Free Pharmageddon by David Healy Page B

and perhaps most important reason is that these drugs also serve as a screen for a set of processes that act on us just as potently as the drugs themselves do. Companies take our inner aspirations and fears and mold a strategy designed to readjust our identities and get us to consume drugs more faithfully than we would do if we were living in a totalitarian regime and required to consume. 2 The changes in the way we live can be so mundane as to be almost invisible. Take the case of Josephine, a fit sixty-year-old who had been told she had osteopenia—a normal state for a woman of her age that comes with no risk of a fracture. But led to believe she has an illness, and put on Actonel or Fosamax, she is now afraid to mow the lawn for fear of falling and breaking a hip—though mowing the lawn instead of taking the drugs is a better way of reducing her risk of a fracture. Josephine's sixties are being shaped in ways she could not easily guess by the patents on a group of drugs. Our very ideas of ourselves are now subject to change at intervals coinciding with the fall of off-patent and rise of newly patented compounds.
    Macbeth's unmet desires for fame and power left him vulnerable to seduction by the witches. Many of us can live without fame and power, but we are almost all vulnerable to seductions that offer us freedom from disease, with possible enhancements of our potency or beauty. Just as reaching for what was on offer produced disaster for Macbeth, so also our reaching seems to have left us with potentially reduced life expectancies, a growing discontent with who we are, and an atrophied ability to care for others.
    If we fall prey to the witches' seduction in the health domain, our abilities to resist the industrial processes now encroaching on teaching and farming and other domains are also likely to crumble. Ultimately even the rearing of children may be affected. The hour is already late; just as patients have been eliminated from medicine in favor of medical consumers, so teachers have been replaced by educators whose brief it is to make available a range of educational products to their clients rather than to try and foster the growth of a person. We may not be far from a time when, for the sake of ensuring quality upbringing, mothers (and fathers) will be encouraged to look after their young clients in standardized ways. If as a society we cannot care for patients, it is not clear that we can care for children or for the planet.
    It doesn't have to be like this. Ironically, indeed tragically, our new medical systems now produce as many perverse outcomes as they do in part because of some mechanisms we have put in place that stem from our recognition of how central health is to everything that counts for us. Given this centrality, it seemed important to Senator Estes Kefauver to control the pharmaceutical industry, and he, on our behalf, attempted to do so by making new drugs available by prescription only and then only letting them on the market once they had been through controlled trials. These safeguards, which were designed to bolster the role of doctors and contain industry, have in industry's hand been turned to do just the opposite. Increasingly alienated, doctors are not the force they once were and it is very difficult to view them as a body likely to rise up and demand change.
    If, however, there is a path down into Hades, there must also be a path up. And there is hope in the knowledge that life often teems even in the most inhospitable environments. The first step back is to decide what kind of society we want to live in, what kind of economy we want.
    At present we are trained from infancy to believe that the key things we produce are cars, computers, pharmaceuticals, and other goods. No one would accept that these are the things we care about the most, but we have slipped into a de facto acceptance that these things have a primacy largely because they can be readily commodified and quantified.