Database Nation

Chapter 6. To Know Your Future

Did you have an abortion when you were fifteen?

A few years ago, when your marriage was going through an especially rough spot, our records indicate that you were treated for a sexually transmitted disease that your wife didn’t have. Does she know?

Is that lonely child with Down Syndrome in the state hospital yours? Why don’t you visit her more often?

I told Janice about the headaches you’ve been having at work. She said that when you guys were kids, your father used to smash your head against the wall. Do you think you might have brain damage?

Did you know that you are adopted?

Most Americans consider their medical records to be the most sensitive pieces of personal information that they have. Medical records are beacons into our past. They reveal secrets about families. They strip us naked, as if we had been prepped for surgery. They remind us about things we would rather forget—and things that we don’t want others ever to discover.

Medical records are also windows into our future. They are imperfect oracles, to be sure—a healthy person walking across the street can be hit by a truck—but many illnesses and medical conditions follow a predictable path. People with untreated blockage of their coronary arteries tend to have heart attacks; diabetics who can’t control their blood sugar are apt to go blind; people with untreated chronic depression are inclined to attempt suicide. Genetic records can be even more revealing.

But medical records tell as much about ...