Rahul Subramaniam 🇮🇳

Surgeon: "Gallstones. Until we take it out, I want you on a low fat diet. Nothing fried, no cheese, no cream, skimmed milk." Patient: "What does the gallbladder do?" Surgeon: "Stores bile. Squirts it out to digest fat." Patient: "When?" Surgeon: "When fat arrives." Patient: "And if no fat arrives?" Surgeon: "It sits." Patient: "Full of bile. Not emptying. For months." Surgeon: "That's the idea. Rest it." Patient: "What do stones form from?" Surgeon: "Bile that sits too long and thickens." Patient: "So the treatment for a bag that's gone solid from not emptying is to stop emptying it." Surgeon: "The fat triggers the pain." Patient: "The fat triggers the squeeze. The pain is the stone in the door." Surgeon: "Which is why we're removing it." Patient: "What was I eating when the stones formed?" Surgeon: "I'd have to look." Patient: "Low fat. Since 2019. The slimming club." Surgeon: [does not look] Patient: "I've been resting it for six years. It's the best rested organ I own."

The year is 1873. Your wife tires easily and reads too much. The doctor prescribes the rest cure: six weeks flat in bed, no books, no visitors, fed on milk, forbidden to sit up without his permission. The man who devised it is the most famous nerve specialist in America, and the women come out of it quieter, which is taken as the cure. The year is 1915. The hospital has a new way of delivering your child. Morphine, then scopolamine, and the mother wakes two days later with a baby she cannot remember having. They call it twilight sleep. The women are strapped into padded cots so they do not hurt themselves while they scream, and the straps are the modern part. The babies arrive blue and slow to breathe. The year is 1945. The truck comes down your street fogging DDT, and the children run behind it in the white cloud because the man on the back says it is harmless. At the beach it is sprayed over the bathers on their towels. It goes on the cattle, over the barn, and across the kitchen table. The year is 1948. Your son has trouble with his ears. The doctor slides a rod tipped with radium up each nostril and holds it there for the best part of ten minutes, and you bring him back three more times. Hundreds of thousands of American children get the same treatment. The cancers arrive in their fifties. The year is 1962. The health visitor tells you breastfeeding is old-fashioned and the formula is scientific. By 1972 fewer than one American baby in four is breastfed at all. The formula is skimmed milk and sugar, with the milk fat taken out and vegetable oil put in. The year is 1971. The family planning clinic fits a small plastic crab called the Dalkon Shield. Its tail is a bundle of fibres that wicks bacteria up into the womb. 2.8 million are fitted in America before it is withdrawn, and the company goes bankrupt under the claims. It had been sold as safe and superior. The year is 1983. The doctor says your arteries are the butter's fault. The dripping tin goes in the bin, the yolks go to the dog, the margarine goes in the fridge, and you have the heart attack anyway, on skimmed milk, having done everything right. The year is 2001. Your 15-year-old is low, and the doctor prescribes Paxil, because the trial in the journal says it is effective and well tolerated in adolescents. The raw data, reanalysed 14 years later, shows more suicidal thinking on the drug than on the sugar pill. The company pays $3 billion to settle. Nobody rings the house. The year is 2009. The government has spent around £500 million stockpiling Tamiflu for the pandemic, on the strength of the manufacturer's trials. When the trials are finally prised loose five years later, the drug shortens flu by about half a day and nothing shows it keeps anyone out of hospital. The stockpile goes out of date in a warehouse. The year is 2026. The doctor has ten minutes and a screen. The number is high, so the tablet is for life. The weight is high, so the injection is for life. The meat is bad for the planet and the oil is good for the heart, and the person in the chair is as certain as everyone who ever sat in it. Every one of those was settled, by a committee, in a journal, with a doubter somewhere being laughed at. The rest cure, the straps, the fog, the rod, the formula, the crab, the margarine, the trial, the stockpile. All of it certain, all of it printed, all of it done to somebody who had asked for help. You were never the one who was wrong. You were the one it was done to, and the only person in the story who did as they were told every single time. The apology comes a generation late, in a footnote, addressed to nobody. The next one is being drafted now.