Pharmageddon by David Healy Read Free Book Online Page A

pronounce on life, death, and disability—not at industry.
    Illich's critique crystallized battle lines already emerging between a medical sciences camp and a social sciences camp over “the medical gaze,” discussed in chapter 6 . For one side this gaze was good, for the other it was dehumanizing. Some critics saw an overlap between scientists, physicians, and capitalism on the one side, and social scientists and socialism on the other. The degree of identification here is not important and it varied widely. But the key point is that there was an opposition, issues were contested, and the debate was open to a wider public. At its extreme it spawned an antipsychiatry that contested the legitimacy of any mental illnesses. Three decades on, debate has all but ceased.
    The turn to quantification in medicine has transformed social scientists, medical anthropologists, and others into Stepford handmaidens of the establishment who embrace the New Biology. A medicopharmaceutical complex has triumphed; everyone seemingly accepts that it would be irrational to do anything but act in accordance with the “evidence.” Any sustained attempt to critique current trends is now likely to be dismissed as not evidence-based or as an advocacy of postmodernism that denies the reality of disease or scientific progress—in just the way that critics of psychoanalysis were once deemed ipso facto to have an unresolved neurosis.
    But, while we now have in branches of medicine the appearances of science—controlled trials, a relentless quantification, and a sometimes stupefying recourse to statistics—the health care planes aren't flying any more, in the United States especially. In fact quite the opposite, over the past two decades the figures for life expectancy in developed countries show the United States falling progressively behind other developed countries, despite spending more money on healthcare than any other nation on earth—falling behind as well in terms of any ability to care, as the expectation that we will be rescued by magic has led us to neglect many of the caring skills we had. 20
    Meanwhile, the marketing departments of pharmaceutical companies are the postmodernists par excellence. They rewrite the text that is the human body from year to year with afflictions such as osteopenia, erectile dysfunction, and pediatric bipolar disorder that appear out of nowhere, creations of ghostwriters who practice to deceive.
    Take Donna, for example. In marketing Zyprexa for bipolar disorder, in 2002, Lilly produced Donna, “a single mom, in her mid-30s appearing in your office in drab clothing and seeming somewhat ill at ease. Her chief complaint is ‘I feel so anxious and irritable lately.' Today she says she has been sleeping more than usual and has trouble concentrating at work and at home. However, several appointments earlier she was talkative, elated, and reported little need for sleep. You have treated her with various medications including antidepressants with little success…. You will be able to assure Donna that Zyprexa is safe and that it will help relieve the symptoms she is struggling with.” 21
    In the 1960s and 1970s Donna would have been seen as anxious, a poster case for treatment with Valium. In the 1990s, presenting with the same symptoms, she would have been seen as depressed, and in need of treatment with Prozac. Neither neuroscience nor any aspect of clinical science had moved forward by 2002 in a manner that might justify rediagnosing Donna as bipolar. But this doesn't stop companies who are quite happy to read the vast majority of our problems one way today and quite another tomorrow.
    And when it comes to the hazards of Zyprexa Donna may suffer from, just as with the hazards of the Lipitor she may have to take because Zyprexa has raised her cholesterol levels, or the Celebrex she may be on because of arthritis linked to Zyprexa-induced weight gain, or the Avandia she