One-Minute Book Reviews

September 18, 2008

Maybe You Don’t Need That Colonoscopy or Those Statins — A Noted Doctor Challenges the Medical Establishment – ‘Let My Polyps Go’

Angioplasties and stents are "good ideas that proved bad."

“Dr. Hadler sees no evidence that mild high blood pressure or mildly elevated blood sugar pose much of a risk to longevity — certainly not enough to warrant the aggressive drug treatment often offered for them. The same goes for … the modest elevations in serum cholesterol that, these days, spell a statin drug for life for many healthy people.”

Self-help books that urge you to micromanage every health risk have become disease unto themselves. So it was cheering to see the New York Times giving serious attention to a new book by a noted physician who still believes that less medicine can be more.

Abigail Zuger, an internist and frequent contributor to Times, recently reviewed Worried Sick: A Prescription for Health in an Overtreated America (Univesity of North Carolina Press, 376 pp., $28), by Nortin M. Hadler, “a rheumatologist and professor of medicine at the University of North Carolina who is a longtime debunker of much the establishment holds dear.” Zuger wrote:

“Dr. Hadler may not actually keep a skull on his desk, but he might as well. We are all going to die, he reminds us. Holding every dire illness at bay forever is simply not an option. The real goal is to reach a venerable age — say 85 — more or less intact.”

Zuger adds that Hadler believes the way to achieve that goal is to ignore much of the conventional advice:

“Reviewing the data behind many of the widely endorsed medical truths of our day, he concludes that most come up too short on benefit and too high on risk to justify widespread credence.

“Dr. Hadler sees no evidence that mild high blood pressure or mildly elevated blood sugar pose much of a risk to longevity — certainly not enough to warrant the aggressive drug treatment often offered for them. The same goes for the extra 20 pounds that make you overweight but not obese, and the modest elevations in serum cholesterol that, these days, spell a statin drug for life for many healthy people.

“He deplores the careful attention we pay to the state of our coronary arteries. Angioplasties, stents, coronary artery bypass grafts — all these procedures, he writes, ‘should be consigned to the annals of good ideas that proved bad.’

“As for the screening that purportedly keeps us safe from cancer, mammography and the blood test for prostate cancer are, in his view, blunt cudgels that can harm as much as help. Nor does he want any part of routine colonoscopies: ‘Let my polyps go.’”

Zuger compared Worried Sick with a new guide by Nancy Snyderman, a surgeon and the chief medical editor of NBC News, who — as anyone who has watched her televised reports may know — is ever-ready to parrot the medical establishment’s prescriptive-flavor-of-the-week. And though Zuger doesn’t come down on the side of either approach, her review is lively, open-minded, and worth reading www.nytimes.com/2008/06/24/health/24book.html?ref=science.

To read more about Hadler and Worried Sick, click here uncpress.unc.edu/browse/book_detail?title_id=1545. Hadler’s book and individual chapters from it are available in e-book or downloadable formats through the Caravan Project www.caravanbooks.org/.

© 2008 Janice Harayda. All rights reserved.
www.janiceharayda.com

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