Prevention Zealotry

When J visited her new pediatrician for her recent physical, she told me in her practice they checked cholesterol levels for all their patients. I looked at her in astonishment. J is only three ! Yet, the worst was not over. I almost fell off my chair when I heard the reading.

J would have to go on a diet post-haste. No more whole milk, cream cheese or eggs. J sat beside me smiling coyly at the doctor as she played with beanie babies. I wanted to burst into tears. J is at the twenty-fifth percentile in the weight charts. Now I was going to have to starve her until she fell right off it. What the doctor was prescribing for J sounded like an ultra-lite version of South Beach meets Zone diet. I had decided to seek a second opinion even before I left her office.

Once home, my resolve had already weakened. The HDL and LDL counts were too powerful an adversary and numbers do not lie. I found myself telling the daycare center to stop serving her whole milk. I did not feel at peace with having age-old wisdom on children's diet displaced by two life changing numbers.

I found a way to explain my situation with J in an article on powerful medicines which included an excerpt from Dr Jerry Avron's essay where he says

"...One early attempt to measure the benefits that come from medications and other health care interventions was based on the notion of 'human capital', and flowed directly from industrial cost-benefit analyses. A decision on whether to repair a machine or retool a factory would start by calculating the future productivity expected from the equipment, given its age and condition...We've all confronted this kind of choice with our cars or refrigerators or computers, though usually not with our grandmothers."

I had only to extend the car and grandmother analogy a little further to see where this was coming from. Children like J were being treated like manufactured goods on an effective preventive maintenance schedule.

Why wait forty years to detect and then put them on Lipitor when Mommy can go South Beach on her three year old for the cost of a cholesterol screen. Getting value out of human capital can get no easier than this. For some reason, I don't believe that J and I are winning in this game.