The Hypochondriac's Guide to Life. and Death. (7 page)

You would think
that as medicine has become more sophisticated, the incidence of hypochondria would diminish. It hasn't. By all accounts, it is increasing.

There are three reasons. The first is medical insurance. To understand the insidious impact of medical insurance on hypochondria, it would be helpful to imagine life before medical insurance. Imagine you were a Jewish peasant in Russia in 1903. If you felt sick, you trudged twelve miles to the doctor. His fee would be a goat. Which means not only did you have to walk the twelve miles from your shtetl to his shtetl, but you had to schlep the goat. On the way, Cossacks on horseback would harass you and make fun of your beard, and they might even take your goat.

Everything about this system discouraged hypochondria. You would do your best to convince yourself that your symptoms, whatever they were, were negligible and that medical attention was unnecessary. Or you attempted to treat yourself. You would try some random nostrum, say, taking a sitz bath in molasses and chicken hearts. And because most ailments eventually resolve themselves anyway, your symptoms would eventually disappear
and you would conclude that whatever you did had worked.
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All over Russia, people would be curing themselves by drinking monkey urine or yodeling with beetles in their mouths. Yes, they were nincompoops, but they were not hypochondriacs. Behind the whole system was the fact that getting medical attention was difficult and costly. Now your doctor is a few minutes away. Your only fee is a $5 “copayment,” which is so puny doctors don't even keep it; it goes into a plastic cup near the reception desk, for gum and panty hose.

The second reason hypochondria is on the rise is the proliferation of scientific studies. It used to be that major achievements in medicine were made by solitary eccentrics like Louis Pasteur, puttering around in their basement laboratories, discovering that bread mold could cure syphilis. Their medical tools were a ball peen hammer, six worms, and spit. These days, things are much more complicated. Scientists work in teams, sponsored by universities, funded by gigantic grants. In order to justify their time and keep their sponsors happy, they must periodically issue reports, however obvious their conclusions may be. A study I just read actually concluded that small thin women tend to live longer than big fat women. (Next: B
AD TO
B
E
E
ATEN BY
W
ILD
D
OGS,
E
XPERTS
S
AY.)

The official house organ of study-promulgating is the
Journal of the American Medical Association,
a highly respected medical periodical that gets quoted whatever it says, because it is so respected. I have never visited the offices of the
Journal of the American Medical Association,
but I suspect it is two guys named Murray and Ed, who sit around smoking cigars, playing practical jokes on each other, and inventing alarming facts. “Let's put it
out that laboratory rats are seventy percent more likely to develop esophageal cancer if spanked continually,” Murray says. “No, wait,” says Ed. “If spanked continually
while being fed a diet of Ovaltine and Snickers.”

No one questions these studies, however preposterous they seem. I am looking at the results of a medical study recently reported by
The Washington Post.
Ordinarily,
The Washington Post
is pretty careful. If someone contended that President Chester Alan Arthur had actually been a donkey named Salvatore, you can bet the editors would demand a second source. But when a scientific study says something, newspapers instantly accept it because it is so darned scientific. This study I am looking at, solemnly reported by
The Washington Post
and other great newspapers, concludes that heart attacks might be prevented by diligent tooth flossing.

The media are the last and most important reason for the persistence of hypochondria in America. They'll print anything.

The New York Times
recently reported that a cure for cancer was just around the corner, in the form of a new drug that can shrink tumors by cutting off their blood supply. Everyone went nuts. C
URE FOR
C
ANCER
J
UST
A
ROUND
C
ORNER,
the newspapers said. Medical stocks soared! Poets rhapsodized! Dying millionaires offered researchers tens of millions of dollars to become human guinea pigs! It turns out the headlines were ccurate in every way except for certain words: “Cure” “Cancer,” “Just,” “Around,” and “Corner.”

For one thing, so far the cure only works on mice. For another, the drug in question is partly synthesized from mouse urine, and at this point it takes two hundred quarts of mouse urine to extract a millionth of an ounce of the drug, which means you would basically have to force-feed a thousand mice a thousand gallons of Gatorade over a thousand years to get enough medicine to shrink a single hemorrhoid.

By the time all this qualifying data came out, however, the media had lost interest in C
ANCER
C
URE,
moving on to yet another Big Medical Story, namely, K
ILLER
E
RECTIONS.
Men who took Viagra, the new potency pill, were reported to be dying like germs in a jar of Listerine. Follow-up stories revealed, however, that
these victims tended to be seventy-five-year-old guys who—suddenly invigorated after twenty years of sexual somnolence—bounded briskly out of bed and into the saddle. Presumably, they died of heart attacks, or of old-lady-style hairpins briskly inserted between the third and fourth rib.

The press also insists on reporting news of horrifying new diseases and shocking medical errors, terrifying the hypochondriac. Some of these so-called medical mistakes are, of course, exaggerated. For example, I am at this moment looking at an Associated Press story about how the parents of a five-year-old girl are suing a doctor in Texas who was supposed to perform an appendectomy on their daughter but instead removed one of her fallopian tubes. Sure, it
looks
bad for the doctor, but I think we must give him the benefit of the doubt. Perhaps he was unfamiliar with anatomy, and when he asked, “What is that?” and a nurse said, “A fallopian tube,” he panicked and cut it off.
I
sure would. A fallopian tube does not sound like a good thing.

Still, these are aberrations. Bad medical news is not happening with greater frequency than in yesteryear. It is just that the press is far better at finding and reporting it. Let's say in 1841 a cholera epidemic wiped out half of Montana. The event would be covered six weeks later, as news trickled in. Journalism in that era was a lot more genteel. Information was disseminated only reluctantly, gradually, in manageable little bursts of increasing gravity, the way one might deliver bad news to an elderly aunt with a weak heart:

NEWS OF THE TERRITORIES

A Distressing Affair

CHOLERA OUTBREAK

M
ANY
S
ERIOUS
I
NDISPOSITIONS
R
EPORTED

Fig Poultices Applied

OUR CO-RESPONDENT'S EYEWITNESS ACCOUNTS

20,000 Dead

It is reliably reported by cable from, our Co-respondent in. the Northwestern Territorial Provinces, that contrary to more sanguine reports published elsewhere, the most Unfortunate Event has occurred of a medical nature. Horses were not affected. As could best be confirmed by presstime …

And so forth.

Hypochondriacs of earlier years did not even read these stories. In fact, no one read these stories. People bought newspapers for the ads, many of which featured products like Dr. Von Otherwise's Patented Lip Balm and Heart Tonic, which promised a cure for Neuralgia, The Vapors, Constipation, Dropsy, Quinsy, Pustulating Bronchitis, and Vomitacious Catarrh.

Nowadays, however, both medicine and the media are better. Hypochondriacs have much more to obsess over.

On June 23, 1997, for example, the American media and the American medical establishment conspired to perpetrate the greatest assault ever on hypochondriacs. On that day, the American Diabetes Association officially announced—and the media dutifully reported—that it had lowered the blood glucose levels necessary to diagnose a person as having diabetes. Overnight,
they created a serious health problem for tens of thousands of people
who had not had a health problem the day before.
Every endocrinologist in America immediately purchased a second yacht.

Here's a recent newspaper story reporting the final days of convicted Virginia cop killer Roy Bruce Smith. Mr. Smith requested a last meal consisting of a glass of Welch's grape juice, one-eighth level teaspoon of Epsom salts, and unleavened bread made with olive oil. He had been eating nothing else for months. His lawyer disclosed that Mr. Smith believed many of the world's health problems, including cancer and diabetes, are caused by soy, and that to counter any ill effects, people should eat more foods containing magnesium, including Epsom salts and Rolaids. Mr. Smith spent the last month of his life bargaining with his cell mates for Rolaids. His biggest regret, he told his lawyer, was that he could not get this information out to the world. Also, he had figured out a way to achieve cold fusion. This secret, too, died with him. He was executed by a lethal injection of soy sauce.
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Now that all this information has been published in an actual book, I predict hypochondriacs all over the country will start gobbling Rolaids.

Not that that will save them from flesh-eating bacteria.

Remember flesh-eating bacteria? They entered the public consciousness a few years ago, more or less the way the AIDS virus enters the human body: right up the wazoo. Some doctor somewhere in some reputable medical journal reported that there was a microorganism that digests protein, and if it gets into an open wound it will, ahem, consume flesh. Pretty soon the responsible media got onto this story, quoting experts, prudently cautioning against panic, noting dispassionately that there was a germ out there that could, under certain conditions,
EAT YOUR FACE OFF.

Instantly this reached the supermarket tabloids, in particular one supermarket tabloid called the
Weekly World News,
and that
pretty much was the ball game. The
Weekly World News
makes the
National Enquirer
look like Kant's
Critique of Pure Reason.
As I recall, the
Weekly World News
promptly informed America that a
CANNIBAL MICROBE
was
ON THE RAMPAGE,
turning ordinary humans into

BLOBS OF GOO.

I do not mean to disparage the
Weekly World News.
The
Weekly World News
is a fabulous newspaper. I say that as a knowledgeable journalist who has worked at several major American newspapers. Not one of them was cool enough to report a cure for cancer but put it on page 27, under a story about a man who eats cockroaches.

Once the tabloids got hold of the flesh-eating-bacteria story, hypochondriacs began to appear in their doctors' offices whimpering and pointing with horror at their zits.

This, of course, was silly. Ordinary-looking pimples do not remotely resemble the skin eruptions created by flesh-eating bacteria.

Ordinary-looking pimples resemble the skin eruptions caused by a malignant tumor of the adrenal gland.

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This illustrates a psychological phenomenon known as “superstitious behavior.” In one study, behavioral scientists placed a dozen pigeons in boxes and fed each bird pellets of food at completely random intervals, to see what would happen. After a few days, the pigeons were behaving bizarrely. One was hopping up and down on one foot; another was moving in circles with one wing raised; a third was incessantly scratching the wall, etc. The scientists eventually theorized that because there was no rhyme or reason to the feeding schedule, the birds had leaped to the conclusion that whatever they had just been doing immediately before they got a pellet—whatever random act—must have prompted the feeding. So they began doing that one thing more and more, and each time they were fed, it reinforced this belief. This is the only specific lesson I recall from four years as a psychology major in college.

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Wouldn't that have been
great?

Hypochondria and Me