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The Medicalization of Life

At a recent ocean side getaway with friends, one couple brought along their dog. When I remarked on its laid back demeanor, they said he was on Prozac.

I shouldn't have been surprised. We seek medical solutions to every conceivable disorder of human behavior - why not pets as well?

The so-called "medicalization" of life - the reduction of every condition or behavior to a standardized diagnosis and treatment by a licensed medical professional - is becoming the dominant paradigm of health in the twenty-first century, and is the chief reason economists confidently forecast a $3.4 trillion health care industry - 18.4 percent of GDP - in 2013.

We are no longer satisfied with medical interventions for the repair of serious mental and physical problems, but now look to the breathtaking vistas of medical technology to enhance performance, skills and appearance on demand, and to increase our capacity for the consumption of an "active lifestyle."

Even the consumer-driven "wellness revolution" is destined to be absorbed into the medical model, as more "natural" products and treatments are reconfigured as scientifically verifiable biological algorithms under the dominion of trained professionals certified to help people achieve "positive well-being and control" in their lives.

The idea that one might actually reach 80 years old and think it was perfectly okay not to have sex is considered quaint and even pathologic in some circles, now that you can pop a pill and be good to go for thirty-six hours.

The view that aging is natural, that all things eventually run down, and that you can have a bum hip and still get some pleasure out of life is fast becoming an anachronism in a time when science and technology promise to make all things possible, and aging is a disease to be "conquered."

From the Enlightenment, we inherited the right to pursue happiness. From the medicalization of human life, we will inherit the right - the demand - to actually achieve it.

What are the consequences of all this? Here is one slightly skewed list of prognostications:

• We will need to rewrite the Hippocratic Oath. The intention expressed in the declaration, "I come for the benefit of the sick," will be changed to "I come for the benefit of the imperfect." The definition of sickness will encompass ever smaller standard deviations from the norm of absolute physical, mental, aesthetic, social and cultural perfection. Today we are born well and occasionally get sick. Tomorrow we will be born sick and need constant professional services to get well.
  
  
• As perfection takes hold, all physical and mental phenomena will be classified as "disorders." The ICD-9, DSM-IV and other diagnostic classification schemes will expand exponentially. Issues of ethics, morality and values will be redefined in the biological reductionist model. If you want to know the meaning of life, you'll have to ask a doctor.
  
  
• The explosion of medical knowledge, technology and classification systems will require a new professional organization to represent the convergence and integration of the system's disparate components: Consumers, Regulators, Administrators, Providers - or CRAP for short.
  
  
• Common sense will become extinct because of lack of use. We will trust self-knowledge and experience less, and programs, technical routines, certified knowledge and experts more. When you're at a dinner party and say, "It's only common sense," people will have no idea what you're talking about.

In the future there will be few practical consequences arising from distinctions between major depression and occasional melancholia, children with serious attention disorders and those with high spirits, people who are extremely short and those who want to be more competitive basketball players, the grossly obese and the neurotically overweight. Simply being well won't cut it. In the words of one observer, we want to be "better than well." We will all need help.

What the medicalization of life will mean for our definition of ourselves as human beings in a finite and temporal world is anybody's guess. Most people probably won't give it much thought one way or the other. We have always wanted to be as gods. We might as well get on with it.

Others may be like my father who, his body crippled with advanced rheumatoid arthritis, used to sit in the car and read the Talmud and essays by Thomas Merton while my mother went grocery shopping. He eschewed most modern medical treatments and preferred the clarity of pain to the fog of medication. His body a full five inches shorter at the time of his death, he referred to himself as the incredible shrinking man, and kept his sense of humor and perspective intact to the end. Shortly before he passed away, his last words to one of his grandchildren was, "Adios, Zorro."

I don't imagine many will follow his example, however. He was well even when he was sick. In the future, most people won't know the difference.