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May 04 2007

What the middle-aged nihilist is thinking this season

If you follow the news — and I pity you if you do — you have already heard that post-menopausal women can supposedly cut their risk of dementia in half if they take HRT (hormone replacement therapy) immediately after the onset of the pause. But the findings are merely “observational,” so don’t go running off half-cocked.

Because four years ago, as the canny blamer will recall, HRT got the bum’s rush after links to breast cancer, stroke, and heart disease were discovered. A few months ago it was announced that the mass bagging of HRT had coincided with a decrease in breast cancer.

So which would you rather have: breast cancer or Alzheimer’s? Or, to put it another way, which drug company do you feel is most deserving of your dough?

I am unimpressed with the Hobson’s choicism of modern medicine. You can either do what they say, and eventually die, or ignore what they say, and eventually die. You can do what they say, and get struck by lightning, and immediately die. You can do what they say, and live a while longer, and suffer debilitating side effects from the “therapy,” and eventually die. You can ignore what they say, and live to be 96, and still die. You can do what they say, and live to be 96, and be disease-ridden and frail, and dependent on drugs, and left to rot in a home, and die. You can want to do what they say, but not be able to afford it, and die. You can afford to do what they say, but paternalistic government interference or the self-interest of a drug company prevents you [1], so you die sooner — or perhaps later, if the drug in question turns out to be a bit more toxic than was hoped — but dead you will be.

Note that there’s a constant. Medical science can’t deliver the only thing that would make it truly useful. And even if it could, unless the dominant culture were overthrown, or unless the cure for death turned out to be “eat more dirt,” hardly anybody would be able to afford it. There’d be a TV show called “Medications of the Rich and Immortal.”

Every morning, as I struggle to choke down the five $22-apiece Guam-sized snake oil pills that are supposedly decreasing my risk of cancer recurrence a point or two, I reflect on the crapshootiness and cosmic futility of the exercise.

So why do I bother? Well, for reasons that are not entirely clear to me, there are chemical reactions taking place in my brain, which reactions produce what is commonly and romantically referred to as “the will to live” but which is perhaps more accurately described as “fear of death.”

A more irksome chemical reaction I cannot fathom.

____________________
1. I allude to the case of 4-year-old Penelope London (link is to subscription-only WSJ article. A post at bioethics.net discussing the article can be found here), who is dying of a rare form of cancer. Having exhausted the options, her wealthy father caught wind of an unproved experimental drug. He actually got the FDA to invoke the “compassionate use” clause to allow the Penelope to take the drug, which is no small feat in itself. But the drug company, Neotropix, said no dice, because even if the father was willing to cough up the enormous remuneration they required, if kid repaid their magnanimity by dying anyway, it would blow their chances for future successful marketing.

77 comments

  1. OM

    Yes, as my late husband used to say when anyone used that well-worn phrase: “In the long run, we’re all dead.”

    I pray (strictly a figure of speech) that I will be able to resist spending the end of my days in misery due to poinsonous treatments, but I doubt it. And I expect to be a cancer victim at some point, given my family history. Ah, well.

    I believe that all of this “drug good, drug bad;” “food good, food bad;” “activity good, activity bad” stuff is just the news media’s method of drumming up business with bullshit anyway. The reporting is brain dead on this sort of thing.

  2. zofia

    Well, if you’re feeling nihilistic, I recommend this.

  3. Andrea

    Without medical science, I would have died at 17, so I can’t quite agree with your “medical science can’t deliver the only thing that would make it truly useful.” Even if I died tomorrow from causes unrelated to my chronic illness, I have had an additional 15.5 years of life. Which I much rather would have had, than not.

    Which isn’t to say that I don’t sympathize with your medical situation; I do. But your medical situation is not representative of the state of medical situations generally. The health care system in the US is certainly terrible, the state of cancer care generally is abysmal, the politics of the situation are often exactly what you say they are. But science is useless because it can’t guarantee us immortality?

    Thanks; I’ll take the quadrupling of my lifespan that’s on offer.

  4. teffie-phd

    Everything you say totally resonates with me. What really bothers me is the certainty and promise of both medicine and media’s take on medicine. What I experience is uncertainty, crapshoots and people I love dying. While the comfort of mindless optimism is nice, I would rather have some truth to temper expectations.

  5. zz

    You didn’t ask for it, but I’m giving you a big, “Hell Ya”!

    I just finished a 3 month tango with tamoxifen and decided that life wasn’t worth living if I felt like that every day. If cancer doesn’t kill you the treatments surely will.

  6. Panic

    Well shit, massive women’s health rant ahead:

    My Mother was given a hysterectomy ten years ago, because of fibroids. They can laser those suckers out now, like they do kidney stones, but back in the day, it was just “yank that thing out.” So that they did. And put her on HRT. And Mom wasn’t right, was bright like Mom, wasn’t there like Mom, but we let it go for a while, probably too long. We’re British, and we’re really good at denial. So when my Dad finally admits that things are bad enough to see a Doc, we find out that my Mom has Pick’s (a dementia related to Alzheimer’s). In my small amount of web research, I actually found stories that said HRT caused pre-existing dementias to get worse. So while I’m not saying that HRT gave her Pick’s, I am saying that, observationally it didn’t help. Observationally, it probably kicked this thing in a lot faster. I might have had another couple years to observe my Mom.

    And after all this I feel like women’s health is such a crapshoot. Remember how Depo was supposed to be this great thing? That they tested on women in the developing world first, because, those women don’t matter as much. And then they gave it to women here and OOOPS! now some of them have osteoperosis in their 30s. Ooops we pulled out your uterus and gave you drugs that exacerbated your dementia. OOOPS! Gee so sorry, here’s another pill.

    I wish I could be more eloquent about this, but I’m so angry about it, and every day of my life I wonder what the fuck those high and mighty drug companies think they’re doing, other than increasing profits. And I can’t come up with anything other than “fuck.” Fuck.

  7. teffie-phd

    Panic, your rant is so on the mark. So much better than the crap my Women and Health students are spouting in their exams.

    Fuck is right.

  8. Panic

    teffie,
    Your comment wasn’t up when I started writing mine, but I find it interesting that we both used the word “crapshoot.” I get the feeling that where women’s health is concerned, the medical establishment throws shit at the wall to see what sticks. And the stuff that doesn’t stick, well that’s just the way it goes. Suck it up! Like everything else, you know? Women should just suck it up, and count ourselves lucky that they notice us at all. I’m so frustrated.

    This also really got to me:
    What I experience is uncertainty, crapshoots and people I love dying.
    Until you see this happen to you, in your own life, it’s so easy to write it off, ignore it, pretend it’s not happening. I am guilty of that. Then it happens, and you’re left with almost everything in your world having its meaning flipped right over. Like many teenagers, I thought I was nihilistic then. I didn’t know the half of it.

  9. Bird

    I’m currently a bit of a wreck while my body adjusts to me quitting the potent corticosteroid I was on for my asthma, so excuse me if I don’t make total sense at some point.

    The horrible side-effects of the asthma medication (an emotional mess I wouldn’t wish on anyone) are likely to have been exacerbated by my birth control pills. Apparently combination pills can increase the side effects of the steroid by up to 50%. Oh, and I had to get the steroid inhaler after I went on the pill—evidently, it can make asthma symptoms worse, but I didn’t know that when I chose hormonal birth control.

    So basically, the whole set of drug interactions has made a mess of my mental and physical health for the last year or so. And I had to figure this out for myself. My doctor never said a damn word about any of it.

    I am getting off all the drugs. I’m also considering a new doctor. Now I’m going to put my head down on my desk and pray for the world to please just stop spinning for a minute.

  10. Keez-R

    I’m glad you brought this topic up, as I’m now suffering through the delights of perimenopause at the ripe old age of 40. After a couple of fun-filled months of feeling like I had PMS every single damn day, I decided to read a couple of books on the subject of perimenopause and see if they offered any enlightenment. Nope! Just hundreds and hundreds and hundreds of discreet and not so discreet references to the wonders of HRT! Having migraines? HRT! Hot flashes? HRT! Weight gain? HRT! Crab grass problem in your lawn? HRT! (I’ll leave it to the reader to decide which of those claims I made up.) The absolute most insulting thing, however, was this maniacal preoccupation with aging skin and HRT! and the claim made by one book that many plastic surgeons won’t even consider potential face-lift patients that aren’t on HRT! because the effects of the face-lift would be so short lived. Ugh!

    The other solution besides HRT! was birth control pills, which I. Absolutely. Despise. Neither of the books I read could even conceive of the idea that at this point in my womanly journey, I’ve HAD QUITE ENOUGH OF THE HORMONES I HAVE, thank-you very much, and am not looking to add synthetic ones to keep me from getting too lonely for my natural ones.

  11. PhoenixRising

    Last weekend I was off my blaming schedule because the aftereffects of a very small motorcycle accident included a little emergency surgery, delivered by a highly skilled team of residents, in the ER of my poor little state’s only teaching hospital.

    Under slightly different conditions–lower obstreperal lobe functioning chiefly among them–I might have been maimed or killed by the so-called medical care I received in the 36 hours after I was objectively saved from drowning in my own fluids by surgical intervention.

    So it’s a bit of a mixed bag, whether disease or accident brings one into contact with the misnamed ‘health care system’, in that some interventions have immediate and highly gratifying effect while over the long term, we’re all dead anyway.

    I’m happy to not be dead this weekend. Of course the performance of the grade-school choir in which my little blamer sings may have me longing for the shouts, moans and eruptions of the ER at 2am. But I’ll enjoy every damn minute of it.

  12. Repenting

    the male body is always the default of the medical community. “women’s” health IS a crapshoot. try this drug, you may live longer. try this drug, you may get cancer. it’s great that some people with chronic illnesses have been able to take advantage of our modern technology in order to live longer and better, but i cannot condone the atrocious state of the pharmaceutical industry and the manner in which it has exploited women’s bodies in order to test and sell experimental drugs. this seems to be a more gendered problem than the previous commenters are willing to consider. it would be nice if the same medicine invented to save women didn’t also often make them worse. i propose investing HALF as much money in testing and producing safe “women’s” medication (including waiting periods before enthusiastic advertising ensues) as is invested in the so-called erection enhancement industry.

  13. Repenting

    ps. keep on keeping on, twisty. you’re still everyone’s hero, and imho the state should pay YOU to take your medication, so that your mind can be freed up from mundane thoughts in order to focus entirely on Blaming.

  14. Sylvanite

    Probably the real triumph of medical care has been trauma treatment and surgery. Antibiotics and vaccination come in second. The rest really is still a crapshoot – might help, might not. Unfortunately, “the rest” covers a lot of ground, including non-surgical cancer treatments, medications for chronic health conditions, and psychotropic drugs used to treat mental illnesses. I know I’m being simplistic, but I’ve read that the current treatment for schizophrenia only brings 10-20% of people suffering from schizophrenia under complete control of the condition. Most are only partially helped (and get to suffer the side effects anyway) and the rest are completely unhelped. That right there is a damned shame, though the neurochemical underpinnings of schizophrenia are apparently still poorly understood.

    I’d like to blame the patriarchy, but I fear the brain’s complexity and our poor understanding of it are really to blame. Sigh.

  15. Antoinette Niebieszczanski

    Hormones are not and never will be an option for me due to clotting problems. A rather sizable clot that traveled from my leg to my left lung just about took me out in 1999. I’m here to tell you, 100 percent oxygenation is essential to a person’s quality of life. No matter what the horrors of peri- and full-blown menopause hold for me, I can guarandamntee you it will be HRT-free.

    If I ruled the world (ha!), little blue boner-popping pills would be classified as strictly recreational and not subsidized by health insurance. Pay for your own stiffie, if you insist on having one. That’s not health care, goddammit. I can think of more valid therapeutic reasons for medical marijuana.

  16. dryxi

    I mentioned in a comment on a previous post that I have been dealing with the nasty side effects of the birth control pill, which included depression, which of course the doctor prescribed me antidepressants rather than switching birth control forms, and of course I trusted him blindly and have only recently (in the past 3 or 4 months) been doing my homework to find the real answers. IBTP, or I blame myself.

    One of the greatest “features” of antidepressants – specifically antidepressant/anti-anxiety combination pills – aside from, you know, suicidal tendencies, is vertigo. That’s right folks, if you’ve ever felt dizzy and motion sick, multiply it a few times and make it a constant feeling. I must contend, this doesn’t happen unless you’re a few hours late taking your antidepressant, or like me, you are trying to wean yourself off the damned things. So far, I have only been 36 hours at most off the pills before I feel so nauseous, weak, dizzy and shaky and must resume the medicine. I’ve only been taking the medication for about a year, but I must say cutting out my high-school THC consumption was a sweet dream in comparison to this shit. At least that was only mentally manifest for me and wasn’t accompanied by physically debilitating side effects.

  17. Tigs

    I think this is what Repenting was getting at, but literally and experimentally the male is not only the default- male is the definition of human.
    I’ve heard about double-blind pharmaceutical experiments that only allow men to participate because they are looking at mood effects/side-effects and women what with all their crazy hormones (or their hysters floating up to their brain) cannot accurately report how they feel because of the drug.
    Also think of that ‘Bodies’ exhibit that has only male figures except when specifically showing women’s insides (and granted the whole Chinese peasant thing adds many other problems to that), it’s a great way to educate the masses that the male body is the only real body.

  18. Hattie

    Spot on as usual, my dear Twisty. That old will to live will get you every time.
    The horrid paradox of chronic illness or frail old age is that you become dependent, something few people want to be. Furthermore, most of us do not want to take care of others (face it!) and so care can be grudging or non-existent. And the cost. If you can find care! Like the thousands of dollars a month it takes to keep my 97 year old mother in law alive so that she can watch Password and American Idol and wonder why her sister never visits her (Her sister died 20 years ago.)
    We want answers to all this, and there are none.

  19. Tigs

    In a different direction, thinking about death and the fact that we don’t like it,
    I have been thinking of radical feminism and its designation that the male-female binary as the root of all oppressions, and I am relatively convinced that we must trace this back to human fear of death.
    In that we fear death, we also hate life because it is fleeting. As such, women embody life as the producers of life. Even though we (women) cannot overcome death in our person, being more intimately connected with creation we have the appearance of a greater hold on life.
    As a result men come to hate us. They fear and are jealous of the apparently greater hold on life we have, and seek to own that creation-power. They dominate and oppress women in an attempt to make the power of creation- literally the power of life and death- their own.
    This build into superstructure, and all binary relationships become gendered. White and black- men are of the light, women of the dark. Men are of the sky and sea, women of the dirt. Women are of the muddy humanities, men are of the pure sciences of math and physics.
    Classism, racism, and colonialism all become imputed into this language.

    My not-nihilism is contingent on the fact that there are such things as Truth & Beauty and that human beings are able, at least sometimes, to recognize and make choices towards T&B.

  20. KMTberry

    WHat I have to say may be moot or dumb, but I have a friend who had to have her works yanked entirely, and she uses “bio-identical” hormones that you buy at the health food store, specifically, drink a lotta soy milk and use lotion that has wild yam extract in it.

    According to many, (including the lady doctors at woman to woman health) no side effects like HRT has, AND very cheap, and helpful.

    Of course it won’t make you LIVE FOREVER, but may make you not feel terrible with peri-and plain menopause.

    Hormonal birth control: some women love it and have no side effects; I have never tolerated it well (I think I have been ON Birth control pills for a total of four months out off my life; everytime I felt like a postal worker about to go on a murder rampage, plus nauseous).

    Bird: May an IUD would be a good option for you? I have heard they are much better now than in the past.

  21. Spinning Liz

    That which doesn’t kill us merely postpones the inevitable.

  22. Mary Kay

    dryxi: I know your doctor got you into this mess in the first place, but really you should see *some* doctor about withdrawing from those meds. They have ways to do it which can ameliorate or eliminate that awful vertigo thing. One of the best ways is to use a few doses of Prozac. Stay with me here. Prozac has a very long elimination time and so does its own form of gradual withdrawal. Really. Been there and done that. It can really help.

    All that said, I have to agree with the person above who was grateful to medicine for extending her life. In my case, it’s happened several times with different diseases. And while I do have some side-effects from the SSRI-SNRI drugs I take, they’re *way* better than serious clinical depression.

    MKK

  23. Antoinette Niebieszczanski

    MKK, amen, sista. I’ll take the slight hallucinations when I’m late with my morning meds and memory lapses over serious clinical depression any day. Without the good ol’ SSRI-SNRI drugs, I think I’d've offed myself.

  24. Sylvanite

    I’d like to know when I’ll be totally back to normal after coming off hormonal birth control about 5 months ago after far too many years on. The fact I can’t predict how I’m going to be feeling is driving me nuts.

  25. Jessica

    Tigs: The Chinese peasant thing? Can you elaborate?

  26. RadFemHedonist

    Why fear death, are people really that afraid of it, you’ll cease to exist and what was you will be either burned and thrown at someone or be wormfood, plus medical science is great for prolonging life, that is a good thing.

  27. Dr. Beads

    It’s hard to be a woman with serious medical issues. We’re always supposed to be taking care of other people, not ourselves, so until we collapse and are no longer able to work the 2 – 3 jobs most of us have (paid & unpaid), we may not spend the time & effort to give a heads-up to the medical professionals. Of course, after the collapse, it’s more difficult to advocate for oneself, do needed research and weighing of alternatives, and sieve out the nonsense that health hucksters inundate us with.

    Most physicians try very hard to provide the most appropriate medical care (including medications). However, they don’t get as much training in avoiding and recognizing medication-related problems as they should. Further, some physicians are still influenced by the “there, there, dear” school of thought and don’t want to deal with women’s problems thoroughly.

    That said, please talk to a pharmacist if you have concerns or questions about medications, including ones that are not regulated by the FDA (e.g., yam extract cream).

    Pharmacists have had several graduate-level years of training in management of medications (and sometimes even a year or two of postgraduate training and practice). They’re less influenced by drug reps than are most physicians and other prescribers (e.g., nurse practitioners, optometrists, etc.).

    BTW, drug reps are those nicely dressed, often startlingly young glad-handers who leave lunch for the medical office staff and pens, calendars, sticky notes, notepads, medication samples, etc., etc. They’re a top source of medication info for prescribers, even though the reps are rarely health care professionals and could be selling tires or anything else. Their skills are in influence and sales, not in anything clinical.

    Pharmacists are also far more likely to know about those supposedly “safe” natural products being sold without any oversight by FDA (thanks, Orrin Hatch).

    ::Warning! Semi-technical rant ahread::
    Re the yam cream: If a product has sex hormones in it, then the product has the side effects of sex hormones.

    There are molecules in those yams that look sorta like sex hormones but actually aren’t sex hormones. Our bodies can’t convert ‘em into sex hormones.

    The obvious inference is that either a) the yam cream does, in fact, contain sex hormones that the manufacturer is officially pretending aren’t there, or b) there are no active ingredients in that yam cream.

  28. Urocyon

    Tigs:
    all binary relationships become gendered

    I am not sure that this is the problem, in itself, so much as a sign of Western society’s obsession with oppositional dualism.

    The world certainly does look like a simpler place when one can reduce the options/alternatives in any case down to two (gender, U.S. racial classifications, good/evil, Virgin/whore, you name it), insist that one of each pair of contortions is inherently better in some way, and start making associations and assumptions based on the (frequently bogus) split. One’s world may not correspond to reality very well at all when forced through this filter, but it certainly does make interpreting things easier.

    I didn’t see the problem–especially since it’s so pervasive–until after I hit 30, but just spent a lot of time confused before that epiphany. I’m still confused by how so many people can rely on that sort of filter, but understanding that they are indeed doing so helps. So many things slot into place.*

    Barbara Mann devotes the better part of a chapter of her Iroquoian Women to this. (Highly recommended anyway, as an excellent reminder that the Patriarchy has not always been so entrenched everywhere. With a good bit of wit, to boot.) One particularly good quote:

    The so-called “metanarratives” of patriarchy, racism, monotheism, and Manicheanism waging eternal war aginst matriarchy, integration, poly/a/theism and relativism are not nearly as “universal” as Eurocentrics would have it. Quite the contrary, in the European/Iroquoian instance, none of the metanarratives of the two cultures coincide. [emphasis hers]

    You can probably imagine some of the weird and just plain wrong interpretations this continues to lead to. The author goes into that at some depth. I think her arguments also do as much to illustrate the sheer rigidity of thinking that “Others”, very much including women, are running up against every day.

    Gendering as such doesn’t imply something oppositional. To get back slightly closer to the original point, I think that the jealousy about women’s ability to “create” which drives icky dominance behavior–as you suggest–is a symptom. It sure is an important point of bogus division. The confluence of oppositional dualism and a completely irrational urge toward dominance behavior and hierarchy (which slots in nicely with the contrived dualism) seem to be at the bottom of this one.

    What can possibly be done about this quagmire, I have no idea. It may not be driving all of the social mess, but it sure does help. Now that I’ve started seeing it around me, I just can’t stop.

    Sorry for the lengthy comment, and I didn’t even get into the medical stuff!

    * The prevalence of snarly dominance behavior is another of the games I didn’t understand until relatively recently. Hitting school, I had no idea what a lowly wretch I was supposed to be; I didn’t have any choice other than being uppity, which is just as well. In my defense, I was not raised in the dominant culture, and am not neurotypical. I still feel like I’ve belatedly woken up into a very bad dream indeed sometimes. At least now I have some idea of what some of the subplots are. *shakes head*

  29. Shabnam

    Dear Twisty,
    I am glad you are taking your pills, and I hope you live forever and get to see the end of the Patriarchy. I don’t know what I’d do without your blog. It has saved my sanity, and is the best anti-depressant. If only it existed 10 years ago. I am most eternally grateful for the continued existence of Twisty Faster.

    Love,
    Shabnam

  30. MzNicky

    Yeah, Twisty, it’s that goddam fear o’ death that keeps us hangin’ on and doing whatever the white-coats tell us to do. Seems to me that’s the way to approach disease, and well, just about everything, really: to not fear death. Alas, mere logical recognition of the fact that it comes to everyone eventually somehow seems insufficient to banish the fear, and for that I can’t even BTP. For those of us who dwell in cancerland, the fear can become obsessive and all-encompassing if we don’t figure out how to keep the beast caged.

    Well, that’s when I began studying Buddhism. To me, that’s the only philosophical/spiritual thought system that actually seems to admit, Yeah, life is a cycle of endless suffering, and then it’s over too soon. Sux, don’t it? Not getting all evangelical or anything, cuz that would be really anti-Buddhist, but Buddha did say things like “Decay is inherent in all compounded things. Strive on with diligence.” An atheistic perspective on how clinging and aversion and a belief in a separate “self” has helped me cage that beast quite a bit, and that’s how I get on these days, with and without the miraculous pharmaceuticals that may or may not help prolong my existence in this current skin bag. Just sayin’. Namaste and shit.

  31. Tigs

    Jessica,
    Re: The Bodies Exhibit uses bodies of sketchy origins, there have been suggestions that they (the company putting up the exhibit) are just taking John Does and shooting them full of plastic.
    While my god-ambivalent ass says- hey, do what you want with my corpse, so long as it’s funny I don’t care– The company has given no assurance that there is informed consent from the people (or families) whose bodies are being gawked at for profit.

  32. maggie

    @ Dr. Beads,

    Thanks you for your technical rant! It’s refreshing to hear from a medical professional that not all ‘natural’ remedies are actually the harmless ‘magical’ cures they’re made out to be, and ask some questions about why the people that make them want them classified as something other than medicine so that they do not need to be tested in such a rigorous way. Or have any active ingredient.

    I think it is especially important to be aware of these cautions because a lot of ‘natural’ or homeopathic medicines and treatments are marketed and aimed at women. They may not be produced exactly on the scale of the large pharma companies, but I’m sure they’re not being hand boiled and strained by some loving cottage industry which only has womens best interest at heart.

    Surely it’s just as important to be as cynical about anything promoting a wonder-cure of unproven provenance as it is to be sceptical about the money-orientated principles of the more traditional health (pharmaceutical) industry? Or has too much research into this just made me grumpy and cynical before my time?

    maggie

  33. Tigs

    Urocyon,
    “I am not sure that this is the problem, in itself, so much as a sign of Western society’s obsession with oppositional dualism.”
    – Yes!

    You’re right. I wasn’t thinking outside my own Western privilege. I will add the Mann to my summer reading list (that sounds funny outloud).

    Also, within the Western schema, the first binary is alive/dead. If I’m asserting that binaries are constructed as gendered, I don’t know what I would do with this one.
    Perhaps the thing to do with it is to reconstruct the dualism in a non oppositional/oppresive way. I think de Beauvoir is suggesting this in a way in ‘The Ethics of Ambiguity,’ and I think it’s very present outside the Western canon (suggested in your account of Mann’s book, Buddhist philosophy etc.).

    But does that mean that in order to fight the roots of oppression we need to reconstruct the Western relationship with death? What does that look like? It’s hard to think about this without being nihilistic.

  34. Tigs

    Correction: Most of the Western obsession is with alive/not alive or finite/infinite, which is very different from alive/dead.

  35. Minerva

    Spot-on post. For me, death is simply not the worst thing that could happen, but I’m scared to death about the prospect of any form of dementia–Alzheimer’s or any other type. I was just at an Alzheimer’s symposium this week and heard all about the promising research going on. The science behind it is fascinating and exciting, and if they come up with anything beyond the band-aid treatments of Aricept and Namenda, then someone is going to make a great deal of money. I picture pharmaceutical bean counters rubbing their hands together with glee while pondering the expectation that the ranks of Alzheimer’s disease victims will swell from the current approximate number of 4 million to 20 million in the not too distant future. However, access to such drugs will be a matter of privilege, and for that, I pre-blame the patriarchy.

  36. eggplant

    Bio-identical hormone cremes: The C option to the bio-identical crapshoot:

    C.) The so-called natural bioidentical hormone cream has pharmaceutical grade progesterone in it, not wild veggies of any type, and the manufacturer is hiding the fact. This jar from that batch might have 10 times the amount the previous jar had.

    Most bio-idential hormone products are made by labs owned by Big Pharma. Did you think they’d miss out on this?

  37. Panic

    Minerva,
    Aricept is bullshit. It made my mother gain weight very rapidly, all around the abdomen (which is very hard on your heart). More importantly, we thought she was getting sicker. My Dad didn’t refill her prescription on time, and she had her first semi-lucid day in months. Aricept didn’t slow her dementia, it just added a zombie-like layer on top of it (something like Lithium). I talked to her on the phone for the first time this calenday year, a couple weeks ago. Before that, she’d forgotten what I phone was. She had no concept of what to do with it. He and I decided to let her die with a little fucking dignity, and she won’t be taking the stuff anymore.

    Sorry for all the swearing, folks. You can imagine this is a very touchy subject for me.

  38. Panic

    Oh and pardon my typos there.:\

  39. Random Lurker

    Given how it interferes with the pill, I’ve always been surprised that more kids today aren’t named Saint John Wort. Beware the herbal remedies!

  40. stekatz

    We do what we gotta do. I hate doctors as a rule, but I am willing to occasionally suffer their distain for various things.

    I found the whole alternative/homeopathic scene to be just as full of patriarchy poisoned losers. Plus, health insurance never covers that stuff. I went to an alternative practice outside my network. Over $500 later I realized they weren’t doing diddly squat for me, just making money for their fancy pyramid scheme.

    Doctors and alternative medicine are TOOLS. You’ve got to be an advocate for your own health care, and know what the right tool will be for the job. And you make your blunders and learn things the hard way. I learned that simple Vitamen C supplementation did wonders for my fibromyalgia. Yet the B supplements recommended by the alternative physician did nothing for some other problems.

    I also cannot say enough good things about paraprofessionals. I had a neck problem that was alleviated not by the GP, rheumatologist or neurologist I saw. I was an exercise regimen given to my by a physical therapist that got me symptom free. Sometimes the paraprofessionals have the time and inclination to get the wider view. They pick up on things that the doctors miss.

    It takes a village.

  41. shitflinger

    “there are chemical reactions taking place in my brain, which reactions produce what is commonly and romantically referred to as “the will to live” but which is perhaps more accurately described as ‘fear of death.’”

    Yeah, I’ve got that.

  42. LMYC

    Doctors have been both bane and blessings, and I have to agree with Andrea about them fighting a holding action, and that not being the same as not offering anything. The hated Western medicine has doubled the lifespan of many people with my particular disability. That counts.

    That said, it’s doubled the lifespan for people who can afford the treatments required to deal with my particular disability, and I know one woman who is currently in hock for $90,000 for her surgery. That’s a relatively small number, compared to some debts. And in the process of being diagnosed, I went through more than my share of asshole doctors who saw me and plainly thought, “Hot skinny fuckable babe — nothing wrong with you obviously, honey. Maybe you’re just overwrought.”

    And while the female doctor I saw to get my referral for temporal lobe epilepsy took me quite seriously, and the neurologist I saw believed every word outo f my mouth, he was also quite happy to try to talk me into taking extremely powerful anticonvulsants that I am NOT PREPARED TO TAKE, and to dismiss every single concern I had for what they might take away from me. He was REAL quick to prescribe them to me despite my telling him that the other medications I was taking for Disability #1 seemed for some bizarre reason to do the trick in getting rid of the spells.

    Then, there was the chiropractor who, when I told him I had Marfan, had no clue what it was and tried to adjust my spine by PRESSING DOWN AS HARD AND JERKILY ON MY STERNUM AS HE COULD WHOA HEY ASSHOLE DOn’T DO THAT OR YOU MIGHT FUCKING KILL ME!

    Then, there was the raft of “alternative” healie-feelie dipshits who smugly told me that their herbal bullshit would “cure” the Marfan (a genetic disability, I don’t THINK so) because evil Western medicine was patriarchal and their herbs weren’t — and they then proceeded to lecture my ass on everything they knew about DNA that they learned from reading some holistic magazine, that was also dead wrong.

    Medicine is a pain in the ass because having BODIES is a pain the ass. If it weren’t for green curry, margaritas, and coffee ice cream, there wouldn’t be any real upside to them stupid things at all.

  43. LMYC

    I should also qualify that my old female GP clicked her tongue and looked skeptical over the Marfan (until she found out that my dad had died form it and my brother’s aorta was twice its normal size), but has been GREAT during my extremely unpleasant PAP smears; I’m built like a drinknig straw, and DESPISE getting the stupid things.

    My current GP, who listened intently and took me seriously when I described TLE spells, is female. The keppra-happy neurologist is male.

    My EXCELLENT TOTALLY TOP QUALITY cardiologist is male, your classic old white guy specialist.

    That incompetent chiro? Guy.

    Those idiot alternative dorkwads? Women.

    There’s just no knowing — I definitely prefer women GPs and GYNs, but when it comes to specialists, I’ve learned a VALUABLE lessons. I’ll take ANYONE who knows what they’re doing, and gender is absolutely no predictor. The only constant is that you must be an advocate for your own medical care, you must OWN your own care, you must educate yourself, and if something doesn’t make sense, don’t leave the dovtor’s office until it does. If he doesn’t like it, screw him. He’s performing a service, and you’re a customer. He can lump it.

  44. EN

    I moved a few months ago, and now, needing to find a new doctor, I’m facing exactly what you’ve written about. I left a doctor who never put me in the position of “you can do what they say,” as she never told me to do anything. She talked to me, checked what needed checking, did what reading she needed to do, and then presented me with the current knowledge (with the recognition that it may not be right) and the different treatment options, and we discussed the pros and cons of each option. Once I’d settled on something, she’d give me a bag full of free samples from the drug company, to make sure it worked before I paid anything for a prescription. She’s now two hours away by plane, and I’m seriously considering coughing up the airfare to keep seeing her rather than trying to find someone else like her. (I never asked, but I’m pretty sure she BTP.)

  45. Jenny Dreadful

    Well, Twisty, whether it be fear of death or complacent adherence to the advisories set forth by your medical overseers, I hope you keep taking the medicine that keeps the cancer at bay. This blog is a lifesaver, and basically, I love you. The End.

  46. The Hedonistic Pleasureseeker

    Yes, agreed: It’s a mixed bag. Antidepressants save lives, so the side effects are definitely worth it for many people. Also, were it not for modern medicine I’d be long dead by now (I’ve had staph three times!).

    Birth control pills made me CRAAAAAAAAAAAAAZY. I mean, take-me-to-the-emergency-room-so-I-don’t-kill-myself crazy. They also mixed poorly with alcohol so that I’d be drunk after one alcoholic beverage. Funny how doctors don’t tell us any of this before we fill the prescription, huh? Only through blogging did I learn that I was not imagining things. Those pills made me NUTS. They make a LOT of women nuts. So where’s the big warning label?

    Reading medical abstracts online is a sick hobby of mine. Without them, though, I would never have learned of intermittent dosing with SSRIs for premenstrual dysphoria. If you understand medical jargon and know statistics well enough to tell whether the results of a study are really meaningful, I say go for it: Google your way to better health. If it weren’t for the internet I might be in a psych ward by now. Either that, or dead, or in jail.

    When I feel nihilistic I like to watch bunnies eat.

    [youtube= http://www.youtube.com/watch?v=Sg9x5mUjbH8

    http://www.youtube.com/watch?v=Sg9x5mUjbH8

  47. rafalah

    Death is…inevitable. That is what makes ANY choice I make about my body so PEACEFUL. It is mine. It does not belong to any group of medicine men, drug peddlers (recreational or otherwise), law makers, religious freaks, or concerned family members who worship with any of the aforementioned.

    I like getting older and slower. It makes me AWARE of my body, in ways I couldn’t even imagine 20 or 30 years ago. Not even child bearing/birth got me as into my body as aging has.

    I mean, every single task is now means I have to ask myself “how much is this going to hurt?” and “is there another way to accomplish this?” and “is this worth it?”

    If I choose to be a guina pig for the pharmaceutical companies–then I choose to (and I have). If I choose to live with and DIE with what ever it is they promise to prolong–then I choose to (and I have).

    I love this blog: it is where I have been coming to peacefully end my day before I head off to bed with a good old fashioned book and a icy cold beer. THAT is my medication of choice. Cheers to all of us who have to navigate the very real promise of medicine lugging around the knowledge we have about their motives.

  48. jaye

    Alright, help me sort this out:
    I take a nice cocktail (that word?) of Zoloft and Welbutrin because I am one depressed woman if I am not taking said drugs. (Long story but the short version is I blame mommy and daddy). I am managing with the drugs, thank you.

    Now, I am writing from my home in which I am sweating like I have just worked out except I haven’t. Perimenopause. I am soaking wet most of the time. I can’t sleep a whole night. I am thinking of axe murder (all you over reactors shut the fuck up, I won’t actually hurt anyone, it is way too messy) and I am really wondering what to do. HRT or what?

    Thoughts?

  49. Ron Sullivan

    Jaye: Any way of switching one of those to Effexor? It’s supposed to help with hot flashes, and gets prescribed off-label for them.

    Plus it’s a whole lot kinder to your guts than either Zoloft or Wellbutrin.

  50. larkspur

    Great post, fascinating comments. Briefly: Jaye – I would totally consider a course of HRT, depending on your family history of breast cancer, or smoking, or other factors. You are feeling miserable, and it might help get you through it. The big problem with previous selling of HRT is that it was presented as THE wonder drug that you could take from perimenopause into the distant magical future, and your skin would look wonderful, and your vagina would stay supple and luscious, and you wouldn’t suffer that horrific descent into cronesville that turned previous generations of women (those who survived past child-bearing) into boring, worthless dessicated husks.

    Okay, well maybe that isn’t exactly the way they marketed it. But you definitely got the impression that HRT was sort of like Flintstones Chewable Vitamins for middle-aged babes.

    Well, of course we know it isn’t. But it’s still medicine, and it still has a use, and I would sure like to see you be not miserable, if that can be accomplished without a significant risk. I wouldn’t like to rule it out, you know? It’s sort of like how hysterectomies were performed almost routinely. If you were done with baby-making, you might as well take that stuff out, right? Not right. But that doesn’t mean hysterectomy is always the bad choice. It’s sometimes the best choice for really intractable fibroid tumors. It’s weird how these choices get so mired in judgmental moralism.

    For the record, I am now menopausal. I’ve got the weight gain and the profusion of nasty visceral fat. Hot flashes haven’t been a real significant problem. Serious depression has been a problem all my life (managing with medication – Jaye, are you my sister?). I took birth control pills for maybe two years, tops. I’ve never had children. That puts me in a higher risk group for breast cancer. The visceral fat is a risk. I’ve never taken HRT. Now it seems I’m at risk for dementia. Sounds to me like it’s time for a beer. Or possibly a margarita. Oof.

  51. MzNicky

    rafalah: Amen, sister. Every single word you said.

  52. Cass

    As someone very wise once said, the worse thing that ever happened on a deathbed was that someone had a thought. People have images of black holes, yawning voids and so forth, when in fact these fantasies have no more relation to our post-life than our pre-birth. You won’t feel a thing. So gather your tacos while ye may, Twisty, and do please continue taking your medication.

  53. ew_nc

    Oh Twisty, once again your eloquence has expressed what has been infuriating me for so long now. Western medicine is just a vast, soul-less corporation now. And I think we all know who to blame for that.

  54. Hattie

    Larkspur said, and it’s so good it bears repeating:
    The big problem with previous selling of HRT is that it was presented as THE wonder drug that you could take from perimenopause into the distant magical future, and your skin would look wonderful, and your vagina would stay supple and luscious, and you wouldn’t suffer that horrific descent into cronesville that turned previous generations of women (those who survived past child-bearing) into boring, worthless dessicated husks.
    That is EXACTLY how HRT was marketed. That was the gist of that famous book, *Feminine Forever.* All my friends took HRT. Their reactions to my not taking it ranged from pity and scorn to anger. It was obvious to me that HRT was not doing them any good, but they were convinced that horse’s urine was just what they needed.

  55. The Hedonistic Pleasureseeker

    Stuck in the spamulator. Rats.

  56. kranky

    That’s right folks, if you’ve ever felt dizzy and motion sick, multiply it a few times and make it a constant feeling. I must contend, this doesn’t happen unless you’re a few hours late taking your antidepressant, or like me, you are trying to wean yourself off the damned things. So far, I have only been 36 hours at most off the pills before I feel so nauseous, weak, dizzy and shaky and must resume the medicine. I’ve only been taking the medication for about a year, but I must say cutting out my high-school THC consumption was a sweet dream in comparison to this shit. At least that was only mentally manifest for me and wasn’t accompanied by physically debilitating side effects.

    I had this when I was on Effexor for about 5 years. I finally decided, even though I have major depression problems when not on pills, to get off them. After 4 years I was starting to suffer random major ‘panic attacks’ my doctor called them (although I think it might have been something else)- I noticed these attacks (which would speed up my pulse/temperature to the point of thinking I was going to die) would present themselves after I took a pill. I was told to simply lessen my dose gradually ( I was on two a day). I think it took maybe 2 years to get off them completely… all the while dealing with that damn dizzinesss/nausea thing, which felt like my face was gonna fall off. No more anti-depressants for me. What’s really hilarious is that everyone assured me at the beginning ‘no, no you won’t get addicted, there’s no problems getting off them’. Right.

  57. edith

    Actually if given the choice, I would take the breast cancer over Alzheimer’s. But this is bullshit preventative medicine. Risk, risk, yawn. Maybe the next study will show if I shave my legs, I’ll prevent paralysis.

  58. jaye

    Perhaps we need a blog about meds?

  59. Meredith

    IBTP for making me think that my bipolar disorder was just typical girly mood swings, since obviously women are just emotional sobbing wrecks who then go do crazy things like drink excessively when they’ve never had problems before. I also BTP for my misdiagnosis (obviously those crazy things I was doing were just normal young people stuff, right?!), my subsequent four-day vacation on the psych ward when I reacted badly to my antidepressants, and my $10,000 (and quickly climbing) med/therapy/hospital bills from the past six weeks, which is only partly covered by my health insurance.

    But yet, I keep going through with treatment, because if I didn’t, I would probably commit suicide, and I figure I’m needed for the revolution. Also, that pesky “will to live” thing y’all are talking about keeps kicking in.

  60. Meredith

    And yes, I think we do need a feminist blog about meds. I’m now considering starting one if there’s not already one out there. Sounds like there is a vast untapped market. I’ll post a link here if I find/start one.

  61. Meredith

    Found two:

    Women’s Health News and Our Bodies Our Blog. Doesn’t look like either are specifically about medication, though. Is there interest in a feminist meds blog?

  62. The Hedonistic Pleasureseeker

    Jaye, are you a long-lost twin sister of mine?

  63. kate

    Oh the wonnerful world of mental health and related pharma. Whilst raising three kids alone, two of which were suffering from some serious emotional problems, with a job that didn’t pay the bills, an ex husband (children’s father) who only popped in by phone to give the kidlets a little more dysfunction — no child support mind you.

    And I was working, which when that didn’t pay the bills or even a sitter, I stopped and lest I be considering a welfare mondering lazy whore, I enrolled in college fulltime as well. Then welfare reform started and I got into activism on that as well. Also don’t forget family counseling, individual counseling and in-home sessions for the kids.

    I was doing too much, too much was going on, I was swinging my arms in the wind trying frantically to be the perfect women, taking care of all, solving all problems and holding up just fine thank you. But I wasn’t.

    I was recommended to a psychiatric nurse that possibly medicaid would cover as it seemed I was an emotional wreck a lot of times, sometimes sad, sometimes angry. Surprise! The woman can’t handle things, call the police! Call the guards and get that woman on meds pronto!

    The final straw was dealing with a possible eviction in the middle of winter and finding no one would rent to a family in crisis (woman on welfare with three brats). I was on lithium per a psychiatrist’s prescription (I was given three choices, lithium would make me fat she said, as a 5’4″ woman with a tendency to gain weight easily I begged not to be on that — but the choice really wasn’t mine, only seemingly a performance since I was put on lithium despite my protests).

    The vertigo, the confusion, the dehydration. I had to give a speech on poverty issues before a major college and sat on the panel in front on a hundred or so people and couldn’t even remember what on earth I was going to say. I was offered a chance to contribute to an anthology of poor women’s stories, but the lithium drained my imagination.

    After about three months I refused to take the lithium any longer and the physical backlash landed me in the hospital where the psych complained that I was non compliant, as if a child. The 50 pounds in a three month weight gain, the absolute drop in my self esteem and personality change seemed to matter little Then I was transfered to a public mental health facility where I was put on depakote. Still feeling like I had the intelligence of a dial tone and after hearing the doc telling me during a routine blood test, “You know, this will shorten your life span some as it does cause liver damage.” I was done with it.

    I finally decided after years of taking care of others it was time to care for myself. I signed up for some cognitive therapy, did it for about a year and decided to fly on my own. I’ve doing pretty well considering. I moved forward with life and haven’t looked back.

    I may die tomorrow. I know for sure that thanks to the mental health industry my life span is shortened due to obesity which robbed me of my former athletic self and is a constant struggle to overcome still after ten years.

    I’ve made peace with death. I’ve had to. Financially I have no choice, right now something could be growing inside me, rotting my various parts from the inside out and I wouldn’t know it, save for some pain here and there which is a daily part of life. I live for the now, placing my actions in play for tomorrow with no guarantee of a damn thing accept my presence here today, which occurance itself hasn’t been all of my own control or making.

  64. MedeaOnCrack

    Sure Meredith.

  65. edith

    Meredith I would read such a blog. All the time. And bipolar disorder solidarity, yo.

  66. PhoenixRising

    “Medicine is a pain in the ass because having BODIES is a pain the ass. If it weren’t for green curry, margaritas, and coffee ice cream, there wouldn’t be any real upside to them stupid things at all.”

    Well, there would still be sex, and I’m all in for that.

  67. edith

    Also kate, I don’t know what to say to your story other than “that really sucks.” Which is cheap, I know. But for me, personally, I don’t know what I would do without lithium. I don’t think it’s overstating the issue by saying it probably saved my life. Still, I don’t want to be on it forever. But if I have to be, I would rather be fat and deal with vertigo than be dead. I’d also rather be seriously in debt than be dead. And that’s why the medipharmacorporapatriarchy has so much power.

  68. LMYC

    Well, there would still be sex, and I’m all in for that.

    That makes one of us.

  69. Rachel

    Meredith,
    Thanks for the link – you’re right that Women’s Health News doesn’t solely focus on drugs. However, I’d be happy to get emails from any of you when studies pop up that you’d like me to take a look at and post about (especially as a medical librarian). I just made a quick PubMed search on HRT and dementia, and was not terribly surprised to find only a handful randomized, controlled trials on the topic popped up (see the link for citations). I’ll try to keep an eye open for the Henderson piece to be published in full with methods and such and put something up then.

  70. octopod

    I’ve got a friend who was put on lithium at age 14 and given as much shit as one might possibly believe for being unwilling to take it. Nothing like a “noncompliant” 14-year-old girl to draw the ire and scorn of the psycho-medical community. I agree the stuff’s good for some, but I think it’s frequently prescribed in a thoroughly stupid way.

    Phoenix and LMYC: I suppose this makes two of us. Though I’m not sure I wouldn’t give up sex, capsaicin, ethanol, and mud-between-the-toes for the eternal brain-in-a-jar lifestyle, though, if it came right down to it.

  71. kate

    Edith:

    I totally respect your need for lithium. I went on an all-out there because I still can’t digest how I felt used and disregarded by the mental health system. I’ve not used lithium or any drug and save for some PMS I’ve been fine.

    Which of course means I don’t have bipolar disorder or depressive symptoms either and if those clueless idiots had taken some time to learn more about my history, they would have known that.

    That was my point. I did not mean to belittle you or offend anyone else here who struggles with bipolar disorder or depression or any other mental illness. Mental illness is a serious disease and not a personal ‘problem’, I hope I did not imply that I take that position. Mental illness in fact runs in my family, which of course was one of their markers for tagging me, but on that note, I know from observation its no joke.

    Please accept my apologies.

  72. Bird

    Well, after five days off the terrible crazy-making asthma medication, I feel like I’m getting my brain back. My partner has also noticed a considerable change (and is extremely relieved). Over the weekend, stuff that would have made me collapse into tears was perfectly manageable, and I actually felt happy for most of the time. I can’t remember the last time it felt that good to chop vegetables.

    Of course, physically, I feel like crap. Corticosteroid withdrawal is not fun. So far, it’s been muscle and joint aches, nausea, dizziness, fatigue, and weakness (all intermittent so I don’t know what to expect from moment to moment). But I feel human again. No more continual anxiety and panic. And so far, no more waking up sobbing irrationally in the middle of the night and no more disturbing desires to be hit by a bus.

    I feel like I woke up and the world had colour again. I did cry on the weekend—it was relief that I wasn’t going crazy after all. Next step: getting off the birth control pill.

  73. finnsmotel

    No one here gets out alive.

    Great post, Twisty.

    The only cure for existential crisis I’ve found, so far, is fishing.

    -finn

  74. Edith

    kate, we’re cool. I got what you were saying and I wasn’t offended. I just always feel this knee-jerk reaction to defend psychiatric drugs when they’re attacked, which is often. Which is not the same as defending the drug companies or the whole mental health system which is a fucking mess, obviously, but again, we’re cool.

  75. Otter

    I work in the mental “health” system and like most women have my share of experience as a patient in the medical system.

    What constantly amazes and upsets me is the arrogance and mistaken logic of most medical professionals, regardless of gender. They are taught about medicines’ relative efficacy based on statistics and probability. So… if a given medicine has an 80% rate of efficacy in general, that’s pretty good and a Dr. will default to that medicine b/c it’s “effective”.

    Here’s the catch. The person sitting in front of the Dr. doesn’t know the statistics, hasn’t read the textbook, and may be on of the 80% or one of the 20%. That person probably has important information to provide that would help the Dr. make a better judgement about which medicine is MOST LIKELY to work for THAT PERSON, but often operates with primary consideration of the statistics and secondary (if any) consideration of the person.

    Also– it is the PERSON who will determine whether that medicine is actually taken and given the chance to have its effects. Dr.s too often operate as if the person will OF COURSE take the medicine as instructed, why wouldn’t they? Here’s why. Non-adherence to medication regimens IS NORMAL!!! Literally…the vast majority of people fail to take medicine as indicated, as instructed, or for the whole course, etc. Most people stop taking medicine if they 1)feel like it’s not helping, 2)feel better so they don’t feel they need it any more, or 3)experience intolerable side effects.

    So – Drs. should be in the business of forming relationships with their patients, building trust, and figuring out ways to support the taking of medicine (and following of other medical instructions) as recommended. Too often, they are quick to blame the patient for being “non-compliant” (which blames/shames the person). Also — they are under a lot of pressure from the system that they work in to spend less time (contain costs/enhance profit).

    Add to that the pharmaceutical racquet… propelled by Big Pharma to market diagnoses that just HAPPEN to need the latest greatest medicine (before it goes generic, of course). Notice how all of a sudden everyone you know is being diagnosed with gastric reflux?

    I actually had a conversation with my Dr. who was trying to convince me of the merits of statins (anti-cholesterol drugs)… who was telling me how certain he was that these are good and tried and true and really truly effective medicine with low risks. I said… “I’m sure you believe that, but they once felt that way about the use of leeches. I’m not saying that these medicines are without merit. But don’t pretend to me that we know everything there is to know about how/why these work or don’t work or what long term use might mean.” He had to concede the point.

    Truth is… each person responds to medicine differently. A good Dr. “gets” that and treats each person as unique, not as a statistic. And, in my book, a good Dr. is willing to admit that the best she/he can do is make an educated guess based on the information available as to what might be helpful.

  76. Edith

    I took a sociology of health class last semester (yeah, I’m a stoodent) and we talked a lot about the concept of the “non-compliant” patient. It’s true that the vast majority of patients are “non-compliant” and rather than going, “Oh my god, how stupid can people get, they’re killing themselves!!!” when everyone forgets the fact that medication is, frankly, a crapshoot, let’s stop fucking blaming the patients for one second and start getting real about the failures of medicine. I mean, part of this whole problem is that doctors are not honest with patients. Either that, or they really truly believe in the golden shininess of medication. It kind of reminds me of, “if you eat right and exercise, you won’t be overweight.” Yeah, right, for some.

  77. Bird

    As a currently non-compliant patient (stopped taking a drug before getting my doctor’s okay because I can’t get in to see her until Wednesday evening and I’m not waiting!), I have to say that there are a lot of reasons people stop taking meds. I guess I’m part of category #3 on Otter’s list. It’s those damn intolerable side effects—like the urge to run out in front of a bus, cry uncontrollably and feel generally like the world was crumbling to bits.

    Once I knew that the asthma drug was the likely culprit, the very thought of continuing to put that crap in my system made me want to smash the inhaler against the wall. There was no way that I was continuing to take something that made me feel that awful, no matter what the withdrawal might mean.

    I was also at one point diagnosed with irritable bowel syndrome and given pills to force food through my system when the real problem was gluten and lactose intolerance. One doctor tried to put my mother on antidepressants to cope with the ringing in her ears—a symptom, it turned out, of her brain tumour. Yeah, that’s right. If she hadn’t fought to get a CT to find out what was really going on, she’d have been put on some pills to just make her care less about the funny noises.

    No more. I am never again taking a drug or accepting a procedure without doing some thorough research and insisting that my doctor look up any potential interactions and discuss them. I am done being a good patient. From now, I’m going to be pushy, obstinate and a genuine pain in the ass.

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