Test me! Treat me!
I am about to go off to the dentist for a routine hygiene/ cleaning appointment where, once again, I will be told I need a new set of x-rays, and once again, I will decline. I take good care of my teeth, see my hygienist three times a year, have no problems/ symptoms, and submit to x-rays every 3 years or so. That is ENOUGH.
I was thinking about this “testing for everything because we can” approach to medicine after reading Barbara Ehrenreich’s bold essay on “Why I’m giving up on preventative care.” She goes too far for me. I don’t see a colonoscopy as rape-by-machine, and frankly I’d rather have an innocent polyp removed than hang around waiting for it to maybe become something. And her point about testing and treating to prolong life doesn’t resonate with me. I am not interested in prolonging life. I am interested in prolonging good health. (Those of you who’ve heard me speaking about this or have read my book, Counterclockwise, know my favorite geeky term for this: rectangularization of morbidity.)
But Ehrenreich makes many good points in this essay. As testing gets more and more sophisticated, the chances for finding something increase. Whether than something is worth worrying about (let alone aggressively treating) is another matter.
This relates to two other health and medicine issues I’ve been contemplating, the value-added component of living with a science writer.
The medicalization of our lives. In above-mentioned science writer Tom Hager’s words (from his upcoming book chronicling 10 drugs that changed our world) this is “a troubling trend in our society, in which things that we once simply dealt with on our own – like lifestyle choices, low-risk health conditions, personality quirks – are now being turned into treatable medical conditions. Often this goes hand-in-hand with the appearance of a new drug suited to treating the new condition.” Everyday anxiety, for example. Classroom misbehavior. Or, gee, how about menopause?
Disease mongering. This is emphasizing or redefining the risks of disease to enlarge the market for medications. For example, even though medical researchers have known for many many years that the total cholesterol number is meaningless, that “number you should be scared about” has gotten lower and lower. When just about everyone is at risk, that means everyone should be treated preventively, right? As Tom Hager writes: “Minor problems can become major money-makers for drug companies. With a much larger group of potential patients getting increasingly worried about their risks, the market for the drug grows. Blockbusters can result.” Cholesterol-reducing statins are blockbusters.
Now we have entered into the world of sophisticated mail-in genetic testing, where I can discover (if I want to) all the disease demons lurking in my DNA. Oh boy. I think I’ll just eat an apple and go for a run.
4 comments
So I’m thinking that maybe life is one big treatable medical condition? Ha. It’s incredibly hard for me to believe that our American culture of “medical care” is geared towards truly healing/helping people when so much of their livelihood is tied to profit. Doing the most profitable thing is their first concern, therein lies the conflict of interest with every single decision every worker in that industry makes. Decisions that affect me. I’ve had several doctors over the years and each one seems to have an agenda. My current one keeps pushing (in a very assertive almost shaming way) to use a particular specialist for a particular treatment and cloaks his wish in concern as if he is truly trying to help me. I wonder what his profit margin is if I suddenly get diagnosed and treated for what he wants me to have (it seems). Instead, talking about what foods to eat for the way my body works and how to go about solving issues in a more holistic/organic way like eating apples and running (!!) are not interesting to almost every doctor I’ve seen. Hmm.
I know some extraordinary doctors who care deeply about the health and welfare of the people who come to them. And then there are the pill-pushers. And the docs who spend 6 minutes with each patient to maximize the profits of their practice…sometimes because they owe $350,000 in student loans. so much is wrong with our health care system.
Lauren, I loved your book Counterclockwise and it, along with a few other things (becoming a grandmother, getting a genetics test), inspired me to be more in charge of my health. While I realize that “DNA is not destiny,” I still found a DNA test interesting. I went with Ancestry for ethnicities and then uploaded the raw data to the reference-heavy site Promethease for health info. Have you thought of writing a sequel to Counterclockwise that would cover things like these DNA tests (comparing results from different companies, pondering the legal and ethical ramifications of such tests), the pill-pushing state of American medicine, and so on? Thanks.
It would be fascinating to compare results across different companies. And the ethical considerations/ privacy are significant. Thanks so much for your kind words about Counterclockwise. It’s because of all I did during the in-the-trenches research for the book that I was ABLE to do my next book, Raising the Barre!
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