You sick people

Draft of 2006.04.25 ☛ 2015.04.05 ☛ 2016.07.16

May include: philosophyhealthcarepolicy&c.


My Mom has sleep apnea. I do too. My Dad did, too, worse than anybody I’ve ever heard. A lot of people do, it seems.

The University Health Services have a fancy clinic now, just down the street from our house, where they will fit you with a fancy CPAP machine that you will wear every night for the rest of your life and it will possibly make you better, so your risk of heart disease is lower because you don’t wake up so much in the night.

The sleep apnea thing is a huge growth industry, clearly. It’s a simply-described condition with a broad range of possibly serious detrimental medical effects, and it’s often treatable. Made for windfall profits: Soon it will be clear that you’re being selfish and hogging medical effort if you don’t get treated. Think of the savings that could be passed on to treat real diseases, if only we mouth-breathers didn’t clog up the healthcare profession with our trivial problems.


An over-produced glossy six-color flyer shoved in every grad student’s mailbox (what? maybe 5000 of them?) the other day pointed out that over 30% of graduate students seek help for depression or stress-related syndromes. That makes sense to me; seems a little scant, frankly.

When I was a Biology grad student at U Penn, there came a point where my cohort suddenly looked across the lunchtime bitch-table at one another, and something in folks’ eyes made me call out, “Anybody not taking antidepressants here, now, raise your hand.” And we all sat there raising our eyebrows at each other. Not our hands.

I’m not depressed but merely stressed these days. I find I don’t get depressed much any more, perhaps because now I am old and like many old people I have much more rational first-hand experience of how much worse it can be. The inimical evil of the world, the relentless march towards the grave, &c &c. Sure there’s some stress, but… stress, well, that’s just an extra dose of cortisol and some insomnia. Everybody knows older people sleep less.

At any rate, I suspect the rate of pharmaceutically treated depression among the populace is relatively high. Every week get between three and five emails announcing “Take Time Off From Your Ph.D.!” and “Winding Down the Stress Levels” and “No, Really, Delayed Gratification is On Its Way To You Someday Real Soon Now, We Promise” meetings from the grad school HQ.

I am led to conclude that smart people probably get depressed more than dumb ones. Which makes a kind of sense, in hindsight. Right? Think of the savings that would result if we all sought treatment, and the accompanying productivity gains if smarties just stopped being depressed and stressed, stopped malingering. It would foster a new era of… well, something.

Medical breakthroughs, surely. Because smart people, they helped make medicine the revolutionary necessity it is today.


Obesity is rampant in America (including Canada and some US Protectorates, I ‘spect). We’re all gonna get vascular disease and diabetes. You’re a bad person if you don’t diligently exercise, eat reasonable amounts of bran and pomegranate and spelt wheat, and end up using valuable resources that could better be applied to help people who need it.

I am led to believe it’s a worse social sin for smart people to be overweight. Which makes a kind of sense. Because poor people are fat, and smart people aren’t poor. Right? (I’m still working on this one). But think of the savings if we all just took three hours a day and walked around in bright white shoes and officewear, and ate salad at the cafeteria—savings that would benefit the really sick.

That’s the feeling I got from my recent Health Maintenance Exam, at least. “When are you going to get in shape?” Because, my young man, we’re not going to wait for you much longer.


I am told that my generation (“13ers”, also known as Early-onset GenX Syndrome Sufferers) and those afterwards are prone to getting allergies and asthma and autoimmune diseases because we didn’t eat enough dirt when we were kids, and now it’s too late to eat dirt because our immune systems have learned incorrectly that (a) many important molecules in our bodies look something like the surfaces of Bad Microbes, and (b) the surfaces of many ubiquitous molecules on the surface of Regular Household Stuff (dogs, books, flowers) also bear a striking similarity to the surfaces of Bad Microbes, so (c) our noses are always running and we complain frequently of serious headaches, and therefore (d) we’ll need to take prophylactic antihistamines for the rest of our lives.

I bet the smart kids are more prone to allergies. Think of the stereotype: asthmatic, myopic dweebs. No dirt-eating at all as a kid = sickly and sniffly. Stereotypes, as it happens, don’t actually lie that often. Right? So as a parent you’re shirking if you don’t take your kids outside now and then and force-feed them some dirt.

And then spray them quickly with antibacterial soap.

Think of the savings &c &c.


And there’s statins. Wow. Biggest-selling pharmaceuticals in the world. We’re all much better for taking them. Think of the savings in the medical community that can be passed on to treat other, more serious pathological conditions. ‘Nuff said.


New-generation NSAIDs. Aspirin is dangerous; it might give you tummy troubles. Never take aspirin! We should all switch to newer NSAIDs, that are much better because they’re newer. Savings. Passed on. Think!

No seriously

Am I saying I think we’re a bunch of whiners? No. These are all real problems, especially the just plain constant pain one—my Mom suffers from terrible osteoarthritis, for instance, and NSAIDs give her the ability to walk around a bit. Depression sucks, is dangerous, is more terrible in a way than all the others, because you watch yourself being sick and unable to do anything about it. Heart disease, diabetes, sleeplessness, are all actual Bad Things. I’ve watched several people die badly from diabetes and its complications.

Nobody should suffer any of these problems or risks. Nobody anywhere. We are not—the sick ones—whiners.

Alas, we all do suffer these problems. If not these, then some other ones. Don’t get me started on cancer.

An underreported statistic I have not read lately, presented here as a reminder: nearly 100% of patients seeking medical treatment eventually die.

How can we stomach that? Why doesn’t anybody do something about it?!

What I’m prodding with my Short Stick here is something about our collective attitudes. Culture. Tacit assumptions, implicit understandings. I don’t know whose in particular. Doctors? Sure. They are, in general, ignorant overworked habitualists who have so little time to listen to details or think about consequences that they often as not end up mistreating their patients. That is, prescribing anything just to get the patients off their backs.

And the patients, well, they’re stuffed so full of risk aversion that they immediately seek advice and treatment and solace for any complaint, including (as noted in (2) above) over-complaining and Generalized Life Difficulty. They want surety, and feel betrayed when something goes wrong that isn’t immediately replaced or refunded under their implicit Warranty Service Agreement.

And then it hits me: This is how religions get started.

Look at it. Think about it.

We have the overwhelming desire for simple, effective solutions to ubiquitous problems. We have a harried special class, who by dint of historical contingency and a few early successes have become the class explicitly charged with providing solutions for those problems. But inevitably they’re unable to cope with the world’s diversity, entropy’s insidious creativity. So these people, they focus on low-hanging fruit, and increasingly point out how much more work they could get done if people just went through a few simple ritual moves: statins, CPAP machines, salad not fat, just plain aspirin is now Bad For You. And the observant populace, and the majority of the specialist priesthood, don’t have the time or inclination to actually think about what happens in the end. What happens to every solace-seeker, no matter what they try. They shunt old and sick people off to special temples, for preparatory purification ceremonies involving respiratory support.

Those sick folks, they’ve gone to A Better Place. Some lucky few come back, briefly, and tell thankful tales of the wonders.

But they always go back, in the end. Back to the place we don’t see them.

Religion is not a symptom of irrationality. Irrationality takes hold of all of us, no matter what. We are not rational beings. Indeed, the modern scientific atheist’s tendency to decry irrational religiosity so flies in the face of facts as to be reduced to an artistic act of Grand Irony. Prescriptivist Philosophy as Performance Art.

Religion is a robust cultural system, a cultural attractor that sucks in societies wholesale. Look at how far it’s progressed, in just the last 100 years or so. In the case of Medicine, I mean.

So many converts. So many ads in all the magazines. “Ask Your Doctor.”

It thrives because any priesthood inevitably fails when asked to work on the Really Hard Stuff. So it adapts by playing to our inherent pain-avoidance, trotting out the old favorite solutions of sequestration and denunciation of problematic facts, elision of complexity, denial of diversity.

Religion thrives because we are built to classify, but made to over-generalize.

Of course it’s more complicated than that.

But we don’t have time to go into that now.