Medical muddle


BOSTON -- I kind of miss seeing Dorothy Hamill glide across the surface of those Vioxx commercials on her silver blades. The Olympic gold medal winner reminded me of the old joke about the man who asks his surgeon if he'll be able to play the piano after the operation. When the doctor says yes, the man says, "That's funny, I couldn't play it before."

I never got beyond a figure eight in my local rink. But I began to have a fantasy that if I popped a couple of Vioxx I could finally do a triple lutz before I got on Medicare.

This heart's desire collapsed when the drug to relieve arthritis was found to increase the risk of heart problems. Vioxx could give you pain relief without ulcers, but you might have a heart attack, and you could get an ulcer just worrying about that.

So Vioxx went off the market and Ms. Hamill went off the air. Celebrex pulled its ads, and the enthusiasm for all the Cox-2 inhibitors was, well, inhibited.

But did you notice the next wave of research saying that Vioxx reduced polyps that could lead to colon cancer? Then last week, yet another study said the protein CRP was worse for heart disease than cholesterol. Guess which drugs lower your CRP? You got it. Cox-2 inhibitors.

What we have seen is the medical equivalent of a triple axel. Medical researchers take off on one foot, do three complete 360-degree swirls and land on the other foot, without ever falling on the ice.

It's not the first time I have watched this feat performed. Nor is it the first time I've seen a drug with a split personality.

I have been something of a connoisseur of the medical good/bad news. I have a collection of studies showing how alcohol may increase the risk of breast cancer and decrease heart disease and how running may be good for your lungs and bad for your shins. Not to mention why worrying about all this raises your stress level, which is bad for your everything.

I started as an observer of the raging hormonal imbalance. The early research promised that hormones would virtually eliminate symptoms of age. Then along came the updated research suggesting they might simply eliminate old age -- by strokes and heart attacks.

By now I have spent years skating ahead of the cracking ice of science.

Of course, I try to look at the sunny side of this, although everyone knows that sun gives you skin cancer. But maybe shade gives you cancer. The most up-to-date reports send off the alarm that Americans are suffering from a national deficiency of vitamin D, which ups the odds on the Big C. Of course, they say if you don't want to sun yourself, you can feed yourself vitamin D from three of four servings of salmon a week. Except for the warnings of other researchers that farmed salmon has PCBs that also give you cancer.

Of course, the true health culprit is still smoking, but the latest battery of statisticians believes that we have traded Virginia Slims for national obesity. Meanwhile, the anxious attention to obesity has up-ticked so far that it should prompt you to go on a diet. Except for the studies this month showing that none of the commercial diet programs works very well.

You will not be surprised to know that I have developed a theory about the good, the bad and the unintended consequences. I suspect that it's a direct side effect of an age of specialization. One scientist goes off looking for a cure for the hip bone forgetting that it's attached to the thigh bone. The cardiologists don't dance with the orthopedists, and nobody talks to the neurologists.

We, the sole owners of used bodies, are the last living generalists. We are left to supervise our own personal risk assessment plans, balancing every ulcer and polyp, while we overdose on this week's information that may be next week's misinformation.

All this should lead you to pray for guidance. But beware of where you're praying. The very latest bulletin from the Netherlands suggests that church may be good for your soul but bad for your lungs. All those candles and incense? They produce air pollution, which means that, yes, fellow sufferers, even church can give you cancer.

Ellen Goodman is a columnist for The Boston Globe. Her column appears Mondays and Thursdays in The Sun.

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