Sunday, October 30, 2005


The Vanishing Child

I have a piece in the Lives column of today's NY Times magazine about our decision to put Morgan on Prozac. It was probably the most physically draining writing experience of my life. Revisiting the experience of my son was slipping from my grasp was not easy; even harder was trying to crunch any meaningful thought about it into 900 words, and then into ever-fewer words as a new layout dictated shortened copy.

One of my main initial ideas was largely lost, as a result -- it became more of a personal essay and less of a pointedly historical one about why we distrust the decision to medicate children. For what it's worth, I hope the piece still helps other parents who find themselves at the same crossroads. But here are how two of the snipped-out paragraphs ran:

We raise our eyebrows at today's glossy pharmaceutical ads, and drug product placement on emblazoned mugs and pens, but it's nothing new. Barker's Nerve and Bone Liniment published branded comic books and cookbooks; Beecham's Pills issued tourist picture books; Hamlin's Wizard Oil printed sheet music; the Kickapoo Indian Medicine Company put on traveling entertainments. And patent medicine advertising didn't just support newspapers: sometimes it made them. The Gannett media chain began with the 1866 periodical Comfort –published primarily to promote Oxien, William Gannett's "Up-to date Pills for Present-day ills."

We laugh now, of course. But if today's drug reps are little different from their Victorian forefathers, a century of scandal-induced drug laws have created laboratories that actually practice some science. Pharmaceutical companies used to be hucksters of snake-oil: now they are hucksters of medicine.

As Marcia Angell and others have abundantly demonstrated of Big Pharma, their conduct and their medicines still fall far short... but they are also clearly an improvement on the past. I do not doubt that in an earlier era, had Morgan continued spinning out of control, we would have been obliged to institutionalize him simply to insure the safety of his baby brother. Morgan is a very powerfully built child -- he's always been in the top percentile of growth charts -- and his tantrums were becoming physically dangerous. One stray fist or foot at a five-month old baby, and... well, I do not care to imagine the result.

I believe this medicine gave me my son back.

The fact that drug companies engage in disgraceful machinations should not cause us to automatically conflate their bad behavior with a bad product. And the medication of children has become a convenient punching bag for lazy cultural commentators. It's an essentially distrustful and elitist stance: the presumption is that doctors don't know what they're doing and parents don't care enough. In my experience, neither is generally true, and the decision to medicate is not undertaken lightly.

Anyway. If it gets letters, I suspect it may be criticism for all the wrong reasons. I don't care, really: it's easy for letter writers to be blithe about other people's decisions. They weren't there and I was. Medication demands that you ask yourself whether you trust doctors, the drug industry, or indeed your own judgment. None of those are yes or no questions. But there are times -- when your child is before you, suffering -- that demand a yes or no answer.

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