Abstract
In researching the biomedically-engineered drug Neulasta (filgrastim), a breast cancer patient becomes aware of the extent to which knowledge about the development and marketing of drugs influences her decisions with regard to treatment. Time spent on understanding the commercial interests of insurers and pharmaceutical companies initially thwarts but ultimately aids the healing process. This first-person narrative calls for physicians to recognize that the alignment of commercial interests transgresses the patient’s humanity.
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Notes
The Indiana University Medical Center is a consortium of tertiary care hospitals, including a school of medicine with over 300 faculty members, located on the campus of Indiana University – Purdue University – Indianapolis, where I teach literature. The cancer “pavilion,” as it is called here, is little more than a hundred meters from my office.
The disease begins in the appendix. A piece of appendiceal tumor breaks off and “seeds” the peritoneal cavity, creating tiny mucin-producing tumors that eventually compromise peritoneal function. Pseudomyxoma patients periodically undergo “debulking” operations, where a surgical oncologist removes as much tumor as possible, without having to resection the intestines.
With all due respect to Susan Sontag, who died on 28 December 2004 while I was writing this piece, I believe that investment in bodily metaphors helps us cope psychologically with illness. Sontag’s position is that the sick must free themselves from the bondage of illness metaphors, which were constructed in medical cultures of despair (tuberculosis in the nineteenth century, cancer in the twentieth, and AIDS currently).
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Acknowledgements
I am grateful to Paul Komesaroff, Chris Jordens, Catherine McGrath, and Miles Little, whose insightful questions and comments helped transform this piece from a conference presentation into its present form. Thanks also to Anne Reifel Miller and Michael Maitzen of Indianapolis, Indiana.
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An erratum to this article can be found at http://dx.doi.org/10.1007/s11673-007-9058-1
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Schultz, J.E. Corpus Interruptus: Biotech Drugs, Insurance Providers and the Treatment of Breast Cancer. Bioethical Inquiry 4, 93–102 (2007). https://doi.org/10.1007/s11673-007-9045-6
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DOI: https://doi.org/10.1007/s11673-007-9045-6