Fieldwork: Weight loss Struggles-Surgical and Nonsurgical

Jotting Scans

Transcriptions

Very early on in the semester, I spoke with a 44-year old woman who underwent Bariatric surgery in June of 2009. I decided not to take down her name for privacy reasons, but in my notes and in this transcription I refer to her as “S.C.” The woman is a co-worker with a member of my family and was happy to discuss some of the issues she went through after her surgery. Because of her hectic work schedule (she is a nurse), she agreed to meet me during her lunch break. S.C. asked me to wait while she finished checking on her patients and asked me to meet her in the break room. I sat alone at a round, off-colored table, staring at four empty cushion-filled light pink seats. This being my first field note experience in relation to my topic, I felt a bit nervous and uneasy. When I was invited to the hospital and entered the unit S.C. works on, I received nothing but positive vibes from everyone. People were interested in learning about the topic I was covering. The other nurses wanted to know what school I was from, what I was studying and what my class was about. S.C. arrived in the break room in good spirits, flashing her perfectly straight teeth. She wore a light pink nurse’s scrub outfit and bright white sneakers. She was adjusting her I.D. badge attached to her shirt while she told me the timeline of her adjustable band surgery.  S.C. told me she brought a chicken salad, but wasn’t hungry.

Final Project Update

This week, I began outlining and working on a rough draft of my final project in relation to my research topic. As I mentioned in a previous post, the final is a fiction piece based all of the real-life research I’ve done on weight-loss surgery over the past three months. While I wouldn’t call the previous assignments (object annotation, annotated bibliography, along with all of the interviews) a breeze, I felt like this is really challenging what I know and love about writing.

I’m not much of a fiction writer. In fact, last semester in Core I was the first time I really wrote a lengthy creative piece to be turned in for a grade. So what I seem to be struggling with is the balance between putting in what is fact and a part of my research and what is “made up” and based in creativity. I wonder if one part of my story is too research-based and then I wonder if I should cut back on the descriptions and fictional aspect.

In short, my piece is about a young woman who is coming to terms with her life after Bariatric surgery. I figured it would be kind of cliché to do a story about a person who is struggling with their weight and decides to under go weight loss surgery, so instead I wanted to explore what happens next. Are they a brand new person? How prepared were they for the changes in their routine such as their diet? What about the relationships with the people in their lives?

This really required me to go through all of my notes such as interviews with patients and doctors and again go through the text I’ve complied and pick and choose what moments are important for this intimate tale. I feel like there’s so much truth that I can put into story and frame it around a fictional setting, which would help create that balance I’ve seem to be battling with.

Post-Interview: Christopher Gunning

On Tuesday, April 9 I had the pleasure of chatting with Christopher Gunning, a registered dietitian at Virtua Memorial Hospital through Skype’s voice chat. Mr. Gunning received his B.S. degree at Rutgers University and recently completed his mandatory supervise practice/internship in 2012, a year before he started working at Virtua. Many times in the past, I would interview individuals that weren’t big on reading blogs or watching the latest news reports, which made me feel a little out-of-touch with what was going on with my topic. Mr. Gunning was truly up-to-date on the latest research and modern trends in nutrition which was accompanied by my ability to stay current on this topic as well, making for a very successful conversation.

I asked Christopher his perspective on a number of issues related to nutrition such as obesity, latest trending diets (what works, what doesn’t), and post-Bariatric surgery dietetic changes.  I started the interview off with questions related to a list of broad topics I wanted to cover but quickly the conversation changed and it felt like I knew a lot of things Christopher was talking about, which made the interview less daunting and less restrictive. For instance, I mentioned a few questions about Robert Lustig’s controversial book, Fat Chance. Mr. Gunning immediately knew what I was talking about and did a lot of his own research and had his own take on Dr. Lustig’s discoveries. In Fat Chance, Dr. Lustig believes that society should stop playing the blame obesity game on each other (schools blame parents, parents blame schools) and theorizes through his own medical research and patient experiences that sugar is the cause of this obesity pandemic (“sugar is the root of all evil”, he writes) and list fructose as the main culprit.

Research Update

While I have focused the last few weeks on the readings and completing the annotated bibliography assignment, I am also nearing the end of my scheduled interviews. I mentioned last weekend I was getting ready to interview Christopher Gunning, a Clinician Dietitian at Virtua Hospital. Unfortunately, that interview has been pushed back until Tuesday, April 9. I have set Mr. Gunning a list of topics we may discuss that day so that our Skype chat interview can proceed smoothly.

I have also decided on what genre my final project will be and where I plan to send it. I will conclude my research project composing a fiction story about life after Batatric surgery for a patient and send a copy (along with a polished query letter) to Confrontation Magazine, a literary publication from Long Island University. Every piece in this magazine has a theme of one confronting or coming to terms with an issue, and I think that’s perfect for my piece as I try to capture the everyday struggle one goes through. My final project will be 2500 words.

Besides the upcoming interview, I am working on my object annotation, which is the fairly recent U.S. nutritional guide MyPlate. I will be working on a document complete with callouts, similar to the one’s found in Harper’s Magazine.

Pre-Interview – Internet Interview with Christopher Gunning

A few weeks ago, I was scouring the Virtua Hospital Facebook page, when I came across a status update on the South Jersey wellness center providing nutritional classes for those they may want to adopt healthier eating habits. I sent an email to April Schetler, the Virtua Center Weight Management Nutrition Coordinator and told her about my research and expressed interest in setting up an interview. Ms. Schetler emailed me back and told me she only specialized in nonsurgical weight loss programs, but wanted to direct me to somebody who could help me advance my research toward the post-Bariatric surgery nutritional aspect. From my conversation with April, I got to know Christopher Gunning, Virtua Hospital’s Clinical Dietitian. In addition to his work at the hospital, Christopher teaches several nutritional courses throughout the week so I was lucky enough to plan an online Skype voice chat/interview with him on Tuesday, April 2.

I have a lot of things to discuss with Mr. Gunning. I want to know more about his nutritional courses and his counseling style when dealing with patients (specifically when it concerns one’s diet, how to get patients to follow a strict meal/diet regimen when people are temped with an overabundance of easy-to-get cheap meals loaded with carbohydrates and snacks filled with sugar everywhere they go!) I want to talk to him about the obesity epidemic, why people are gaining weight at such a rapid pace in this day and age and what the government is doing about things (example: the implementation of MyPlate, which replaced Food Pyramid in 2011 as the main nutritional guide, which also happens to be the topic of my object annotation). I hope I can ask him about his thoughts on the ever-growing multimillion dollar obesity/weight loss consumer market because everybody thinks they’re a nutritionist, with celebrities selling diet books and magazines promising you can lose weight by following “3 easy steps” or discussing the latest diet fad.

I think this will be a very insightful conversation and I look forward to sharing my findings later this week!

Post Interview with Dr. Clarke

About an hour after the presentation, when all those that attend the seminar scheduled appointments or discussed insurance coverage, Dr. Clarke’s invited me to her office down the corridor from the conference room. I felt that our conversation was propelled by the questions, comments and concerns others brought up earlier that day. I told her from what I gathered from her presentation, I felt like Bariatric surgery was a tool for somebody to use and it is solely on them if they want to use this ‘tool’ correctly in their life or not. She completely agreed, telling me that while Bariatric surgery helps with significant, sustainable weight loss and yes, some of these options restrict a person from taking in food (a person cannot eat solid food for three months after surgery), the relationship one has with food must be the sole focus of this lifestyle change. She went on to tell me that the main culprit after surgery isn’t food, but “sweet-high calorie liquids.” While the patient isn’t able to eat large amounts of food anymore, because the digestive tract has changed or parts of the stomach is cut out (in duodenal switch), a patient will crave and be able to consume milkshakes, soda/soft drinks, alcohol, frozen flavored drinks, etc.  I told her I knew something about the nutritional diets post-surgery and I had heard positives about low-calorie, low-sugar protein drinks, and she told me that is the recommended source of protein and fluid for a patient, but because protein drinks don’t provide people with that “delicious, addictive sweet taste…many [patients] do not always want a protein drink.” Almost feeling a level of frustration, Clarke says she’s focused on nutrition more than ever because she wants her patients to remain healthy and sustain this weight loss. “People will do what they want to do, but it is important for patients to understand the consequences,” she admits.

Bariatric Surgery Seminar Fieldnotes/Transcriptions

Jottings:

Transcriptions:

When I arrived on the third floor (Zone D) of the Temple University Hospital, I entered a conference room filled with 20-25 potential Bariatric patients who signed up to attend the free seminar. I immediately checked in with Laurie White, the surgical assistant and talked to her about my research. She asked me about what I have discovered and why I am interested in learning about this operation. I told her it stemmed from pure curiosity and like I’ve discussed, although coming into this research, I didn’t know anyone who had undergone this surgery, it is an integral part of our society and the ongoing obesity epidemic, or pandemic, if you will, affect all of us in some way, shape or form. She thanked me for coming out to today’s event and told me I would find the information fascinating and hopefully useful in my research.

After conversing with Ms. White for a bit, I took a seat in the very front of the room, the bright morning sunlight pierced through the window directly in front of me. I turned away from the light and watched people gathering in the room. They were people of all ages, shapes and sizes from all different walks of life. There was a Hispanic family of four that did not speak English. The youngest of the group, a female, asked Ms. White, in broken English if there was a translator available for her father. While Ms. White left the room for a bit, the room became crowded. The majority of the people coming in were, as expected, overweight, but they did not come alone. Many people came in with what I would imagine would be a support system: a friend, a family member, a loved one. Some were holding hands when they walked in. Some were unable to walk and came in a wheelchair. A few very heavyset women walked in with canes, slowly, painstakingly finding a seat among the crowded room.

Pre-Interview: Temple University Hospital Seminar and Meeting with Dr. Clarke

On Saturday, March 23, I will be attending the Temple University Bariatric Surgery Seminar at the Temple University Hospital in Philadelphia, PA where I will have the chance to learn more about the procedure, and have a chance to sit down and talk to Dr. Tatyan Clarke, MD. Dr. Clarke is the Assistant Professor of Surgery at the Temple University School of Medicine where she specializes in Bariatric surgery (Roux-en-Y Gastric Bypass) and smaller procedures including laparoscopic hernia surgery, according to her Temple University profile.

As an undergraduate in the Journalism program at Rowan University, I’ve had plenty of opportunities where I’ve been asked to interview a subject, but for the first time, possibly ever, I do not have a specific number of questions nor do I know exactly what questions I am going to ask. I decided not to write a list of questions so I am forced to step out of my comfort zone during this interview. I really want to try the active interviewing approach that James Holstein and Jaber Gubrium talk about in Chapters 2 and 4 in Postmodern Interviewing. It would easy to interview Dr. Clarke with the mindset that she is this “vessel of knowledge” and I can extract information from her, but instead, through a conversation about my topic, we both can participate in “construct[ing] versions of reality interactionally rather than merely purvey data.” (pg. 32) While I know Dr. Clarke is a surgeon and knows much, much more about Bariatric surgery than I do, I can deliver some of my findings that I’ve uncovered during research and discuss it with her. Some of the possible topics I may bring up include the effect weight loss surgery has on the metabolic syndrome (the risk factors that lead to heart attacks, strokes, diabetes) and certain misconceptions about the process. I am also looking forward to the “hows” of the interview, specifically how my subject will interject her own life experience when we are speaking (i.e. when I ask Dr. Clarke about how she developed an interest in this field of surgery).

There is a strong possibility I will be speaking to others at this seminar, including potential patients and those curious about weight loss surgery. I will have my field notebook ready, preparing myself for anything that comes my way. I will seek out potential interview subjects, but it will be more of a casual conversation, if anything.

I will be posting my post-interview piece sometime this weekend.

Interview Schedule

This week, I have made tremendous progress with my research by reaching out to those in the Bariatric and Weight Loss Surgery community, making contacts and moving forward with setting up interviews. While I am focusing on the literature and creating my annotated bibliography, I am also in the midst of communicating with others that will help me answer some of the questions that arise during my readings. This is a list of confirmed interviewees; please note that some of the times are approximate at this point:

1.  James Zervios – Director of Communication at the Obesity Action Coalition in Tampa, Florida – Phone or Skype interview – Week of March 25-29 – Pre-interview will be two days before the Interview.

2.  Dr. Tatyan Clarke, MD Bariatric Surgeon at Temple University Hospital – I will be speaking to Dr. Tatyan in person during a Bariatric Seminar at Temple University Hospital in Philadelphia, PA on Saturday, March 23 at 10am – Pre-interview will be up on Thursday, March 21. Post-Interview will be up on Sunday, March 24.

3. Reached out to Dr. Jeffery Monsash, MD on Twitter and he invited me to give his office a call to set up an email interview the week of April 1-5. The pre-interview will be up on Saturday, March 30.

4. I have reached out to former Bariatric Surgery patients. I will not disclose their names until I confirm they are willing to sit down and discuss their experience. I believe I will interview them after I have completed speaking to the surgeons/doctors. One in person interview may be on the weekend of March 30, the other two (Skype or email) may be April 8-10.

Recapping the Student Center Experience

Just to recap last week’s blog posts, I transcribed my jottings, described two different scenes in explicit detail, described somebody’s hair and wrote a reflection/recap.

I really loved hearing all about the ways my classmates approached the task. Some took a lot of field notes, some interviewed Student Center occupants. Some (including me) shied away from any interviewing. Some asked an extensive amount of questions, some simply observed. I think what this assignment really taught me is that there are so many different ways to approach and observe a setting I know little to nothing about, especially when research is involved. I felt inspired when I heard my classmates talking about how they went about their process because some had never been in this Student Center and somehow was able to overcome any uncertainty and discover things they didn’t know such as when the center closed, what task student managers were responsible for, what food was being served, as well as finding a laundry room and an unusual vending machine.

I want to be able to approach a new setting or interview somebody pertaining to my research topic with as much confidence. Although it’s easier said than done to leave our preconceived notions at the door, sometimes it’s nearly impossible to do so. As budding researchers, we’ve all experienced life in different ways through different channels, so we may pick up on something in a discussion with our subjects because of life experience. I can only imagine what it would be like to conduct group research and complying all of the jottings, the artifacts and constructing it to represent the insights from every member.