The Culture of Fear_ Why Americans Are Afraid of the Wrong Things - Barry Glassner [92]
Gulf War Syndrome and MCS raise questions as well about a common institution: medicine. Kroll-Smith and Ladd proclaim in their journal article that by “not responding to biomedicine’s use of invasive treatments,” MCS patients represent “a serious challenge to the legitimacy of institutionalized medicine.” Internists and allergists are not equipped to understand an illness caused by chemicals in the environment rather than by traditional pathogens such as bacteria or viruses, the sociologists go on to assert. Patients and advocates of Gulf War Syndrome make similar claims, even though for both GWS and MCS, much knowledge has been gained by researchers from the medical disciplines most intensely criticized.33
Hearing Voices
The most sustained and influential critique of medical science has come, however, from sufferers of another variety of metaphoric illness: breast implant disorders. “We are the evidence. The study is us sitting here,” a woman in the audience yelled out during an Oprah Winfrey Show in 1995, upbraiding the CEO of Dow Corning, the leading manufacturer of silicone breast implants, for daring to suggest that studies from the Mayo Clinic, Harvard, University of Michigan, and elsewhere should be taken seriously. These studies found no evidence that implants had caused diseases in women who used them, but in many quarters scientific evidence could scarcely get a hearing amid the cries of implant victims.34
Emotional accounts being the stuff of TV talk shows, it is probably unreasonable to expect medical expertise to prevail in these forums. The clamor over breast implants raises profound questions, however, about whose voices, and which kinds of knowledge, are heard in fear-driven public policy debates. One of the greatest triumphs of anecdotes over science occurred at a federal regulatory agency whose express mission is to enact policies on the basis of scientific data. In 1992, when the U.S. Food and Drug Administration banned the use of silicone implants except for breast cancer patients willing to participate in research studies, the agency’s leaders made their decision not primarily in response to findings from medical science (the American Medical Association denounced the ban). Rather, the FDA banned implants in the wake of congressional hearings and TV talk shows where implanted women spoke poignantly of a variety of ailments from chronic fatigue to rheumatoid arthritis to cancer, all attributed to their implants. 35
Although at the time of the ban the FDA issued alarmist projections that 75,000 women would develop major health problems as a result of their implants, epidemiological studies have documented quite the opposite: women with implants have come down with illnesses at about the same rates as women without implants. The issue, like many in science, is not entirely resolved. Another major epidemiological study—this time focused on atypical diseases—is due out in 1999. It is important to bear in mind that with a million women with silicone implants, hundreds of thousands will become ill by chance alone. The general public can be excused for failing to appreciate this fact. Whenever another major scientific study came out refuting the claim that implants made women ill, anti-implant activists made sure we knew that “many women with implants don’t find the new study reassuring,” as reporter Joanne Silberner indicated on National Public Radio in 1996, following the release of a Harvard study