The Medicine Show

We tell ourselves stories about health in America. Stories about miracle cures, about scientific progress, about trust in institutions. The kind of stories that let us sleep at night, that promise order in a disordered world. Robert F. Kennedy Jr. wants to change one of those stories.

I think about the Xarelto commercial I saw last night, somewhere between the evening news and sleep. A middle-aged couple dances in their kitchen, carefree despite the voice-over listing potential side effects including fatal bleeding. The scene is meant to comfort, to suggest control over the chaos of illness. But beneath the soft lighting and gentle music lies a more complex truth about how we've chosen to talk about medicine in America.?

If Robert F. Kennedy Jr., as Secretary of Health and Human Services, were to pursue a ban on direct-to-consumer (DTC) pharmaceutical advertising, it would threaten to unravel this carefully constructed narrative.

The numbers at stake are staggering: billions of dollars, thousands of jobs, entire agencies built on the foundation of selling hope in 30-second spots. But numbers have always been an inadequate measure of cultural shift.?

I remember the first time I noticed pharmaceutical ads becoming part of our collective consciousness. It was 1997, and suddenly Claritin was everywhere, promising blue skies and clear sinuses. The ads felt like a revolution then, a democratization of medical knowledge. Now they feel like wallpaper – familiar, unremarkable, part of the background noise of American life.?

Years ago in Manhattan, I worked in agencies that derived 100% of their revenue from pharmaceutical clients. "We're artists," I remember one Creative Director saying, "We tell stories that help people understand their bodies, their choices." I wonder how they feel today.?

The truth is, we've built an entire ecosystem around these stories.

Television networks schedule their programming around pharmaceutical ad blocks. Magazine editors shape their content to attract medical marketing dollars. Digital platforms optimize their algorithms to serve pill promotions between cat videos and vacation photos. It's a system so intricate, so deeply woven into the fabric of American media, that imagining its absence feels like trying to imagine New York without its skyscrapers.?

But perhaps what's most revealing is not the potential economic disruption, but what it tells us about ourselves – about how we've chosen to medicalize our everyday experiences, to frame our health decisions through the lens of consumer choice.

We've created a world where being informed about our health means watching actors perform wellness in perfectly lit scenes, where medical decisions begin with "ask your doctor about..."?

Some say this shift would return power to healthcare providers, making them once again the primary source of medical information.

Others worry about patients losing access to information about new treatments. Both arguments miss something essential about how we've come to understand ourselves through these narratives.?

On YouTube, I watched a conference on healthcare marketing. Professionals in sharp suits discuss "patient engagement strategies" and "digital health platforms." They spoke with the confidence of people who believe they're shaping the future. But what if we’ve been telling the wrong story all along?

That's the thing about stories – sometimes we don't realize we're telling them until someone threatens to take them away.

A ban on DTC advertising isn't just about marketing: it's a challenge to one of the fundamental ways we've chosen to think about health in modern America. It's about questioning whether we need the comforting fiction of the dancing couple in their kitchen, the smiling woman on her morning jog, the grandfather playing with his grandchildren – all of them made possible by the miracle of modern pharmaceuticals, all of them carefully crafted to sell not just medicine, but a particular vision of what it means to be well.?

As I write this, another pharma ad plays on my television. A woman walks through her day, her narration explaining how a new medication changed her life. The scene is beautiful, controlled, reassuring. But I find myself wondering about the stories we'll tell ourselves about health when these familiar narratives are gone, and what new fictions we'll create to replace them.

If pharmaceutical advertising were to change significantly, what alternative channels could ensure patients stay informed about treatment options? Also, what might the ripple effects be of such a ban?