Life as an Extreme Sport

If You’ve Got a Pulse, You’re Sick – New York Times

If You’ve Got a Pulse, You’re Sick – New York Times

For a nation that spends more than any other on health, the United States certainly doesn’t seem very healthy.

Many cancers are on the rise ”” prostate, breast, skin, thyroid. We’re fatter than ever. As for diabetes, the number of people who say they have it has doubled in the last 10 years. Now a report says that the English ”” those smoking, candy-eating, fish-and-chips lovers ”” are actually healthier than Americans. And they spend half as much on health care.

The American-English comparison, published this month in The Journal of the American Medical Association, analyzed data from people’s own reports of their health and also used some objective measures: a blood test for diabetes, using hemoglobin A1c, and blood tests for proteins associated with heart disease risk, fibrinogen and C-reactive.

Their blunt conclusion?

“Americans are much sicker than the English,” wrote the investigators, led by Dr. Michael Marmot of University College Medical School in London.

…But the lesson for Americans is clear. These days, and especially in the United States, with its screening and testing, “we are labeled,” said Dr. Hadler of North Carolina.

“I call that medicalized,” he added. “And one of my creeds is that you don’t medicalize people unless it is to their advantage. When you medicalize people, they think they’re sick, and in our culture it’s, ‘Do something, Doc. Don’t just stand there.’ ”

Dr. Hadler has written a book about the problems of medicalization, calling it “The Last Well Person: How to Stay Well Despite the Health Care System” (McGill-Queen’s University Press, 2004). The title refers to a story told by Dr. Clifton K. Meador, director of the Meharry-Vanderbilt Alliance, a cooperative program between the medical schools in Nashville.

One day, as Dr. Meador tells it, a doctor-in-training was asked by his professor to define a well person. The resident thought for a moment. A well person, he said, is “someone who has not been completely worked up.”

The medicalization of life is a very interesting concept, and one coming more into play in the philosophy of medicine and bioethics. It’s well worth thinking about how we define illness and health, and whether or not there is ever a perfect state of health one can reach.