diseased discourses

I’ve never been a fan of the quick fix. The consequences of major surgery undergone in my teens taught me to distrust most doctors, while chasing instant gratification left me with regrets in the form of hangovers, STDs, acute psychoses etc. So I had the sense to say no thanks to the first book deal that came my way when the publisher wouldn’t negotiate a fair contract.

Predictably, his press didn’t last long. Yet I remain (aside from a few short stories) unpublished, partly because I’ve failed to grow a social media profile (due to the tedium of engaging with virtual strangers who display the attention span of a fruit fly and often less independence) – and in the context of today’s increasingly virtual world, a distaste for self-promotion borders on a disorder.

A reader and writer of fiction, I recognise the power of story. Whether it’s true or false is irrelevant. As our fake-news pandemic has emphasised, all narratives – even those of, say, science and medicine – contain fictive elements.

Osteoporosis is one of those diagnoses that need no translation from the Latin: porous bones. It’s self-explanatory. Styled as a disease by Western medicine in cahoots with Big Pharma, it’s a common corollary of ageing in our culture. And if it’s never been more prevalent than at this time on the planet, we can thank the rise of BMD (bone mineral densitometry) scanners.

Bones lose density as we age. So the longer we live, the lighter they get. And the work of reading and writing (which some of us do full-time) doesn’t help: bearing weight – e.g., chopping wood and carrying water – slows down the process, while exposure to sunlight enables Vitamin D production, without which bones can’t absorb calcium, even if dietary intake is ample. Other risk factors include smoking and boozing. And if a sedentary lifestyle gives bones less to do, their progressive loss of substance seems natural enough. Yet most health professionals fixate on scores if you sustain a fracture, and suddenly you’re objectified, reduced to an abstraction.

The digital graphic precision of high-tech medical imaging has displaced the subtler human imagination, making healing, such as it is, reliant on passive compliance with advice informed by statistics. Are there any alternatives to taking medication? I asked my GP as she prepared to write a prescription. Weight training, she conceded. But lifting a weight might break your wrist. I’m on par with the worst of the 90-somethings, she told me. She hadn’t seen me smashing up furniture to load a 10-cubic-meter skip to capacity, or supporting my weight with my hands while balanced on top of a ladder (as you do when clearing out a house and moving in to a flat).

But my GP was in essence telling me not to trust myself, while dismissing the risks of a drug that comes with a list of dire side effects: a legal requirement of marketing, and fleshed out by countless horror stories on forums, a source of information she ignores. Most people don’t get any, she said with an edge of impatience. You didn’t get any from the flu shot, she added irrationally (I don’t need a med degree to know that comparing a vaccine to a drug that blocks bone cell resorption = a category mistake). You didn’t get any from taking zinc, she continued – another crackpot comparison. But if I did get side effects from the alendronate, she assured me, we could try an intravenous infusion, which lasts for a year. I needed more facts, but Big Pharma had funded all the studies I could find online.

In his magisterial magnum opus, The Master and His Emissary: The Divided Brain and the Making of the Western World, Iain McGilchrist, a shrink who used to teach literature, argues that modernity, characterised by our alienation from spirit and nature and the attendant loss of meaning, reflects a left-brain bias run riot – also true of schizophrenia. And he makes a convincing case for the schizophrenic mindset of Western medicine.

If I could take alendronate for five years, said my GP (not adding that to take it for longer can promote ‘atypical femoral fractures’), we should be able to nudge my BMD a few points up the scale. And this focus solely on numerical values (to the exclusion of others that might account for all my falls that haven’t caused fractures, which my GP calls ‘luck’) exemplifies our culture’s left hemisphere emphasis.

Would higher BMD scores on my next DEXA scan results help to alleviate her guilt? She’s never accepted responsibility, but a blood test I had in 2010 showed elevated levels of ‘activated’ Vitamin D, and she said my body was making so much, despite my avoidance of sun, that any more could make me sick: advice I took until, seven years later, a car slammed into my knee, and the ER X-rays showed porous bone.

Meanwhile, a blood test showed severe Vitamin D depletion. Too late, I retrieved my old test results and read the fine print, which said: ‘The 1,25–Dihydroxy Vitamin D assay is not useful for detecting Vitamin D deficiency, as levels may be normal or even elevated as a result of secondary hyperparathyroidism.’ And one of the most common causes of the latter is Vitamin D deficiency. How did my GP miss what Dr Google knew? Too late, I’ve lost trust in her clinical opinions.

And I’ve long since lost what trust I had in the publishing industry. I used to think that if I took its advice – via how-to books, peer feedback and a degree in creative writing – my work would naturally get accepted. But as publishing houses spawn ever more half-baked books lacking substance let alone editing, inspired by accelerated semiliterate online culture, I’m going feral, subverting realist conventions (‘show, don’t tell’, anyone?); letting narratives grow organically instead of plotting and planning.

So, would an infusion of identity politics rescue my voice from obsolescence? Or do I need to cultivate a following on, say, Instagram? Who wants to read fiction in which the protagonists don’t conform to categories or tick the diversity boxes that might align them with a high-profile cause? Like my fiction, I’m someone who’s fallen through the cracks, defied statistics, and never known how to fit in. And, unlike creative writing techniques, some skills may not be teachable.

Why opt to do a one-hour workout with weights every second day, when I could just pop a cheap, convenient pill once a week? That more money went into marketing than researching that pill seems like a good reason. And that, as an author, I’m meant to spend more time selling myself than writing (flattening content, kissing depth goodbye) also seems symptomatic of capitalism.

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2 Responses to diseased discourses

  1. …as always I love your honest, intelligent writing and sharing about this ‘stuff’. It’s a quagmire with Big Pharma and you send out a lifeline to those that wish to think about it. “Styled as a disease”…my brain is pinging! Thank you!
    (I am inspired to read more into Ian McGilchrist)

  2. Been there. We have ‘advanced’ so far in medicine yet it has also become so intrusive requiring tests, retests, further investigations and follow ups, as well as being part of multiple research programs for new products… all of which seems to exponentially increase with age. In the end time is filled with just doctors appointments and tests. I look at my parents who died in their 90’s and survived mainly with the help of bp pills and vitamins (plus pain relief for a disintegrating back in one case, and repair of a broken hip in the late 80’s in the other…and their parents = even less. I have decided to try and go down a similar path and have put an end to most intervention and follow up tests unless life threatening or emergency…and see how that goes. Just got sick of the carousel. May not work…but, hey, I’m no longer on the up curve of the graph.

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