APPARENTLY ONE of the benefits of living longer and being healthier is that it greatly expands the opportunities for feeling terrible. Dr. Arthur J. Barsky, discussing this strange state of affairs in a recent issue of the New England Journal of Medicine, notes that by any objective measure, the health of the American people has improved greatly during this century, and yet people "report more frequent and longer-lasting episodes of serious, acute illness now than they did 60 years ago, despite the introduction of antibiotics during the intervening period."
He cites two surveys taken 19 years apart: "Asked about common somatic symptoms such as dyspnea, palpitations, and pain and whether they felt healthy enough to do the things they wanted to do, men and women both reported more ill health in 1976 than they had in 1957."
Dr. Barsky, a psychiatrist at Massachusetts General Hospital, doesn't exactly suggest that we have become a nation of hypochondriacs. He says the paradox is due in part to the fact that many of the diseases which used to strike people down early in life have been overcome, while less progress has been made against "the chronic and degenerative ailments that come with longevity." The result is that "we live longer, but a greater proportion of our life is spent in ill health."
He also believes, however, that the widespread feelings of ill-being may have something to do with the national trend toward health-consciousness. He means by this the pursuit of the "healthy life style" as well as the "growing fascination with diet, nutrition and weight loss," the preoccupation with how good we feel and the general belief that modern medicine can cure just about anything. "Paying increased attention to one's body and one's health," he writes, "tends to make one assess them more negatively, with greater feelings of ill health."
Dr. Barsky doesn't know quite what to make of all this and so confines himself to advising his fellow doctors to try not to raise unrealistic expectations among patients and the public. For laymen seeking further temporary relief, we suggest that you take two pizzas and stop complaining about dyspnea if you don't even know what it means.