Grand Rounds XXVI is up...

with posts on Terry Schiavo and.......surgery on conjoined marshmallow peeps? Go immediately to The Well-Timed Period, and see our favorite posts of the week.

(I'm trying to stay out of the terribly sad debate about Ms. Schiavo. I've read that bulimia caused her heart attack, which then caused her brain damage. I've seen many eating-disordered patients locked in power struggles with their families, jockeying for control. Usually, the major battles involve food: what will be eaten, and when, and how much, and under what circumstances. Food becomes a metaphor in these struggles. I have never met an eating-disordered patient who welcomed a feeding tube in any circumstances, perhaps because it is so often mentioned as a threat: "Eat, or you'll get the tube." It raises the specter of losing control, and the specter of gaining weight, with all the dreaded emotional baggage therein.

So it's interesting to see the debate about her feeding tube. We don't know what was going on emotionally in this family before or after Ms. Schiavo's brain injury, and it's wrong to speculate. Ms. Schiavo should not be a Rorschach test for the rest of us, an "inkblot" toward whom we project our own wishes and feelings. Based on what I've read, only her husband and family are suffering now...)

Update: Medpundit has written about "Ms.-Schiavo-as-Rorschach" here.