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Mind

If It Ain’t Broke, Improve It

Science Not FictionBy Kyle MunkittrickApril 19, 2011 8:04 PM

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Raise your hand if every aspect of your body and mind is as good as it could possibly be. Did anyone out there raise their hand? If you did, I congratulate you. But, if you're like me, a list of minor malfunctions and maladies that you'd love to fix popped up in your head. None of us are perfect, there is always something to improve. We are, after all, only human. And most of us would jump at a chance to improve some of those little issues. The last time I went to the doctor's office, the nurse who took my vitals said, "What are you doing here? You're as healthy as they come!" That can hardly be true. I eat street-vendor food more often than I go to the gym. How can I be a picture of health? The fact is, I'm not. Just because I'm not ill (save the sniffles from the end of a cold) and not injured, doesn't mean that I am, by default, as healthy as I could be. For some bizarre reason, we don't think about our bodies that way when it comes to health care and self improvement. We don't pursue excellent health the way we strive to be better in our hobbies and work. So, where did we get the idea that mediocre health is good enough? It's simple. When we look at our bodies, we apply the phrase "If it ain't broke, don't fix it." I hate that saying. It's one of the most anti-human phrases out there. No one who ever innovated, pioneered, explored or invented ever said that to themselves. The people who push the human race forward look at everything around them and say, "I think I might know how to make this better." As Oxford bioethicist and human enhancement proponent extraordinaire Julian Savulescu says, "to be human is to be better." To see the "If it ain't broke, don't fix it" mindset in action, let's look at an example. The Independent's Jeremy Laurance investigation of cognitive enhancing drugs looks at possible problems, but only comes up with minor side effects. A fellow journalist with the Independent, Johann Hari, experimented with Provigil in 2009. Provigil is an anti-narcolepsy drug that improves mental focus and clarity with no known significant side-effects. Hari's only complaint was that it seemed to mute his creativity when taken all the time. After reducing his dosage to only occasional usage, he was able to benefit from boosts in focus and clarity without losing his creative edge. Yet, according to Laurance, Hari eventually stopped: "I concluded that taking narcolepsy drugs when you don't have narcolepsy is just stupid." Hari's reaction that taking drugs for a disease he didn't have was stupid is erroneous. He wasn't taking Provigil for narcolepsy, he was taking it because he was burnt out. And Provigil helped. It's right there in the article! He felt better, worked better, and thought more clearly. After finding the right dosage, he was able to keep creative dampening side effects to a minimum. So why did taking Provigil seem stupid? Hari isn't out of sync with most folks, who are wary of taking medicine for it's prescribed use, let alone taking it for off label uses as Hari did. That is, we generally don't trust drugs even if they have been tested and approved by the FDA for specific uses. Off label uses are all the more suspicious. But here's the interesting thing: neither the US nor the UK have regulations in place for prescription pharmaceuticals that are not therapeutic. Drugs that don't cure an illness but still have a beneficial effect have one of two paths: either find an illness they do cure or invent an illness that the drug seems to cure. An example of the latter is Viagra. I don't care what the DSM says, erectile dysfunction is not real illness. But Viagra works. It doesn't "cure" anything, but it sure makes a lot of people's lives better, which is great thing. But it's a massive problem that there is no way for drugs that make our health better to find their way onto the market. And there in lies the problem. Save vaccines, modern medicine just doesn't know what to do with medicine that prevents disease or improves a person's life. But there is a branch of health care that does focus on preventative care: the dentist. Compare an average visit to the doctor with a visit to the dentist. Dentists don't say "no cavities, go home!" They poke and scrape and clean and x-ray and pester me to floss more often and to get a better toothbrush and to use clinically-tested toothpaste. When was the last time your doctor sent you a note that it was time for your biannual check up? Never. But like clockwork, every six-months I get a post card with a tooth holding a toothbrush beckoning me back for a cleaning. Dentists are always pointing out ways you can better take care of your teeth and pestering you to come in for a regular cleaning. Thus, dentists are in the business of preventing problems and teaching us how to improve our oral care. Prevent and improve. Those are the two words I'd argue are most underused in every other aspect of human health care. Why does self-improvement not include pharmaceuticals that make us smarter or stronger or happier? Because we've been convinced and told and reminded and scolded that taking a pill means something is wrong with you. For example, take the phrase, "feel better." We've all felt better than we feel right at this moment. I have had a handful of moments of pure jubilation. But if you were to walk up to a friend who was laughing, pat them on the shoulder and say "Feel better!" that friend would probably stop laughing and ask what was wrong. It's as if we've decided that, when it comes to our bodies, it doesn't get any better than average. That needs to change. Because if we aren't getting better, we aren't being human.

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