Thursday, March 09, 2006

The cholesterol test

I am cynical. I admit this. It is in my genes, a honed Northern Irish trait, perhaps as a result of 'the occupation.' I don't know the exact reason. All I know is I am more cynical than the average American citizen. I know this for a fact because I find so many Americans--perhaps the less well-educated or those pre-disposed toward gullibility--believe in crass corporate hype and exploitation. For example, it astonishes me that thousands and thousands of otherwise sensible Americans will wear Eagles, Phillies and Yankees, etc sports merchandise, will pay top dollar for the 'privilege' of doing so, will paint their faces in the corporate colors and again pay top dollar to go to the stadiums to root for these teams. They see a team; I see a corporation and players that will strike in mid-season when they feel their million dollar salaries are threatened. I should also say I am not so cynical that I am a crashing bore--at least I don't think so--but I have always subscribed to my favorite grandmother's philosophy that a bit of cynicism is healthy.

And I am viciously cynical when it come to the behavior and practices of the pharmaceutical industry in the United States. When I first moved state-side I could not believe the blizzard of 'in your face' commercials touting the amazing benefits of taking drug 'A' for lowering cholesterol, Drug 'B' for ending depression and no sexual side-effects, Drug 'C' for coping with a child's Attention-deficit Disorder and its sibling, Attention-deficit Hyperactivity Disorder, and Drug 'D' for turgid 'long lasting' erections that will have women swooning a.k.a erectile dysfunction banishment, etc. And the great majority of these drugs came with warnings, usually dispensed during the most visually pleasing parts of the slick-willie (no pun) commercials, that taking the drug could cause liver damage in some people, or kidney damage, or could give rise to suicidal thoughts in children, or could even be fatal.. Being cynical, I know there is no way for the pharmaceutical marketing people to say 'fatal' in a politically correct manner. I mean, let's face it, they can't say, "Taking this drug may cause you to pass on or pass away, though I'm sure they would love to because they sure know the public prefers the term 'pass away' to the 'D' word or saying terminal or fatal.

It was astonishing (and still is) to see these blatant commercials on the telly, more so because I grew up in a culture that expressly forbids such self-interested drug advertisements. I am not saying that the British National Health Service is in any way superior to the system in the United States; both in my opinion are abysmal in their own distinct ways, but I will say that the British (and European) ban on prescription drug advertisements to the public is sound practice.

So, when I went into my local 'upmarket' supermarket recently and saw they were offering FREE cholesterol tests, needless to say the words 'be cynical, be very cynical' began circling in my mind faster than the ticker tape at Times Square.' I bet they're trying to get a bunch of people onto cholesterol reducing medications,' my inner voice screamed. At the same time, I felt both curious and uneasy because my doctor informed me a year ago that I had to make an appointment for my next 'cholesterol screening' because my result was borderline last time. I have quite simply been avoiding my doctor as a result.

However, that it was 'free' overcame the healthy cynicism (we Irish love 'free' things), so I went over to the 'representative' from the testing agency--yes, cynicism levels soared again--and I was handed a form. The form was short, with space to enter name, address and phone number (no email, oddly) and warned they might have to contact my doctor if results were dangerously high. And, of course, I had to answer the thinly veiled marketing questions, to wit:

Do you shop here often?
Do you use the pharmacy?
What sort of products do you buy in our pharmacy?

I scoured the form for a logo or anything in the small print that might hint at the whole exercise being sponsored by a major pharmaceutical company. It was clean, refreshingly clean. The rep was a nurse, a friendly nurse, and asked me to take a seat with about four others while she attended to another customer--I mean patient. The others waiting were slim or slightly overweight. I watched like a hawk as this nurse attended to her patient. The gentleman was young (late twenties, ruddy Irish-American, German or Polish complexion. He was also Alabama fat. (I say Alabama fat because an Alabama woman visiting Ireland crammed into a flimsy chair at a social event was my first experience of a truly obese human being. As a curious child, it was jaw-dropping, and I looked at my mother--who was trying desperately to conceal her alarm about the possible demise of grandmother's antique parlor chair (one of a set), which she was assigned to inherit--and she nodded at me and said in a hissed whisper that she's "a distant relative and very religious and visiting from Alabama in the depths of the American bible belt. That's an experience a child takes with it into adulthood.)

While I did not hear this young man's cholesterol number, it was not good because the nurse wanted to get on the line right away with his doctor. He gave his consent and she went off to ring him. Everyone seated began to shuffle, wondering if they were in for the same daunting awakening, and I expected at any minute to hear the shrill wail of an ambulance plus a phalanx of buxom, sexily tanned drug reps--the ones you encounter in doctors surgeries everyday--snake from behind the cereal aisle waving tiny bottles of samples in their manicured, fire-engine red talons. It was all very anticlimactic in the end because an appointment was made and off he plodded with his results in hand.

When my turn came, she pricked my finger, took blood, dropped some onto strip which she inserted into a machine that resembled a calculator. As it did its number crunching (and at this point I was very nervous on account I was borderline) she took my blood pressure and pronounced it 'excellent.' A few seconds later, it beeped and she looked at the monitor and said, "You're really good."

I couldn't believe it.

'You're way below the 200 and that's great news.'

And I must say such tests are a good and beneficial offering from the icy heart of American corporatism, and I believe European institutions interested in health should learn from this practice and organize so that their populations could also be cost effectively and widely tested, though the person being tested should realize that 'selling' is taking place and remain cynically vigilant. Now go Yankees, go. Or is it, go Eagles go. Or...

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1 comment:

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