Republicans prepare for Brave New World (of 1835)

“I read somewhere that Mitt and I have a storybook marriage. Well, in the storybooks I read, there were never long, long rainy winter afternoons in a house with five boys screaming at once. And those storybooks never seemed to have chapters called [multiple sclerosis] or breast cancer,” offered Ms. Romney, who has battled both diseases. “A storybook marriage? No, not at all. What Mitt Romney and I have is a real marriage.”

That was a quote from Ann Romney speaking at the Republican Convention; apparently she is meant to humanize her husband who is perceived as wooden and clinical.

I did like the photo of her in the Globe – however much my evil twin wonders if that smooth forehead of hers has something to do with Botox some other cosmetic filler. (hey, we should all look this good at 63)

It is ironic, though, that she brings up having been ill, when her husband’s party so demonizes government spending, in particular anything that might benefit the less fortunate, namely programs like Medicare, Medicaid and Social Security.

But, I suppose when you have a gold-plated health insurance plan it doesn’t occur to you that not everyone has the means or the employment (private insurance being so tied in with work in the U.S.) to afford breast cancer treatment or long-term therapy for MS. Or can get any care outside of an ER.

I am of course sorry that she has been so afflicted; one would not wish those diseases on anyone. But they happen and it certainly helps if you can get reasonable care. As a friend of mine used to say, money may not buy happiness but it’s a easier to cry yourself to sleep on satin sheets.

Meanwhile, a rather good piece in a recent Archives of Internal Medicine plaintively asks why nobody is questioning the “multiple examples of overdiagnosis that arise when technology, rather than clinical findings, are the catalyst for finding disease”. The authors, Jerome Hoffman and Richelle Cooper, both MD’s, point out that incidental findings of “disease” that will never lead to anything are both a waste of time and money. Not to mention turning people into patients. Their italics. (Arch Intern Med/Vol 172 (No. 15), Aug 13/27, 2012, pp 1123-4)

I thought of this article because of what Ann Romney said about having had breast cancer. Mea culpa but whenever I hear the word “cancer survivor” my first thought is: was that a real cancer (the kind that would actually kill you) rather than one that you would die with. An  incidental finding when you went to have that mammogram everyone assures you is part of good, pro-active care? Simply having a handful of cancerous cells in your body (or “pre” cancer) is no indication of anything. As you age, some cells mutate. Doesn’t mean anything. My grandmother had colon cancer for the last 25 years of her life; she died at 92. Wasn’t the colon cancer what did it, just old age.

But Americans are staunch believers in the power of technology, in the predictive power of science and the ascendancy of good old American know-how in controlling disease just as they have tried – with such success – in controlling various countries in the Middle East.

One of the signatories of the Declaration of Independence, Benjamin Rush, was a physician. He, like many of his ilk at the time, genuinely believed that American diseases were meaner and tougher than their effete European cousins. Rush’s claim to fame was treating the yellow fever (which was said to have killed more enemy soldiers in Panama a century later than the enemy did) by using humungous doses of mercury which, presumably, if it didn’t kill the patient effected a “cure”. Historians later questioned Rush’s prowess, suggesting that the individuals he was said to have cured actually weren’t that sick (hence were able to withstand his toxic treatment). Rush and his contemporaries, nevertheless, were convinced that massive purging, bloodletting and strong dosing were key to good medicine.

A handful of physicians like Oliver Wendell Holmes, who had studied in France (the French were much admired at the time for their diagnostic prowess), disagreed with Rush and his ilk. Holmes felt the American penchant for aggressive cures had more to do with cultural constructs than science. But it was Rush’s perspective that prevailed; it fit better with how Americans saw themselves.

Women were particular victims of this “heroic” ideology of strong medicine – starting from pregnancy and childbirth, where the use of forceps, episiotomies (cutting the perineum in childbirth) and later Caesarians became increasingly common to midlife and menopause when  hysterectomies and oophorectomies (removal of the uterus and ovaries, respectively) became the norm, as these organs were no longer considered “useful” once the woman could no longer bear children. Ah yes, now we know what women’s utility consists of …

Oh, and thank you sociobiology so much for keeping that swell idea alive.

Hubris, children, hubris. How the hell do you know what’s useful and what’s not? Tonsils were routinely yanked out until we realized that they were actually part and parcel of natural immunity. We have an unfortunate tendency to dismiss any organ or part we can’t figure out – a case in point being the large junk of genetic material we call “junk” DNA.

“An aggressive approach, of course, implies that the doctor can do something for the patients, and this ‘can do’ attitude is as much a characteristic of American medicine as it is of the American character in general,” writes Lynn Payer in Medicine and Culture.

You’d think by the 21st century we’d have evolved somewhat but no. Romney, Ryan and the Republicans hang on to these nonsensical notions. Zero clue  that today’s globalized, cyber-connected, micro-blogging world is hardly the same as the one Rush knew in the 1800’s. (He died in 1845.)

I shan’t delve too deeply into the right-wing perspectives on women’s reproductive rights, abortion, rape and so on lest I self combust. I will simply quote an old line from a Whoopi Goldberg one-woman-show that I always loved. Her character, a wise-cracking, foul-mouthed former drug addict, walks past a group of marchers – men – holding anti-abortion signs. She (playing a he) pauses, thinks for a minute and says: Hey, you want to stop abortion? Shoot your d—k.