biblio

Prescribed reading

Before You Take That Pill

Before You Take that Pill: Why the Drug Industry May Be Bad for Your Health
J. Douglas Bremner ’83
448 pages, Avery, www.penguin.com

With attention deficit disorder meds now commonplace among kids and erectile-dysfunction commercials a staple of pop culture, prescription drugs play an increasingly prevalent role in our society. More than half of all Americans take a prescription drug, and 81 percent take at least some kind of pill every day. Americans take twice as many drugs and spend twice as much money on them as people in other industrialized countries do.

Yet, compared with people in these same countries, Americans are among the least healthy. Two-thirds of Americans are obese or overweight—a phenomenon that threatens to reduce the average life expectancy in the United States this century. In a survey of 13 industrialized nations, the United States ranked last in many health-related measures and second to last overall. What’s more, an estimated 100,000 Americans die every year from medications that either weren’t needed or were incorrectly prescribed. One out of every four prescriptions written for senior citizens contains “a potentially life-threatening error.”

What’s going on here? According to J. Douglas Bremner—a physician at Emory University School of Medicine whose study on Accutane and depression made headlines—the motivations of the drug industry are a big factor. “My experience and my reading led me to the conclusion that it wasn’t always about saving lives,” Bremner says. “It was also about making money, a lot of money, meaning billions of dollars.

“I began to question assumptions that all doctors make,” he continues. “Were medications for cholesterol really that helpful for people without heart disease? … Do you need to take a pill to go to sleep? Do you need to take vitamins and supplements to meet that USDA requirement, and who came up with those requirements anyway?”

Today, Bremner says, to increase revenue, drug companies have gone from providing medicines to the sick to pitching them as preventative measures. Consequently, “we are now urged to obtain screening and potential treatment [for various conditions], including high cholesterol, osteoporosis, hypertension, diabetes, and heart disease.

“However, the potential benefit of medications to treat these conditions is often exaggerated.”

Marcia Angell, author of The Truth About the Drug Companies, contends that doctors, overwhelmed with medical literature, often get a lot of their information from drug company reps—“typically young, attractive women with no background in health or science.” Bremner even cites a New York Times article that says former college cheerleaders are often recruited for this job.

The Food and Drug Administration, meanwhile, was downsized in the 1980s as part of government deregulation, and subsequent legislation allowed pharmaceutical companies to pay the salaries of FDA staffers. Today, Bremner argues, the agency finds itself “paralyzed by politics and its desire to balance scientific advancement, commerce, and safety.”

So what’s the remedy? For starters, Bremner says that, while many drugs do help people live longer, healthier lives, people should select the drugs they take very carefully. “There are simply too many medications being needlessly taken. … It is costing us too much money for too little benefit.”

He also encourages people to go see their doctor only when they are sick and to skip the annual exam—a ritual that, he says, exists only to promote a closer doctor-patient relationship. “But with HMO-style care, how much time do you really spend with your doctor during an exam anyway?”

Moreover, Bremner stresses that all of us should focus on prevention rather than medication—that we should adopt healthy diets and lifestyles and exercise daily, approaches that have “no side effects.”

“Find something you like to do. Walk to the post office or store. Swim laps. Ride your bike. Take up tennis. Grab your spouse or a friend and go out dancing every night. … How hard is that?”

Finally, Bremner encourages readers to become active health care consumers. “Question your doctors, other health care providers, insurance companies, your senators, and your congresspeople. … Don’t just mindlessly follow ‘doctor’s orders.’ We have a lot more control over our health and well-being than we’ve been led to believe.” — Andy Boynton

There’s a Lot More to Chess: Begin Your Games with Genius
Andrew Tocher ‘91
108 pages, Christian Services Network,
www.CSNbooks.com

In this slim guidebook on chess, Tocher offers a series of innovative opening chess moves, along with his insights on the pros and cons of each. The table of contents reads like an old Dungeons and Dragons manual, with cryptic terms like “The Latvian Gambit,” “Gruenfeld’s Opening,” and the “Dragon Variation of the Sicilian.” The move profiles, meanwhile, are sprinkled with references to Rodin, Rudolph the Red-Nosed Reindeer, and, for good measure, Lyndon Johnson. This book is best suited for advanced chess geeks interested in ways to retool their game; a novice could go cross-eyed trying to make sense of the details. The text is accompanied by diagrams outlining a variety of chess moves. — AB