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Although critically acclaimed, Wonderland was canceled after three episodes. Leyner and I continued our strong friendship. We would talk about each other’s work, and I particularly enjoyed reading his scripts and adding my meager suggestions. We decided a collaboration was in order and pitched several TV pilot ideas together. Working with Leyner brought me back to my long-standing idea for a book of cocktail party medicine questions. Leyner greeted my invitation to work on this book enthusiastically.

  Mark: I considered it for a moment or two and remember thinking, “Hey, I could make a shitload of money and do almost no work!”

  Billy: I felt that I had offered Mark the opportunity to be the doctor he always wanted to be. I thought he was ready to share the burden of this project, and what you are about to read is the result of all our, well, no actually, all my hard work.

  Enjoy.

  INTRODUCTION

  When you’re at a cocktail party, someone inevitably asks you what you do for a living. If you say that you are a doctor, the barrage begins.

  Soon you’re looking at someone’s mole, consulting someone else on his brother-in-law’s painful flatulence, racking your brain to explain the etiology of your hostess’s episodic vertigo, and that’s just the beginning. You would think that after twelve years of rigorous training and sleepless nights, doctors would have all the answers. But no! Not so. The sad fact is that one of the medical establishment’s great shortcomings is its failure to teach what the general public really wants to know about medicine.

  This book is an attempt to rectify this unfortunate situation. Inside these pages we will begin to answer some of the medical questions that real people ask. Pressing questions such as “Why does my pee smell when I eat asparagus?” “Is it true when they say ‘beer before liquor, never sicker; liquor before beer, never fear?’” “Is sperm fattening?” “What causes an ice cream headache?”

  This is not a self-help book or a medical manual. It’s a glimpse at some of the strange things that people want to know from their doctors, but are too embarrassed to bring up in the ER or during an office visit. They only seem to find the courage to ask these questions after their third martini.

  That’s when the party begins.

  DISCLAIMER

  What you are about to read is mostly true, as far as we know. But this book in no way should substitute for a visit to your doctor. Remember, doctors are trained professionals. Also, do not attempt to answer these questions yourself unless you are a mother. Mother always knows best.

  CHAPTER 1

  YOU ARE WHAT YOU EAT

  It’s 10 P.M., and my partner in writing and crime, Mark Leyner, and I are late as usual, but the party is in full swing. We brought a bottle of Don Julio tequila, which Leyner sampled voraciously in the cab, insisting that it needed to be screened for industrial toxins. We enter the elegantly appointed Park Avenue home of Eloise Cameron, a philanthropist, patron of the arts, and Botox junkie. Hors d’oeuvres are being served and the slightly inebriated and flush-faced Leyner grabs a mouthful of Swedish meatballs, kisses our hostess, and then comments, “Eloise, baby, better lay off the collagen. Kissing those lips is like making out with the Michelin man.” She attempts to smirk with disdain, but the Botox leaves her face impassive.

  I corral Leyner and we proceed into the living room. No sooner have we entered when I’m embraced from behind. I turn around and it’s Jeremy Burns, an investment banker who sits two rows behind me at the Knicks games. Jeremy is well known to the Madison Square Garden food vendors for his insatiable appetite for hot dogs, cotton candy, and beer. He is now almost unrecognizable in his new Atkins-induced skeletonlike state. “Who exhumed you?” Leyner belches. I am overcome by embarrassment but secretly wetting myself with laughter. Jeremy tries to sidestep Leyner and as their arms brush, Leyner is covered with the grease that now oozes from Jeremy’s pores. Leyner whispers to me, “This dude is all greased up like a rectal thermometer.” I push Leyner away and he uses this opportunity to sneak over to the bar for another blast of Don Julio. I am left with Jeremy and his insufferable stories about life on the meat-and-fat diet, and a million medical questions about food.

  If we are what we eat, why do we know so little about food and nutrition?

  DOES IT REALLY TAKE SEVEN YEARS TO DIGEST CHEWING GUM?

  What is it with seven years? You break a mirror, seven years of bad luck. Each dog year is seven human years. Seven years to digest swallowed gum? What if a dog broke a mirror then swallowed a pack of gum? Sounds like an algebra problem.

  Chewing gum is not digestible but it definitely doesn’t sit in your stomach for years. Gum actually might help things move through the bowels faster. Sorbitol is sometimes used as a sweetener in gum and this can act as a laxative. What does this mean? Yes, if you look carefully, you should see it floating next to all of those lovely yellow corn kernels.

  WHY DOES YOUR PEE SMELL WHEN YOU EAT ASPARAGUS?

  Asparagus contains a sulfur compound called mercaptan. It is also found in onions, garlic, rotten eggs, and in the secretions of skunks. The signature smell occurs when this substance is broken down in your digestive system. Not all people have the gene for the enzyme that breaks down mercaptan, so some of you can eat all the asparagus you want without stinking up the place. One study published in the British Journal of Clinical Pharmacology found that only 46 percent of British people tested produced the odor while 100 percent of French people tested did. Insert your favorite French joke here:________________________________.

  3:32 P.M.

  Gberg: Mr. Leyner, sir????

  Leyner: Sir, reporting for duty, sir!

  Gberg: You ready for a little work, son?

  Leyner: Sir, permission to discharge my weapon into the sky, sir?

  Gberg: Just don’t hit the keyboard.

  Leyner: What should we do today?

  3:35 P.M.

  Leyner: I have an idea . . .

  Gberg: We have several things to do. Finish the preface, which we need to do together. Then we have 2 more intros.

  Gberg: Or else we can add some funniness to some questions.

  Gberg: You had an idea?

  Leyner: Let’s do that stuff (i.e., the preface and last two intros) . . . the real “writing” on Tuesday at your place . . . I think it works better with pacing.

  Gberg: So let’s work our way through the book.

  Gberg: Let’s start in the food chapter.

  Gberg: We need to add something to this mother.

  Leyner: Like?

  Gberg: Some sidebars.

  Leyner: I’m getting a Propel.

  Gberg: Okay, so we need to add some expert medical commentary. By the way, do you think if we keep mentioning Propel, that delicious vitamin-enhanced beverage from the makers of Gatorade, we can get some free stuff?

  Gberg: Only 20 calories per bottle. Sweet candy water!!! Where are you?

  Leyner: OK, Pops. I’m here, eating my sandwich, drinking Propel . . . yes, absolutely!!!! We should shamelessly and unethically claim that Propel cures impotence, Crohn’s disease . . .

  Gberg: . . . and the smell of your urine from asparagus . . .

  Leyner: . . . halitosis, and rectal whatever the hell you have.

  Gberg: Should we add some French jokes?

  Leyner: Certainly—let’s claim that Propel deodorizes your urine EVEN after eating asparagus . . . then we’ll get cases of the stuff!

  Gberg: And you have to be a little less vulgar otherwise my wife won’t be able to give this book to anyone as a gift without offending them.

  Gberg: Bunch of puritans!

  DOES SUGAR REALLY MAKE KIDS HYPERACTIVE?

  Parents are always looking for an excuse to explain their children’s bad behavior, and sugar has taken a lot of blame. This may come as no surprise, but the Coca-Cola Company doesn’t want to take responsibility, and makes it very clear that studies have failed to find any substantial evidence proving a relationship between sugar consumption and hyperactivity. Well, the company is c
orrect. Sugar does feed the body as an energy source, but it doesn’t make kids hyperactive.

  It is more likely that kids tend to eat sugary foods at times when they would be excited and rambunctious anyway (parties, holidays, movies, weddings, funerals). This can only be good news for the producers of such fine healthy treats as Cap’n Crunch with Crunchberries, Pixy Stix, cotton candy, and Laffy Taffy.

  WHAT CAUSES AN ICE CREAM HEADACHE?

  Aaaah, the joy of a Popsicle on a hot summer day.

  One theory places the source for the brain freeze in the sinuses, where the pain may be caused by the rapid cooling of air in the frontal sinuses. This triggers local pain receptors.

  Another theory postulates that the constriction of blood vessels in the roof and rear of the mouth causes pain receptors to overload and refer the pain to your head. There is a nerve center there, in the back of your mouth, called the sphenopalatine ganglion, and this is the most likely source of the dreaded ice cream headache.

  A friend of ours suggested a quick cure of rapidly rubbing your tongue on the roof of your mouth to warm it up. Her demonstration included a bizarre clucking sound. Leyner tried this and found himself followed by a large goose of whom he seems to have become inordinately fond.

  DOES EATING CHOCOLATE CAUSE ACNE?

  For those of you who use chocolate as a substitute for sex, you can breathe a sigh of relief. There is no evidence that acne is caused by chocolate. Acne is connected more to changing hormones than to food choices.

  Links have also been made between stress and acne. Recently, a group of dermatologists set out to prove that this common belief was also a myth but they found the reverse. Their study of twenty-two college students found that emotional stress was directly linked to acne severity.

  But back to the chocolate issue, the University of Pennsylvania and the U.S. Naval Academy both demonstrated that chocolate does not cause acne. At the University of Pennsylvania, researchers fed subjects “chocolate”; bars with no chocolate, while another group ate chocolate bars with nearly ten times as much chocolate as in a typical bar. Results of the experiment showed no significant difference in acne in either group. Other forbidden greasy foods like French fries, fried chicken, nachos, potato chips, and pork rinds probably don’t cause dreaded zits either. So lighten up, kick back, and relax, and if that doesn’t work go to McDonald’s for a supersize fries and a chocolate shake.

  WHY DO YOU CRY WHEN YOU CUT ONIONS?

  Cutting an onion releases an enzyme called lachrymatory-factor synthase. This starts the process that leads to tears. This enzyme then reacts with amino acids of the onion and the amino acids are converted to sulfenic acids. The sulfenic acids spontaneously rearrange to form syn-propanethial-

  S-oxide, which is released into the air. When this chemical reaches the eyes, it triggers the tears by contacting nerve fibers on the cornea that activate the tear glands. Now you are crying.

  Scientists have tried to make a “noncrying”; onion but it seems that the crying enzymes are also responsible for the zesty onion flavor. But there may be some hope on the way. The group of Japanese plant biochemists that only recently discovered lachrymatory-factor synthase, the crying enzyme, believe that “it might be possible to develop a nonlachrymatory onion by suppressing the lachrymatory-factor-synthase gene while increasing the yield of thiosulphinate.”; Sounds delicious!

  In the meantime there are several solutions to try to avoid the problem of onion-induced tears. Heating onions before chopping, cutting under a steady stream of water, or wearing goggles.

  The most reliable: ordering takeout.

  DO CUCUMBERS RELIEVE PUFFY EYES?

  A well-placed cucumber may feel wonderful, but there is no special ingredient in it that reduces swelling under the eyes. Cucumbers are 90 percent water, and it is the cooling effect of the water that constricts the blood vessels around the eyes, therefore decreasing the swelling. The colder the cuke the better.

  Some other swollen-eye solutions include black tea bags in cold water, the tannic acid content being the key to reducing swelling. Hemorrhoid cream also helps, but I’d prefer puffy eyes.

  WHY ARE YOU SERVED JUICE AND COOKIES AFTER YOU DONATE BLOOD?

  There is no solid medical reason for juice and cookies after blood donation. The idea is that this little snack will help to replenish your fluids and raise your blood sugar. But donating blood shouldn’t really affect your blood sugar, and the small amount of juice that you drink probably has no significant effect on your fluid status. The best use of this snack is to allow you to rest and adjust before you go on your way after doing your civic duty.

  Perhaps other food combinations could attract more blood donors:

  1.For the upper-crust crowd: champagne and foie gras.

  2.For the hipster: Vitamin Water and a PowerBar.

  3.For the Atkins crowd: diet soda and a steak.

  4.For the hip-hop gangster: a forty and some fried wings.

  WHY DO WOMEN CRAVE CHOCOLATE DURING THEIR PERIODS?

  There is little scientific support for a link between food cravings and the menstrual cycle. There have been suggestions that chocolate cravings during menstruation are related to a deficiency of magnesium or are linked to carbohydrate consumption to self-medicate depression, but no strong evidence has been found to prove either one. Studies have placed volunteers on liquid diets that provided plenty of calories and all the essential vitamins and minerals needed, and participants still craved certain foods. This suggests that nutritional deficits are not necessary for cravings of any kind and that these desires are more psychologically based.

  Medical texts, however, are filled with fascinating stories about bizarre “food”; cravings.

  Pica is the medical term for a pattern of eating non-nutritive substances (such as dirt, clay, paint chips, etc.) that last for at least one month in the body. The name comes from the Latin word for magpie, a bird known for its large and indiscriminate appetite. Iron deficiency can cause pica and can also cause a craving for ice, referred to as pagophagia. “Tomatophagia”; has also been reported in a sixty-six-year-old woman with iron deficiency who consumed several whole tomatoes daily over a two-month period. Her tomato cravings disappeared when her anemia was treated.

  WHY DO YOU GET BLOATED WHEN YOU EAT SALTY FOOD?

  This is a common question that is most often asked by women who feel bloated because of PMS and believe that it is related to the amount of salt they eat. We both have learned over the years that you should never upset a woman if she is having premenstrual symptoms, so we went back to the medical school textbooks on this one to get the answer right.

  Water accounts for 45 to 50 percent of the body weight in adult females and 55 to 60 percent of the body weight in adult males. Approximately 50 percent of this water is in muscle, 20 percent in the skin, 10 percent in the blood, and the remaining 20 percent in the other organs. Despite wide variations in dietary intake, the volume and composition of the body’s fluids are maintained in an extremely narrow range as we lose (by urinating, sweating, etc.) as much water as we take in. In other words, the amount of a substance added to the body each day is equal to the amount eliminated or used by the body. This is called the balance state or the steady state.

  Translation: if your kidneys are functioning normally, the amount of salt you eat shouldn’t make you feel bloated. Maybe your pants are just too tight because you ate all that chocolate as a substitute for sex.

  WHAT IS A FOOD COMA?

  We are sitting at i Trulli, a top New York City Italian restaurant, and I have already unbuttoned my pants as I try to gather strength for dessert. I glance to my left and my sister-in-law has eaten herself to sleep. Her head is slumped on my wife’s shoulder and drool is about to begin trickling from her mouth. After taking several pictures to add this event to family lore, I was again asked about the cause of the dreaded food coma.

  There are many possibilities as to what causes the classic “food coma.”; Many people rep
ort drowsiness after eating the traditional Thanksgiving meal. Turkey is blamed for this soporific effect, specifically the amount of L-tryptophan contained in turkey. L-tryptophan is an essential amino acid and is a precursor of serotonin. Both serotonin and L–tryptophan have a calming, sedative effect in the human body.

  L-tryptophan is naturally found in turkey protein but is actually present in many plants and animals, including chicken and cows. The average serving of turkey (about 100 grams or 3.5 ounces) contains a similar amount of

  L-tryptophan as found in an average serving of chicken and ground beef.

  Two other factors that contribute to the desire to sleep at the dinner table are meal composition and increased blood flow to the gastrointestinal tract. Studies have shown that a solid-food meal resulted in faster fatigue onset than a liquid diet. The solid-food meal also causes a variety of substances to jump into action that ultimately leads to increased blood flow to the abdomen. This increase in blood flow and an increase in the metabolic rate for digestion can contribute to the “coma.”;

  Now, I can tell the end of the family story. A good double espresso can sometimes be enough of a pick-me-up to get through dessert. But, in an attempt to resuscitate her comatose sister, my wife took her to the bathroom to splash water on her face and press her belly against the cold bathroom tiles. Unfortunately, time is the only true cure for the food coma.

  WHY ARE YOU HUNGRY AN HOUR AFTER EATING CHINESE FOOD?

  We fear that getting into any diet debate will cause us to be besieged by a gaggle of Atkins followers in a bacon-induced frenzy. But we may be safe this time, because the culprit may be carbohydrates—specifically, rice and pasta.