Medicalizing People -- and Mongering Diseases

The title of my monograph, "The Last Well Person" was borrowed (with his enthusiastic encouragement) from Clifton Meador.

In 1994, Meador published an essay in the New England Journal of Medicine in which he described a 53-year-old academic whose symptoms defy diagnosis despite extensive medical investigation. No other person in this brilliant parody is said to have escaped diagnosis.

Today, it's no longer a parody.

We are a country of obese, hypercholesterolemic, hypertensive, diabetic, osteopenic, depressed, pitiful creatures perched on the edge of a cliff staring at condors: cancer, heart attacks, strokes, dementia, fractures, and worse. We fear for our future. We teach our children that they, too, must live in fear for their future.

We mobilize all our courage when faced with creakiness, achiness, heartburn and heartache, headache and bellyache, constipation or diarrhea, impotence, sleeplessness, and even restless legs. No infant can simply be fussy and no child can simply be fidgety, obstreperous, or below average in performance. We are told that all these are symptoms of disease, or harbingers. We are a vigilant society.

We are also a modern people blessed by remedies. For us, mortality is an abstraction, a formless beast that we can bring to heel by the determined application of the latest and most convincing scientific insights.

Defining Our Diseases

All daunting, unpredictable challenges to our sense of well being can yield to a canny choice of ministration. We exalt our modern scientific medicine; our forefathers had but sages, often religious sages, pointing to the path to a good life, if not a longer life.

Today we wait, breath bated, for the next pronouncements of the biomedical establishment. Nearly all in our personal, intimate life that is untoward is now under their purview.

How are we to know if we are well, or still well? We are bombarded by the print and broadcast media with the scare of the week. We are bombarded by purveyors with the cure of the weekend.

Can we ignore these helpful people? They have taught us to be proactive. Can we ever ignore our body whenever it seems the slightest bit awry?

What's not a disease?

Something will go awry, and do so repeatedly, some alteration in our body that makes us question our wellness and that challenges our sense of invincibility. And each of us will die, usually carried off by one of several diseases standing between us and our 85th birthday. To be human is to be challenged in the course of living and to have it all come to an end.

What's not a disease?

To be well is not the absence of disease. To be well is to have some sense of invincibility; nothing, or nothing more will happen to me that I can't overcome.

Living in Fear of Death

Rare is the person whose sense of invincibility cannot be rattled, if not pulverized by the voice of authority.

When the authority is medical, and there's little or no valid reason for alarm, it's called medicalization (as opposed to chiropracterization, or physical therapistization, or naturopathization, or ...) When you should be reassured, but instead, you are taught to fear, that's disease mongering.

None of this is new.

Your parents and grandparents confronted medicalization and disease mongering. For these past generations, orgasm and thinness were medicalized. Today, both are normal, while lack of orgasm and chunkiness are medicalized.

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