The Problem With Medicine: We Don't Know If Most of It Works

Less than half the surgeries, drugs, and tests that doctors recommend have been proved effective.

By Jeanne Lenzer and Shannon Hall
Feb 11, 2011 12:00 AMJun 27, 2023 7:37 PM

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Lana Keeton is accustomed to taking her licks standing up. She has worked as a steel broker and boxing promoter who rubbed elbows with Don King in the rough-and-tumble fighting world. She is also a kickboxer who doesn’t like to lose. But in 2001 a routine surgical procedure knocked her off her feet and led to the loss of her health, her business, and her dream home, a three-bedroom condominium in Miami Beach.

Keeton was in her thirties when she began suffering from intermittent bleeding and pain caused by fibroids, benign tumors in her uterus. She had the tumors surgically removed in 1983 and a second time in 1991, after they recurred. When her symptoms flared yet again in early 2001, her surgeon recommended a hysterectomy to get rid of the problem once and for all. During a discussion with her doctor about the upcoming surgery, Keeton mentioned that she occasionally leaked a little bit of urine when she coughed or sneezed. Nothing serious; she was still kickboxing without any problem. The surgeon told her that as long as he was “in there” doing a hysterectomy, he could fix her urinary problem by using some synthetic mesh as a sling to support her bladder. “He told me it was new and that I’d like it,” Keeton says. “I didn’t question it. I trusted him.”

The mesh was indeed new, but it was also relatively untested, as Keeton would eventually learn. Just 48 hours after her discharge following surgery, she was rushed to a nearby hospital, where doctors diagnosed a life-threatening infection called necrotizing fasciitis and told her she required emergency surgery to remove dead tissue. After a rocky 16 days in the hospital, Keeton was sent home, where she was bedridden for the next three months. A nurse came twice a day to dress the gaping wound in her belly, which had to be left open to control the infection as she healed. Unable to work, Keeton couldn’t keep up with her condo payments.

During the 16 subsequent surgeries and procedures Keeton would undergo, doctors discovered that the mesh had sliced its way through her bladder like a grater through cheese. Infections were forming on the mesh itself. Doctors worked to extract that mesh bit by bit, but it was so embedded in her internal tissues, they are still trying to remove every last piece today.

To understand why this was happening to her, Keeton went online. What she encountered left her dumbfounded: hundreds of patients talking about their problems with surgical mesh implants. Many told stories like hers, of recurrent pain, infections, and bleeding. Men whose hernias had been repaired with mesh were left incontinent and forced to wear adult diapers. Keeton was enraged. Here she was reading about serious, even life-threatening complications, yet her doctor either hadn’t known or hadn’t told her of any of the risks—risks she says “I would never have taken for such a minor inconvenience as urinary incontinence.”

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