subjective mental age, while learning new skills can decrease subjective age. Loss
of friendships can increase subjective social age, while expanding social connec-
tions can decrease subjective social age. In this way, Agogo et al. ( 2014 ) argue that
individuals can“bend time,”with a resulting change in the distance between
subjectively perceived and chronologically measured age.
Finally, it may be getting harder to keep emotions within a black box.
Computers can read faces and identify even complex emotions (Du et al. 2014 ).
This may have implications for individuals with psychiatric disorders, social and
cognitive impairments (e.g., autism spectrum disorder), or pain. Even without
looking at our faces, mouse movements and keystrokes can detect emotions when
we are at the computer (Hibbeln et al. 2016 ; Nahin et al. 2014 ).
When Should the Invisible Stay Invisible?
In this book, we have been interested in phenomena that can be perceived, and how
that perception corresponds with objective measurement. We have also grappled
with the measurement of phenomena that cannot be perceived subjectively, such as
bone health. However, making something visible that was previously unknown,
such as one’s bone mineral density or genetic risk, is not without dilemma. Clinical
decisions and lifestyle choices are affected by increased knowledge about what is
going on inside the body and mind. Increased knowledge also alters the experience
of living in the body. Is there ever a reason to let well enough alone and not make
visible the invisible?
Twenty years ago, whole-body computed tomography (CT) screening was
marketed as a form of proactive health care. This matched public enthusiasm for
screening, as demonstrated in a national telephone survey carried out in 2001–2002.
The results indicated that 87% of older adults believed routine cancer screening to
be a good idea, with 66% saying that they would want to be screened even if
nothing could be done, and 56% saying that they would want to be tested to see
whether they had a slow-growing cancer even if the cancer grew so slowly that it
was unlikely to cause problems in their lifetime (Schwartz et al. 2004 ). What better
way to see inside the black box of the human body than to undergo multiple
cross-sectional radiographic images of the head, neck, chest, abdomen, and pelvis?
In a BMJ editorial, radiologist Swensen ( 2003 : 894) wrote,“Whole body screening
with computed tomography is the focus of a major advertising campaign in the
United States. Enticing testimonials on billboards and radio spots urge the public to
use this technology, implying that there is much to gain and little to lose.”
According to Anderiesz et al. ( 2004 ), 15 million whole-body scans were performed
in about 400 centers from 2000 to 2003 in the USA. It turns out that the cost of
making visible the invisible was high.
Although early stage cancers could be, and were, found using whole-body scans,
the value of whole-body screening was diminished by the high likelihood of
clinically unimportant ancillaryfindings that resulted in needless further diagnoses
320 L.L. Sievert and D.E. Brown