What Floats?

By Michael Applebaum, MD, JD, FCLM

We each have our own obsessions.

One of mine is a fascination with certain types of behavior.  A favorite is the blind following the blind.  More precisely, the overfat following the overfat.

Robert Atkins is dead.  Rest his soul.  The Physicians Committee for Responsible Medicine apparently released a copy of his medical records containing information about Atkins at the time of his death.  Personally, I am not so sure that the unauthorized release of medical records to the public is responsible medicine.  Especially when done by physicians or a committee of them.

Still, the toothpaste is out of the tube.  Atkins apparently died obese.  The handlers of the late man’s business empire have disputed this.  Instead they prefer to argue that he entered the hospital overweight and died obese due to fluid administration while he was comatose.

Overweight or obese.  It would seem as if the point is he was not at a proper weight.  At the very least, the diet guru’s diet failed him.  Except of course in the making money hand over fist department.  There it succeeded.

Another overfat diet guru who is cleaning up is Phil McGraw.  Phil’s a big, fat guy.  He appears jolly, too.  For the record, I would also be jolly if I could make a fortune by selling the instructions to my failures.  It is arguably better to be lucky than smart, good or excellent.

Phil did not become a big, fat success on his own, however.  He had help from a big, fat, rich and powerful person who also gives weight and fitness advice.

In the diet guru game, it seems to be elephants all the way down.  Which is very appropriate since “guru” is a Hindu word and “elephants all the way down” is from a Hindu myth of cosmology.

But this rant is about floating and what floats.

Things lighter than air float.  Helium balloons, for example.  Things lighter than water float.  Buoys, for example.

Then there are the qualitative things that float.  Things that are so good that they rise above the rest.  Cream, for example.  Or the superlative crème de la crème.

In medicine, there is another thing that floats.  The technical term is steatorrhea.  Steatorrhea is excessive fat in the feces.  Steatorrheic stool floats.  So now we need another bumper sticker.  Not only does it happen, it also floats.

Steatorrhea is another qualitative thing that makes it to the top.  Sometimes people reach a peak position without any bona fides.  Somehow they got there and others, with qualifications, did not.  In these instances some look at the situation and explain it away by saying, “Stool floats.”

In many domains, possibly even in the domain of the diet gurus, it may pay to ask yourself, “What is at the top?” or “What floats?”  Because it is not always the cream that is floating on top.