Friday, July 1, 2011

Literacy, health, and the 4th of July

When power leads man toward arrogance, poetry reminds him of his limitations. When power narrows the areas’ of man’s concerns, poetry reminds him of the richness and diversity of his experience. When power corrupts, poetry cleanses, for art establishes the basic human truths which must serve as the touchstones of our judgment. The artist becomes the last champion of the individual mind and sensibility against an intrusive society and an offensive state.” JFK[1]

It is easy to lose our peace of mind in todays fast pace cities and societies[2] where loud noises, consumerism, dense traffic, pollution and superficial, meaningless data flood our senses. Watching too much TV and playing too many video games contribute to the problem, and also push out reading printed matter (and loved ones, too for that matter.) These are some of the reasons why depression will be the number 1 disease in this decade,[3] outpacing heart disease, which also is worsened by the above inherent inactivity.[4]

Despite the tsunami of data in our lives, we are “dumbing down,” a problem that also afflicts most medical doctors, I am afraid:

The amount of information published in the medical journals far outpaces the ability to organize it... we don’t know a whole lot anymore about too many topics... This dumbing down is not ideal for medical education… A broad glimpse of recent medical findings may help some of us retreat from reductionist ways of thinking that have been ingrained as we become increasingly specialized. Such cross fertilization can stimulate new avenues of research.”[5]

Somewhat aware of this pitfall, I chose to become a Generalist Doctor while in training. To prepare myself, I seldom took my medical books home, so I would have more time with my family and read literature. Asimov, Chekov, Hugo, Miller, Hemingway, Pagnol, Wolf, Buddha, Aquinas, etc helped me keep grounded and conscious of what medicine really is service to “humanity.”

Medicine and scientific developments rely on multidisciplinary involvement of science and humanities. The arts and humanities can also contribute ways to re-conceptualizing medicine itself... Medicine and health are human concerns in the widest sense... The humanities can foster a depth of humane understanding, knowledge and experience…

The medical humanities encompass history, literature, philosophy, ethics, theology, sociology, anthropology and law. They value the aesthetic as well as reason, focus on meaning as well as emotion and explore ambiguity, uncertainty and complexity as well as theoretical lucidity. They offer understanding through synthesis as well as analysis. The humanities develop analysis of personal and professional values and the capacity for empathy and teamwork.”[6]

Patients also benefit from cultivating peace and the finer things in life. Of course, low incomes make this difficult, but, still, used books are cheap. Less TV and more reading do improve our health.[7] And, we may find out some of the reasons our health care system is so chaotic and dysfunctional.

In his last book, “Bill Moyer’s Journal,” he interviews many thought leaders, including Wendell Potter, a former insurance company PR executive. Mr. Potter’s testimony before Congress was not publicized very well at the time, but it had profound revelations. He claimed that his insurance company, following the play book of every other insurance company, engaged in well orchestrated and funded tactics to discredit sound solutions to the problem by falsely planting misinformation about “socialist” control of their industry. Mr. Potter’s cronies felt that the movie “Sicko” in 2007 was quite dangerous because it told the truth about their industry’s nefarious dealings that are based on maximizing profits, not patient care.

In his book Bill Moyer also interviews Dr. Margaret Flowers who was arrested for trying to reach President Obama with her proposal, backed by most doctors and patients, that the USA adopt the Single Payer system. Of course, under pressure from Mr. Potter and his ilk, President Obama abandoned his campaign promise to look into a system used by the top 5 ranking countries in health parameters.

And so it is that We The People must always be “educated” and aware of the “noise” from special interests that will tend to demonize anything that favors We The People and cuts into their profits. But, as history has it, We The People are the real leaders. Every mayor movement and social change has been started and carried out by grass roots movements. This fact is well documented by another Moyer interviewee, the late professor Howard Zinn who wrote one of my most favorite books, “A People’s History of the United States.” of the USA.” I first became aware of this point reading Tolstoy’s “War and Peace” while in Medical School; so-called “leaders” are ultimately forced to follow We The People. But, since the “leaders” end up controlling the media and other institutions, history ends up written in a way that discounts We The People’s input.

Our role in society demands that we stay informed and aware that the “dumbing down” of our society threatens our very democracy. Unfortunately, getting the education our children need is proving to be a challenge these days. Believe it or not, our climbing obesity rates is also keeping some of our children from attending school, which then sets them up for lower incomes and related health problems.[8] But, if they do end up going to school, the lunch they are given, which is leftovers from industrialized food that the regular consumer won’t but (for example, chicken that were egg-laying hens have splintering bones,) will add to their bulging waistlines.[9]

As we celebrate our country’s independence, let us ponder our role in our democracy and commit to be “educated,” to read and inform ourselves so that our government remains “of the people, for the people and by the people.” Staying well informed must include the humanities and art, in pursuit of which countless Americans have been and are open-minded enough to seek lessons from other cultures. The number #1 non-fiction bestseller right now, McCullough’s “The Greater Journey,” (he also wrote “1776”) chronicles the lives of pioneering American artists and writers who lived in Paris over a hundred years ago, a time charmingly covered by the movie “Midnight in Paris,” now playing in your neighborhood theater.

Happy 4th of July!

[1]Spend slightly less on health and more on the arts: health would probably be improved,”

British Medical J. 2002;325:1432

[2] J. Nature, July 2011

[3]Using Ecological Momentary Assessment to Determine Media Use by Individuals With and Without Major

Depressive Disorder,” J.Arch of Peds & Adol Med 2011;165:360

[4]Television Viewing and Risk of Type II Diabetes, Cardiovascular Disease, and All-Cause Mortality,”

JAMA 305:2448

[5]Dumbing down” JAMA 2003;289:1349

[6]Medicine, the arts and the humanities,” J. Lancet 2003;362:93

[7]Reading is fundamental,” J. Arch Int Med 2005;165:1943

[8] Utah State University study reported on June 20th 2011 in the Salt Lake tribune

[9]National School Lunch Program Participation and Sex Differences in Body Mass Index Trajectories of Children From Low-Income Families,” J. Arch of Ped & Adol Med 2011;165:346.