Mass Listeria: The Meaning of Health Scares

British Medical Journal, March 21, 1998 by Abi Berger

Theodore Dalrymple Andre Deutsch, 8.99 [pounds sterling], pp 157 ISBN 0 233 99137 9

One of the recurring puzzles that led me to try my hand at public health medicine was the "revolving door" phenomenon. It was beginning to dawn on me how frustrating it is to help "save" a patient in extremis--from chronic airway disease, say--only to watch the patient return to hospital a few weeks later in exactly the same acute state.

Arguably a little slow on the uptake, I had worked in Britain, the Solomon Islands, and New Zealand before realizing that these personal reflections were being played out in a similar fashion everywhere I went. On my return to Britain I took a step back and viewed the scene from the vantage point of public health, and from this lofty place I thought I began to appreciate the point of health promotion and epidemiology.

Clearly, Theodore Dalrymple does not. Mass Listeria is an eloquent and bad tempered rant on a familiar theme. His thesis is that, in an era when we've never had it so good and modern medicine can protect and provide for us as never before, we have been induced by politicians, the media, and the medical profession to become more neurotic, more self absorbed, and more fearful of disease than ever.

We have come to expect perfect health and feel cheated if we lose it We have lost passion, stopped taking risks, and acquired anxiety, all for the sake of a longer life. He also believes that our desire to hang onto life is the root of all health scares, most of which are manufactured through distorted statistics and poorly understood epidemiology to create news. In essence, we have gained years at the expense of living.

Mass Listeria is an enjoyable read and propounds some interesting theories. It is written in the style of a lengthy newspaper column--anecdotal and opinionated, but with sufficient information and gravitas to sound almost convincing. I don't agree with everything he says, but just as you start to wonder if Dalrymple is writing simply for outrageous effect, there is something indefinable that catches you unawares.

Why does "modern man" desire to reach a ripe old age when this seems to bring only more hypochondriasis and anxiety? We are constantly being induced to stop taking risks with our health--to stop eating beef, to give up smoking, to drink less--yet this risk reduction is probably producing more misery than happy, healthy lives. Our fear of the unknown has been overtaken by something far more crippling--fear of the known. Perhaps it's time to lapse from perfectionist ideals and relax the rules a little. I think he has a point.

Abi Berger, science editor, BMJ Rating: **