Some Thoughts on Health and Money

At a time when the gap between the super-rich and the poor is getting dangerously wide, it’s good to hear that Mark Zuckerberg, the billionaire founder of Facebook and his wife are giving $3bn  to medical research over the next ten years, to “cure, prevent or manage all diseases” in their children’s lifetime. It’s a nice gesture,  suggesting that perhaps capitalism has a more acceptable face, too, yet after a few moments of feeling nice about it,  I begin to experience some doubts.

It’s not just that $3bn sounds less impressive if set against, for instance,  the $6bn to be spent over five years by the British Wellcome Trust; it’s the grandiose aim of the donation that bothers me. All diseases? Is there anyone who can even begin to list them? Another generous billionaire, Bill Gates, has been spending billions over 15 years on trying – and failing – to wipe out nothing more than malaria or polio, never mind the whole blooming lot. Surely Mr Zuckerberg (German for Sugar Mountain) should think up a less ambitious project to support?

And while I am in the mood for cutting things down to manageable sizes, allow me to jump on my hobby-horse whose name is prevention, the poor relation of the cure and management of disease. “Prevention is not sexy,” says a disillusioned doctor friend of mine, “so no-one is taking it seriously.” And yet and yet the evidence is piling up to show that an alarming lot of our diseases are caused by ourselves out of sheer ignorance, or as a result of having poisoned the world which now, in turn, is poisoning us. There is nothing new about this: poor lifestyle, suicidal diets, obesity, too much alcohol, stress & co. add up to a litany piously recited by official voices, but there is no official action to rein in the misbehaviour of the food industry, to name only one major culprit. Cynics claim that Big Food is in cahoots with Big Pharma: if you consume enough processed stuff, you are bound to end up with a fistful of prescriptions for the rest of your life. Elementary, my dear Watson.

Maybe so. But what’s more alarming, because less obvious, is the piecemeal emergence of new health hazards. For instance we’ve just been told that dementia has overtaken heart disease as the biggest cause of death in England and Wales, a staggering development – how come, what has changed to cause this rise? The next day a newspaper report provided a possible answer. According to some researchers, particulate matter, typically released by diesel engines, can enter human brains, suggesting that there is a link between traffic pollution and dementia. Magnetite, a by-product of traffic pollution, has been found in the brains of people with Alzheimer’s, and there’s evidence that people living in areas with high levels of airborne pollution are more likely to get the disease. Ironically, diesel has been promoted for years now as being less harmful to health  than petrol…

Another example of the hidden link between innovation and health damage cropped up some years ago, when a Europe-wide research programme tried to establish the cause of poor sperm production by otherwise healthy males. In the end the men with the best sperm production, both in quantity and quality, turned out to be Danish organic farmers, namely men who never worked with herbicides, pesticides, fungicides or anything else ending with -cides; nor did they eat food treated with those same agri-poisons, which were hailed as the essential tools of modern farming, leading to bigger yields and healthier plants.  Since then the popularity of organic foods, guaranteed to be poison-free, has grown enormously, but it’s still a minority trend. As far as the manufacturers of agricultural chemicals are concerned, they keep producing ever stronger poisons, as  weeds and pests adapt sufficiently  to the current range to survive them. Never mind the humans who are the last link in the toxic food chain.

We’ve made a real mess of things, and surely trying to undo the damage and prevent further disasters should have absolute priority in medicine. But it hasn’t. Perhaps it never had. I recall a cartoon, used many years ago  by that great medical maverick Denis Burkitt, whenever he gave a talk on the need for prevention. The cartoon showed an overflowing hand basin with both taps full on, and two doctors in white coats busy mopping up the flooded floor, but not turning off the taps. “You get paid more for mopping up,” was Burkitt’s devastating comment.

Despite all this, I hope Mr Zuckerberg’s project will do some good in the hellishly difficult area of health in our not so brave new world.





One in two – you or me?

I’m afraid this is a heavy subject, but one we need to consider. Until very recently we were  officially told  that in this country one in three people would get cancer during their lifetime. But on the 4th of February the leading British  cancer charity,  Cancer Research UK, suddenly changed that proportion to one in two. Now that is an alarming change indeed; supposing if at any one time half the population goes down with cancer, will the other half be able to look after them? Yes, this question is purely theoretical,  but not unreasonable. Anyway, the news was duly, though briefly, reported in the media, before vanishing under the cascade of other news, mainly about murderous warfare somewhere or other in the world. Cynics might suggest that being killed in  battle at least saves you from getting cancer, but that’s hardly the point.

The official comment accompanying the bad news sounded comforting. Cancer, it claimed, was primarily  a disease of old age, of those aged 65 and over. Also, we could take some steps to protect ourselves. Leading expert Professor Peter Sasieni, of Cancer Research UK and Queen Mary University, London, even gave some advice on how to protect ourselves.  Give up smoking, he said in an interview, be more active, drink less alcohol and keep a healthy weight.

If that was meant to reassure me, unfortunately it failed to do so. For one thing it’s simply not true that cancer “primarily” attacks the elderly. In the UK, every year 3600 children are diagnosed with cancer; the childhood incidence rate has grown by 38% between 1966 and 2000, and cancer is the most common cause of death among the 1 to 14 year olds. Children apart, the incidence is even higher among young adults and those in early middle age. (Come to think of it, I was nowhere near 65 when I became ill with malignant melanoma several decades ago.)

So the age excuse doesn’t hold water. But hang on a second: why do our medical experts and other decision-makers act as if cancer were a natural disaster, an intruder from outer space, or the punishment of some angry deity? It’s none of those things, it’s the result of our increasingly unhealthy lifestyle, self-destructive habits and all the negative facets of modern existence that don’t suit our bodies’ true needs. Hence if we are causing much of our trouble, we can also undo it – pull out all the stops and write PREVENTION on every available surface. And let all the doctors, researchers, nutritionists and other experts take the lead, educate the public, make clear the simple means to build up their immunity, if need be with the help of celebs on TV who are more likely to be followed than a mere professor of oncology. This would be a big step towards reversing the trend, much more effective than making people wear pretty pink ribbons or March Against Cancer, whatever that’s supposed to do.

Alas, Prof.Sasieni’s advice about prevention is inadequate. “Give up smoking” – yes, absolutely essential; personally I’d prefer “stop smoking”, because “giving up” has a noble melancholy flavour, as if the smoker were to make a great sacrifice instead of getting rid of a harmful and frankly disgusting habit  (I say this as an ex-smoker myself). Either way good advice. But then comes “Be more active” – more than what if you lead a totally inactive life? Why not specify say twenty minutes’ brisk walk five times a week, as many doctors already prescribe? Next, “Drink less alcohol”. Again, less than what? If the man who drinks a bottle of wine every night cuts down to half a bottle, will that save him? And just how unscientific is this vague advice?  Finally, “Maintain a healthy weight.” Yes, sure. And that’s it. Isn’t something missing? H’m, yes.

Professor Sasieni didn’t say a word about the need to eat good, nutritious food and avoid chemical-rich junk food and sweet fizzy drinks; not a word about organic produce being demonstrably healthier and more pure than conventionally produced edibles. Yet  food is what keeps us going from our first breath to our last: surely its quality has much to do with what happens between those two breaths? And how can a medical authority of Professor Sasieni’s eminence simply omit this major subject when talking about cancer prevention?  Alas, nutrition plays no big part in medical education, and we all are the worse off for that.(Years ago, when an eminent oncologist told me that diet had nothing to do with cancer, I asked him whether his beautiful new car would run as well on washing-up liquid as on five star petrol. I am still waiting for his reply.)

All in all, for the time being it seems to me that we’ll have to research and create our own programme of prevention, since the medical profession doesn’t do the job properly. Still, I am inspired and comforted by the motto of the late great Norman Cousins: “Accept the diagnosis, but not the prognosis.” The diagnosis is that our current modern lifestyle increases the risk of cancer, but the prognosis, that one in two of us will go down with it, need not come true.