Henrietta Lacks. Her cells were massively important in the development of twentieth century medicine. You should read Skloot's book about her.

Almost without conscious thought, I have read three books in the last six months on medical history, all three enthralling, and with stunning casts of characters–doctors, researchers, patients, government and elected officials, journalists, insurance companies. We sit on the other end of the story, knowing what “happens” at the end of the sagas and what has evolved in the field of medicine and disease control, and this gives us an advantage on the people whose lives, discoveries, and decisions play out for us on the pages of history. We know which procedures will end badly, or which will prove miraculous cures, or which doctors and politicians will later be discredited or heralded as heroes.

It is almost the same way we look at medical practices now, imagining ourselves on the very cusp, the cutting edge of innovation, or medical breakthroughs, of cures and solutions without error. But we are humans, created procedures on solid research data, but apt to err all the same.  Shannon Brownlee, author of Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer, gets to just that point in how we view the medical field, some impenetrable, foolproof tower, and tribute to human medical achievement:

… We live in the age of science, after all. We think the difference between experimental and standard care is well-defined; that doctors adopt new medical advances on the basis of valid evidence; that new treatments represent improvement over the old. We look back at the history of medicine and its litter of discarded treatments with a sense of superiority, smug in our belief that superstition and ignorance have been banished from medicine. Until only a few generations ago, disease was thought to arise out of either an imbalance among the four humors or a contagion in the blood. Treatments were based on this faulty paradigm, and thus it seemed to follow, for example, that cutting a vein and letting the blood run out would rid the body of what ailed it and restore balance. Patients often did feel better after a bloodletting, or at least different, while the doctor could feel the satisfaction of having done what was right according to the prevailing conceptions of disease. We now know that bloodletting at best did nothing and at worst hastened death.

It is important, essential, to remember that we also lie within the timeline of medical history, as it unfolds and we learn more about disease, viruses, and the human body, and seek new methods of treating all three. The stories behind how we’ve gotten where we are now humble me, remind me of our fragility, our hubris, our good intentions–and not in an all-bad or all-good way. Modern medicine has improved our lives, given us the tools we need to protect ourselves from the things we can, saved the life of at least one person you know, and probably more than one.

Alleged "Patient Zero" Canada Air flight attendant Gaëtan Dugas, who is a complex and defiant character in Shilts's book.

Our medical past certainly belies the mistakes and hardships that can occur no matter how “developed” and wealthy a society may be. And it is good to be aware of our humanity, and our mistakes, so that we don’t go thinking too much of ourselves. We’re far from the end of the tale of human medical science and discovery.

Reading list:

Rebecca Skloot, The Immortal Life of Henrietta Lacks

Randy Shilts, And The Band Played On: Politics, People, and the AIDS Epidemic

Shannon Brownlee, Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer

Also, read a blog post about so-called “Patient Zero” of AIDS, Gaetan Dugas: “We all know the plague is coming”

The Women’s Health Initiative, which has been researching and publishing findings on women’s health since 1991, has recently come out with some new results, involving the doses of estrogen and progestin that women who are menopausal should take in order to maintain healthy hormone levels–and so reduce risks of things like breast cancer and strokes. But the study, over the years, has had the additional effect of leaving women often confused or cynical about what it all means, what is good or bad for them.

The short answer, as a recent New York Times report suggests, is that–shocker–every woman will respond to certain doses and combinations of hormones differently. The study has not been a bad thing, and we have learned much about mid-life women’s health than we did before it began, when women of all ages were prescribed all kinds of doses in the 1980s.

The real crux of the article, for me, highlighted what I think is the much deeper problem than thinking of ways to lower our risks for certain conditions: we turn too quickly to a pill that we hope shall fix it all. Andrea Z. LaCroix, who is quoted below, is the lead author on the Journal of the American Medical Association study and a professor of epidemiology at the Fred Hutchinson Cancer Research Center in Seattle.

The fact that women are frustrated by the twists and turns the study has taken, and possibly more skeptical about the drug industry, may be a good thing, said Dr. LaCroix.

“If women are more skeptical then I think that’s a good outcome,” said Dr. LaCroix. “We have a history in our country of wanting to believe that if we take a pill, we can prevent bad things from happening to us, and wanting to take those pills before the evidence comes in.”

The most compelling lesson of the research should be that science is always worth the wait. Consumers should insist that doctors make recommendations based on scientific evidence, say investigators, rather than allowing drug companies or marketing hype to dictate patients’ health care choices.

Couldn’t have said that better, myself. Something I continually find interesting and worthy of some serious discussion in the United States. So I needed to share. Let’s consider medical research and new drugs as absolutely worthy investments of our scientific talents, and use them to do amazing things to help people who have ailments and diseases. But let’s approach new treatments with sounds minds, patience in allowing the drug testing time, and a proper mindset that no medication is a miracle drug on its own, right out of the box. Most of all, let us not get bedazzled by the marketing and media streams that sell drugs to consumers as though they are coffee pots or lawn mowers or a new haircut. The whole industry of drug marketing is pretty appalling.

So it it great to hear that medical studies and drug research results actually bring us pause, make us skeptical. That is crucial.

So why have I had this change of heart, this embracing of dental floss? It took being ripped off to show me.

When I studied in China, I could not wait to get home and have my teeth cleaned. For some reason, I just felt so transient, and having so few things with me, my teeth were on the back burner. I made sure my mom had scheduled an appointment back home, for the first available date. That was July 2007, and that was the last time I had been.

In the developed world, teeth cleaning is normally an every-six-months check-up. This ensures that hard plaque doesn’t build up to much and allows the dentist to monitor the health of gums and teeth, since many dentistry procedures can be avoided altogether later in life by simple good maintenance. I understand all that, and finally decided it was time to get established with a dentist in the Kennesaw area (instead of trekking to Dublin to see my parents’ dentist); I made an appointment for March 27, just about one month ago, at a place nearby that took our insurance (apparently).

Almost two hours after I sat down in the exam chair, I got out of the chair without a cleaning. The doctor and his assistant poked my teeth in this newer process they do nowadays where they measure the millimeters deep a metal poker can be poked, thus determining whether you have periodontal disease. I had never heard of this apparently horrible disease. And I, also apparently, had “early” stages of periodontal disease.

I don’t consider myself unwise to health concerns, and I believe I take relatively good care of myself. Like my mom said, too, it had only been two years, not a decade; her first visit to the dentist was when she married my dad at age 19– and she does not have major teeth-health issues. So I was slightly offended and very skeptical when the assistant proceeded to show me this scrapbook they had assembled with photos of the horrible things that can go wrong with your teeth. You know the kind– those fright-inducing photos doctors place strategically around their offices to let customers– I mean patients– memorize the blood and ooze until they’re scared enough to hand over money to get whatever procedures are needed to keep the disease at bay. She wouldn’t even show me the whole book, just the parts closest to my current “condition,” because, to use her words, “They’re just too bad.”

The office would not give me a cleaning because I needed to have this “deep cleaning” instead– a more intense process that my insurance would not cover. Also, I had two cavities, and the doctor recommended that I have the tooth-colored filling instead of the silver fillings that my insurance covers. I asked if I could please opt for the silver-colored ones, because I knew from previous experience that these were fine, and covered fully. Nope, that is not what the doctor recommended. (Ok, but it is a filling, and it is my tooth. Whatever.) Oh, and after the “deep cleaning,” I will need to come back every three months to make sure my disease has not worsened, and each time there will be an additional fee. I leave with an estimate for procedures that I “need,” an estimate of over $500 in charges that my insurance won’t cover.

Now, I am a reasonable person. I listen to what intelligent doctors have to say, and usually, I think the advice is sound. But let’s be honest– I am a young adult, therefore age is not against me yet. Low risk. I brush my teeth regularly, and I live in developed country– meaning I’ve had my teeth cleaned dozens of times more than most of the people on this planet. I think–I think–I will make it through this devastating condition that is going to cost me (and my family) hundreds of dollars. In my head, I’m thinking, yeah, right, count me out of this. I’m going to go home, start brushing my teeth longer, using mouthwash at least once a day, and floss each night. I’d start my own little daily regiment, and take this into my own hands. Practical advice is the better path, I think, but the answer is do-it-yourself health care, with minimal cost and a simple trip to the drug store on my part. Practical advice would not make the doctor’s office an extra $500– that is the truth of this picture, and that is a horrible shame.

Fast forward one month, and I have successfully been performing my regiment morning and night. April 24 I head to a different doctor’s office, one my mom found online after we both expressed concern with the business practices of the previous scare-tactic dentist. I feel good about my teeth, and have not even had any pain in one particular back tooth that had been hurting whenever I would eat sugar (I attribute this pain going away to my own enhanced teeth-cleaning). When I sit down in the chair, the assistant tells me that I have very little hard plaque to scrape off, and all my millimeter readings (for that periodontal nightmare) are 1′s, 2′s, and 3′s all the way around my mouth (at the other dentist I had had some “bad zone” 4′s and 5′s). She does a normal, insurance-covered cleaning. Then, she and the dentist both commend me on my exceptionally clean teeth. They did not say anything about having one single cavity.

I left the office thinking about the stark contrast between these two experiences; could I really have reversed that much tooth damage in one month? Either this is a miracle in tooth recovery, and flossing is really all it is cracked up to be, or I was about to be scammed big-time by that first dentist. I was basically awestruck. I think perhaps that first practice is really out to get anyone who may be marginally “in danger” of early periodontal, or has sort-of-unclean teeth, to milk every dollar out of an unknowing patient that they possibly can. I knew when I left that day that a few months could have fixed up some of the issues I had. I mean, it had been a long time since I’d had my teeth cleaned at a dentist’s office. Cut me some slack. Give some practical advice, clean my teeth, hand me some floss, charge my insurance company, and I’m happy. Try to trip me off, and I’ll tell the internet all about it.

(By the way, when I went to their office to pick up my x-rays to bring to my New Dentist, the desk attendent tried to charge me a $25 fee per x-ray, with a 48-hour minimum “process” period. I told her that one x-ray series hadn’t even been taken at their office, and so I would like to have that one. She handed it over. The other one shall forever remain in the files of Great Expressions, Inc offices.)