Preventive Medicine Column
Dr. David L. Katz
My mandate in this column is all matters related to disease prevention and health promotion. I don’t want to wander off that reservation, but I find it impossible to address any other topic while the earthquake, tsunami, and incipient nuclear calamity in Japan are so full occupying my mind. In fact, I believe they harbor implications directly germane to my mission.
Events in Japan are unfolding even as the tragic aftermath of the catastrophic earthquake in Haiti continues. As I write this, I am in Montreal at a conference; my cab driver from airport to hotel was Haitian. Much of his family is there, and he told me to date little reconstruction has yet occurred. The Haitians hope it will begin in earnest following their upcoming election.
Haiti was ravaged by not only the earthquake, but by its relative lack of modern resources. Rather primitive construction greatly compounded the damage of the quake to building and infrastructure. Limited means of organizing and distributing relief materials contributed to, among other things, the outbreak of cholera. The Haitian disaster called out, and calls out still, for more modern resources, better governmental oversight and response.
As many of us looked on at events in Haiti from places of relative privilege, I suspect our deep compassion was mingled with a bit of smugness that we were defended against any such fate by the armor of modern progress. I did not realize it at the time, but I now recognize I felt this way.
The juxtaposition of the Haitian and Japanese quakes precludes any such pretensions. While a lack of modern progress compounded the toll in Haiti, its presence is compounding it in Japan.
What strikes me most about the Japanese crisis, beyond the raw emotional impact of so much devastation, are the disquieting implications for the comfort we derive from modern progress. As dreadful as the brute carnage of the earthquake-spawned tsunami was, it is the leak of radiation from an atomic energy facility that harbors the most dire portents for the Japanese people. In other words, it seems likely that the worst of all the harms associated with this disaster will result from the collision of the most primitive forces of the planet with the most modern of human technologies.
Japan, despite recent political and economic difficulties, epitomizes the modern. If modern technology and design cannot defend Japan against the rumblings of the planet, our own vulnerability is plainly discernible.
Worse still, Japan’s leadership in the use of modern technologies has actually exacerbated its plight. Nuclear energy has figured ever more prominently in on-going discussions about U.S. energy independence. Nuclear power has the potential to be a sustainable, low carbon-footprint source of virtually limitless energy. The dark side of that power, of course, is the potential for release of radioactivity.
Whether the worry is radiation poisoning, or heart disease, we tend to focus more on prevention after than before an emergency. So suddenly nuclear energy seems like a less good idea for the future of U.S. energy. Odd, when the hazards on display in Japan are hazards we knew about. It is a bit disquieting that our thinking is so consistently responsive to the crisis that is, rather than ahead of the crisis that might be. The BP oil spill and Hurricane Katrina spring to mind.
There are also implications for our judgments about both nature, and science. Among my patients, I routinely encounter those who see conspiracy theories in modern science, and believe that nature is exclusively home to all that is good and healing. This world view is, of course, nonsense. Nature, and the primitive inclinations of our planet, doled out both the Haitian and Japanese earthquakes.
Yet while highlighting the capriciousness of nature to those who expect benevolence there, this crisis equally highlights the hazards of progress to those who believe in our scientific mastery over the planet. The current situation equally reveals that the ultra-modern remains vulnerable to the ultra-primitive. Aside from the evolving nuclear crisis, the Japanese tsunami has created a toxic brew of modern industrial chemicals, the health implications of which will play out for years to come. We have the capacity to abuse the planet, but in this very humbling lesson, we are reminded we don’t have the power to rule it.
It is the interaction of one of the most planet’s most primitive forces- the floating of tectonic plates and their collision at fault lines with one of its most modern- the exploitation of atomic energy by human beings- that may give us one of the great and enduring calamities of our age. Those of us far from this particular collision of the modern and the primitive have the opportunity to mull over the implications for what we may expect from nature; what we may expect from science and technology; and what we should expect of ourselves regarding crisis intervention, and crisis aversion.
As we reflect, our thoughts and fervent hopes are with those whose lives lie along the fault line.
Dr. David L. Katz; www.davidkatzmd.com