If It Ain’t Broke, Improve It

By Kyle Munkittrick | April 19, 2011 11:04 am

Raise your hand if every aspect of your body and mind is as good as it could possibly be.

Did anyone out there raise their hand? If you did, I congratulate you. But, if you’re like me, a list of minor malfunctions and maladies that you’d love to fix popped up in your head. None of us are perfect, there is always something to improve. We are, after all, only human. And most of us would jump at a chance to improve some of those little issues.

The last time I went to the doctor’s office, the nurse who took my vitals said, “What are you doing here? You’re as healthy as they come!” That can hardly be true. I eat street-vendor food more often than I go to the gym. How can I be a picture of health? The fact is, I’m not. Just because I’m not ill (save the sniffles from the end of a cold) and not injured, doesn’t mean that I am, by default, as healthy as I could be.

For some bizarre reason, we don’t think about our bodies that way when it comes to health care and self improvement. We don’t pursue excellent health the way we strive to be better in our hobbies and work. So, where did we get the idea that mediocre health is good enough?

It’s simple. When we look at our bodies, we apply the phrase “If it ain’t broke, don’t fix it.” I hate that saying. It’s one of the most anti-human phrases out there. No one who ever innovated, pioneered, explored or invented ever said that to themselves. The people who push the human race forward look at everything around them and say, “I think I might know how to make this better.”

As Oxford bioethicist and human enhancement proponent extraordinaire Julian Savulescu says, “to be human is to be better.”

To see the “If it ain’t broke, don’t fix it” mindset in action, let’s look at an example. The Independent‘s Jeremy Laurance investigation of cognitive enhancing drugs looks at possible problems, but only comes up with minor side effects. A fellow journalist with the Independent, Johann Hari, experimented with Provigil in 2009. Provigil is an anti-narcolepsy drug that improves mental focus and clarity with no known significant side-effects. Hari’s only complaint was that it seemed to mute his creativity when taken all the time. After reducing his dosage to only occasional usage, he was able to benefit from boosts in focus and clarity without losing his creative edge. Yet, according to Laurance, Hari eventually stopped: “I concluded that taking narcolepsy drugs when you don’t have narcolepsy is just stupid.”

Hari’s reaction that taking drugs for a disease he didn’t have was stupid is erroneous. He wasn’t taking Provigil for narcolepsy, he was taking it because he was burnt out. And Provigil helped. It’s right there in the article! He felt better, worked better, and thought more clearly. After finding the right dosage, he was able to keep creative dampening side effects to a minimum.

So why did taking Provigil seem stupid? Hari isn’t out of sync with most folks, who are wary of taking medicine for it’s prescribed use, let alone taking it for off label uses as Hari did. That is, we generally don’t trust drugs even if they have been tested and approved by the FDA for specific uses. Off label uses are all the more suspicious.

But here’s the interesting thing: neither the US nor the UK have regulations in place for prescription pharmaceuticals that are not therapeutic. Drugs that don’t cure an illness but still have a beneficial effect have one of two paths: either find an illness they do cure or invent an illness that the drug seems to cure. An example of the latter is Viagra. I don’t care what the DSM says, erectile dysfunction is not real illness. But Viagra works. It  doesn’t “cure” anything, but it sure makes a lot of people’s lives better, which is great thing. But it’s a massive problem that there is no way for drugs that make our health better to find their way onto the market.

And there in lies the problem. Save vaccines, modern medicine just doesn’t know what to do with medicine that prevents disease or improves a person’s life. But there is a branch of health care that does focus on preventative care: the dentist.

Compare an average visit to the doctor with a visit to the dentist. Dentists don’t say “no cavities, go home!” They poke and scrape and clean and x-ray and pester me to floss more often and to get a better toothbrush and to use clinically-tested toothpaste. When was the last time your doctor sent you a note that it was time for your biannual check up? Never. But like clockwork, every six-months I get a post card with a tooth holding a toothbrush beckoning me back for a cleaning. Dentists are always pointing out ways you can better take care of your teeth and pestering you to come in for a regular cleaning. Thus, dentists are in the business of preventing problems and teaching us how to improve our oral care.

Prevent and improve. Those are the two words I’d argue are most underused in every other aspect of human health care. Why does self-improvement not include pharmaceuticals that make us smarter or stronger or happier? Because we’ve been convinced and told and reminded and scolded that taking a pill means something is wrong with you.

For example, take the phrase, “feel better.” We’ve all felt better than we feel right at this moment. I have had a handful of moments of pure jubilation. But if you were to walk up to a friend who was laughing, pat them on the shoulder and say “Feel better!” that friend would probably stop laughing and ask what was wrong. It’s as if we’ve decided that, when it comes to our bodies, it doesn’t get any better than average. That needs to change. Because if we aren’t getting better, we aren’t being human.

Follow Kyle on his personal blog and on facebook and twitter.

Image of innovative preventative care device and associated cleaning gel by ToastyKen via Flickr Creative Commons

CATEGORIZED UNDER: Medicine, Philosophy

Comments (9)

  1. greendream

    I think an important, and overlooked, point is that, in general, teeth do not go wrong as regularly as the rest of the body. Dentists rely on regular check-ups, new lines of dental products and the idea that without regularly dentistry disasterous things will happen to stay in business. On the other hand healthy people going to the doctor keeps the doctor from seeing the long list of people who currently ARE ill, or injured. I feel that this is supported, at least in part, by the system here in the UK with the NHS. Go to an NHS doctor when you are relatively healthy (mediocre health) and the reaction will be much the same as in this article, but private healthcare in the UK DOES involve regular checkups and suchlike, I would imagine because most people opt for the tax-based alternative.

    I am not saying this is certainly the truth, far from it, and maybe I am a little too cynical, but it seems to me that the dentist needs to employ more business-like tactics than GPs and hospitals.

    And finally, on a personal level, I look after my teeth as well as the next guy. I brush twice a day using a standard toothpaste and budget toothbrush, scrape off plaque every now and again, I don’t use mouthwash or floss, and I also don’t go to the dentist twice a year. In fact between my most recent checkup (2 months ago) and the previous one 30 months had elapsed. It turned out, and it came as no suprise to me, that when I saw the dentist 2 months ago there were no problems at all with my teeth. No cavities, no gum disease, no decay and no problems.

    I’m not saying dentists don’t promote dental hygeine, and don’t prevent problems, but, in my own experience at least, common sense and regular brushing does a similar job.

  2. Bee

    I think the reason is simply that it’s not what doctors were educated to do.

  3. Robert S-R

    I think a lot of it is caution. If you think about it, the standard, average human form is the result (same as any current living creature) of a couple billion years of evolution at work. What are the odds that any particular substance we add to our system would be a net improvement? Many things found in nature that we don’t find in our bodies is acutely hazardous, and much else has little or no effect. Occasionally we find something that makes us feel better when something else has gone wrong.

    The problem is that there is no natural precedent for improvement through supplements or surgery. Those treatments and procedures can only make us feel better at all if we are currently feeling much, much worse.

  4. Ruth

    I would disagree with you on the drug thing–“no KNOWN side effects” does not equal “NO side effects,” and studies rarely cover long enough periods of time to uncover all of the long-term effects. There are effective non-drug therapies for burnout, and using drugs to feel better doesn’t solve the underlying problem.

    However, with reguards to regular doctor’s visits, here in Canada, that nurse never would have said what she said. I go to the doctor yearly (or more often)–it’s part of our health care package. Sure you might be feeling fine now, but the truth is that regular checkups can catch a disease before it gets out of hand, and save you a lot of trouble in the end.

  5. Lucilia Cuprina

    Provigil side effects include erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis. That last one is difficult to ignore: Your skin blisters up like chicharrónes, then sloughs off. All of it.

    US ethical pharma has one simple, overriding, felonious fortification rule: Thou shalt not take pleasure in pharma. Nothing that brings joy is tolerated unless accompanied by Martin Luther’s Third Thesis. Projectile vomiting, icthyiosis, choleroid discharge, suicidal thoughts (yeah, harmless daydreaming)… are all good.

    Are you depressed? Smoke a joint. 90+% cure rate within 20 minutes. Then, watch what happens to you in the name of moral propinquity.

  6. Kyle Munkittrick

    @Ruth: I agree, that’s why I added the qualifier “known.” Part of the problem is that if a drug is submitted to the FDA for curing some disease, it receives a battery of tests to ensure that it 1) treats that disease and 2) does so with acceptable levels of side-effects. When a drug is submitted because it enhances some feature of a healthy person (i.e. focus), it is summarily rejected. Neither how much the drug actually improves performance nor the side-effects are known. And so people use it off label and risk complications simply because regulatory bodies have decided you can only feel better if you get sick first.

    @Lucilia: 6 cases in 9 years is hardly a regular occurrence. Those instances are listed as reactions to the drug, not side effects. Every drug has potential problems and lots of drugs cause severe adverse reactions in a small percent of the population. The problems you listed with Provigil are, like a penicillin allergy, a result of a very specific reaction to the drug in a few people, not a general or expected side-effect of the drug.

    And calm down with your pro-pot sermon. I don’t disagree with you that it should be legal. “90% cure rate within 20 minutes?” Please, weed treats symptoms in some individuals, which is wonderful, but it doesn’t cure a damn thing.

  7. Bevan

    “For some bizarre reason, we don’t think about our bodies that way when it comes to health care and self improvement. We don’t pursue excellent health the way we strive to be better in our hobbies and work. So, where did we get the idea that mediocre health is good enough?”

    Not everyone!

    I have what you could call an ‘obsession’ with self improvement. Up until a few years ago, it was purely intellectual – lots of time spent learning computer programming languages, learning spoken languages, etc.

    Stereotypes will tell you that all intellectual people are either one of two things:
    a) Horribly fat
    b) Horribly skinny

    I was b! :) Then I did some research on how I could ‘improve’ my body in the same way that I was improving my mind. 3 years of intense physical training later, I am 3 times as strong as I was, I have much denser bones, and my previously skinny body is starting to look rather … not skinny at all! Now I’m just as interested in improving my health and physical self as I am my intellectual self.

    It might all be a waste of time once I get my body replaced after the singularity, though! ;p

  8. Scott

    I’ve noticed for years that there is more subliminal messaging in any medical advertisement than anything else out there. Every single one of them has the implied message that “something is wrong with you,” and “we ARE the miracle cure,” even if the drug has absolutely nothing to do with you. Usually it’s some convincing [blue or green-eyed] actor swearing by the stuff, even though it was JUST released. Pay attention the next time there’s some medical ad, you’ll see what I mean.

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