EXPLORATIONS

The Lemon Juice Syndrome and the Hunger Games

| Larry Dossey, MD | In knowing that you know nothing, that makes you the smartest person of all.1 —Socrates On January 6, 1995, McArthur Wheeler, 45, walked into two Pittsburgh banks with an accomplice in broad daylight and robbed them. Oddly, he made no obvious attempt at disguise. In fact, the first thing he did was look directly into the surveillance cameras and smile. That night on the 11 o’clock news his picture was broadcast during the Pittsburgh Crime Stoppers segment. When he was arrested less than an hour later, Wheeler was incredulous. “But I wore the juice!” he protested.* Wheeler was under the impression that rubbing one’s face with lemon juice made it invisible to cameras.2 Even though the lemon juice was burning his face and eyes and he was having trouble seeing, he was totally confident his face could not be photographed. As journalist Michael A. Fuoco reported in the Pittsburgh Post-Gazette, he got the idea from two people he trusted, but he did not take their word for it. He performed an experiment to evaluate their claim. He bought a couple of lemons, rubbed the juice on his face, and snapped a Polaroid picture of himself and saw he was nowhere in the image. It was like a version of “Where’s Waldo?” with no Waldo, said one detective. A lawman, who nabbed Wheeler, offered three possibilities for his successful Polaroid test: the film was bad, he had not adjusted the camera correctly, or he had rotated the camera

*

I extend thanks to anesthesiologist Margaret Overton, MD, author of the superb book Good in a Crisis, for calling my attention to McArthur Wheeler and for reminding me of the Dunning-Kruger effect.

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at the last moment and took a picture of the ceiling.3 The lemon juice idea was no doubt derived from the old custom of using lemon juice as invisible ink. When the invisible writing is exposed to heat, it becomes visible. Wheeler apparently assumed that his face would remain invisible as long as he avoided a heat source.

THE ILLUSION OF CONFIDENCE Hollywood has long glamorized criminals as masterminds. But as scenarios such as Wheeler’s show, those convicted of crimes are, on average, less intelligent than law abiders. There is an unbroken thread of nearcomical mistakes that criminals make.3 For instance, there is the high-school student who vandalized his school by spray-painting his own initials on a wall. A Brit named Peter Addison went further, spray-painting “Peter Addison was here” on the side of a building. Peter Porter, a 66-year-old American lawbreaker, became irate and conspicuous when a supermarket cashier refused to make change when he gave her a onemillion-dollar bill. Then there is the criminal-to-be who filled out an employment application at a fast-food restaurant providing his correct name, address, and social security number—before he decided a couple of minutes later to rob the place. All such people demonstrate what is been called the “illusion of confidence,” an inflated view of their skills.3 This illusion is not confined to criminals, of course. It is also painfully obvious in many of the aspiring contestants on shows such as “American Idol” and “Last Comic Standing.” The individuals who have no hope of qualifying, to say nothing of winning, appear genuinely shocked when the judges reject them.

THE DARWIN AWARDS Gross incompetence that is not recognized by the incompetent individual has been parodied for years by the Darwin Awards, which honor Charles Darwin’s maxim of the survival of the fittest. Originating around 1985, they were formalized in 1993 by the creation of a website that has become widely known, along with a series of books starting in 2000. As editor Northcutt describes the criterion for the awards, “In the spirit of Charles Darwin, the Darwin Awards commemorate [posthumously] individuals who protect our gene pool by making the ultimate sacrifice of their own lives. Darwin Award winners eliminate themselves in an extraordinarily idiotic manner, thereby improving our species’ chances of long-term survival.” 4 Some of the recipients include the following5: 2000: An Iraqi terrorist did not put enough postage on a letter bomb, and it came back marked “return to sender.” He opened the package and was blown away. 2002: After being pulled over for erratic driving, a man chose to run from the stolen car while shooting at the police over his shoulder without looking back. He accidentally shot himself in the head. 2003: During festivities in a park, an Australian man was rushed to the hospital after placing a lit firecracker between the cheeks of his buttocks before stumbling and falling on his behind. The emergency surgeon noted that it looked like “a war injury.” 2004: After a few drinks, two Taiwanese university students attempted a jousting contest on motor scooters to impress a girl they were both interested in. They collided at 50 miles per hour, both dying on impact. The

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girl later stated that she was not interested in either man. 2005: Two muggers in South Africa were fleeing after stealing a cell phone and a purse from a couple at knifepoint when one of them attempted to jump a fence to get away. After his 10-m drop on the other side, one of them realized he had jumped into the tiger den at the Bloemfontein Zoo. He was fatally mauled. 2006: An Englishman was found slumped over in his home with stab wounds to his chest. Though police initially thought he was attacked, his wife later told them that she remembered his wondering earlier that week whether or not his new jacket was “stab-proof.” The coroner ruled his death “accident by misadventure.” 2009: In an attempt to disguise himself for a robbery, a man chose to spray-paint his face gold. He did not realize that the fumes from the paint were toxic and died from inhalation shortly after the burglary. 2011: During a protest of motorcycle helmet laws, a New York resident was riding his bike without a helmet when he lost control, flipped over its handlebars and died on impact. 2012: A man was at a friend’s apartment where he saw a salsa jar with an unknown fluid. He presumed it was liquor and took a sip before realizing it was gasoline and spitting it out. Shortly thereafter, he lit a cigarette, setting himself on fire. I have never liked the Darwin Awards. I find no humor in the death of people who make wrong choices. Moreover, the awards reek of condescension and superiority. Worse, they are a misrepresentation. Nearly all the recipients are adults who were well past puberty and into their reproductive years. Many no doubt had already reproduced before they managed to kill themselves. They had already contributed to the human gene pool before they accidentally removed themselves from it. In order to be consistent with their stated goal, the impresarios of the Darwin Awards should present them to deceased prepubescent, pre-reproductive children. In my view, the awards are mainly an indelicate

opportunity to laugh at someone else’s misfortune, while posing as a champion of Darwinian theory. Does stupidity protect the human gene pool? Not according to social psychologist David Dunning (of whom, more later). “People,” he says, “will often make the case, ‘We can’t be that stupid, or we would have been evolutionarily wiped out as a species a long time ago.’ I don’t agree… [A]ll you need to do is be far enough along to be able to get three square meals… so that you can reproduce. And then, that’s it. You don’t need a lot of smarts. You don’t have to do tensor calculus [or]…quantum physics to be able to survive to the point where you can reproduce. One could argue that evolution suggests we’re not idiots, but I would say, Well, no. Evolution just makes sure we’re not blithering idiots. But, we could be idiots in a lot of different ways and still make it through the day.”6 In any case, the implication of the Darwin Awards, that if one’s intelligence quotient (I.Q.) is above a certain level one will be a positive contributor to the gene pool, is specious. In fact, a high I. Q. may turn out to be deadly. As the saying goes, “Life is extinct on other planets because their scientists were more advanced than ours.”7 A dimwitted member of Homo sapiens who fits into his environment and faithfully provides food and protection to his progeny may in the long run prove more valuable than the brilliant physicist who perfects nuclear weapons that convert Homo sapiens into Homo sapiens emeritus—emeritus being a Latin past participle that means “having served one’s time.”

THE DUNNING–KRUGER EFFECT Even though the lemon juice did not work, McArthur Wheeler unwittingly made a significant contribution to modern psychology. In 1999, when social psychologist David Dunning of Cornell University was perusing the 1996 World Almanac, he came across a section called “Offbeat News Stories.” Included in it was a report on bank robberies committed in Pittsburgh the previous year. He tracked down the article by journalist Michael A. Fuoco, mentioned above. As

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Dunning read the article he wondered whether, if Wheeler was too stupid to be a bank robber, he was also too stupid to realize that he was too stupid to be a bank robber. Did his stupidity protect him from an awareness of his own stupidity?3 Dunning thought it might be possible to measure one’s self-assessed level of competence against something more objective, such as actual competence. Soon he and Justin Kruger, his graduate student, had put together a research program. The result was their 1999 seminal article “Unskilled and Unaware of It: How Difficulties of Recognizing One’s Own Incompetence Lead to Inflated Self-assessments.”8 Dunning and Kruger wrote, “When people are incompetent in the strategies they adopt to achieve success and satisfaction, they suffer a dual burden: Not only do they reach erroneous conclusions and make unfortunate choices, but their incompetence robs them of the ability to realize it. Instead, like Mr. Wheeler, they are left with the erroneous impression they are doing just fine.” In other words, if you are severely incompetent you cannot know you are incompetent. It is not that you refuse to admit your incompetence, are denying it, or are lying about it. You simply do not realize it. The result is a profound degree of blindness. Kruger and Dunning noted historical observations that point in the same direction, including Confucius: “Real knowledge is to know the extent of one’s ignorance”; Bertrand Russell: “One of the painful things about our time is that those who feel certainty are stupid, and those with any imagination and understanding are filled with doubt and indecision”; Charles Darwin: “Ignorance more frequently begets confidence than does knowledge”; and Shakespeare in As You Like It: “The Foole doth thinke he is wise, but the wiseman knows himself to be a Foole.”9 Or as my grandmother used to say to my twin brother and me when we little tykes would do something abysmally stupid, “To be so smart, you boys don’t know very much.” Physician Lewis Thomas (1913–1993), director of research at Memorial Sloan– Kettering Cancer Center, would have

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agreed with Dunning, Kruger, and my grandmother. He believed that a mark of wisdom is the recognition of ignorance, even in science. Toward the end of the 20th century he wrote, “The only solid piece of scientific truth about which I feel totally confident is that we are profoundly ignorant about nature.”10 “… We do not really understand nature, at all… Only two centuries ago we could explain everything about everything, out of pure reason, and now most of that elaborate and harmonious structure has come apart before our eyes. We are dumb.”11 The legendary Nobel Prize-winning physicist Richard Feynman was in the same camp. “Learn from science that you must doubt the experts,” he said. “As a matter of fact, I can also define science another way: Science is the belief in the ignorance of experts.”12 Meditation teacher Wes Nisker agrees. He extends ignorance to the culture at large, writing, “Just imagine how good it would feel if we all got together once in a while in large public gatherings and admitted that we don’t know why we are alive, that nobody knows for sure if there’s a higher being who created us, and that nobody really knows what the hell’s going on here.”13 Dunning and Kruger performed a series of experiments that confirmed the effect that now bears their name. In one, they tested college students about grammar. The students who were doing badly in grammar did not know they were doing badly in grammar. “Even if you are just the most honest, impartial person that you could be,” said Dunning, “you would still have a problem— namely, when your knowledge or expertise is imperfect, you really don’t know it… We’re not very good at knowing what we don’t know.” Thus the Dunning–Kruger effect was born: a cognitive bias in which unskilled individuals suffer from illusory superiority, mistakenly rating their ability much higher than average.3

THE INVISIBLE DEFICIT

Anosognosia, literally “lack of knowledge of disease,” is a neurological term introduced by the famous neurologist Joseph Babinski (1857–1932). An anosognosia patient who is paralyzed on

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one side simply does not know that he is paralyzed. If you put a pencil in front of him on that side and ask him to pick it up, he will not do it. He may say, “I’m too tired,” or “I don’t need a pencil.” The awareness of paralysis is absent because of damage to one side of the brain. The brain damage prevents him from paying attention to one side of his environment. A man thus affected may shave only one side of his face. He may eat the food only on one side of the plate, then complain that there is not enough food. The deficit is not willful. It is unperceived.14 Dunning and Kruger believe they have identified a psychological version of physiological anosognosia. But the psychological blindness can be worse than the physiological kind, because the latter affects only single individuals while the former can spread far and wide in a society.

SOCIAL ANOSOGNOSIA Errol Morris, the award-winning American film director and writer, has explored the possibility that anosognosia may extend beyond the individual. In a penetrating series of essays he asks, “Can a group of people, perhaps even society at large, devolve into a state of destructive cluelessness?”15 Morris finds evidence for this possibility in the tenure of Woodrow Wilson, the 28th president of the United States, who served from 1913 to 1921. On October 2, 1919, Wilson suffered a stroke that was almost fatal. It resulted in visual impairment and muscular weakness on the left side of his face, tongue, jaw, and pharynx, with difficulty in swallowing, and impairment of his speech. “Following his stroke,” says neuropsychiatrist Edwin Weinstein, “the outstanding feature of the President’s behavior was his denial of his incapacity… or anosognosia…”16 Morris adds, “Wilson described himself as ‘lame’ and referred to his cane as his ‘third leg,’ but otherwise he considered himself perfectly fit to be president. There was even talk of a third term.”15 Wilson’s great goal was the ratification by Congress of the treaty guaranteeing the participation of the United States in the League of Nations following World War I. However, Wilson’s stroke and the

subsequent change in his personality made him so intransigent, inflexible, and unwilling to compromise with his political opponents that the defeat of the treaty was inevitable. Morris suggests that a pervasive social anosognosia was also operating. The public wanted to believe that the president was healthy, that nothing was wrong, and that even if he was paralyzed “his mind was clear and untouched.” Wilson’s personal blindness to his defects was compounded by the coverup of his impairment by his wife, Edith, and those close to him, including his personal physician. Levin,17 in her book Edith and Woodrow, is convinced that Wilson’s inability to perceive his own incapacity had devastating consequences for the nation and world he helped to lead. Levin ponders a counterfactual history in which the League of Nations included the United States. Would the course of history during the 20th century been different? Might World War II have been averted? Morris: “It is one of history’s great what-ifs.” The Wilson saga involves multiple currents of anosognosia—that of Wilson following his stroke; that of his wife and his staff, whose denial of Wilson’s defects was profound; and that of the public, which was willing to believe their president was mentally clear even though partially paralyzed.

IGNORANT BUT NEVER IN DOUBT I have bumped into the Dunning–Kruger effect often over the years without realizing that one day it would be formally described and named. If I had known about it, it would have shed light on my experiences, clarified them, and made them easier to tolerate. In one such instance, I was invited to lecture on healing research at one of the leading medical schools in the country by a nationally known member of the medical faculty, who had performed a controlled experiment on the effects of distant healing intentions. His faculty colleagues were nervous about these directions, so he asked me to join him in a meeting with the research advisory committee. It was a strange experience. The advisors gingerly voiced their ambivalence toward the research in question. It was clear they were unlikely

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to approve any further investigations along these lines. I supported the healing researcher by citing foundational experiments in remote healing not just in humans, but also in other organisms including bacteria, animals, and plants. There was nothing new in the research on which they were passing judgment, I said; positive findings had been reported for decades in careful studies. The reaction of the advisors was a mixture of suffocating boredom, non-comprehension, and veiled hostility. Why were we wasting their time on something that “everyone knows” is impossible? No one was prepared to acknowledge the existence, let alone the possible validity, of any prior research that might have affirmed the respectability of the experimental approach in question. This was an incandescent example of the Dunning–Kruger effect. The ignorance of the advisors protected them from an awareness of their ignorance. They were blind to their blindness. It is not just dumb criminals like McArthur Wheeler who are susceptible to the Dunning–Kruger effect. Superintelligence is no guarantee of immunity to blindness, but may make one even more likely to be blindsided by one’s ignorance. As the eminent psychologist Eysenck18 observed decades before the Dunning–Kruger effect surfaced, “Scientists, especially when they leave the particular field in which they have specialized, are just as ordinary, pigheaded and unreasonable as anybody else, and their unusually high intelligence only makes their prejudices all the more dangerous…”

OUR CULTURAL LEMON JUICE Our society has smeared our collective face with lemon juice. We think we are completely competent in several areas and cannot see that we are not: social anosognosia. Consider our national healthcare debate. Like many people, I am unable to comprehend some of the twists and turns in this discussion. I do not understand, for instance, why it is a bad thing, as many claim, to help provide health insurance to the 50 million Americans who do not have it, a demographic that includes around eight million innocent

children. And I cannot grasp why some politicians strenuously attempt to deny school breakfasts to impoverished, hungry children who have done nothing wrong. As novelist Kurt Vonnegut19 said, “There’s only one rule that I know of, babies—‘God damn it, you’ve got to be kind.’” I fail to comprehend how certain congressmen can work to shut down the federal school lunch program because, they allege, it does not “fall within the framework of our United States Constitution.”20 How about the framework of common decency and empathy? It mystifies me how individuals can defend fetuses by opposing abortion, yet paradoxically deny prenatal care for pregnant women who are poor and food assistance after the baby is born. I do not understand why we cannot better deal with the 600,000 Americans who are homeless on any given night, nearly a quarter of whom are children, a third of whom are living in unsheltered places like cars, parks, or abandoned buildings.21 And it seems ungrateful, as well as insulting, to cut food assistance to the approximately 900,000 veterans and 5000 active-duty troops who currently receive it, which will be the result if the current congressional efforts to slash the food stamp program succeed.22

THE HUNGER GAMES Let us put nutrition assistance under the microscope and take a closer look at how cultural lemon juice can blind us. First, some basic facts. Seventy-six percent of households receiving food stamps through the Supplemental Nutrition Assistance Program (SNAP) include a child, an elderly person, or a disabled individual. These households receive 83% of all SNAP benefits.23,24 Some 45% of food stamp recipients are children.25 Still, every night, 17 million children go to bed hungry in the United States.26 This means—critics, listen up!—that no matter how you slice it, the nation’s nutrition assistance program is significantly a program to keep poor children from going hungry. The reason given most frequently for cutting SNAP is cost. Although the program is a lifeline to millions of struggling households that include children,

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opponents say we cannot afford it.27 Yet the average American household pays $6000 annually in taxes to subsidize wealthy corporations who have no need of charity.28 Seen in this context, it seems obscene to tell a hungry child that we cannot afford to alleviate her hunger and that she must bear it because her hunger is too costly. Corporations do not go hungry, but people do. It is obvious that cost is not really the issue here, and that deeper factors are at work. Contrary to the criticism that food stamps are a drain on the economy, many economists consider SNAP one of the most effective forms of economic stimulus. Moody’s Analytics estimates that in a weak economy every dollar increase in SNAP benefits generates about $1.70 in economic activity. Similarly, the Congressional Budget Office rated an increase in SNAP benefits as one of the two most cost-effective of all spending and tax options it examined for boosting growth and jobs in a weak economy.29 Others say nutrition assistance programs should be cut because hordes of people are illegally trafficking in food stamps—collecting free food and selling it or peddling SNAP cards for cash or ineligible items. In the media, stereotypes dominate this particular objection. There is a steady drumbeat of stories about recipients who spend their benefits on cigarettes, beer, or cosmetics, but there are few reports such as the single mother who figured out how to cut the family’s electricity bills by taking the light bulb out of the refrigerator, and who gives part of the food she obtains from the local food pantry to a homeless woman who is always pleading for help.30 While flagrant examples of abuse can be found in any major governmental (or private) program, the U.S. Department of Agriculture, which administers SNAP, reports that the fraud rate in the program has remained steady at around 1.5%, making it one of the least-abused federal programs in existence.31,32 By comparison, Medicare fraud rates are roughly estimated to be between 3% and 10% of expenditures.33 As to defense spending, no one knows how much money is siphoned off by fraud and waste, but experts use words such as “epic” to describe the abuse. Proper accounting methods for defense

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allocations are acknowledged to not exist. “We [don’t] have the detail… for a lot of it,” says one Defense Department insider, which is a delicate way of saying that no one keeps track of where all the money goes.34 It is almost certain that the 1.5% attributed to cheating in SNAP is a figure the Pentagon and American taxpayers can only envy. Yet the conservative congressmen who complain loudest about SNAP fraud seldom utter a whiff of objection about the massive lapses in the Pentagon’s lack of accountability. For them, colossal waste and fraud in military spending can be overlooked with a wink and a nod, while minuscule cheating on food stamps for infants, children, the disabled, the elderly, and veterans elicits a display of righteous indignation. We are also warned that if the government tries to prevent people from going hungry by giving away food, this destroys their incentive to work. More stereotypes: “Food stamps don’t work” because they create a culture of dependency by rewarding parasitic “moochers and takers.” Food assistance, we are told, fosters deadbeat, Cadillac-driving welfare queens who prefer making babies to gainful employment. As one of Senator Paul Ryan’s35 (R-Wisconsin) colleagues described his view, “Paul wants people to dream again… You don’t dream when you’ve got food stamps.” The concept of food as a kind of psychological Botox that paralyzes one’s dreams for the future is quite novel. Ryan should be congratulated for this bold leap of imagination—if only the leap had landed in fact-based reality instead of the bog of fantasy. But Senator Rand Paul (R-Kentucky) agrees, contending that helping people secure food, shelter, and other necessities is a “disservice” to the long-term unemployed, as if cutting off the funds they live on will magically produce a job.36 These hunger-is-good-for-you arguments are blind to a fact that critics never mention: infants and children are involved. Lemon juice in action. In this cherished theory, free food is such a logical disincentive to work that the concept is considered immune from disproof. But in fact the majority of SNAP recipients who can work do so. Among SNAP households with at least

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one working-age, non-disabled adult, more than half work while receiving SNAP—and more than 80% work in the year prior to or the year after receiving SNAP. The rates are even higher for families with children—more than 60% work while receiving SNAP, and almost 90% work in the prior or subsequent year.37 The 90% return-to-work statistics following food stamp support suggests that nutrition assistance acts not as a disincentive to return to work, but helps people while they are searching for work. Bost,38 who served as President George W. Bush’s Undersecretary of Agriculture for Food, Nutrition, and Consumer Services, testified before a House Committee, “The Food Stamp Program has also contributed to the success of welfare reform by supporting the transition from welfare to work. The reasons are easy to understand—if you are worried about your family’s next meal, it is hard to focus on your future. For many households, food stamps can mean the difference between living in poverty and moving beyond it. And for many, it has.” You may be wondering why a medical journal such as Explore would engage in politically tinged controversies such as food stamps. The reason is simple and direct. Long-term data over decades show that nutrition assistance works in a variety of ways—economic, sociocultural, and medical. Statistics reveal that children with access to food stamps fare better by 19 years of age with a reduction in stunted growth, a lower incidence of heart disease, a reduction in obesity, and a higher completion rate of high school.39 Of the medical issues, more later. I do not doubt the sincerity of those who disagree with this perspective. I do doubt their logic. Like McArthur Wheeler, they often make decisions based on partial or bogus information that is encrusted with conservative ideology—although what can possibly be conservative about denying food to children is beyond me. The anti-food stamp crusaders resemble the university students studied by Dunning and Kruger who were grammatically challenged, but who simply could not comprehend they were terrible at grammar. They are blind to their blindness: the lemon juice syndrome and the Dunning–Kruger malady.

This sort of blindness is not just metaphorical; it is reflected physically. Princeton University psychologist Susan T. Fiske performed functional magnetic resonance imaging (fMRI) brain scans on individuals while they were viewing photos of the poor and homeless. Their brains often reacted as if they were seeing things, not people. Her analysis suggests that Americans often react to poverty not with empathy, but with revulsion.40,41 The revulsion is sometimes acted out violently—as when state representative Tom Brower took a radical approach to solving homelessness in Hawaii by roaming city streets, looking for shopping carts that homeless people use to transport their possessions, and destroying them with a sledgehammer.42 Revulsion toward food stamp recipients is often marinated in hypocrisy. In 2013, Congressman Trey Radel (R-Florida) backed a Republican bill that would require food stamp recipients to undergo monthly urine drug testing to prove they were worthy. Shortly thereafter, Radel achieved notoriety when he was busted for cocaine possession.43 Psychologist Fiske’s conclusions are supported by readers’ responses to an article on food stamp recipients by columnist Nicholas D. Kristof in the New York Times. One reader responded, “If kids are going hungry, it is because of the parents not upholding their responsibilities.” Another reader agreed: “Why should I have to subsidize someone else’s child? How about personal responsibility? If you procreate, you provide.” Another reader suggested an alternative to food stamps: forcibly taking these children from their parents and putting them in orphanages.25 It would be difficult to find more unambiguous, full-throated expressions of social Darwinism. Kristof25 gives a nod to John Rawls, “the brilliant 20th-century philosopher [who] argued for a society that seems fair if we consider it from behind a ‘veil of ignorance’—meaning we don’t know whether we’ll be born to an investment banker or a teenage mom, in a leafy suburb or a gang-ridden inner city, healthy or disabled, smart or struggling, privileged or disadvantaged. That’s a shrewd analytical tool—and who among us would argue for food stamp cuts if we

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thought we might be among the hungry children?” Economist Hilary W. Hoynes of the University of California at Berkeley and her colleagues Diane W. Schanzenbach and Douglas Almond have exposed the blindness associated with the current food stamp controversy. In their research paper “Long Run Impacts of Childhood Access to the Safety Net,” they report, “Our findings indicate that the food stamp program has effects decades after initial exposure. Specifically, access to food stamps in childhood leads to a significant reduction in the incidence of ‘metabolic syndrome’ (obesity, high blood pressure, and diabetes) and, for women, an increase in economic self-sufficiency. Overall, our results suggest substantial internal and external benefits of the safety net that have not previously been quantified.”44 As one observer at the Center on Budget and Policy Priorities noted, “Hoynes and her collaborators have really broadened our understanding of how programs like food stamps not only relieve hardship in the moment but can trigger long-lasting gains in participating children’s later health and education. The implications of the research are considerable. In this long view, such assistance is not only helping struggling families to scrape by, it’s a good investment in the next generation of citizens and workers.”45 In a study from the University of California, San Francisco (UCSF), researchers found that slashing monthly food stamp programs could cost more than it saves, because of a resulting increase in healthcare costs. The UCSF researchers found that California’s lowincome population was more likely to be admitted to the hospital for hypoglycemia, a low-blood sugar condition linked to diabetic patients who continue to medicate while not eating enough. The risk for admission increased 27% in the last week of the month when food runs low, compared to the first week, while they observed no weekly difference among high-income Californians. “This is people going hungry, skipping meals and ending up in the hospital,” lead study author Hilary Seligman said of the low-income patients who may run out of food stamps at the end of each month. “From my perspective as a

public health researcher, it’s cheaper to make sure people don’t get hungry than to deal with the far more expensive healthcare costs of not having access to food.”46,47

A MORAL OUTRAGE One thing I want to do is create something called Ring Around Congress. It would be a state deal and also a national thing, where the kids, as a field trip, will go and join hands around Congress and give the politicians report cards on how they’re voting on hunger issues.48 —Jeff Bridges I have emphasized hunger—especially the hunger of children—as an example of cultural blindness and anosognosia. For, in spite of the labyrinthine arguments that attempt to justify the nightly hunger of 17 million children, there is simply no justification for it. This gnawing realization exerts a painful torque on the national conscience that only food to the hungry can relieve. Even if critics of nutrition assistance were right on every one of their specious allegations—that the cost is prohibitive, that food assistance sabotages the willingness to work, that fraud is rampant in the program, that food allowances are a disservice to the poor—even if all these contentions were valid, they would still ring hollow because widespread childhood hunger in a land of plenty is, always has been, and always will remain a moral outrage. The ultimate justification for nutrition assistance is simply that childhood hunger is deeply, morally wrong.

RACISM AND HUNGER When you share your last crust of bread with a beggar, you mustn’t behave as if you were throwing a bone to a dog. You must give humbly, and thank him for allowing you to have a part in his hunger.49 —Giovannino Guareschi The most horrific social blindness in our nation’s history was slavery. In signing our Constitution in 1787, the

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Founding Fathers asserted that all men are created equal, with equivalent claims to life, liberty, and the pursuit of happiness. They simultaneously recognized slavery. Some of them realized that this contradiction could not stand. A few had the courage to say so; Benjamin Franklin is the shining example. In his later years, he became a vocal abolitionist. In the decades leading up to the Civil War, eloquent statesmen filled volumes justifying slavery with complex, ingenious arguments. The nation’s conscience could not be assuaged by this high-toned talk, however, because it was impossible to justify a practice that was being judged evil by an increasing number of Americans. But not even the bloodbath of the Civil War could wipe clean the stain of racism. The stain lingers, and for this reason we should not pretend that racial prejudice does not infect our national debate about food assistance. Food aid has long been considered a black issue, despite the fact that, since the inception of the Food Stamp Program, the majority of recipients have always been nativeborn white people. According to 2010 census numbers, about 26% of food stamp recipients are African-American, while 49% are white and 20% are Hispanic.50 There are parallels between slavery and our current struggle over food stamps. Perpetual hunger in children is a form of slavery, often condemning those affected to reduced circumstances for the rest of their life, including devastating health problems, as mentioned. Moreover, racial rhetoric in this debate never dies. When presidential candidate Newt Gingrich called President Obama “the food-stamp president” in 2012, this was a dog whistle to those enamored with the stereotype of the black welfare queen. Gingrich’s slur, said the conservative British magazine The Economist, “flatters the bigots, who… are roused by talk of food stamps and an underdeveloped taste for honest labour.”51 It has long been so. As Joel Berg, Executive Director of the New York City Coalition Against Hunger, writes, many of the strongest supporters of racial segregation in the 1960s were also

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the fiercest opponents of increasing government support for anti-hunger programs. Senator Strom Thurmond of South Carolina, a leading segregationist, almost succeeded in halting efforts to require the federal government to measure hunger, saying, “There has been hunger since the time of Jesus Christ and there always will be.” Thurmond neglected to mention that Jesus practiced nutritional assistance by feeding the hungry multitude. Powerful House Agriculture Appropriations Chair Jamie Whitten from Mississippi complained to Senator George McGovern that, if “hunger was not a problem, nigras won’t work,” and that McGovern was promoting revolution by seeking an improvement in food stamp benefits, which Whitten thought would be used for “frivolity and wine.” Whitten even opposed expansion of the School Lunch Program to many of the nation’s poorest jurisdictions that did not yet have such programs. Conservatives supporting welfare reductions in Wisconsin in the late 1960s called welfare recipients “gorillas.” In the 1996 welfare reform debate on the floor of the U.S. House of Representatives, a Congressman held up a sign that said, “Do Not Feed the Alligators.”52 A single hungry child is a telling rebuke to a thousand rants in Congress about the evils of nutrition assistance. Hunger should not be a partisan issue but a moral one bridging all political divisions. It comes down to what we value. What do we care about? What merits our nation’s expenditures? We can take a hint from President Eisenhower,53 who said, “Every gun that is made, every warship launched, every rocket fired, signifies in the final sense a theft from those who hunger and are not fed, those who are cold and are not clothed.”

COMING CLEAN I acknowledge that the anosognosia sword cuts in all directions. We are all susceptible to blindness, unable to comprehend our ineptness and irrational beliefs. I often find myself wondering what personal blindness I don’t recognize. Will I ever know? Can I ever know? Still and all, we are not equally ignorant; some of Dunning and Kruger’s university students were better at grammar

Explorations

than others. The argument of equivalent stupidity in the form of the oft-heard rationalization that “everybody does it” fails. This argument says, “If I’m blind, then so are you, so stop criticizing,” as if across-the-board blindness cancels itself out. This ignores the plain fact that both psychological and physical blindness vary in degree. It can be partial or total, temporary or permanent, curable or incurable. Our lemon juice does not wash off easily, but it can be removed. The best soap for the job is hard facts, such as the long-term data on food stamp outcomes assembled by economist Hoynes and her colleagues, and the UCSF study on medical costs resulting from hunger and food shortages. Our irrationalities can be upgraded and our sight regained. But this is difficult because the illogic that appealed to us in the first place is comforting and brings with it a sense of personal accomplishment and superiority. It affirms our unexamined prejudices—often without a glimmer of awareness on our part. But it is surely better if we remove the lemon juice, no matter how difficult, than suffer what awaits us—the arrival of Wheeler’s “cops” in the form of the merciless consequences of our stupidities.

FOOD AID: AS AMERICAN AS PILGRIMS The lemon juice syndrome prevents the awareness of one’s inadequacy and protects one’s irrationality and illogic— temporarily. We are approaching a reckoning in many areas of our cultural debates that have enormous, even planetary, consequences. As my Explore colleague, columnist Stephan A. Schwartz, has pointed out, there are critical areas in which blindness is rampant. Among them are biological evolution, the nonlocality of consciousness, global climate change, and the American healthcare system, whose inadequacy is increasingly obvious, as repeatedly judged by objective measures year after year.54,55 There is a pattern. Generally speaking, Americans who, under the rubric of conservatism, oppose nutrition assistance to children also tend to deny the looming devastation of global climate

change, the human costs of an inept healthcare system, the negative consequences of a constricted view of consciousness, and the dangerous costs of denying biological evolution. Currently the price of admission to certain political alliances in America depends on whether the individual is willing to deny all these challenges. This is very troubling. It suggests that sociocultural anosognosia works like an autoimmune disease with multi-system involvement, affecting not one organ but the entire body. But therein lies an advantage: it may not be necessary to treat each organ separately to effect a cure, but the underlying autoimmune process itself. In the narrative I’m offering, this means shifting one’s worldview so that a cascade of solutions can then fall into place. What is that worldview? It is a perspective that is held in place by two pillars: evidence and caring. Weil56 wrote, “It is an eternal obligation toward the human being not to let him suffer from hunger when one has a chance of coming to his assistance.” Our nation grew out of this principle. During the first terrible winter after landing at Plymouth Rock in 1620, many of the Pilgrims and their children were saved from starvation by the food given to them by Native Americans. It was our first supplemental nutrition assistance program. Our national narrative and legendry were set in motion by this act of lifesaving food aid. We should not abandon this noble tradition, but honor it. REFERENCES 1. Socrates. Quotes.net. http://www.quotes. net/authors/socrates. Accessed December 5, 2013. 2. Fuoco M. Trial and error: they had larceny in their hearts, but little in their heads. Pittsburgh Post-Gazette, April 21, 1996. 3. Morris E. The anosognosic’s dilemma: something’s wrong but you’ll never know what it is (Part 1). Nytimes.com. http:// opinionator.blogs.nytimes.com/2010/06/ 20/the-anosognosics-dilemma-1/; 2010 Accessed November 23, 2013. 4. Northcutt W. History and Rules. www. darwinawards.com. Accessed November 23, 2013. 5. The Darwin awards. Knowyourmeme.com. http://knowyourmeme.com/memes/sites/

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