Nena Baker, The Body Toxic (North Point Press, 2008) & Melody Petersen, Our Daily Meds (Sarah Crichton Books, 2008)
Remember when we, as consumers, were hoodwinked by the insidious marketing techniques of big tobacco? Dubious science, aggressive advertising, and lax regulatory standards clouded our judgment and we puffed away, blissfully oblivious. But the truth was revealed, we learned our lesson and developed a shrewd skepticism, right? Maybe. Two new books, The Body Toxic by Nena Baker, and Our Daily Meds by Melody Petersen, reveal how the methods used by the tobacco industry—along with new and improved ways of misdirecting our attention—have been adopted by the chemical and pharmaceutical industries to great success. Baker and Petersen argue that the chemicals we ingest, whether unknowingly in the form of common household items or voluntarily in the form of medication, pose serious risks. What both authors show is that no matter how informed, diligent, and precautious you think you are, the powers that be have found a way to circumvent your efforts.
There are currently more than 80,000 chemicals registered with the Environmental Protection Agency, the regulatory body tasked with monitoring chemical safety. But, as Baker explains in The Body Toxic, the system is built so that the EPA can’t enforce its own standards, what she deems a “bureaucratic Catch-22.” She explains that, “Under our regulatory structure, ignorance is rewarded: manufacturers have no obligation to test for the safety of the substances they sell…The agency lacks the statutory power to request data on a chemical prior to proving it causes harm. And it can’t make that kind of risk calculation without the data it is seeking.” The result is thousands of chemicals being manufactured and used without scrutiny or surveillance.
After a brief look at the industry’s history, Baker chooses a handful of chemicals as case studies to reveal the potential danger lurking in everything from our lipstick to our computers. Endocrine-disrupting substances, as Baker defines them, are those which “play with the complex physiology that controls basic systems of the body from fetal development through adulthood.” All of the chemicals she profiles are known or probable culprits. Because most of the research “suggests” rather than “proves,” it sometimes feels like Baker overstates the problem. But, her aggressive stance is not unwarranted. Just last month New York Times writer John Tierney came out with “10 Things to Scratch from Your Worry List,” an article listed among the most popular on the newspaper’s website. His number six was bisphenol A (BPA), a chemical used in polycarbonate plastic. For example, your Nalgene bottle—which Baker also profiles because it has been linked to developmental defects. Tierney scoffs at the fear surrounding BPA, dismissing evidence from high-dose animal studies as irrelevant. Baker contends that animal studies are valuable predictors of human reactions and explains that low-dose risks can evade detection because of a studies’ design. Tierney’s doubt is understandable; science relies on questioning even that which seems certain. The Body Toxic, however, takes a better-safe-than-sorry, preventative approach to chemical exposure which is hard to argue with considering the dearth of long-term research.
While she has compiled a hefty amount of information and research, Baker often lets the data overwhelm her argument. Chapters are loose conglomerations of facts presented without an organizing structure. But perhaps the most distracting aspect of The Body Toxic is Baker’s reliance on acronyms – and not the only the familiar ones like the EPA. Rather than cutting a path through the bramble of bureaucracy, The Body Toxic snags at every turn. At one point, Baker invokes the legacy of Rachel Carson, whose book Silent Spring led to the ban on DDT. It’s clear that Baker reveres her predecessor’s work, particularly Carson’s ability to write with fluidity and passion about subjects that a general audience would otherwise find impenetrable. Unfortunately, in this case, we see the painstaking effort of Baker’s reporting.
Melody Petersen, by contrast, does Carson’s memory justice with her compelling and thoroughly disturbing book, Our Daily Meds. Petersen blends storytelling with rigorous reporting, a technique no doubt honed during her years at the New York Times where she wrote about the pharmaceutical industry. Baker’s resume is impressive, including stints at The Arizona Republic and The Oregonian, but The Body Toxic appears to be her first venture into the chemical industry which may account for the book’s flaws.
The world of pharmaceuticals parallels that of chemicals in many ways. Like the EPA, the Food and Drug Administration puts the onus of regulation on the drug companies, who work hard to protect their bottom-line. Scientific studies are shaped and conducted with desired outcomes in mind, rather than as safety and efficacy inquiries. But, there is one defining difference between these two industries: prescription drugs require the signed consent of a medical professional, which means that we must seek them out—or, as Petersen argues, be sought out by the drug companies and the battalions working on their behalf.
If you’ve turned on the television in the last decade, you’ve no doubt seen ads for prescription drugs. In 1997 the FDA changed the rules governing how drugs could be advertised on television. Previously, drug companies had been required to provide extensive and detailed information about all possible side effects—information that couldn’t easily be communicated in a thirty-second television spot. But the new rules dictated that companies provide, as Petersen explains, “Simply a few of the drug’s more common risks, along with a toll-free phone number where the curious could find out more.” Petersen marks this as the beginning of a new age, a fundamental shift in the ideology of drug companies away from producing new and necessary medicines towards making money.
The television ads were only the beginning. Unlike the tobacco industry, which could count on consumers to see the idealized life pictured in their ads and rush out to buy a pack, drug companies understood that patients needed help buying their products. Doctors were the next target. Sales representatives for drug companies wooed doctors with lavish gifts, from cash to luxury vacations, creating a sense of indebtedness that led some doctors to prescribe their products. But, not all physicians are willing to be bought. To reach the skeptics, drug companies began sponsoring ongoing education seminars, paying those doctors who didn’t object to a little dirty money to promote the research (conducted by scientists on the drug companies’ payroll) of yet-to-be-approved drugs. Articles published in reputable medical journals, authored by doctors who may not have had anything to do with the content, tout the efficacy of upcoming products. And on, and on it goes, all made possible by a regulatory body that can’t keep up with the industry’s size or schemes.
If such devious marketing resulted in more patients receiving helpful and needed drugs, we might be able to excuse their cunning ways. As you may have guessed, that’s not the case. Dangerous “off label” prescribing (when a doctor uses a drug for a condition not approved by the FDA) creates unexpected, and sometimes fatal side-effects. Health insurance is squandered on unnecessary treatment, and research money that could be used to develop antibiotics and vaccines is spent creating drugs that will yield higher incomes. Rather than treating diseases, pharmaceutical companies focus on developing drugs for chronic symptoms, like those associated with lifestyle discomforts (i.e. hair loss and incontinence) or with psychiatric disorders.
Using her home-state of Iowa as a representative of “no-nonsense” middle America, Petersen details the ways in which drug companies infiltrate our lives, weaving together individual narratives of Iowa’s citizens, doctors, and lawmakers. Personal stories give emotional warmth to the industry’s cold tactics, but Petersen is careful to place these anecdotes within a context of well-documented facts. Unlike Baker, she helps the reader along, keeping us informed without confusing us with industry jargon. Our Daily Meds presents the complex system of pharmaceuticals with clarity and purpose.
Our Daily Meds finds complicity at every level, from marketing professionals down to the patients who become unwitting drug companies’ mouthpieces. By now, it’s hard to understand why we don’t expect such depraved conduct from money-making industries. Though the drug companies’ techniques are new, the goal is simple and predictable: buy our product. The question then becomes, “How do we make safe decisions about what we should and should not put into our bodies?” At the conclusion of The Body Toxic, Baker provides information about how to avoid each of the substances she profiles as well as a list of public health organizations where readers can follow-up with their own research. Petersen can’t offer such simple advice. Breaking down the pharmaceutical’s systemic corruption requires steps like, “Stop physicians from taking drug money,” and “Make science honest again,” transformations of grand proportion. Tobacco’s heyday came crumbling down when the government finally stood up for the health and safety of its citizens. Because of the enormity of the pharmaceutical industry—and the far-reach of its power—it seems that healthcare reform might be the only solution. And we’re all waiting to see if that will ever become a reality.
Katie Rolnick is a freelance writer and co-editor of the Brooklyn Rail Books section.