely something going on, even if it may be more complex than the usual addiction paradigm.  

Not a lot of scientific proof, but it does seem to function as a “reward” on some level, in both brain chemistry and behavior, and of the great ocean of information about it as an alleged chronic condition, there may be more daily common sense than real medical research. I submit that whatever is going on with sugar and our desire for it, whether it be simply an addiction to the sweet taste, or a true sugar addiction, is a thing that lots of food manufacturers use to keep us coming back, surely more than we know.  My guess is that it works even subliminally, even when we can’t taste the sweet taste.

I do not condemn those who use this.  I mean everyone out there is out to maximize profits for their corporations.  If they did not do this, they could not have enough money to send their kids to college.

(NOTE: The following link opens up a PDF file and you need the free Adobe Acrobat reader to read it) The official list of contents in McDonald’s food is like a roll call of sugars.   Anyone patient enough to read down to the contents of the buns will find, not terribly far from the top (contents are generally listed in decreasing amounts) both high fructose corn syrup and sugar. I cannot honestly see why else one would put sugar in bread, except that maybe, just maybe, it could foster some kind of addiction. My grandmother of blessed memory made wonderful delicious bread and I saw her make it countless times and I never ever saw any sugar find its way into that bread.

Just a little scientific side-light – bread with no sugar added is a starch, and starch is a sugar. I doubt I had any effect on the life of my young patient, but it was not lack of trying.  It would take more training than a responsible doctor could give in a county mandated length medication management session to get her to read a label, let alone make intelligent decisions about food or money. At least she did not complain about my nails.