Overdiagnosis is beginning to be recognized as a public health problem, and is sometimes referred to as an “epidemic.”

Things I had been taught to believe are inert, passive, or merely insignificant—like individual cells—are in fact capable of making choices, including very bad ones.

I present the emerging scientific case for a dystopian view of the body—not as a well-ordered machine, but as a site of ongoing conflict at the cellular level, which ends, at least in all the cases we know of, in death.

You can think of death bitterly or with resignation, as a tragic interruption of your life, and take every possible measure to postpone it.

Or, more realistically, you can think of life as an interruption of an eternity of personal nonexistence, and seize it as a brief opportunity to observe and interact with the living, ever-surprising world around us.

I didn’t want more tests; I wanted a doctor who could protect me from unnecessary procedures.

It’s not only a profit-hungry medical system that drives overtesting and overdiagnosis.

A few physicians are more decisively proactive, and have themselves tattooed “NO CODE” or “DNR,” meaning “do not resuscitate.”

Being old enough to die is an achievement, not a defeat, and the freedom it brings is worth celebrating argued social critic Ivan Illich in his 1975 book Medical Nemesis,

which documented the negative effects of medical care on both sexes, in particular the toll of iatrogenic illnesses, that is, those induced by pharmaceuticals and the medical procedures themselves.

Furthermore, he stated that medical institutions represent a vast system of social control, ruled by an “educated elite”:

The medical profession won its monopoly over the business of healing by invoking its scientific basis, and maintained that monopoly by diligently patrolling its borders against the alternatives

Disturbingly enough, breast biopsies are themselves a risk factor for cancer and can “seed” adjacent tissue with cancer cells. been found to be no more accurate than much cheaper, noninvasive tests such as examination of the feces for traces of blood.

As for colonoscopies, they may detect potentially cancerous polyps, but they are excessively costly in the United States—up to $10,000—and have

As it turns out, though, size is not a reliable indicator of the threat level. A small tumor may be highly aggressive, just as a large one may be “indolent,” meaning that a lot of people are being treated for tumors that will likely never pose any problem.

One recent study found that almost half the men over sixty-six being treated for prostate cancer are unlikely to live long enough to get the disease anyway.10 They will, however, live long enough to suffer from the adverse consequences of their treatment.

The physical part of the annual physical is largely determined by the individual physician and of course the insurance company or other institution underwriting the exam.

What’s the ROI [Return on Investment]?” answers its own question with what amounts to a firm “not much”—and for all the reasons I have given here: the frequency of false positives, the dangers of the tests themselves (such as radiation), and the unlikelihood of finding a problem in a still-treatable stage.

The doctor’s detachment is not a defense against excessive empathy, but a “downright negative” emotional stance, Konner suggests.

Fixx wrote in The Complete Book of Running, “Having lost faith in much of society, government, business, marriage, the church and so on—we seem to have turned to ourselves, putting what faith we can muster in our own minds and bodies.”

It was the existence of widespread health insurance that turned fitness into a moral imperative. Something seems to be going very wrong with the human mind, not in its emotional responses to the world, which have always been a bit unreliable, but in its ability to perceive and understand that world.

Evgeny Morozov terms it, “‘solutionism’: an intellectual pathology that recognizes problems as problems based on just one criterion: whether they are ‘solvable’ with a nice and clean technological solution at our disposal.”

Similarly, with sufficient ingenuity—or malicious intent—almost any death can be blamed on some failure or mistake of the deceased.

“Theodicy”: If God is perfectly good, how can he let bad things happen?

“junk food” is chemically engineered to provide an addictive combination of salt, sugar, and fat.

A more informative foundation for macrophage classification should be based on the fundamental macrophage functions that are involved in maintaining homeostasis [a state of balance supposedly necessary for the health of the organism]. We propose three such functions: host defence, wound healing and immune regulation.

Agency, she goes on, is “simply an intrinsic capacity to act in the world, to do things in a way that is neither predetermined nor random.

Riskin’s point is that the mission of science—the determinist science that arose in the middle of the seventeenth century—has been the elimination of the last vestiges of agency from the natural world.

We have become what the cognitive scientists call “hyperactive agency detection devices”: We see faces in clouds, hear denunciations in thunder, and sense conscious beings all around us even when there is nothing there.

The price of survival is endless toil. The price we’re paying for extended life spans is a high rate of late-life disability.

The survival of an older person is of no evolutionary consequence since that person can no longer reproduce—unless one wants to argue for the role of grandparents in prolonging the lives of their descendants. “old age isn’t a battle; old age is a massacre.”

We do not look into mirrors, for example, to see our “true” selves, but to see what others are seeing, and what passes for inner reflection is often an agonizing assessment of how others are judging us.

This is the inescapable paradox of self-reflection: How can the self be both the knower and the content of what is known, both the subject and the object, the lover and that which is loved?

Many historians have argued that the rise of self-awareness starting in roughly the seventeenth century was associated with the outbreak of an epidemic of “melancholy” in Europe at about the same time, and subjective accounts of that disorder correspond very closely with what we now call “depression.”

As Jessica Riskin explains, it initially gave him a lot more work to do. If nature is devoid of agency, then everything depends on a “Prime Mover” to breathe life into the world.

The question I started with has to do with human health and the possibility of our controlling it. ========== God really does play dice.

The immunologist Alfred Tauber wrote of the self as a metaphor for the immune system, but that can be turned around;the immune system is a metaphor for the self. Its ostensible job is the defense of the organism, but it is potentially a treacherous defender, like the Praetorian guard that turns against the emperor.

On his deathbed Bertolt Brecht wrote: When in my white room at the Charité I woke towards morning And heard the blackbird, I understood Better. Already for some time I had lost all fear of death. For nothing Can be wrong with me if I myself Am nothing. Now I managed to enjoy The song of every blackbird after me too.

Do not desire to fit in. Desire to lead.

Money won't buy happiness, but it will pay the salaries of a large research staff to study the problem.

Science explains what nature is doing; money often explains what we're doing.

I just wanted to be in show business. I didn't care if I was going to be an actor or a magician or what. Comedy was a point of the least resistance, really. And on the simplest level, I loved comedy.

I like doing something romantic with a girl on Valentine's Day, like making her dinner and keeping it simple. The more quality time, the better.

One thing about the business and investing world that I connect to very intimately is that there is little room to deny the harsh realities of your mistakes. A bad call can lose you many millions.

The true secret of happiness lies in taking a genuine interest in all the details of daily life.

Trust yourself. You’ve survived a lot, and you’ll survive whatever is coming.

I think I wrote the first draft of 'Nightmare on Elm Street' in '79. No one wanted to buy it. Nobody. I felt very strongly about it, so I stayed with it and kept paying my assistant and everything. At a certain point, I was literally flat broke.

With roadracing, it takes a lot more time and money.

We were just a bunch of high school kids who got into the Ramones together.