Everyone has been trying to come up with a good nickname for the 10 years we’re concluding in December. Terror Era really sounds like too much of a downer. How about the Decade of Medical Backtracking?
Somewhere between the reports that Pap smears and tests for prostate cancer aren’t all they were cracked up to be and the news that a high fiber diet doesn’t do anything to prevent cancer, the health establishment began looking decidedly nonomniscient. Then recently, a United States government task force reported that most women don’t need annual mammograms.
Even more fascinating, they suggested that doctors stop telling their female patients to self-examine their breasts for lumps.
If you happen to be a woman, particularly a somewhat obsessive woman, this is huge news. The to-do list just got one item shorter. Now if dentists would just decide to withdraw the flossing directive, we may have enough additional spare time to learn a foreign language.
The task report didn’t say whether doctors should do the examinations themselves, but my general impression is that the United States Preventive Services Task Force feels that younger women should not let anybody near their breasts unless the plan is to have sex.
The report triggered two immediate and inevitable responses. Doctors and patients began an animated discussion. And Republicans declared it was all a Democratic plot.
“I mean, let the rationing begin. This is what happens when bureaucrats make your health care decisions,” said Representative David Camp, the ranking Republican on the House Ways and Means Committee.
Camp is definitely on to something. Whatever happens, Americans do not want the government conducting any studies on whether current health practices actually do any good. Let this continue and soon you will not be able to get your hands on a good leech when you need one.
There is no possible political advantage in coming out against medical testing, so the Obama administration scurried away from the report. The task force did not consider the matter of cost, but, of course, people like Camp depicted it as the first step toward rationing. The current position of the Republican Party seems to be that it is not possible to spend too much money on medicine. Party on.
(Has anybody noticed that the people who darkly warn about government bureaucrats forcing insurance companies to cut back Americans’ coverage appear to be the same ones who voted to force insurance companies to stop covering abortions? Where’s the sanctity of the marketplace when we really need it?)
Every rational American wants qualified experts to keep re-examining current medical practices. The only thing that bothers me about the mammogram report is all the emphasis on the “anxiety” that might follow a false-positive. Americans live in a time when we are constantly being reminded that a fellow plane passenger might be trying to smuggle explosives in his sneakers. We can manage anxiety.
I am going out on a limb to say that the real problem with a test that creates a lot of false-positive results is that it leads to a lot of other medical procedures, some involving hospitals. Unless you are genuinely sick, there is no more dangerous place to be than in a hospital.
I had breast cancer back in 2000, and I am trying to come up with a way that I can use that experience to shed some light on these new findings. I have never believed that everything happens for a reason. But I do feel very strongly that everything happens so that it can be turned into a column.
Whatever the moral would be, I don’t think it helps Camp’s argument. I had mammograms every year like clockwork, and I had just gotten a clean bill of health from my latest one when I found a lump on my left breast while watching a rerun of “Buffy the Vampire Slayer,” multitasker that I am.
It turned out to be cancer, of a fairly low-grade variety. My oncologist felt strongly that it never would have developed if I hadn’t taken estrogen replacement therapy — another one of the medical marvels that has now been consigned to the Seemed Like a Good Idea at the Time category.
So, in summary, the cutting-edge of medical thinking of the 1990s may have induced my cancer, and then the universally recommended testing protocol failed to detect it.
Nevertheless, everything seemed to work out fine, except that I had to have radiation while I was covering the Republican National Convention in Philadelphia. In retrospect, it is possible that my attitude toward the Bush-Cheney ticket was colored by the fact that I was thinking a lot about mortal danger at the time.