He's working on a new cocktail

I was writing the other day about framing some of the ethical conflicts in my book as environmental issues. As I am starting to see it, our right to be physically healthy is being compromised by big pharma in several areas: the side effects of all the drugs we are now taking, as well as the persistence of those drugs in our environment, which exposes all of us, whether we like it or not.

The omnipresence of these substances also introduces another element of uncertainty: how the prescription drugs so many of us are taking (3.7 billion prescriptions in the US are written a year, an increase of 12 percent over five years ago, according to The Guardian) are interacting with what we are getting in our water supply. Surely this "cocktail" of exposure affects some of us more than others (in terms of overall physical health and the health of our offspring, even, I would guess, of the potential for introducing spontaneous mutations). It could still prove that something like this even explains autism and other pervasive developmental disorders. Perhaps a shot of a vaccine is just one of the straws that causes the body to throw some kind of overload switch in certain sensitive individuals (e.g., babies and children) who have already been exposed to complex chemicals with long half-lives in their drinking water and breast milk.

Yet it's clear that it's not just big pharma that can act as a sort of public health riptide. We also must consider the role of food in questions of overall health. Learning about the effects of gluten is teaching me a lot about the gut's complex role in the body. I see a distinct possibility that more of us than we know, by far, are sensitive or even allergic to some of the foods we take for granted (wheat, dairy, eggs are common allergens). It seems more likely that our guts are affecting our brains, rather than our gut diseases being "all in our heads." If we can change our thinking, doctors have argued for years, then our guts will heal. But what if our injured guts won't let us think straight? Then we have to heal them before we can heal what's in our heads. It's hard to remember that not all food is love, isn't it? We all want to believe that about what we eat every day. Most of our mamas told us so.

Yet I feel we have to start drawing our line in the sand, defining the limits of what kind of side effects and increases in expenditures on drugs and medicine and insurance costs we are willing to tolerate, what kinds of concentrations of chemicals we will tolerate in our environment, and we must continue defining those boundaries repeatedly and over time given new knowledge and data, before our rights to do so are preempted by the rights claimed by corporate America to profit at any cost.

The largest Elizabeth in the room

I keep examining why this story is important to me and what is driving me. Part of it is this conspiracy-theory feeling that the fatcats (because this all feels like such a throwback to gilded-age policy and practices, doesn't it?) don't want us to see the eight-zillion-pound Enron -- I mean elephant in the room. And I am seeing it, and I can't help seeing its parts and effects everywhere: the heaps of poop, the detritus left after the trees have been chomped as if they were celery stalks, the dirt and dust from the bathing rituals, and their massive presence in the room, their audible and subsonic sounds and signals, their memories, their histories, their needs.


Today I spoke with someone involved with a government agency long ago. She asked me about my project and I explained there were three inspirations, the film Taken as Directed, the film Syriana (in how it looked at a problem from so many different angles), and the prevalence of side effects of medications on everyone around me. My interviewee agreed heartily with my perception that more people than ever are taking prescription drugs, noting that the populace only started taking them in 1964. If you think of that blip of time on a geological scale, it's a subspeck, but if you analyzed the effects on human health over this tiny timeframe, what would you see on an evolutionary scale? Would there be a balloon in mutations, I wonder? What sorts of divergences from established equilibria would be notable? Cross that with the effects of global warming and increased exposure to complex environmental chemicals in our daily lives, and then what?

So I find myself wanting to not only blow the whistle on big industry and a government that lets big industry call the shots but I also want to blow the whistle on all who believe the hype: the ones who ask for that medication we saw in the ads, the ones who hold stock in biopharm companies. The prescribers who take the tiny tokens and don't even notice that they have obligated themselves to return the favor. The nurses, pharmacists, and care workers who know better who persist in doing things like taking antibiotics as preventive measures, flushing expired prescription medications down the drain, and using antibacterial soap (which inhibits the natural inoculation against asthma in youngsters and upsets the pH balance of the water downstream for all the plants and animals that depend upon it). The prescription drug users who don't understand the potential effects of the pills and the myths they swallow.

I see how I could easily take just one part of this story, and for example, frame it in terms of an environmental debate about the concentration and persistence of these chemicals in our bodies and our water supplies.

But there are other sides, too. Human nature must be carefully considered in evaluating the results of all these drug studies. We all know belief is a fundamental component of health and healing, but we don't often consider how this works in combination with other principles that drive us. I'm thinking of commitment, for example: once you have chosen a means of trying to solve a problem, be it by taking a government-approved medication or by participating in a clinical trial, that solution becomes your favorite in the race for a cure. You commit to it, you talk it up, and you naturally pin your hopes on it. When you combine your commitment with your desire for something to believe in, this form of rooting for the chosen solution is bound to affect the outcome. Even if you take the placebo, you are under observation, being cared for, and you get the placebo effect, of doing something as opposed to nothing at all. Your participation surely has an amplification effect that could be as influential as the chemical composition of the pill or injection that you have chosen as your deliverer.

Doing something is always going to have an effect, and I want to explore what that can mean to people, how people aren't necessarily limited to the options suggested on the commercial breaks during the Late Show. How doing something can mean taking an Advil instead of a Vicodin or listening to music or learning to ski or painting a picture or meditating or making a garden bed.

For some people, I understand that making a garden bed is not even possible, much less enough to keep them from walking in front of a bus. But I also see a recent and dramatic about-face on the efficacy of SSRIs in the general population and that little fact alone is enough to scare the bejeesus out of me: I think we still know so little about our brains and bodies and about the effects of these strong medicines on our brains and bodies that we should be very careful with our brains. They are the only ones we get.

A near and dear bipolar says, "I love Lithium because it's the second element in the Periodic Table of Elements!" But in some cases this can be as disingenuous as letting big pharma decide what's best, as pointed out in a terrific expose of the supplements industry we both read by Dan Hurley called Natural Causes, "all natural" does not necessarily equate to "all good."

It's complex stuff, our health, and I feel I am walking around scoping out all the angles to see the elephant from: making my little director's finger-frame from up close, from afar, in discrete parts, and as a whole. Is there anything new to be seen from here? I'm convinced there is, even if I haven't a clue what the heck it means yet.

Part of this verge-of-discovery feeling may be connected to my recent forays into gluten-free baking and eating, too. That adventure is fodder for another post or several, it's led me to feel that what I am eating is more nourishing. I am eating a greater variety of grains and everything is tasting good. I even found a dish that totally eased the transition to gluten-free flour for me, and the help of a decent cookbook recommended by a neighbor. Now I'm not feeling I am cheating my body of something when I have a piece of banana bread or blueberry cake. I feel I am giving myself health and well being and nutrition, and it makes a world of difference to me. I'm also noticing my need to be in motion and active more during the day lately, perhaps just because I'm interested in my physical health, perhaps because we're on the brink of spring, but in any event these days I am riding my bike more and working out and walking more. I feel I have found my own way to give myself the gift of better health, and I find am not as depressed or manic as I was a few months back when I was having a much harder time keeping things in perspective. So that's my story, and everyone's is different, and some people wouldn't be alive without big pharma's fruits. But I still think there are many more ways to look at this elephant that is public health.