Some weeks ago I and a number of colleagues braved the frigid temperatures and icy winds of the early January Berkshires to venture out for dinner. On the way back, the relative silence inside the thankfully warm, dark vehicle heightened our senses and was, in time, interrupted: a cough here, a sniff there, and the fateful question was finally asked: “Are you sick?”
A hand of ailment poker was thus dealt.
“Well, I’ve had this cold on and off for a few weeks…”
“I hate that. I get this cough periodically, and it either ends in a cold or the flu…”
“I tend to get a sore throat at the beginning of the season, but at the end I get hives…”
“You have that too? That used to happen to me, except now my sinuses get infected…”
Within five minutes, everyone in the car had shared, and lamented, their personal health woes: all acute and relatively minor, but in exquisite and passionate detail. Sneezing, sore throats, a bad back here, a neck pain there. Occasional indigestion, periodic headaches, temporary insomnia, the list went on.
My mind drifted to thoughts of my grandfather, who’d spent the earliest portion of his life on an island off the coasts of Germany and Denmark. Although he eventually came to the United States, lived through the Great Depression, started a family and started a successful business, many of the trappings of the old country (and his Viking heritage) stayed with him.
He did all of his own dental work, which amounted to disappearing into the basement with a pair of pliers and a handful of napkins periodically. Once, after a small accident with a drill (which undoubtedly required a few stitches), he wordlessly poured alcohol on the wound, bandaged it up, and never said a further word about it.
He’d also, in his early 70s, been essentially dying of cancer before finally going to see a doctor at the prompting of friends and family. Making a full recovery he wound up living another sixteen years in complete remission. And he never once, in the nearly thirty years that I knew him, complained about a cold, an ache, a pain, or any other physical problem.
I think of this nonjudgmentally when a discussion about competing sicknesses is joined, or when I see commercials offering treatment for “restless leg syndrome” (allegedly afflicting some 12 million Americans), “extreme exam anxiety” (for which at least one school will now ease graduation requirements in light of), or “adrenal fatigue”.
How did we - not just Americans, but most people in the world - become serial, enthusiastic whiners? It seems to have happened in one or two generations. I’ve asked others and they have confirmed the same. Their older relatives never complained; we complain about everything.
I suspect that the explanation is straightforward. At the time that many of our grandparents (I speak, here, as a Generation Xer) were in their youth and young adulthood, especially if they were living abroad, medical choices were extremely limited. There were medications, of course, but they were understandably limited in availability and scope. Stoicism wasn’t a choice: it was an inevitable consequence of the exigent conditions of life at the time.
We, today, are certainly weaker than them in some ways, although I tend to think of our increased sensitivity to ill-health as a hard-won, arguably splendid state of affairs. We live so insulated from the awful, debilitating diseases and conditions of our forebears and their communities that we expect to spend the majority of our lives in a state of well-being.
Waves of innovation in vaccines from the ‘40s through the ‘80s, the vast expansion of over-the-counter products, the proliferation of walk-in clinics, telemedicine, WebMD, have all resulted in a largely healthy (setting aside obesity), readily carping population.
Medicalization – the process by which health conditions come to be seen as medical issues and treated accordingly – is an inevitable byproduct of markets for medicine. And it has been unjustly pilloried. On one hand, it has undeniably led to disease mongering; but it has also led to such conditions as infertility and mental illness – once, simply accepted as an unfortunate but unavoidable part of life – being treatable for many sufferers. And even if untreatable, often the solace of understanding gives some degree of relief or context to the afflicted. An often overlooked factor is that markets have also assisted in the facilitation of demedicalization, such as for home childbirth options and physical therapy.
Like poverty, perennial illness is the default state of mankind. Markets have put human beings at the center of a dense web of affordable, effective choices to meet our needs and desires: those relating to our health are no exception. As a consequence, physical problems which can’t be addressed quickly or with full efficacy tends to prompt some degree of disappointment.
For our grandparents and forefathers more broadly, there was simply no reason to complain, because there was little that could be done: discomfort and pain were as much a part of life as anything else.
The basis of our complaints about a sniffle here or a cold there have far more to do with expectations arising from rapid progress than physical frailty. Neither am I here to lament this change of personal verbal habit. To want more, to expect something better, to feel dissatisfaction with the present state of affairs and long for something better, to enunciate that expectation to our friends, is the driving force of progress. More even: it is evidence of progress.
If we do things right, our children and future generations will have reason to fuss more and more about smaller and smaller afflictions.