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Show TheSalt Lake Tribune OPINION Al3 Wednesday, July 24, 2002 Now for a Hot Flash: Menopause Is Not a Disease in Need of a Cure Wantto clear a crowded room?Try starting a discussion about menouse. 1 know; I did it several times tended tofall into the “critic wayI chew and doesn’t fix up her hair” school of husbandry. befare I got the message to sit down and shut up. Or, as onefriend finally Nevertheless, within a decade millions of womenwere taking hormones as a matter of course, even as one leaned in at lunch to say, sotto voce, “Just take the Premarin.” Now the whole world knowsthat that mantra simply will notdo. Since the news broke ofa governmentstudy with reproductive problems had hys terectomies and everybody with NEWSWEEK those women whotook hormones find overstating its benefits and understating its risks, pharmaceutical companies were just doing what was most profitable. Both groupsare culpable, but so are company whose shares tumbled on the newsthat its biggest-selling product might cause breast cancer, heart at. tack and strokes? But if the discussion merely concerns menopause and hormones, it will have been a huge missed oppor- tunity. Instead,this is the ideal time to confront the issue of one-size-fits-all health care, which has been the standard for far too long. Here is where the expected attack on the medical establishment would normally begin. Notthis time. Asaneditoroncetold me, “Cherchezle contract.” By deciding to willy-nilly prescribe hormones to every female patient, from those whohad dry skin to those tormented by hot flashes from hell, doctors were just doing whatwaseasiest. By decid- ing to sell that medication by breast cancerhad mastectomies. patients, who need to take responsi bility for their decisions,or for deciding not to decide and letting doctors and the marketplace decide for them. a lot of the blame, andpatients were a victimclass. That has becomeridiculous. Publishing houses keep churning out more and more books on health. Newspapers and magazinesrun stories constantly. Holistic medicine and herbal remedies ticularly glaring in this regard. How are finally getting the respect and at could the most ostentatiously selfaware generation of women in the history of this country allow them- selves to be led like lemmings to a “cure” for a condition that is not a disease and a “remedy” for symptoms that were originally described largely in terms of howthey inconvenienced men? first foisted wholesale on American females. A doctor whose own son says hewasinthetank for the estrogen industry wrote a book called Feminine Forever about ways to alleviate the symptoms of menopause. But many of Ina stunning reversal, California’s mercial airliners, full of innocent people, because hijackers have taken it over and are ready to do a repeatoflast Sept. 11. Wecan only hope thatthe adminis- tration is as willing as Sen. Boxer to re-think its position of opposing the armingofpilots. But the Department of Transportation remains bikke an exact science,” it says on one sur- Fifty years agoa doctorsaid to my mother,in effect, “Just take the DES.” Probably he didn’t even name the gun. But rationally I also learned to bring the same setof questions I bring to my workto my health: What is this? Why is it needed? Where doI go for another opinion? In the drama of my body, I have becomeboth the story and the reporter. It is easier to simply take the pill, whatever it insteadof studying up the MDeity should be over; doctors has become the poster child for bad medicine. DES is a synthetic estrogen that wassaidto prevent miscarriage, but didn’t. Whatit did was cause cancer, infertility and perhaps autoim- muneproblems in the daughters of those womenwhotookit. studytitled More Guns, Less Crime, he points out that most instancesof the successful use of a gun in self-defense beif the pill always did what it ought to, with noill effects, no downside. But that’s sci-fi, not reality “T understand that medicineis not gical consent form. Where does that admission leave us? With choices, preferably informed ones, not the “yes, doctor” ofyears past. The day of haveacted likelittle gods because patients have treated them as though on diet, exercise, alternatives, the they were. The woman wholooks to a doctor to dictate rather than advise may wind up treatmentthat she risk-benefit equation of surgery or lives to regret. Or perhaps doesn’t. places where other people are unarmed, like schools or offi And reaction to firearms maybe that we they stop when they encounter someone else who is armed. If not, they get stopped, like the assassin at Los Angeles International Airport on July Fourth. Depending on armed marshals aboard airplanes might bean alternative to armingpilots if there were any realistic prospect of putting mar- now havea whole generation of people especially in politics and among opinion-makers in the media who have neverserved in the armedforces and have no experience with guns. Fear from ignorance is understand able. But that it should be presumptu- ousignoranceis not. Are there any possible dangers to armingpilots? Of course! Nothing on shals on even half the vast numbersof planesthat areflying every day. But the face of this Earth is 100 percent safe. Wealready know thatflying on a hypothetical marshals are no substitute for real pilots with real guns. armedtoresist terrorists is not safe. Depending on stronger cockpit closed-minded on the issue. When do not involve actually firingit. Just doors might be anotheralternative asked by Congressman Don Young, “Do you really think that 9/11 would showing an aggressor that you have a firearm is usually enough to make him back off. Having it widely known in advance that people in certain places have guns is a hugedeterrent to than pilots can get guns. But hypo- armed?” a spokesman for the Depart: ment of Transportationreplied: “Our position remains unchanged.” It was like being told to shut up, he explained. Opponents of allowingpilots to be —— the way somepeople look at a loaded information on issues from nutrition the main reason for arming pilots is not so that they can re-enact the gunfight at the OK corral. The mainreason for having guns for self-defense anywhereis deterrence. In John Lott’s iandmark scholarly have happened if ourpilots had been armed, as they should have been DISEASE SCREENING Lie STARTS HERE By to transplant surgery. not just a shopping channelfor linens and things, but a boundless source of ing it out in the aislesofairliners. But to carry guns if they wish, while the ae drugs. What an orderly worldit would tention they deserve. The Internet is armedhave portrayed horror movie visionsofpilots and terrorists shoot- liberal Sen. Barbara Boxer has come ae CARDIOLOGY As aresult of myin utero DES exposure, the product of my mother’s well-meaning ingestion of a hormone that her doctor automatically prescribed, I look at a prescription scrip stuff, just prescribedit, in a case that That is how hormone therapy was femhino Someofthis treatment was appropriate and helpful; some was unnec- The case of hormonetherapy is par- out in favor of allowingairline pilots to shoot down one of our own com- oa LINE stAaTS HERE essary and even harmful. Doctorsgot Armed Pilots Would Deter Hijackers Bush administration opposes it. Meanwhile, the House of Representatives has passed a bill to permit pilots to carry guns bya vote of 310 to 113. Although Sen. Boxer is a staunch supporter of gun control, on this particular issue she clearly understands that it is better to have an armedpilot than to haveto ordera militaryplane ie HORMONE| | THERAPY | ing links with various cancers. Ev erybody did it, just like everybody there's been discussion aplenty. Will the combination of estrogen and progestin that the womenin a federal test were urged to abandon? Wil! they sell their stock in Wyeth, the drug | studyafter another emerged suggest- showing that hormone-replacement therapy does more harm than good, other remedies? Will they stick with PRESCRIPTIONS the symptoms described in ANNA QUINDLEN if all these doors on vast numbers of airliners could bestrengthened faster thetical doors are no moreprotection those who might otherwise be inclined to start trouble in those places. Even masskillers labeled “irratio- than hypothetical marshals. Tests have also repeatedly shown that the effectiveness of security screening at our airports is also largely nal” by the media and byshrinks almost invariably start shooting in Part ofthe reasonfor the knee-jerk hypothetical. plane with no one on board who is The only meaningful question is whichdangeris greater. The swiftness with which the idea of arming pilots wasdismissed suggests noserious interest in weighing one dangeragainst another. It may be understandable that the Bush administration does not wantto buck the media on this emotional issue in an election year. But will the widows and orphans ofthose wholose their lives, because there was no armed person on board to thwart terrorists, be understanding? Save $100 on your next PC at the Gateway Power Up for School Sales Event. 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