introDuCtion
A doctor tells his patient, “Your blood pressure is off the chart, you’re
overweight, out of shape, and your cholesterol is god- awful. In short I find
you perfectly normal.”
A doctor tells his patient, “the good news is that your cholesterol level
hasn’t gone up. the bad news is the guidelines have changed.”
t
hese two jokes are both funny, and their intersection points to a
new kind of health, one in which to be normal is to have symp-
toms and risk factors you should worry about, and at the same
time to not know whether you should be worrying about yet more
things. In fact, to not worry about your health, to not know as much
as you can about it, and to not act on that knowledge is to be irrespon-
sible. Some public relations campaigns feature people who are the
“picture of health” but yet warn, “You might look and feel fine, but
you need to get the inside story” (fig. 1). It appears to be that feeling
healthy has become a sign that you need to be careful and go in for
screening. To be normal, therefore, is to be insecure: this is the sub-
ject of my book.
Health in America today is defined by this double insecurity: never
being sure enough about the future—always being at risk—and never
knowing enough about what you could and should be doing. Para-
doxically, the insecurity continues to grow despite there being an
equal growth in research about risks, screening, and treatments and
constant growth in the amount of medicine consumed each year—as
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