Preventive Medicine: A world of reasons for thanks

Dr. David Katz

Dr. David Katz

Thanksgiving Day in Washington, Connecticut, could scarcely have been more beautiful. The sunset was stunning. So, too, the night sky. It’s a beautiful world — and it is in peril.

More than 15,000 scientists from nearly 200 countries have signed their support for a scientific publication reminding humanity that we are soiling our nest. This is thought to be the largest assembly of scientists ever to co-sign and directly support a journal article — and I am proud to be one of them. I hope our unity of voices is audible above the din of our seemingly oblivious culture, but I have my doubts.

An hour of watching television is enough to indicate that despite the urgency of our environmental peril, it’s business as usual down here: the relentless peddling to ever more of us of ever more material goods and bigger bacon-cheeseburgers we don’t need at devastating cost to the planet we do. As James Cameron so compellingly put it: we are sleepwalking off a cliff.

We have been doing so for decades. The new publication, and the global scientific support of it, is, as noted, merely a reminder. The original memo was delivered 25 years ago in just the same manner: a publication by the Union of Concerned Scientists as a “warning to humanity,” signed by some 1700 scientists, including most Nobel laureates living at the time. Then, as now, leading scientists from around the world pointed out that we are using up the planet’s resources far faster than they can be replenished; overpopulating the globe with our own species and wiping out others in a mass extinction event; disrupting ecosystems; and putting the survival of our own kind in question.

This is a crisis of the first magnitude, and like most crises — a mix of danger and opportunity. The danger is that we will do far too little far too late, and Homo sapiens may join the ranks of the innumerable other species our ravages are consigning to extinction. That’s depressing news for us, and far worse for our children and grandchildren.

The opportunity is that this time, while there’s still time, we will snap out of it — and save ourselves and them by saving our home. Neither you nor I, nor our children, have much hope for real vitality if our world is critically ill.

Why, 25 years after the initial warning, have we done so little to correct our course? There are, I believe, two basic reasons: uncertainty, and time. Uncertainty about the future is routinely invoked to discredit scientific predictions those in profitable power find inconvenient. This is invalid and inappropriate for two reasons.

First, while we carry on about not trusting science or scientists, we demonstrate our trust in both with our actions every day. Every time we board a plane or drive our family over a suspension bridge, we are casting a vote of confidence in science. Every time we send a text or email, we are pledging our support for the prodigious aptitudes of science. Let’s acknowledge that typing a message on a handheld device in Chicago and having it show up with perfect fidelity on exactly one other handheld device in Mumbai or Tokyo instantaneously would be magic — if it weren’t science.

Second, we know that some degree of uncertainty is inevitable. The opposite of certainty is humility. We clinicians don’t withhold treatment from our patients because we don’t know the future. We use the information we have, make the best possible decisions, and leave room for adjustments if things don’t go as hoped. Climate change is now a tangible thing, up close and personal. But even for those who want to claim we are still uncertain, the argument must cut both ways. Uncertainty means things might not be as bad as our predictive models indicate, but it also means they could be worse.

The one remaining issue is time.  If it took years for text messages from Chicago to reach their destinations in Tokyo or Mumbai, we would have all the same reasons to doubt and debate cause and effect that we have for diet and health, or the impact of our exploitations on the planet. More importantly, we would lose interest as the message inched its way across the globe. We like our gratification, like our texts, tweets, and effects in general — immediately.

There are simple and powerful actions each of us can take that can add up to make an important difference. There are other actions we can take together, as citizens, that can make a bigger difference still. Both require that we stop sleepwalking, and wake up before we fall irrevocably down. As we acknowledge the world of reasons many of us have to be thankful, let’s be sure to put the world we share on every list.