Paula Poundstone thinks Ring Dings make life worth living

I'm a middle-aged woman, a stage in human development that can be cross-indexed to conditions like "I no longer sleep," "I can't see for squat," and "My thermostat is busted." Although I'm mostly aggravated by these changes, I've found a happy byproduct of insomnia: In the early morning hours when I'm not sleeping, I listen to podcasts of interesting programs, interviews, and books that wouldn't otherwise fit into my busy days. (And when I don't find these interesting, they often put me back to sleep.)

A few weeks ago, though, my husband (who has no problem in the "sleeps soundly all night" department) is awakened because the bed is shaking and I'm laughing out loud, listening to an exchange between Paula Poundstone and Michael Pollan on Wait, Wait...Don't Tell Me, NPR's weekly news quiz show.

Michael Pollan is a well-known food and food economics expert, who describes a reasonable approach to eating as, "Eat food. Not too much. Mostly plants." Attempting to spread this message to an untapped constituency, Pollan agreed to be interviewed by Wait, Wait's host, Peter Sagal and a panel of celebrity comedians. Here's a link to the audio exchange between Paula Poundstone and Michael Pollan. (You'll get a brief ad that supports NPR programming, then cue the next recording to 2:20 and listen until 4:40. But do this only when you have time for a good laugh.)

If you can't access the audio, here's the gist of the exchange:

Pollan: It's very hard for people to know what food is these days, because there are so many edible food-like substances competing with food in the supermarket.

Poundstone: One of the things that has made my life worth living is, uh, Ring Dings. Are you going to tell me that's not food?

Pollan: Well, there's a few simple tests to figure out if a Ring Ding is food or not. How many ingredients does a Ring Ding have....

Poundstone: (interrupting, and sounding optimistic) Devils food cake, one. A creamy filling, two. And a rich chocolate outer coating, three. What's the matter with you?

Pollan after an exchange that suggests Ring Dings are not, in point of fact, food, moves on, offering Poundstone middle-ground advice: There are things that could be characterized as "special occasion food."

Poundstone: And what part of, 'Ring Dings make my life worth living' did you not hear?

The conversation ultimately concludes with an aggresive-sounding Poundstone telling Pollan, "You may know a lot about food, but you don't know the first thing about living, buddy!"

This conversation is instructive for anyone who has ever tried to tell anyone something they simply didn't want to hear. It's a window, an opening that shows how culture influences health, health-defining choices, and why the need for health care in the U.S. looks the way it does. Who knew so much rested on the answer to the question, "Are Ring Dings a special-occasion food or an edible food-like substance?"

I hope you'll stop back at Florence dot com again this week for more commentary about barriers that prevent people from engaging in health-promotion and disease management, plus some useful links to resources for managing them.

Bon appetit!

The Problem with System Problems

You may have heard of Jennifer Thompson-Cannino and Ronald Cotton, authors of a recently published memoir "Picking Cotton," an accounting of Thompson-Cannino's mistaken identification of Cotton as her rapist and what happened in the aftermath of the tragic error. (Cotton served 11 years in prison before being exonerated by DNA evidence, an event that triggered Thompson-Cannino to experience near-stiffing guilt for her role in his conviction.) I've seen Jennifer and Ronald on 60 Minutes and caught them on several radio interviews, most movingly in a piece recorded for NPR's This I Believe series. (http://www.npr.org/templates/story/story.php?storyId=101469307).

They're sharing their story, a powerful testimony of love, forgiveness, and redemption. Jennifer and Ronald also champion a cause both hold dear: judicial reform, specifically the processes used to gather and present eyewitness testimony.

Thompson-Cannino and Cotton's journey is particularly remarkable because they have undertaken it together. When an accuser apologizes and a victim forgives, each experiences grace that only the other can offer. We are infrequently given a glimpse of healing like this, healing that comes from such a deeply personal place. But what may be easy to lose in the story of their personal triumphs is the role that system deficits played in the tragedy that befell them.

The problem with "system problems," I think, is that they often beg individual accountability, leaving us with the sensation of a debilitating ethical itch that simply cannot be scratched. Expressions like, "Lead, follow, or get out of the way," and "If not you, who? If not now, when?" suggest a general belief that things are under control, or can be brought under control. It's a matter of personal responsibility. Take me to your leader! If good people bring the good times, surely bad people must bring the bad.

So it's particularly interesting to me that Thompson-Cannino and Cotton, two people whose capacity for introspection and personal accountability are remarkably deep, are talking about system problems, looking past "the people" to focus on "the processes."

An analysis of events in the Cotton case reveals that the circumstances that led to Thompson-Cannino's initial identification of the perpetrator predisposed her to identify the most likely attacker, not the attacker. Cues and clues, erroneously, but not maliciously, offered by investigating officers further reinforced Jennifer's perception that she was right. The 60 Minutes piece was told, in part, by another person affected by this tragedy: the detective who investigated the case. A professional who, using the standard operating procedures employed at the time, helped to send an innocent man to prison for 11 years. If you're feeling the beginnings of an ethical itch, it may or may not be helpful to know that more than 75% of individuals convicted of crimes, then later exonerated because of DNA evidence, were convicted with eyewitness testimony that turned out to be erroneous.

DNA now offers us access to highly reliable evidence about what happened to who, under what circumstances, and where. When it's available, DNA evidence can corroborate or refute eyewitness testimony, making the likelihood of uncovering an objective truth far greater than it ever has been. Even without DNA evidence, the procedures used to identify perpetrators and preserve, but not influence, the memories of victims are now evidenced-based and should look different today than they did 25 years ago.

I think it would be fair, a word I use with great caution given what happened to Ronald Cotton, to say that it was not wrong to have used 'standard operating procedure' 25 years ago. But it would be wrong to use 25-year-old standard operating procedures today. It would be wrong to continue to do things in an unreliable way when someone's liberty or someone's life is at stake.

System level analysis offers a way to improve reliability in judicial processes, in aviation, in healthcare. It gives people who are very close to the action--like patients and clinicians--tools to see that everything may not be exactly as it appears on the surface.

That's what we're going to tease apart and talk about here at Florence dot com! I hope you'll come back again. Because it is not wrong to have used standard operating procedure 25 years ago, but it is wrong to use 25-year-old standard operating procedures today.

Next time: This picture paints a thousand words. (But I'm only going to use 500.)