The Name of the Game is Blame

I read an interesting post over at DrugMonkey today. The pharmaceutical primate takes Terrified Tabetic (@TTabetic) to task for inaccurate statements about HIV/AIDS. These posts plus the ensuing discussions raise a question for those of us who are healers and investigators:

What do we do when the patient contributes to their own illness?

We may know how we feel. I know that I don’t have much empathy for smokers who get lung cancer or chronic obstructive pulmonary disease. For my entire lifetime, smoking has been linked with these illnesses. Does that mean we shouldn’t study these illnesses? Should we refuse to attempt to treat them because they are self-inflicted? No, I believe we should fund research into these disorders and continue to find ways to ameliorate the suffering associated with them. I am just not the best person to do it (this may be part of the reason I ended up in pediatrics).

Many people in our society seem to have a “blame the victim” mentality for, well, almost every illness. Some magazines would suggest that if we live right/ eat right/ exercise right we will never die! My husband, the director of our diabetes center, lectures medical students on endocrine pathophysiology. A student once asked him after class why so much research was done on type 2 diabetes when it would not be a problem if people quit committing the sin of gluttony. My spouse handled the question tactfully; I am afraid I would not have. You see, my hubby has type 2 diabetes. I would have taken the time to teach that student a lesson s/he would never forget.

The biggest problem in the research arena is the scarcity of resources. I doubt that most people would mind the study of so-called self-inflicted illnesses (although none of these illnesses is due to a single factor; we really don’t understand why some smokers get lung disease but many do not) if all areas of research were money away from what I want to study that I cry foul.

That’s my one gripe with disease-based lobbying. While I belong to groups that do it, ultimately we need to increase all research funds and let the NIH, not congress, sort out where it goes. Otherwise we have politicians micromanaging biomedical research saying where money must or must not go. Special interest groups can raise funds for their own programs, as many have done, and direct research toward their cause that way.

There is nothing in this universe that is unworthy of further study.

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