Side Effects: A Cultural Shell Game?

According to a FDA study, 100,000 people die annually in the US from drugs that are properly prescribed and taken as directed. The third leading cause of death in this country after heart disease and cancer is undergoing a medical procedure. So why do we keep buying these drugs–and buying into elective medical procedures in growing numbers?

We seem to be caught up in a shell game: you know, where the carnival huckster does something flamboyant with the left hand so that his audience misses what he is hiding with his right one. That’s the kind of sleight of hand in pharmaceutical ads, according to Melody Petersen, author of Our Daily Meds. Such ads depict a “Disneyland” atmosphere in which an arthritic person (or an unhappy or an incontinent one) transforms before our eyes into a tango-dancer as a result of swallowing a pill.

With their attention diverted to the magic, viewers ignore the voice-over that hastens through the list of side effects that include “in rare cases, death”. A study co-sponsored by the FDA found that nearly 50 million people responded to pharmaceutical ads by requesting the named drug from their physician.

This selling technique not only works, but works spectacularly–and as a result large pharmaceutical companies have recently shifted their major investment from research to marketing. Today almost 65 per cent of the US population is taking physician-prescribed drugs.I’m sure that the 470 who committed suicide after taking a drug for urinary incontinence might have thought twice about swallowing it had they been told in a more sober atmosphere that the side effects of this drug included severe anxiety, depression and mental disorientation.

A number of modern drugs, including the ones implicated in the suicides, mimic Alzheimer’s-like symptoms. Petersen notes that thirty per cent of those recently diagnosed with Alzheimer’s were taking drugs that were likely responsible for their symptoms. However, instead of stopping these drugs, their doctors characteristically give them others.

If drugs cause a problem, it’s because we haven’t taken enough of them?

If we want to become those happy people depicted in the drug commercials, we’ve got to risk a dollop of death as a side effect?

Evidently we’re supposed to swallow this line along with our drugs and risk our death—or someone else’s–in the process. This is not only the kind of thinking that sells us drugs; it’s also the kind of thinking that sold us the war in Iraq. In fact it’s the kind of thinking that has gotten industrialized countries into similar problems all over the globe, as Naomi Klein points out in her book on “disaster capitalism”. A disaster is an excellent distraction: a perfect way to get people to accept what they wouldn’t normally accept.

President Bush played this game when he used the grief and fear generated by the September attacks to justify his war. One side effect– “collateral damage” it’s called when it happens in war– is the somewhere between ninety thousand and one million civilian casualties. A pretty broad range, but we don’t keep good data on side effects. We do know, however, that the tally of the dead from this war has surpassed the number of those who died under Hussein.

Like “friendly fire”, the Bush administration tells us we must accept such “collateral damage”. We only swallowed the bitter war pill because our eyes were fixed on vaporous “weapons of mass destruction” (a carnival trick if ever there was one). Absent that, we might have considered whether bombing their children would convince anyone to follow our way of life.

Meanwhile, there was money to be made by the contractors who sold substandard supplies to outfit our soldiers at exorbitant rates– including contractors related to the business interests of our current vice-president. But we weren’t looking at that. In fact, we still aren’t. Even though we now know George Bush was well aware there were never any weapons of mass destruction in Iraq, he is still president and Cheney is still vice-president.

TV networks such as Fox who helped engineer the shell game in this instance are implicated in this tragedy. But much as I’d like to blame them– and in spite of their cynical agreement with their advertisers not to show body bags (it seems it dampens the urge to buy things), I can’t make them wholly responsible.

If our cultural tendencies didn’t prime us for the shell game, we wouldn’t be taken in by it. But it’s the way we’ve been thinking since we “settled” this country and used the rubric of Manifest Destiny to “civilize” indigenous people by devastating them– a bit of a side effect that might have caused us to re-evaluate our actions had we focused our attention in that direction.

We are no longer living in those times, but we ought to learn something from history. What we ignore in the shell game doesn’t go away–its costs just surprise us when they come due.

We are still holding on to ideological bulldozers– and technological ones. We bulldoze our landscape to “develop” it, neglecting side effects on storm water systems, soil quality, fire and slide dangers and aesthetics—not to mention habitat loss for uncounted species. The price of one such side effect is $250,000 per tree cut down in the process. That is the recent Forest Service valuation of the ecosystem services of a standard urban tree during its life cycle.

I can’t imagine what the price would be for pesticide to spray a residential lawn if we counted the side effects involved. Some of those can’t be priced, like the autism resulting from exposure to chemically fixed pyrethrum. This side effect isn’t very surprising. The drug is, after all, a nerve toxin–and one specifically engineered to persist in the environment, unlike its botanical counterpart. Mercury still used as preservative in certain vaccines is also a neural toxin: but is only now coming into public disrepute for its own connection to our rising autism rates.

We saw only vanished insects and vanquished disease as we went “full steam ahead”, but our children pay the price for this negligence.

There is a tale from ancient India that relates how a do-gooder, in his single-minded attempt to control an inconvenience in nature, creates a drought that empties the entire world of water.

Modern Westerners still haven’t learned the lesson in this tale. We might mean to do well: to alleviate suffering or terrorism—or weeds and fleas. (Eliminating other peoples is something else again). But if we look for quick fixes, ignoring the complex results of our actions, we might as well hand over our money and our lives to the hucksters now and eliminate the suspense as to how things will turn out.

You are always welcome to link to this post. Note, however, it is copyright 2008, by Madronna Holden, and if you wish to copy it, please email for permission. Thanks.