Stepping from the shower the other morning, I had the chance to glance sideways at the mirror and confirm anew what had been true for some time: the topography had shifted somewhat, a good bit of it moving southward, and under the 66-year-old forest hiding my chest, an obvious protrusion of manopoausal globes indicated that I might soon need female lingerie for support.
I wondered for a while about genetics, or whether I had seen too many Dustin Hoffman and Tony Curtis films, and, of course, I thought about the residue of the myriad drugs (oh, those birth control pills) that we now unwittingly ingest in our drinking water. I had read about some fish changing sex simply by living in such chemical-laden water and concluded that pharmaceutical drugs, no matter how helpful, involve significant tradeoffs and, at worst, are toxic time bombs.
All this ruminating becomes seriously focused during the 6:30 network news broadcasts each weekday in the United States. Like all television, from the Super Bowl to The Sopranos, TV shows are mere vehicles to pitch products. In the free market, the higher the ratings and the more valuable the airtime, the better the product does.
But these concurrent newscasts, differentiated only by dissimilar anchors, provide eerily similar stories and sound bites, always bringing bad news from Iraq, reports of president George W. Bush under siege in Washington, the latest in domestic carnage (hurricanes, floods, tornadoes), and the controversy surrounding immigration policy, health care and racial profiling. Political leaders seem helpless to do anything about any of these problems.
The newscasts pretend to compete, but they don't. They are carbon copies of one another: they cover the exact same stories with minimal differentiating spin; they break for commercials at precisely the same times; and they even carry identical advertisements, most of which make clear that the target demographic is somewhere between 50 and 80 years of age - that time of life when the body starts to go. Few ads tout fast cars, trips to retreats in the Caribbean or outward-bound experiences.
When I was a child back in California in the 1950s, DuPont - whose spokesman promised, in solemn baritone, "Better things through chemistry" - bankrolled a radio show named Cavalcade of America. Little did we know how important to our lives these "better things" would become. For chemicals now play myriad roles in our lives - and, yes, there are times when Big Pharma is indeed a friendly big brother. One recalls the impact of the Salk/Sabin vaccines for the polio virus, exceptional gains against the hydra-headed adversary called cancer and the drug cocktails that keep people with HIV/AIDS alive for years after becoming infected.
But there are other times - and ads on U.S. TV news programs highlight the point - when Big Pharma is not friendly at all. Indeed, U.S. pharmaceuticals have moved way beyond helping physicians treat patients. In the last two decades, advertising has created a prime role of its own, a video plebiscitary, if you will, in which ad writers speak directly to viewers in the tube-world of consumerist plenty. Their message is simple: "Buy me!"
These advertisements and products, approved by the febrile Food and Drug Administration (often partly staffed by Big Pharma representatives), seek to create a direct one-to-one marketing relationship with the consuming public. This is the free-marketer's ultimate wet dream. Most of the drugs featured in this video emporium are available over the counter; some are only available through a doctor's prescription ("talk to your doctor to see if 'X' is right for you").
Big Pharma promises marvelous outcomes to most who use its snake oil. It even creates illnesses for its pills and potions. For those persons with the malady known as "restless leg syndrome," a little pill will solve the problem immediately. Look, there's an absolutely gorgeous woman lying on a chaise-longue doing a crossword puzzle. And, my goodness, her legs are not moving. (A woman friend of mine once asked, half-jokingly, if there was a pill for "restless hands.") And there are those purple pills for acid reflux (which seems to threaten cancer if you don't take them) and allow adults to run to treehouses with their kids.
Then there are the guys who have to go to the bathroom all the time, especially when they are on the golf course. They take pill Y, and there they are, amazingly, playing 18 holes with nary a pit stop. And they all look so healthy.
And look! There is Robert Jarvik, the creator of the artificial heart that bears his name, looking directly at the camera with a demeanour so honest that he could not be kidding. Product X will wipe out all the bad cholesterol in our bodies and allow us to row a single scull across miles and miles of pristine blue lake. I saw Jarvik vanquish his bad cholesterol four times in a half-hour. This is overkill.
Then there are the people who can't sleep. A derivative of the Spanish word for moon takes care of them. A beautiful, perfectly coiffed woman lies in bed looking stressed when she is visited by a luminescent butterfly that alights on her as she suddenly nods off to never-land. She awakens the next morning looking like Wonder Woman: twice as beautiful, able to kick a soccer ball down the hall, kiss her children and pat her husband on the head as she heads off to work, briefcase in hand.
There also is the erectile dysfunction issue. Ads for erectile dysfunction drugs are always heterosexually centred and feature couples that do nothing but smile meaningfully. One huge-selling product alliterates Niagara Falls, rushing in its intensity, oh, so powerful as it reaches its goal. A competitor sounds like the word "levitate," aping the Lazarus in all of us as we rise from the ashes of physical decay to please our female partners.
A final entry in the erection sweepstakes must be spelled out to get the point. Cialis, like its stable mates, promises a long-standing construction, no doubt giving the guy who takes the pill the chance not only to see Alice, but also Mary, Ginny and Barbara Jane.
This is the short list, and it continues on indefinitely. Canada is fortunate because the Canadian Radio-television and Telecommunications Commission has had critical things to say about direct drug marketing on television. But there are signs that Canadian pharma is beginning to gnaw its way into our consciousness. The next decade or so will tell us if we, too, become marketing targets for little purple pills, big white ones, yellow ones and green ones. "Eat me, drink me," is the line Lewis Carroll allows the protagonist to hear in Alice in Wonderland. And Alice and her readers behold the immediate, wondrous consequences.
They also confront the horrendous side effects caused by one wonder drug alone or taken in tandem with another. There are always the warnings, spoken with excessive speed at the end of the ad, with the admonition to "see our ad in Golf Magazine, Home and Garden, or Health," where all the troubling side effects in their myriad glory may be discerned. So, even if there is always a man or woman in a white coat, generally holding a stethoscope, standing by to give these ads the authority of the pharmacist and physician, the phrase caveat emptor - let the buyer beware - applies more than ever.
Indeed, we now have evidence that wonder drugs like Avandia (diabetes) and Vioxx and Celebrex (arthritis) have killed people by reregulating their heartbeat in problematic ways. Yes, that's a side effect - "collateral damage," the pharmaceutical companies might explain.
Cynicism aside, all this reminds me of a joke I once heard. It was filled with the kind of wisdom that experience alone provides. Seems that a little boy, aged seven or so, was poking around a drug store for half an hour or so. Finally, he brought his purchase to the cash register, where a kindly gentleman dressed in white (Marcus Welby's brother, perhaps) inquired, "What do you need this for?"
The little boy held up the package of Tampax and pointed to information printed on it. "It says here that you can swim, shoot baskets, ride horses and play golf, and I have not been able to do any of those things at all well," he replied.
Moral of the story? Simple: you can't tell the contents of a package from its wrapping.
Geoff Smith is emeritus professor at Queen's University, where he taught a course on Drug Cultures and Drug Wars and considered similarities between pharmaceuticals and illegal substances. This column appeared in the Kingston Whig-Standard 17 January 2008.