Tag Archives: Melody Peterson

Our Daily Meds

Debbie says:

I finished Our Daily Meds, by Melody Peterson, last week. Sometimes, I think I understand the scope of a social problem, until I read a detailed and well-researched account and realize that what I knew was just the tip of the iceberg. Usually, that’s because I just can’t be cynical enough to take in what’s actually happening.

book cover

This book is a perfect example: Peterson is writing about how the American pharmaceutical industry has intentionally transformed not just the country’s prescription drug habits, but our national health, our attitudes towards our health, and our real income levels.

Basically, Peterson convinced me that it isn’t possible to be cynical enough. Her basic premise is that, while the benefits of prescription medications are obvious and crucial, the concept of marketing them like toys or candy has done an incomprehensible amount of harm. Drug marketing is not only pretty advertisements in public media, it’s also hundreds of millions of dollars spent paying medical doctors and movie stars to convince other medical doctors to prescribe drugs without any scientific evidence for their use–and sometimes with significant scientific evidence that those drugs do harm. It’s taking over the medical journals with articles actually written by the drug companies and their affiliates, lying eloquently about what the drugs do. It’s packaging strong narcotics in berry-flavored lollipops, and writing “children’s books” about how a particular drug transformed an unhappy child’s life.

Peterson details how drug companies have literally (and consciously) invented “diseases,” (such as “overactive bladder”) because they had a drug (in this case for incontinence) that not enough people needed. She has a chapter on Neurontin: an epilepsy drug so ineffective that the FDA approved only as a second drug to supplement some other seizure drug. (Why was the approval so limited? Because it “had not reduced the number of seizures in most volunteers in the company’s clinical trials” and “5 to 10 percent of the epilepsy patients taking [it] actually got worse.”)

The small-time approved use didn’t fit the company’s bottom line. And the law says once a drug has been approved for any single use, doctors can prescribe it “off label” for other uses. So the company decided to sell Neurontin for profitable uses, “from children with attention deficit disorder to adults with sexual dysfunction,” as well as migraines and uncontrolled hiccups. This would be bad enough, if the company had not then gone on to mount a wide-ranging illegal campaign to bribe doctors to prescribe it for these uses … and to pay doctors to convince other doctors to prescribe it. They spent tens of millions of dollars on upscale events at expensive restaurants and country clubs, where paid doctors spoke about nonexistent benefits and drug company salespeople got huge commissions based on number of prescriptions written.

Peterson comes off as a sensible researcher, not a starry-eyed crusader. She never forgets that most of the drugs she is discussing actually do some good. One thing I thought the book might be when I bought it was a deep critique of “brain meds,” but instead she writes about psychoactive drugs as part of the greater pharmaceutical picture, which is much more useful.

She also discusses some hidden social issues: she estimates the number of drug-related deaths in the U.S. at more than 250 per day (!) and shows how these deaths are hidden in the statistics. (I understand that, because anorexia and bulimia deaths are hidden the same way; the cause is “pneumonia” or “heart failure,” and the underlying issues disappear.) She talks about the measurable presence of trace pharmaceuticals in urban water supply (a 2002 study found prescription drugs, fragrances, insect repellents, disinfectants, and other household chemicals in 80% of the streams sampled in 30 states). She discusses the thriving high-school and street-corner market in pretty pills, and the highway and military deaths caused by prescription drug misuse or overuse. She talks about the marketing of drugs to children and the elderly, despite no studies regarding those groups: this results in particular in overprescribing for the elderly, whose body systems often process drugs less efficiently.

I’m a critical reader: I always look for how the author might be slanting her data to make her points. I saw that occasionally in this book, but the vast bulk of the time, Peterson was either giving me statistics on something I already basically believed, or convincing me it was worse than I thought.

Why is this a body image issue? Because body image isn’t just about how we look; it’s also about how we feel. And one of the nastiest aspects of the whole slimy mess is that by promoting sweetness and light, the drug companies have made Americans perceive ourselves as sicker, more in need of help, and less powerful than people anywhere else in the world. (And America’s government and citizens have supported the effort.)

The U.S. is the only country that has let this madness run unchecked. Peterson’s last chapter is a prescription for how to fix this on a personal level and a social level. If your stomach is strong enough, this book is well worth your time.

The High Cost of “Normal”: Children’s Height, Intersex, and Other Pressures

Laurie and Debbie say:

Jessa Crispin, well-known “bookslut,” is talking about a book we hadn’t known about: Normal at Any Cost: Tall Girls, Short Boys, and the Attempt to Manipulate Height, by Susan Cohen and Christine Cosgrove. In Crispin’s longer review, she covers not only this title, but Wetlands by Charlotte Roche (a novel) and Bodies by Susie Orbach.

Crispin also references another of her long reviews, this one of Thea Hillman’s Intersex (for Lack of a Better Word), and Fixing Sex: Intersex, Medical Authority, and Lived Experience by Katrina Karzakis.

Lots of books, and we haven’t read them (yet.) Crispin’s reviews alone make interesting points and raise good questions. First, what does children’s height have to do with intersex? Lots, and Crispin sums up the connection in one pithy sentence:

We have always gone to extremes to occupy some sort of physical middle ground.

Oddly, despite the book’s subtitle, Crispin doesn’t discuss how Normal at Any Cost covers the issue of short boys. However, Debbie has been reading Our Daily Meds by Melody Peterson (watch for a review here soon), and Peterson does talk about this issue:

Iowa doctors sometimes referred their young patients to a nonprofit group called the Magic Foundation, which was started by mothers with children with rare growth disorders in 1989. Over the years, the foundation had accepted hundreds of thousands of dollars form the companies selling prescription growth hormone products. In a campaign in the early 1990s, the Magic Foundation, as well as another group, the Human Growth Foundation, had measured the height of children in public schools. The screeners suggested that the shortest children visit their doctors for medical treatment. …

A story published in the foundation’s glossy magazine in 2005 was entitled “Me and My Growth Hormone.” The story began, “I was short. My little sister was taller than me. Kids at school picked on me and called me names.” The tale continued with the child getting growth hormone injections and growing so much his pants got too short. “I’m almost grown now,” the story ended. “I’m in the normal range on the growth chart. Growth hormone is like a miracle drug.”

Here’s Crispin on tall girls:

In the mid-20th century, doctors discovered they could control excessive height in girls medicinally, as opposed to the previous method of breaking and surgically removing sections of the leg bones. … If girls were brought into an accelerated puberty with high doses of hormones, they would stop growing earlier and shave off a few inches from their potential height….

Girls were loaded up with DES, short for diethylstilbestrol — a synthetic estrogen primarily prescribed to pregnant women to help prevent miscarriages. Unfortunately for the pregnant women, and the girls who were too tall, DES had a bevy of side effects: vaginal cancer, breast cancer, sterility, blood clots, increased rates of miscarriage, and depression. (The babies in utero were not spared: Many of the girls developed problems like T-shaped uteri, sterility, and vaginal and cervical cancer.)

We’ve known for decades about DES and pregnant women, and the next-generation girls who died from those treatments to their mothers. We didn’t know until now that the drug had other, less justifiable and equally dire, uses. It isn’t clear from these excerpts if tall girls are still getting hormone therapy, but a quick web search seems to imply that the practice has been so frequently revealed to be dangerous to the girls that we can hope it is no longer widely practiced.

And here’s Crispin on intersex surgeries:

Doctors and parents think they are sparing children embarrassment and pain. But now intersex activists are fighting to create a new protocol, one that waits until the child can participate in “hir” (forgive me — I know the pronoun is a clumsy compromise, but one that comes up a lot when you start reading about gender theory) own treatment.

… surgery that is mostly cosmetic is still performed on infants — despite the fact that it usually requires follow-up surgery, that puberty will alter the appearance of genitalia anyway, and that it can elimination sensation or even make arousal painful means — that this is an issue beyond functionality or health alone.

“The debates over when to perform surgery and how best to decide gender assignment obscures the fact that in trying to make infants with intersex diagnoses ‘normal’ boys and girls, physicians and parents are necessarily drawing on cultural ideas about what constitutes male and female.” That includes assigning sex by guessing future sexual orientation in the hopes of avoiding any homosexuality.

The pressures on us as individuals, and especially as parents, to do what ever we can to move toward “normality,” (always a slippery concept and most frequently a divisive and nasty one) are enormous. Some of the most tragic mistakes are made “for the sake of the children.” Every parent wants their children to be healthy, happy, and successful: it’s incredibly easy to transfer this protective motivation into dubious or inappropriate choices. The pharmaceutical companies, the doctors, the media, and often our families and friends are arrayed on the side of this middle ground. Holding our own, accepting ourselves as we are and our children as they are born, dividing medical necessity from cosmetic panic, embracing variety: these things are difficult.

Crispin buries one clue to what makes them so difficult in her comments on Orbach’s Bodies:

One wishes she offered an action plan for women on how to navigate such a toxic environment with confidence. She has been writing about this issue for years, publishing her monumental book Fat Is a Feminist Issue in 1978 — surely she has some tips by now.

This is a terrifying statement. In Fat Is a Feminist Issue more than 30 years ago, Orbach laid out exactly such an action plan. She was one of the first to do so, she has hardly been the last. We can find these action plans in Our Bodies, Ourselves and all the spin-off books. We can find them in almost any size acceptance book, or blog (including this one). We can find them wherever feminists gather, wherever feminists write, wherever feminists talk. Our voices aren’t as strong as the “normality” crowd, and we don’t have as much money–but we still have the power to move even the multibillion-dollar beauty industry, as in Dove’s “Campaign for Real Beauty,” which is not only popular but has many imitators.

Crispin herself makes one of the key points: “If we want to raise happy, healthy daughters, it would seem we have to start with ourselves.” That the well-read careful thinker Crispin knows so much about this issue and is still looking for such roadmaps tells us not how hard they are to find, but how hard they are to remember and hang onto.

Thanks to Arthur D. Hlavaty for the pointer.