From The New England Journal of Medicine
Sex is by definition a social business -- the basic design presumes two. But the marketers of Viagra (sildenafil) would have us believe that sex is an individualist, male pursuit. Meika Loe's core argument is that the unprecedented success of Viagra in America is not the result of an exciting scientific breakthrough bringing relief to the desperate or dying. Rather, commercial interests have created a socially desirable but medically limited product -- ironically, by denying the fundamentally social nature of sex. By reducing sex to penile performance, then equating penile performance with masculine identity, a man's self-worth and social worth are reduced to the hardness and sustainability of his erections. To use Loe's example, Senator Bob Dole just had to pop a blue pill and all would turn out right at night -- except that no one asked Elizabeth. (Figure) Loe's "institutional ethnography" sets this right. She weaves together excerpts from interviews with Viagra users and their partners and friends with commentaries and illustrations of how Viagra is sold in the popular press and discussed in academic journals and at conferences. The real success of her approach is the juxtaposition of glimpses into people's intimate lives with analyses of the inner workings of large corporate institutions. Viewed through the lens of her interviews, particularly those with elderly women, Loe's analysis of the Boston Forum and its role in the search for a female Viagra is especially compelling. She concludes that this time the marketers struggled. Perhaps women's sexuality is just too complicated, or perhaps the well-honed feminist critique of the medicalization of women's bodies is too strong. Whereas American men have bought the message wholesale, women have not. Viagra is an example of the growing phenomenon that Loe calls the medicalizing of discontent. Ritalin (methylphenidate) and Prozac (fluoxetine), she suggests, are others. It involves reinventing complex sociopsychological problems as simple medical conditions. To create the market for Viagra, impotence is reinvented as erectile dysfunction and frigidity as female sexual dysfunction. In each case, the identified problem is shorn of its social, cultural, emotional, and psychological elements, leaving a core physiological dysfunction that is intrinsic to the individual and independent of society. This can be "cured" with a specific medical treatment. In short, the problem is designed to fit the treatment, not the reverse. In the case of Viagra, this "cure" actually exacerbates the wider problem, cynically ensuring the continuing growth of the condition, the treatment, and the profits from drug sales. Loe shows how in America, this medicalizing of discontent has been facilitated by the passage of legislation permitting direct-to-consumer drug advertising, online drug sales, and the entanglement (even merger) of health professionals and drug marketers. The central argument gains pace through the book, becoming increasingly compelling as the ominous implications of Viagra for American society unfold. Yvonne Marshall, Ph.D.
Copyright © 2004 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
*Starred Review* Beyond the lame jokes and self-conscious double entendres, how do women really feel about Viagra? How should they feel about a pill and an ad campaign that play upon the deepest, most personal fears of the men in their lives? Armed with sociological skill and a sense of humor, Loe takes on those and other questions in a slim volume exploring the meteoric success of, and the social fallout created by, Pfizer's little pill. She points out how the word normal has supplanted common in defining behaviors or conditions with which people ought to feel comfortable. In other words, even though reduced sex drive is common for half of all men older than 40, those who make and market Viagra--and Cialis and Levitra-- would have us believe it isn't normal. There, Loe says, begins a campaign to redefine sexual dysfunction and broaden the market for a sexual elixir. In interviews with several female partners of Viagra's target population, however, Loe learned--surely not surprisingly--that their feelings about the pill range from delight to disgust. She also learned about and reports on the pharmaceutical industry's thus-far vain attempts to create a female version of Viagra. Freely acknowledging her personal bias, Loe raises important issues, which her heavily documented research suggests are real, regarding America's "quick-fix pill culture." Donna Chavez
Copyright © American Library Association. All rights reserved
Review
"[An] engaging account and trenchant critique of the powerful blue pill. Based on extensive research, and written with clarity, grace, and wit, The Rise of Viagra chronicles an incredible intertwining of bodies, pleasures, marketing savvy, and the undying quest for the medical fix." -- Steven Epstein,author of Impure Science: AIDS, Activism, and the Politics of Knowledge
"A fine piece of contemporary history. The Rise of Viagra paints a thoughtful portrait, letting the reader decide whether the Viagra phenomenon is ultimately to be celebrated or rued." -- Katharine Greider,author of The Big Fix: How the Pharmaceutical Industry Rips Off American Consumers
"Meika Loes book tells the story of Viagra with skill and verve. She brings to that tale a sharp eye, a fine ear, and just the right degree of irony." -- Daniel Callahan,author of What Price Better Health: Hazards of the Research Imperative
"The book is not a polemic but a deep and thoughtful examination of derivative problems not anticipated by Viagras aggressive marketers. It is especially effective when placing the campaign to promote Viagra (a trade name) in the greater context of the medicalization of modern health care." ― Choice
"Meika Loe's core argument is that the unprecedented success of Viagra in America is not the result of an exciting scientific breakthrough bringing relief to the desperate or the dying. Rather, commercial interests have created a socially desirable but medically limited product-ironically, by denying the fundamentally social nature of sex. . . . The central argument gains pace throughout the book, becoming increasingly compelling as the ominous implications of Viagra for American society unfold." ― The New England Journal of Medicine
About the Author
Meika Loe is Professor of Sociology and Women's Studies at Colgate University. She is the author of The Rise of Viagra: How the Little Blue Pill Changed Sex in America and Aging our Way: Lessons for Living from 85 and Beyond.
