Health morbidity Curt Mudgeon February 2008 I recently observed that watching the news on cable television raises my blood pressure. I find it dreadfully annoying to see, day in, day out, prime-time adverts about disease and pharmaceutical drugs. There are brand V lozenges for heartburn, W pills for enlarged prostate, brand X tablets for cholesterol, brand Y caplets for high blood pressure, and brand Z pastilles for ailments that I did not know existed, like the "restless leg syndrome." The disease clips and their gloomy sound tracks have replaced the Wrigley’s Spearmint Gum cute cartoons of yore and their happy jingle.T hen, there is "E.D." It seems that most middle-aged males in this country have "E.D." For those who are not conversant with the medical jargon that delights navel-watching boomers, "E.D." is the catch-all acronym for difficulties to get an erection. The most ludicrous of E.D. drug adverts includes (1) a man who tells you that he has E.D. and seems rather happy about it, (2) his taking a stroll with a woman in a rural setting, presumably after taking the magic pill, (3) the happy couple lying in separate antique bathtubs in the middle of a some field that looks like a vineyard, and (4) a voice-over that recites a long list of side effects that the E.D. drug may bring about, including nausea, abdominal cramps, headaches, vision problems, and diarrhea—did I forget something? Ah, and the voice-over warns that one should call a doctor if the drug induced an erection that would last more than four hours.T he first time I saw this E.D. ad, I found its implications somewhat amusing. Picture a guy who after taking the miracle pill has a splendid erection, but to no avail because of persistent nausea, irrepressible diarrhea, and vision troubles—let’s make love, dear, don’t mind if I puke … and … darn headache! … where are you? I can’t see you … Also, what is it with the four-hour problem? It should not be a problem; it should be a blessing. The other loopy thing is that shot with the bathtubs. Would it be the script writer’s ultimate erotic fantasy? Even though I hate to brag, I am sure that I could come up with something better; at least, I would put the couple in the same bathtub.M ost of the pharmaceutical ads recommend that any patient should "asks his doctor" or "tell his doctor" about drug X, which is supposed to be much better than drug Y. This recommendation has intriguing implications. It could mean that some doctors do not know that drug X exists—probably because they do not watch prime-time cable television—or they do not read medical journals, or drug salesmen do not know that they exist. Of course, this is silly. When I had my last physical, I asked my doctor what he thought of the "tell-your-doctor-about-it" ads. His answer let me infer that he found them rather irritating. I would too if I were in his shoes.I do not know exactly when it started, but I believe that more than ever a lot of people are obsessed with matters of health and medicine. The morbid fixation with lawyers and doctors and shrinks that used to be confined to soap operas has invaded our lives. It is not just radio or television programs of the "lawyer talk" or "disease talk" categories. Weekly magazines of general interest sometimes devote more than half their pages to medical topics. About every day, newspapers report university studies from all around the world that keep contradicting one another. One day, coffee is good for you, and the next day it is not. On Saturdays, a local station in my neck of the woods devotes a full morning to extended "interviews" with flacks who call themselves dietitians or nutritionists and push "food supplements." These wonder pills are supposedly finely tuned to provide all the metals, metalloids, and oligoelements guaranteed to keep you forever young, smart, sexy, and … gullible. Apparently, that snake-oil industry, which is allowed to escape scientific controls, is doing very well, thank you.A nother type of advert that raises my blood pressure is of the public-service type from the Ad Council. It may go like this: a woman’s voice in a concerned tone tells me that "m out of n people suffer from [some possibly fatal condition] and do not know it! You could be one of them." Well, would not that give you pause? And make you call a radio disease-talk program? And there are those ads for foundations devoted to some particular maladies, which start with "Do you know that one of the leading causes of death in the United States is … " It is no wonder that more and more people are depressed. About every hour of the day, they are reminded of their mortality and their vulnerability to terrible diseases that can strike any time.T here will always be leading causes of death, and we know bloody well the main one. It is old age, and it will always be old age. There is nothing we can do about it, and we had better be at peace with that. Of course, science has been able to increase the life expectancy of Americans and Europeans by almost ten years in the past fifty years. This may be why more people get Alzheimer’s disease. So, the big question is whether one should spend a lifetime worrying about diet and general way of life to live—maybe?—five or ten years longer, with a substantial risk that these extra years might not be that enjoyable. A scientist friend of mine remarked some time ago that since he had to die one day, he would rather die of a way of life that he enjoys. He has eggs and bacon for breakfast, eats big steaks, likes a good cigar after dinner, takes his bourbon straight, and chases women. He also works out because he engages for fun in sports rather dangerous where brute strength is a must. He enjoys every bit of his life, which he considers complete, intellectually and physically. He may have a point. After all, it is not so long ago that most people smoked, drank martinis, and ate bacon and eggs for breakfast and steak for dinner. They were not too concerned about living forever and had a good time. There was no epidemic of obesity, and most died before they could fall victim to Alzheimer’s or Parkinson’s disease. OK, their life expectancy was then a tad shorter than it might have been, but that was seen as a fact of life, something to be expected and to be taken in stride. Those were times when cars did not have seatbelts and airbags, and one did not have to wear a helmet to ride a bike.G oing back to the matter of the advertisements, we have them very likely because there are in the cable-television audience enough health worrywarts who want to live forever. This naturally leads to a question about the cause of this evolution of the past fifty years from a reasonably care-free, happy living to an overly concerned, perfunctorily "correct," humourless, fearful view of life. Several factors are at play. One is the big footprint of big government. Progress in medicine make people live longer, which strains government programs of health insurance for old folks, like Medicare. So, the message of big government is that we must live a "healthily correct" life in the hope that we can kick the bucket at an advanced age without making too many demands on Medicare. And in case we would not observe a "healthily correct" way of life, we must be reminded by public-service adverts from the Ad Council that bad diseases are lurking in the shadows. Then, there is the big footprint of business, through which many people get medical insurance. The message and its motives are the same as those of the government. Now, why should business be providing medical insurance? Well, again we find there the government’s big footprint: if a business gives an employee a good raise, the IRS takes a substantial slice of it, and the bigger the raise, the bigger the slice. It thus seems better to give the employee some benefit that the government forgot to tax, like health insurance. The problem is that, after a while, it becomes part of the culture that business should provide health insurance, and few people object when politicians want to make it obligatory.O f course, boomers prominently figure in the crowd that insists on living forever. This was to be expected, since they think of themselves as the first generations worthy of populating the Earth. For that reason, they have endeavoured to seek all possible means of protection against what we used to call "life" and its natural risks, and they do not mind trusting the government with more and more of that responsibility. Sooner or later, they will succeed in persuading a majority of the population that the government should be in charge of our health care system. That should not be too difficult since more and more people expect governmental favors paid for by others. Unfortunately, Big Brother will find there more "good" reasons to control our lives, which will help advancing "the fascism with a smiling face" against which Jonah Goldberg warns us in his book, "Liberal Fascism."T he invasion of the airwaves by pharmaceutical ads is a direct consequence of the mania for matters of health and the discussions of their minutiae on radio or television talk programs. Since people liked so much to wallow in such topics that they do not really understand but believe they do, it makes sense to market drugs directly to them. The attention can only flatter them, as if they knew something about medicine and pharmacology. Yet, ambulance chasers being a fact of life, prudence dictates that the targeted audience should be advised to ask or talk to physicians about this or that drug, and that nausea, abdominal cramps, headaches, vision problems, and diarrhea may be the price to pay for trying to feel better.M y physician advised me to stop watching the news on cable television. To follow his advice, the only cable channel I allow myself to use is TCM. I have also taken a subscription to Netflix™. My blood pressure is now OK.
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