The Medicine Man

Americans will swallow anything.

The medicalization of the human condition has reached new heights. A quarter of American women in their 40s and 50s are taking a daily pill for unhappiness, because unhappiness itself has become a focus of medical attention. In 2016, there were an average of 15 prescriptions written for every American, and over half of Americans were taking daily prescription medications. That doesn’t include all the other pills and chemicals ingested, including vitamins, food supplements, and over-the-counter medications.

Pills and other chemical conduits have occasionally been stunningly successful in the last hundred years. From the magic bullets of the early 1900s for syphilis and other illnesses to penicillin to insulin to vaccines (to fluoride in drinking water to iodine in salt), humans have benefited extravagantly from ingesting chemicals. Medical science looked to fulfill the dream of cheating death.

Meanwhile, we began poisoning ourselves in new and unexpected ways. Cholera was not caused by a miasma but by contaminated water. Cigarettes turned out to be responsible for the vast majority of lung cancers. Industrial waste, like automobile exhaust, is toxic. So, some chemicals provided cures that seemed miraculous, and many of life’s ills were linked to bad chemicals. Even water, we were told in advertisements, is a chemical.

If syphilis were not caused by the sin of sexual relations but by a bacterium, then the disease might not be a retribution. A search for blamelessness has helped drive the medicalization of humanity ever since. Strangely, moral blame was linked and is still linked to the ability to do something about a problem, rather than to ill intentions. If you tell someone that they could have prevented lung cancer by not smoking, they will accuse you of blaming them for getting cancer instead of thanking you for pointing out how to avoid a potential recurrence. This is true for virtually every other ill that befalls humans because of their own behavior. The magic of penicillin is expected now for every sort of unhappiness, not just the ones that clearly have a biological origin.

Lung cancer is probably not a good example, since once someone gets it, they have about a fifty percent chance of dying of it, and the upside of quitting cigarettes is not as great for them as it is for people who have never smoked or for those who don’t yet have cancer. Obesity is a better example. It’s hard not to notice how many obese people will tell you that you are blaming them if you point out that exercise and cutting calories could help them. Many obese people respond that experiments show that “diets don’t work.” Well, that’s true. If you’re expecting a diet to work, you won’t lose weight. You can lose weight only if you work. The promise of medicine is not only to cheat death, but to do it in a way that requires nothing of you but to receive communion. This promise is promoted in the hundreds of billions of dollars that Big Pharma has spent advertising drugs, the effect of which is to inundate the average person with suggestions that what ails them needs a pill. (It’s a short step from medication to drugs.)

For much of human history, the political leader was also the religious leader. That’s still true in the UK, for example, where Queen Elizabeth II is the leader of the Church of England. Today, she would have as little success trying to exercise her technical religious powers by, say, advocating some new dogma or ritual, as she would her political powers. The American Founders were so keenly aware of the ills of combining political and spiritual leadership that they took what steps they could to keep it from happening here (particularly in the First Amendment). Still, they never dreamed that the spiritual leadership of a society—those to whom we turn with angst, despair, and ennui (which are not yet medical disorders)—would be medical rather than religious practitioners. Now we see President Trump taking the role of doctor-in-chief, recommending specific drugs and claiming special knowledge about hygiene. Prince Charles is doing the same in England with his advocacy for homeopathy.

The title of this post, The Medicine Man, needs some explaining. In many Native American tribes, people would turn to a spiritual healer in times of angst and despair and ennui, and those healers came to be known in English as medicine men for reasons I don’t think are well understood. The label was then used to ridicule their practices for their medical ineffectiveness when many of those practices were never meant to cure diseases caused by germs. When psychologists conceptualize human suffering as a disease, they are as ineffective as Native American medicine men were at curing biological diseases. When we conceptualize human suffering as angst, despair, and ennui; as the sense of not belonging; as investment in a fantasy of how things ought to be rather than making the most of how things are; then our “medicine” is very strong. Medicalized (diagnostically precise, prescriptive, “evidence-based”) therapists are now in the same boat as their patients: the effort to be special is impossible to achieve, and it costs them the joys of being ordinary.

The title of this post is also a nod to the influential book, The Organization Man, which criticized what postwar Americans had become. Now the mainstream American is a Medicine Man or Woman, seeing the world through a medical lens, certain that there is a solution, not unlike that proposed by some but not all religions, to death and despair that requires of us nothing but belief and a willingness to swallow whatever is handed to us.