Spaghetti on the Wall: A Spoonful of Sugar

Fitting us up for consumption

Public Image Limited, Electric Ballroom, London - Pic by Michael Johnson, 12/22/09

Hepatitis C’s been rebranded. There was stigma because nobody thinks about blood transfusions or the 20% that contract it via “unknown.” Everybody assumes an injection, sexual or hypodermic, is the culprit and so there’s shame, deserved or not. My TV tells me it’s “Hep C” now. We can talk about Hep C.

I don’t like it. There’s doubtless good to be found in bringing people into the light. We like liberating people from stigmas, even when – and I’m not saying this is the case with hepatitis - some stigmas are doing important jobs. What I don’t like is that “Hep C” smacks of ad speak.

Latin reinforces the solemnity of a doctor’s office. Gonorrhea comes to us from Latin gonorrhoia, which itself sprouted from Greek gonos, meaning "seed.” Same root as gonads, which is a silly word in any other setting. A doctor won’t tell you you’ve got the clap. That’s street corner greaseball talk from a French crack about rabbits banging.

Doctor talk is serious talk. It’s personal and privileged. Ad people don’t want personal and privileged. They want water cooler talk. They want nicknames and casual conversation. That’s when people mention ads they saw. That’s when people talk about their cousin who takes Declapatrex, or whatever. That’s how you sell pills.

But they don’t sell pills anymore. They sell “meds.”

We honestly call them “meds” like we’re combat medics or the new kid EMT trying to fit in by aping the grizzled vet’s idiom. If we sprain something we go to “PT.” Businesslike Medical Service is now a more intrusive but warmer sounding Health Care. Something similar happened when Cops got popular in the nineties. Suddenly there were perpetrators and the words male and female were acceptable as nouns when referring to human people. “I was talking to this female,” and “He was dating this female.” I didn’t hear male used all that often, but I assume. LEO (there’s another one) talk was all the rage. Jargon spreads so easily and sounds so foolish. This is the kinda stuff that killed Martin Amis.

There used to be a socially imposed HIPPA among friends. We made fun of old people because they allegedly went on about sciatica and “making.” Medical information was personal and privileged, spoken about with doctors and spouses, shared with older children or prospective guardians, and speculated on by aunts. It was all circumspect in comparison to today. Most importantly, there wasn’t a wall of sound blasting from every news channel break, between Candy Crush levels, during injury time outs, and whenever else a moment is up for capture, telling us to “ask your doctor about…” We didn’t have commercials, friends, and relatives telling us to solicit brand medicine from our physician. The doctor looked us over and wrote a prescription. Or didn’t. That was it. We buy so many damn pills now.

Pharmaceutical ads aim to normalize a casual attitude towards medicating; make it less foreboding, a conversational pass around, make us accept it as part of a skiing, biking, brunch embrace of life and all it’s got tucked away in the cornucopia, a life where we chat about our A1C and Hep C ala Seinfeld or Sex in the City. It’s not a product they’re selling first and foremost. It’s acceptance they’re after. They’re getting it.

There’s a waiter I talk to every so often. He’s a kid from my perspective; early twenties. During our first conversation - which was not about medical conditions in any way - he managed to let me know that not only did he have ADHD, but three different kinds of ADHD. I didn’t know there were ADHDs. He seemed on point to me, but his multiple addlings did things. They acted. “That’s my ADHD talking.” “My ADHD won’t let that go.” He put those diagnoses out there like plumage, like they enriched his image and talked as if he was a construct. I wondered if there was a part he called himself, or if he saw his existence as an expression of interplay.

I see an ecstatic commercial vision of circles upon circles, covalent friendships and acquaintances where medical conditions are discussed openly and tag lines spread like gossip. It’s creepy as all hell, but it makes us susceptible. It’s not an odd thing to be taking two pills a day, or four or more. Jenny does it. Kai’s parents, too.

Let’s get this out of the way first: RFK Jr.’s Central Park bear story needs to be celebrated. Take whatever shots and umbrage you will at the man, when presented with a bear carcass, he put it to best and highest use in the finest Eric Stratton tradition. That done with, there’s a lot to like and a lot to dislike. I’m not sure what to say about his proposal to ban pharmaceutical commercials from… I assume just federally-controlled airwaves. He can’t reach beyond that as far as I know.

I don’t like telling people how they can communicate, but we’ve agreed federally controlled airwaves are subject to censor within limits; no dildo commercials during Paw Patrol, for example. We’ve shut the Marlboro Man out from the same. The EU doesn’t allow pharmaceutical television advertising. They’re horrible on speech over there, but as I mentioned, we already accept a bit of hushing on public airwaves so I feel like we’ve got a good grip on this slope’s rails. The EU is a mixed bag of single payer and not comparable to our consumer driven market. I don’t know that we can predict by looking at their numbers what would happen here if we had a similar advertising ban though I’m on board, aesthetically.

Prozac Nation came out and I didn’t read it. It seems like it was of a time and a place and I missed both. They sold it as a memoir, so it’s probably not an indictment of a society but the title caught on and became part of the zeitgeist. I’m told it aptly described what was happening. Doctors started throwing prescriptions around. The opioid epidemic is news now, but we had, and still have, an antidepressant epidemic first. Doctors were handing it out like crazy.

I had a physical in the nineties and happened to mention to my doctor that I was having trouble sleeping. He wrote me a prescription for something that would help. I didn’t need anything, but he said it wasn’t a big deal and he’s had success with other patients taking it. I was working in a bar at the time and one of our regulars, a Babylon 5 loving doctor - he honestly wouldn’t shut up about “Bab 5” - a few years out of medical school, happened to come in. This was guardian angel work for certain. I was going out with friends later that night and asked him if I need to worry about a sleeping pill after a few drinks. He asked a few questions, I showed him the prescription, and he freaked the hell out.

I’d never heard of Zoloft before. It hit the market in 1992. It’s a high-grade antidepressant. It can cause “emotional blunting,” most easily described as numbness, but a hell of thing to read about. People need this stuff and it saves lives, but it’s not for indiscriminate use. At the time, the one person I knew taking any such thing went from manic before, to dullard after. He’d nod and say in even tones, “That’s very funny. Very funny.” Rather than an example of what modern medicine could do, he was our cautionary tale. I don’t know what the troughs of his mania were like, and maybe he was blessed to be done with them, but he was seemingly left with nothing. No highs. No lows. I just mentioned that I had trouble sleeping and my doctor prescribed Zoloft.

Could I have pulled out of a Zoloft regimented outlook? People who start are warned about stopping and I wonder if the possible numbness allows for wanting off. Is your chemically compromised thinking something that your brain adapts to? Do you get used to having rails and run narrow even after you stop taking the drug because you’ve developed mental habits? Are you like an ex-stoner still saying “Brah?”

I think about that prescription I never filled and that doctor I never went back to the way I think about a singer I almost went home with. After her band’s set, we started talking, playing pool, flirting, and as we were walking out and off to her place, a friend stage bumped me and whispered “Herpes” in my ear. I forget what excuse I made, but I trusted that guy and went home alone. Various grapevine inquiries later confirmed the whispered diagnosis. A lot would have been different going forward. I doubt I would have ever dated my wife.

I’m very happy about not contracting herpes, but I wonder if I’m missing out on smart set chit-chat. Are there cool herpes conversations now? Does it have a nickname? Herp Simp Deux? Are people alfresco sipping mimosas at brunch and recommending designer brand meds to friends who have “The H Deuce?”

Anybody remember those “ring around the collar” commercials?