Nature has the upper hand. So far it has “gently” protested, but …

Bernard Lown, MD

Essay 33, Part 1

The planet is warming. Facts are marching in battalions, their steps in cadence, their destination known. The few contrarian scientists who in the past demurred are now overwhelmed by the sheer weight of confirmatory evidence. It is certain that Earth will grow hotter and less hospitable to life. Not a day passes without new warnings. Among scientists, the optimists profess that global warming will inflict dislocations, misery, and colossal social costs. The pessimists envision doomsday scenarios.

The recent quadrennial national election, the costliest spewing of political speech in human history, provided a democratic catharsis. Presumably all key issues confronting our society got an airing. There was ample opportunity in the four major “debates,” with 60 million or more viewers, to raise the salient issue of our age. Yet the phrase global warming did not cross the lips of any of the four moderators, nor did the presidential or vice-presidential candidates mention this seemingly proscribed subject. Once elected to a second term, President Obama said that his first priority would be jobs and that he intended only to foster “a conversation” on climate change.(1)

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Power to the people: Patient in command

Blog Essay 32*

Bernard Lown, MD

Benedictions to patient-centrism, patient privacy, patient autonomy — everything-for-the-patient rhetoric — flow from the pervasive PR of the health establishment. The more I hear these jingles, the more my heart skips a beat. At my age I can’t afford arrhythmia’s. My experience as a cardiologist murmurs that these extra-systoles may be auguries of the hereafter.

I have learned that in our market culture, whenever a message is oft repeated, you can suspect a sales pitch. Indeed the patient looms large as a commodity to be seduced by medicalization, to be showered with drugs, subjected to endless tests, imaged to expose hidden recesses of anatomy, probed by magical genetic analyses for the Ur-self, and salvaged by so-called life-saving interventions. At the same time the patient has grown ever more Lilliputian. You the patient, with real or imagined dysfunctional biological machinery, is largely present; but you the sentient human being is largely absent. The contradiction is beyond Hegelian dialectics.

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