Los Angeles Times

We’re not happiest or healthiest


Sanjay Gupta is a country doctor — not in the old sense of the term but because he travels the world learning different countries’ medical success stories. In his new CNN series, “Chasing Life,” each episode offers a contrast to the United States, where medical technology is top-notch but life expectancy and happiness are in decline.

So other places show us up as not top of the heap?

There’s a lot of great things about our healthcare system. [But] we’re spending trillions of dollars [and] life expectancy is 23rd, 24th in the world. Life expectancy has dropped three years in a row in the United States.

One word that comes up in the series is stress.

Other countries that have lifestyles that maybe aren’t that different than the United States continue to go down in mortality and up in life expectancy. Why? They have structures and systems in place to allow people to have reprieve from stress. They assign real value to it. In the rugged individual­ist society in the United States, we take great pride in not getting a break from that stress.

You went to Nor way. What makes Nor way healthier and happier?

They have a tremendous social safety net in terms of healthcare, in terms of education, in terms of the elderly. There’s something else too. We were in a city north of the Arctic Circle, so it’s freezing cold and plunged into darkness for months. People overcome a significan­t challenge just in living in a harsh environmen­t like that. Psychologi­sts talk about where, if you overcome some sort of challenge on a regular basis, your capacity for real joy becomes much higher.

What have you adopted in your life as you’ve traveled?

Something I did not expect was [finding out about] the stress we unwittingl­y place on people around us. In my case, especially children. The expectatio­ns on the next generation can create a toxic level of stress. [Japan] lost the Second World War, and then built the miracle economy. There’s no way that you can maintain that pace of growth, and yet the next generation felt like they had disappoint­ed, that they had not [met] expectatio­ns. I’m trying to be very careful not to do that to my own children.

The U.S. creates the most advanced treatments in the world, and yet millions of people here can’t afford them. If you were building a system what would it look like?

[Ours is] a hybrid system, half public, half private. You got intermedia­ry insurance companies, you got intermedia­ry pharmacy benefit managers. It’s so opaque; we just have no idea what things really cost and where these costs are going up. This is not a political answer: I think when you look at single-payer systems you recognize the advantages. People will say, should that single payer be the government? Is the government the best arbiter? Those are fair questions. But I think once you start to eliminate or at least reduce third-party interventi­on [it] would over time cost less — maybe not right away — and provide care for every American.

Can you unpack our decline in life expectancy?

Heart disease and cancer remain the biggest cause of death; the big thing [that] has changed has been this increase in deaths of despair. Death by suicide has gone up some 30%, 35% over the last 20 years. Everyone knows what’s been happening with drug overdoses and particular­ly opioids. And then there’s also liver cirrhosis due to alcoholism, which surprises a lot of people. It is primarily whites, and primarily white working class that has had the most significan­t increase in mortality.

The last time we had three years of sustained life expectancy drop was 100 years ago. And what was happening 100 years ago? We had a global flu pandemic and we had a world war.

Other cultures don’t first turn to the medicine cabinet when they have a problem.

Turkey is a country that is the largest producer of legal opium in the world. They export almost all of it to the U.S. I was in intensive care units [in Turkey] where patients were coming out of open-heart surgery — no narcotics. They were doing things that you might find surprising. Surgeons playing instrument­s for their patients as they wake up from anesthesia. And I said, “Does that really work?” And they gave me some answer like, “It’s not that the music is a narcotic medicine. It’s more that we’re changing how someone perceives pain.”

“Chasing Life” — the title is compelling. Do we ever catch it, or does it just catch us?

Not to sound too simplistic but it’s not how many years of life, it’s the life in your years. We expect near the end of our lives that we’re going to spend time in hospitals, that we may spend time in extended-care facilities, that we may have difficulty getting around, require multiple medication­s. In Japan, they [say] you want to live your life like an incandesce­nt light bulb: Burn brightly, and then one day just go out. You don’t want to live like a fluorescen­t light bulb, with a bunch of flickering near the end of your life.

This is an edited excerpt of the podcast “Patt Morrison Asks” posted at soundcloud.com/pattmorris­onasks.

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