One for the Books: Looking into the health industry

Some of the players in the health industry want you to be as healthy as possible for as long as possible. Others couldn’t care less; they’re in it for as much money as they can make, and if you die, … meh. Here are three informative nonfiction works.

“No More Tears: The Dark Secrets of Johnson & Johnson” by Gardiner Harris is a stunning exposé. The author was a drug reporter for the New York Times when he had a chance encounter with a pharmaceutical sales representative for Johnson & Johnson products. Her story opened his eyes to the company’s misleading claims and shady practices. The author’s subsequent research showed him J&J’s deception, greed, unsavory sales practices, lies, and disregard for life.

“In February 2023,” Harris writes, “Fortune magazine ranked Johnson & Johnson among the most admired corporations in the world.” Yet, “Again and again and again Johnson & Johnson sold dangerous products and hid the risks from patients and regulators, all while being widely praised for a high standard of ethics.” He reveals problems with J&J’s baby powder, Tylenol, medical devices, vaccines, prescription drugs and more. He claims that J&J knew about the asbestos in its baby powder and knew about the harm its prescription drugs and medical devices caused, but suppressed the truth for years, while people died. “J&J kept whatever evidence it had secret.”

J&J (though not the only company that did this) used sleazy pharmaceutical sales practices with doctors, offering cash and “freebies” for higher prescription numbers. Incentives included meals, sports and concert tickets, vacations, lucrative speaking engagements, and even hookers. Once J&J found a professional with “pliable ethics,” they’d hire the person to undertake “scientifically dubious clinical trials” and then to “write up the results in deceptive ways.” The author says that “All of this created a fog of disinformation.” When taken to court, J&J would even create false affidavits, replacing real records with false ones.

There’s much more, including the company’s overpricing, their misleading ad campaigns, and even the complicity of the Food & Drug Administration. Some of this reads like a crime thriller. Harris concludes that “For all intents and purposes, Johnson & Johnson was a criminal enterprise.”

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John Green, the author of “Everything Is Tuberculosis,” is an advocate for global healthcare reform, and the book reflects his sincere concern for his fellow human beings.
We don’t often think about tuberculosis (TB) anymore, but the world still loses 1,250,000 people a year to this disease — and it’s been curable since the 1950s. Green writes that, by one estimate, TB has killed about one in seven people who have ever lived. The problems preventing its complete disappearance include poverty, superstition, and access to drugs.

TB seems to have been around forever; even mummies from ancient Egypt show signs of the disease. Literature is filled with characters who had “consumption,” as it was once known. Long ago, writes the author, superstitious people thought it was “caused by demonic possession, or poisoned air, or God’s judgment, or whiskey,” which made judgmental people blame the victims for being sick, causing families to hide their loved ones away. “A tuberculosis case in the family was a tremendous mark of shame,” writes Green.

The author visited Sierra Leone and got to know some of the doctors and patients there. He became close with one young man, Henry, whom he follows for several years through the ups and downs of his treatment. When they met, he thought Henry was about 9 years old, but he was really 17. He was so small because he’d grown up malnourished, and then the TB had further emaciated his body.

Green gives us a bit of history and a bit of easy-to-understand science, with an overview of how the bacteria work and what the treatments have been, including the fact that some of the drugs used to combat it are too expensive to be of practical use in impoverished areas. As a doctor in Uganda said, “The drugs are where the disease is not and the disease is where the drugs are not.”

The book may sound depressing, but it’s actually hopeful, and it’s a quick read at less than 200 pages.

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“Outlive: The Science and Art of Longevity” by Peter Attia, M.D., is back on the bestseller lists because of its practical advice. Attia writes that longevity has two components: how long you live and how well you live. The latter he terms “healthspan,” and he advises readers to “start thinking about it and taking action now” for a longer and better life. He calls for “an evolution in our mindset, a shift in the way we approach medicine.” He claims that medicine’s biggest failing has been waiting until a disease has taken root before treating it, when doctors should be working to prevent it in the first place. He writes, “I believe that our goal should be to act as early as possible, to try to prevent people from developing” one of the major conditions that lead to premature death.

Attia offers a strategic approach. “Our tactics,” he writes, “fall into five broad domains: exercise, nutrition, sleep, emotional health, and exogenous molecules, meaning drugs, hormones, or supplements.” His bottom line is that “You, the patient: You must be well informed, medically literate to a reasonable degree, clear-eyed about your goals, and cognizant of the true nature of risk. You must be willing to change ingrained habits, accept new challenges, and venture outside of your comfort zone.”

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Happy reading!