We live in the greatest place on Earth. I am reminded of this every day on my radio show, when I spend an hour talking to people about the most amazing -- and sometimes shocking -- subjects. We have few limitations. The government, religion, sex, politicians, and medical practices are all fair game, as they should be. Despite our country's problems -- and I don't want to minimize those -- we do have the proverbial life, liberty, and pursuit of happiness.

But we -- you and I -- have created a kind of chaos because of where we live. Our freedom -- freedom to do business, freedom to make personal choices, freedom to say whatever we want -- has allowed us to have the best and worst that society has to offer. And nowhere is that more evident than in the world of health and medicine.

If I have to be sick anywhere, I'd rather be sick here. But that doesn't mean everything is perfect; and many Americans have become riddled with doubt or confusion about the state of medicine in America. Sometimes it really can be difficult to determine what is best for you and your family. It seems that everyone has an opinion about the best path to good health.

I am reminded of a letter I received not too long ago, one that symbolizes the craziness that we all have to sort through.

"Dear Radio Host," it began, like so many of the commercial pitches I get every day from product and personality promoters -- most of which go right into my wastebasket.

This promotion was straightforward but instantly suspect: "How to protect yourself against West Nile fever without toxins." Mosquito season was on the way, and this "expert" was seizing the moment.

OK. We have a disease that has killed hundreds of Americans who've been bitten by mosquitoes, and the best protection, according to all medical experts, is to use a potent repellent and take other protective measures when outdoors during mosquito season. But this guy had better ideas, and he wanted the opportunity to talk about them on my show.

Over my dead body. But I kept reading.

Instead of using traditional repellents, according to this letter, we should all go to the kitchen for "natural substances for killing the virus fast." Aha. "Natural" -- the word that's launched multimillion-dollar supplement companies, alternative grocery chains, and endless lines of beauty products. If it's "natural," it's got to be good for you, right? Well, tobacco and certain wild mushrooms are natural and look where they'll get you. The cemetery.

The West Nile fellow's natural repellent ideas were imaginative, to say the least, and my favorite made me want to plan a trip to Italy. In short, he seemed to suggest that before heading outdoors we all smear ourselves with a combination of spaghetti sauce and honey. Yes, you read it right.

I knew some talk show somewhere would soon have him on as a featured guest, because he claimed thousands of past bookings on radio and television programs. And people would hear him and not know just how ridiculous his advice was, and somewhere unfortunate little kids would spend a summer outdoors looking like giant meatballs. Hopefully, that would be the only damage done by his advice.

How did the most sophisticated, technologically advanced country on earth get to the point where fears can be manipulated like this? Why are so many of us gullible? Why are some of us convinced that conspiracy is behind much of legitimate modern medicine and health science?

I don't have a simple answer to these questions. I sincerely believe that most of us want to do the right thing for ourselves, but the pursuit of healthiness is not a straightforward matter. Far from it. One day the newspaper headlines and morning talk shows trumpet news of research showing that margarine is good for you. A few months later, oops, it now appears it will kill you. Carbohydrates go from being the healthiest foods on earth to a hidden menace in cakes and cookies, a quick path to a coronary. Chocolate is the devil or it's the answer to everything from toe fungus to baldness. Who wouldn't be confused by the ceaseless information overload -- even if every story were thoroughly and accurately reported? Which they frequently aren't.

And sometimes, science has been known to cut a wide swath through an issue -- estrogen is a good example -- before we fully know what's right and what isn't. Early research doesn't always tell us everything we need to know, but occasionally our society is so desperate for a solution that doctors and patients grab at whatever seems best at the moment.

When women began calling my show twenty years ago with their first estrogen therapy questions, lots of good doctors had already bought into this treatment. I couldn't see the proof that menopausal women would benefit from it, but that was one opinion -- and I can't blame women who went with their doctor's advice. These were smart physicians who wanted nothing more than to help their patients -- we just didn't see the research quite the same way.

It took a long time for studies to get to hard answers on estrogens, but we now know that not only do they do no good but also that they may actually promote killers like heart disease and Alzheimer's. If doctors are confused about something this profound, how can the public fail to be confused -- and fearful?

Unfortunately, some of the very liberties we so cherish in this culture have now become a source of danger to our health. The promotion of health has become a huge business that sometimes veers out of control. Yes, we have amazing new medications, medical tests, and technology that save many lives. But the bad apples in the industry -- and medicine is an industry -- have no qualms about cashing in on our anxieties.

We are told we can fight cancer, protect our memory, and improve our sex life, and almost everything seems to come with a "guarantee." The manufacturers and marketers often hide behind the right to free speech, but they can make Pinocchio look like a saint in need of a nose job. Tiny tight buns, bulging bosoms, and six-pack abs are not just an 800 number away. Remember: Nothing good or lasting comes that easily.

In spite of our ever-increasing longevity and strides toward better health, we are a society of the worried well. We often rush to emergency rooms and doctors' offices for the most minor ailments. While images of terrorism, bio warfare, and SARS swirl around us, we freak out about the mercury in our fillings, the mold in our basement, the trans fats in our Oreo cookies. The incongruities are humorous, but they are also unsettling.

At a deeper level, I see worries that border on paranoia, and those could endanger all of us. I have talked to people who think there is a medical conspiracy that will prevent cancer from ever being cured. One in five Americans -- 20 percent -- believes that an AIDS vaccine already exists but is being kept secret from the public. And over 40 percent of us don't know that all vaccines first must be tested on human volunteers before being made available to the public.

The panic about childhood vaccines shows itself on my show at least once a week, and some people are nearly hysterical in their belief that these protective substances cause autism. Why don't more of us remember the horrible diseases that have all but disappeared because of these vaccines? And why don't we want to believe the scientific proof that infants are showing the earliest signs of autism months before they are exposed to any vaccines?

I still remember the women with breast implants who picketed the San Francisco television station where I broadcast, because of my view that breast implants did not cause disease. But science be damned. By the time implants were exonerated, billions of dollars had been paid out by juries that were overwhelmed by slick lawyers and questionable experts. I hate that, but do I still believe in our justice system? You bet, though changes are in order.

"Junk science" -- the use of marginal or faulty research presented by people with initials after their names -- has destroyed many otherwise reliable companies and products. In most legal situations, a high standard is required for evidence presented in courtrooms. But when it comes to health and science issues, we lower the bar. How else to explain the fact that one recent lawyers conference on how to cash in on the mold panic was promoted as "Mold Is Gold."

And our society's penchant for lawsuits has taken a new turn. We are abdicating our responsibility to take care of ourselves. We are too fat because McDonald's forces us to eat their fries. We have lung cancer because the tobacco companies made us smoke. Blaming others for our poor health habits means we have given up the control to improve them. That scares me.

With all the voices out there vying for your attention, no wonder you're calling me with questions about stress and anxiety like never before. I want to help, but you have to believe you can help yourself. You can regain control, you can feel more optimistic about the future, but it won't happen overnight, and it requires hard work.

My approach in Life, Liberty, and the Pursuit of Healthiness is to educate by example and focus on the health issues of most concern to you. To do that I've drawn on a familiar yet untapped resource: You.

Over the past twenty-five years I have probably answered fifty thousand questions on the air. You have been my greatest teacher, and now I want to return the favor by providing the latest information I can find on issues that you have most consistently brought to the fore. These questions are the ones that we all face at different points in our lives and that dominate our collective health consciousness.

You may recognize yourself or a friend on one of these pages, because we've kept the questions real, with all their quirks and idiosyncrasies. While you may not be dealing with exactly the same problem, we've packed the answers with information that we hope will be beneficial to all.

Sometimes you will find clear-cut, black-and-white responses, but not always, because medicine doesn't have all the answers -- and the questions keep changing. No two headaches or stomachaches are the same. That's what makes life and medicine both interesting and, at times, a bit scary.

As you sort through the chapters, looking for a specific topic or just browsing, please remember two points that I believe are critical to moving healthcare in the right direction.

One: Science and objective thinking are our only allies against fear, superstition, and hype. It's much healthier to be skeptical than fearful, but don't ignore hard facts. And if you don't have the facts, ask for them.

Two: Doctors will get off their pedestals when patients get off their knees. We are your partners. We want you to get well. We need your help. So, let's get on with it.

Copyright © 2004 by Dean Edell, M.D.