Will Reading The End of Illness Improve Your Health?

Health and medicine explained.
March 28 2012 6:00 AM

The End of Illness

A new book on proteomics, and how getting a dog can improve your health.

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The End of Illness by David Agus.

In addition to his alternating moments of iconoclasm and of staleness, Agus embarks on a strangely uninformed detour into the weird world of inflammation, proclaiming it “bad” because football players tend to die young. Apparently, that’s because their bodies are often inflamed, not because they are wildly overweight and chock-full of anabolic steroids, uppers, downers, weight-gain shakes, and all the rest. It is ironic that after striving to elucidate the world of proteomics with so much subtlety and nuance, the book would be so casual in its explication of this topic. Inflammation comprises a complex and interlocking web of chemicals pushing and pulling in all directions, none of which is intrinsically  good or bad. Like the proteome itself, it defies catch-all descriptors or value judgments.

And Chapter 11, called “The Wonder Drug of Keeping a Regular Schedule,” seems unrelated to any reality experienced by a member of Homo sapiens. Here Agus offers some sound, grandmotherly advice in favor of the regular life. Wake up at the same time, go to sleep at the same time, and live happily ever after. But this is a very simple and unrealistic solution: After all, shit happens. People are restless because children are sick, bills can’t be paid, threatening memos appear at the end of the work day, and pretty strangers smile suggestively. Life is full of excitement good and bad; for most adults, sleep is what children do.

The author covers a lot of ground and can be forgiven for many standard crimes—pushing his own wares, talking down to the reader, and guessing wrong on some remedies. (His breathless endorsement of the statin class of drugs seems especially ill-timed, for example, given the recent FDA warning linking their use with the development of diabetes.) But he goes way too far at the book’s end. Here, in the final pages, Agus enjoins us to follow him in the March to Total Health, and hints, strongly, that failure to do so would not only mean ducking good advice but actually inviting illness, as if disease were by its nature self-inflicted. In his words: “The end of illness resides in all of us. It’s up to each of us to do what we can to put an end to it. For those who have the courage to join the revolution currently taking place in medicine, I welcome you.”

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This blame-the-victim mentality lays responsibility for sickness clearly at the feet of the poor sucker who didn’t join the right team, but could have. This is scientifically incorrect and morally appalling. As David Rakoff writes in his book, Half Empty: “A sense of humor … is a fine stance if it works for you, but its inverse seems to constitute a failure of character; ultimately a judgment against those folks who just aren’t funny or stylish enough to disarm their metastases with well-dressed wit. “

Yet Agus’ final, dismal flourish exposes the secret reason for the continued popularity of these sorts of books for writer and reader alike—they perpetuate the faulty premise that we are in control of our future. Yes, if we just keep our nose clean enough and do (or don’t) eat our vegetables, vitamins, health shakes or whatever, then we, too, will live forever, or almost!  But this point of view misses the most basic fact about human health: Illness often happens in ways that neither Agus nor the proteome nor the genome nor even Mr. Wizard could ever predict. To embrace this sort of cosmology is as narrow and restrictive as endorsing a system of divine retribution for the sinner who dallies too long with the devil.  In matters of human health, neither science nor faith is as good as advertised; but science at least has the responsibility to acknowledge its limits. 

Kent Sepkowitz is a physician in New York City who writes about medicine.

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