goodbye health, hello “health”

Anthropologist Joe Dumit has written one of the most important and radical (getting to the root) books about health, marketing, medical research, and the pharmaceutical industry in recent decades, Drugs for Life: How pharmaceutical companies define our health (Duke, 2012). It’s compulsively readable with “aha” moments on almost every page. I’ve got a dozen colored tabs sticking out of my copy! Drugs for Life must go on the shelf of every follower of Angell, Abramson, Brownlee, Cassels, Welch, Healy, Goldacre, and all the other brilliant doctors, journalists and social scientists broadcasting wake-up calls about how our current social perspective on health has been hijacked and how the public has been duped.

Dumit uses anthropology to scrutinize the worlds of health and medicine and help the reader see them anew. How is it that we no longer think of health as freedom from treatment, but rather as taking pills and scheduling screenings for asymptomatic risks? He analogizes this transformation to a “rite of passage” (think marriage, emigration, college) whereby you first become separated from the old ways, then exist in limbo, and finally adopt new views – even of your own body and how to understand how it feels! He offers diagrams that show the precise vocabulary used in marketing to move each “patient-in-waiting” along the transformative path. And that’s only chapter 2!!

There’s lots of ideas about how we have learned to lower the level of risk to be at risk, how our capacities for decision-making have been overwhelmed by the smoke and mirrors of  statistics, how “facts” have become bullets in wars of interpretation, how clinical trials are all about growing markets and that basing medical guidelines on them is nuts, and on and on. But the book is written coolly. It’s not a rant. There are many many footnotes.

The beautiful thing about this kind of analysis is that it helps stall and even reverse the rites of passage. The reader becomes distanced from overdiagnosis and overtreatment and begins to look around (with Dumit’s help) for other platforms for understanding. The already-skeptical reader, like me, no longer feels alone or weird in claiming the emperor is naked.

I am so glad we were able to get this book into BOOKTIVISM. It surely needs to be part of everyone’s disease-mongering library.