Sick, Sick, Sick

I have no idea how many readers associate this title with Jules Feiffer; but I figured that, with all the attention that Michael Moore is getting with the release of Sicko this weekend, some of us ought to remember the old master. Besides, Feiffer's turn of phrase should have been the headline for Maggie Fox's Reuters report yesterday evening:

Hospital and doctor visits in the United States have surged by 20 percent in the past five years and the most commonly prescribed medications are antidepressants, according to statistics published on Friday.

This is the conclusion from a study by the National Center for Health Statistics at the Center for Disease Control. Ms. Fox elaborates as follows:

The report estimates that 1.2 billion visits were made to hospitals, emergency rooms and physicians' offices in 2005.

"It was only a few years ago that we released that the total number of visits had reached 1 billion. And now we are up to 1.2 billion," Catharine Burt of the CDC's National Center for Health Statistics said in a telephone interview.

"That's a 20 percent increase in the just the last five years -- a huge number," said Burt. "I can tell you that the number of hospitals and physicians has not increased 20 percent."

The reason is clear -- Americans are getting older. "When you reach 50 things start going wrong, just little by little, and you keep going back to the doctors," Burt said.

The baby boom generation -- born between 1946 and 1964 -- are now prime users of the medical system.

Burt's team surveyed 352 hospitals and about 1,200 physicians throughout 2005 for the study.

The part of the study that interests me, however, is the bit about antidepressants. In this case the explanation may not come from the CDC but from Bill McKibben and his recent book, Deep Economy: The Wealth of Communities and the Durable Future. Reviewing this book for The New York Review, Professor Tim Flannery of Macquarie University in Australia wrote:

In one aspect of life after another McKibben shows us how globalization has destroyed communities and detracted from the quality of life of Americans. Lumber now comes from overexploited forests rather than carefully shepherded local woodlots. Our food travels 1,500 miles to reach us, and as we gather in celebration to eat it, globalization deprives us of further pleasures. I suspect that most older Americans can remember an uncle or aunt who sang at family weddings and get-togethers. Today, the pride they and their family took in such performances has been replaced by recorded music. It may be technically superior, but it lacks the heart and "community" of the old ways.

There is evidence that all of this dysfunction is leading to an epidemic of psychological depression in America.

This is where the story links back to Jules Feiffer. When that first collection of his cartoons was anthologized in Sick, Sick, Sick, the word "dysfunction" was not in our working vocabulary and was rarely used in any context other than physical (as opposed to psychological) medicine. Yet Feiffer saw the clouds of social dysfunction forming and predicted the consequences with his acidic illustrated vignettes. Now the CDC has confirmed that this social dysfunction is (normative?) way of life; and we have authors like Bill McKibben trying to tease out the causes. Unfortunately, just trying to puzzle out the mess we are now in is enough to make one reach for a prescription for "industrial strength" antidepressants!