Blog | Thursday, November 16, 2017

Ode to the bulletproof


I am a specialist in “preventive” medicine. My career has been all about leveraging the many means at our disposal to add years to lives and life to years; to prevent the frequently avoidable reasons for mourning. Instead of preventing mourning, I find myself mourning prevention.

The massacre in Las Vegas is almost too horrible to address; the utter carnage of a battlefield, transfiguring a scene of sweet recreation. The juxtaposition—one image in which we might easily picture ourselves with loved ones; the other fuming with the admixture of panic, dread, and trampled blood polluting the air—hits one almost with the force of a bullet.

Thankfully, though, we are bulletproof. Scenes of carnage just don't matter. Facts don't matter. Why should they? We have ideology. We have dogma. We have alternative facts, or at least, alternatives to facts.

These things work beautifully. They allow us to propagate conspiracy theories about vaccines, while enjoying freedom from the ghastly, historical scourges vaccines so reliably prevent. And then, they allow us to invoke other reasons when our children are once again vulnerable to diseases we might have spared them.

They allow us to keep finding reasons to extract fossil fuel from more places, despite our capacity to generate energy from sources that would not in turn help generate storms that utterly devastate our cities and island neighbors. What a boon it is to be spared such inconveniences.

They permit us to feign ignorance to the true liabilities of our diet and play instead at debating deep mysteries, even as the global reality hides in plain sight: everywhere our hyper-processed diet of foods that favor corporate profit over public health go, obesity and chronic disease follow. We will, I presume, throw in bulletproof coffee for the countries we are raping, but at the customary extra charge. No freebies!

We are bulletproof to the truth.

Perhaps it is the ascendancy of alternatives to truth that so polarizes us into the paralysis that always favors the way we are, however bereft of sense or hope, over any aspiration to how we might be. Perhaps it is our righteous minds that return again and again to their opposing corners, only to come out fighting.

Even in such context, it is notably bizarre that the recurring butchery of gun violence is in defiance of the majority will for reasonable gun control measures. Defense against tyranny is invoked as the sacred basis for a Second Amendment yoked into a tyrannical act: majority will, denied by the concentrated power of few.

What needed to be said about Las Vegas has been said, any number of times. But we will conspire to ignore it. We will continue to prioritize the theoretical threats of morbid fantasies over any number of actual body bags filled with former loved ones. We will continue to let profits for the few prevail over the will of the many, and along the route of this endless parade of injury, suffer the insult of hearing that we are being tyrannized thus for the sake of defense against tyranny.

We are bulletproof to hypocrisy, too.

Einstein famously told us we should never expect to solve problems with the very methods that created them. One is tempted to think selling ever more weapons of mass destruction to deter mass destruction might qualify. But we are, it seems, bulletproof to Einstein's counsel.

We are bulletproof to Ben Franklin's counsel, too. An ounce of prevention is worth a pound of cure, except to those selling the cure at a mark-up. Except to those selling the causes, too, from bullets to bacon, soda to donuts, weapons of mass destruction to the conspiracy theories that invite us to use them. The better angels of our nature aren't buying, but they've long since left the building, leaving us to barter.

We are bulletproof to truth. But to the actual bullets that tear into our children, our sisters and brothers; to the climate that drowns and parches us; to the foods that fatten us; to the viruses that pock and ravage us; to the diets that degenerate us, alas, not so much.

My career has been devoted to preventive medicine, the art and science of assessing the vulnerabilities we have now to prevent the tragedy we need not encounter tomorrow. The preferred method these days is to deny the vulnerabilities, refute the message, repudiate the messenger, and find someone to blame for the tragedy when it happens. Find them, blame them, and maybe shoot them.

We seemingly have no interest in prevention, preferring to let horrible circumstance of every description we knew full well how to prevent happen, then finding a favored scapegoat. Our children, in line behind us, awaiting their turn to play, deserved better. Sorry, kids; meet the enemy, it is us. We are the Once-ler, and every other villain in every fable we ever read you.

There was much, all along, we might have done to prevent all this mourning. We may, instead, mourn prevention, and so, today, I do. Alas, preventive medicine.

We are bulletproof to the truth, and the truth is, we can never be bulletproof. We are all bleeding already. To stop the bleeding, we would actually have to stop shooting.

We are bulletproof to reality as vivid as a hemorrhage. Hemorrhage, though, is unaffected by our capacity not to notice.

Our solace, it seems, is one of the great truisms of medical education: eventually, all bleeding stops.

David L. Katz, MD, FACP, MPH, FACPM, is an internationally renowned authority on nutrition, weight management, and the prevention of chronic disease, and an internationally recognized leader in integrative medicine and patient-centered care. He is a board certified specialist in both Internal Medicine, and Preventive Medicine/Public Health, and Associate Professor (adjunct) in Public Health Practice at the Yale University School of Medicine. He is the Director and founder (1998) of Yale University's Prevention Research Center; Director and founder of the Integrative Medicine Center at Griffin Hospital (2000) in Derby, Conn.; founder and president of the non-profit Turn the Tide Foundation; and formerly the Director of Medical Studies in Public Health at the Yale School of Medicine for eight years. This post originally appeared on his blog at The Huffington Post.