Jewish World Review June 4, 2004 / 14 Sivan 5764
Drs. Michael A. Glueck & Robert J. Cihak
It's A Medical Life I Remember Yesterday
While making the coffee-pastry rounds in Orange County, Calif., the one
nagging complaint I hear is, "What do we do with all the new pills the drug
companies throw at us hourly on TV - while simultaneously trying to deal
with the medical profession's constantly juggling and lowering of the
normal lab values?"
Actually we ponder the same questions. Here is our lament.
"Yesterday. All my troubles seemed so far away. I remember yesterday.
Suddenly I'm not half the man I used to be.There's a shadow hanging over
me. Oh, yesterday came suddenly." Yesterday I was healthy. Then they went
and changed all the laboratory values for normal. Now overnight I am really
My blood pressure is now abnormally high (just above the now normal
120/80). So is my cholesterol (just above 200). And this week my prostatic
antigen (PSA) is suddenly considered elevated by a lead original scientific
The New England Journal of Medicine, the self proclaimed Medical New York
Times and journal of record, writes that yesterday's normal PSA of 4ng./ml.
may be too high. You see the PSA ain't all that accurate as they once told
us. There are some prostate cancers in the previous normal PSA range.
To make it just a little more confusing, annoying and uncomfortable - the
worst kind of cancers don't produce high levels of PSA! Perhaps all men
with a PSA of 2.5 or over should have their prostates biopsied! Yikes. Just
the thought of all us older men with a value over 2.5 getting nine needle
core biopsies will get us depressed.
With depression comes medication and sexual dysfunction. Now we can cure
the latter with Viagra, Levitra and Cialis. The latter is so effective that
a current TV ad with a glamorous model wife reminds all of us - somewhat
gleefully - that sometimes erections will last four hours and require
emergency room intervention and treatment. The ad doesn't tell us if that
is for him or her!
To look younger and feel better about myself I can take Propecia and maybe
get a thick full head of hair. The problem again is that of severe sexual
side-effects. So now I look good but can't give a "quality' performance.
Or I can dye my hair but that can lead to bladder cancer or multiple
myeloma. I can shampoo the color out in a few months but just last week
learned that ingredients in shampoo like formaldehyde can cause cancer in
Shampoo may contain sodium laurel sulphates and propylene glycol which are
harmful to health. Sodium Laurel sulphate foams readily, making the shampoo
or gel thicker and therefore seem richer. Sodium laureth sulphate is a less
harmful form, but both damage hair follicles and cause hair loss. I guess
clean really isn't all that religious after all.
I can increase my memory a little with the proper chemical but I forgot to
take the tiny little pill last week and now can't remember its generic name
to re-order it.
Now the one drug many would like for their senior severe arthritic years -
pain medications - we can't get because the government has decided to put
physicians in jail for legally prescribing them.
So now I am medically sick by computer algorithm. They want us all to live
and die in perfect electrolyte, laboratory and chemical balance. It doesn't
matter that half my friends and their wives walk around like zombies
half-asleep. Calculate the permutations and calculations of side-effects
for a dozen medications and you'll figure out why.
Of course all this runs counter-current to rising medical costs, the number
of uninsured at 42-46 million, and a rising and older sicker population.
The politicians will go crazy - but we don't need to talk about that now.
The medical profession, drug companies and advertisers need to get ahold of
themselves. Some perspective - please! In medicine these days, as in
politics, their false utopia beats my reality any day.
In response to all this I may need to start anti-depressive therapy which
will increase my chances of happiness but with the side effects of
somnolence or suicide. Why can't we in medicine just "Let it be, let it be.
Shine on 'til tomorrow. Let it be, let it be."
All this stuff will be rewritten in seven years anyway. So find a
well-trained family physician or internist you trust and talk it over and
reach some type of reality based approach. Or we could solve the problem
with a "Life with Dignity" Act.
Til then. Good night moon. I remember yesterday - but not so well.
Editor's Note: Michael Arnold Glueck, M.D. wrote this week's column.
Michael Arnold Glueck, M.D., is a multiple award winning writer who comments
on medical-legal issues. Robert J. Cihak, M.D., is a Discovery Institute
Senior Fellow and a past president of the Association of American Physicians
and Surgeons. Both JWR contributors are Harvard trained diagnostic radiologists.
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