Books: I'm prudent, you're neurotic

BY ALMOST any medical index, human life in our culture is more secure and risk-free than at any time and place in history. We enjoy very low rates of infant mortality. Our prospects of living to a ripe old age are excellent. Our chances of escaping from or recovering from debilitating disease are very good, and even if we do fall sick or have an accident we will generally not suffer anything like the pain and degradation of our ancestors.

Why is it, then, that we respond to wildly unlikely threats to our health with hysteria and outrage? Certainly, health scares seem to reflect as lack of proportion. Appalling though CJD is for its sufferers, only a tiny handful of people have developed the disease as a result of eating mad cows. Individually, any of us might reasonably have fed beefburgers to our infant daughters on a daily basis with less expectation of (salmonella- ridden?) chickens coming home to roost than of winning the lottery.

Dr Dalrymple, the pseudonymous Spectator columnist on medical affairs, is of the opinion that we have an immortality complex; that we have come to regard perfect health as the normal state of human existence and illness and death as intolerable aberrations. Essentially his book is an extended echo of the Vogons' impatience with the human race; "Oh, for heaven's sake, Mankind," he wants to say, "grow up!"

Dalrymple has particular contempt for our need to find a culprit whenever we are faced with a crisis (the government, the drugs companies, the agriculture industry), and for the scientists who pursue what he calls associative epidemiology (noting a statistically significant coincidence of a disease and, say, the consumption of coffee). He thinks the main purpose of these enterprises is to attract research funds rather than to improve the lot of the human race. He is also very stern with those of us who discover that we have been made ill without our noticing it - the victim syndrome, whether it be post-traumatic stress or silicone breast implants. We become hypochondriachal, he says, and develop a financial stake in being sick.

Dr Dalrymple writes entertainingly, and while many of his observations are prejudices, one often finds oneself sharing them. It is possible to quibble with almost everything he says, but his broad description of the idiocy of health paranoics is unarguable.

Dr Dalrymple contends that in fretting about illness that will not happen, and in positioning ourselves as victims of expected illness, we actually experience a reduction in our happiness. He seems to think that we have just about reached the limit of the improvement in human life that medicine is capable of, and in fact that happy state was reached the moment he qualified as a doctor.

He approves of the Clean Air Act, but wouldn't bother with any modifications. He accepts the association between smoking and lung cancer, but doubts that such clear-cut connections will be made again.

But is it neurotic to eat less salt to avoid the risk of stroke? To practise safe sex for fear of AIDS? To avoid passive smoking? To take regular exercise? Clearly, health consciousness as far as I practise it is reasonable and prudent. Anything further is neurotic.