and interventions that increased healthcare costs and affected the patients’quality of
life (Anderiesz et al. 2004 ; Swensen 2003 ). Also, there were risks associated with
radiation (Brenner and Elliston 2004 ). In 2002, the American College of Radiology
(ACR) issued a statement: There was not sufficient evidence to justify total body
CT screening for patients with no symptoms or a family history suggesting disease.
“In addition, the ACR is concerned that this procedure will lead to the discovery of
numerousfindings that...will result in unnecessary follow-up examinations and
treatments and significant wasted expense”(ACR 2002 ).
In another clinical quest to make visible the invisible, the use of CT scans during
childhood came under surveillance. One study found that cumulative ionizing
radiation doses from 2 to 3 head CTs could triple the risk of brain tumors and 5– 10
head CTs could triple the risk of leukemia (Pearce et al. 2012 ). Low-level radiation
exposure may also increase the risk of circulatory disease (Little et al. 2012 ).
How often to screen for breast cancer (Oeffinger et al. 2015 ; US Preventive
Services Task Force 2009 ) and whether to be screened at all for prostate cancer
(Harris and Lohr 2002 ; Lin et al. 2008 ) are continuing debates. As Schwartz et al.
( 2004 ) point out, public health officials, physicians, and disease advocacy groups
have worked hard to persuade individuals in the USA about the importance of
cancer screening. There are dilemmas associated with“seeing”what was previously
unknown.
Conclusions
This book has been a multi-disciplinary endeavor because the examples and
questions are multi-disciplinary, from the nuts and bolts of measurement, to com-
parisons between subjective experience and biometric assessment, to the phe-
nomenology of lived experience. Given our long history of search and discovery, it
is perhaps not surprising tofind that we still yearn to know what’s going on inside
the black box of our genes, bodies, and minds.
Thisfinal chapter reviewed the relationship between methodological innovation
in physical and functional assessment and our human experience. It also examined,
one more time, the potential disconnect between subjective and objective measures
of morphology (e.g., obesity) and physiology (e.g., hotflashes). It ends with the
assertion that making something visible that was previously unknown, such as
one’s genetic risk or a slow-growing cancer, is not without dilemma.
We live in our bodies, if we are lucky, for sixty, seventy, or more years. How
much can we know about what is going on in that body? We live our genetic code
every waking moment, but it is, for the most part, invisible to our experience. We
grow from a fertilized cell to a human adult, but we are generally unaware of the
growth and development taking place. The physiological activity of the ovaries and
testes plays a major role in shaping our bodies, our behavior, and the shape of our
lives. Yet much of the activity of the gonads is“invisible,”without noticeable
external signs. Premenstrual syndrome may give us a clue to changing levels of
15 The Shrinking Black Box of Human Biology 321