Earth Day? Mind Your Business…

David L. Katz, MD, MPH, FACPM, FACP, FACLM
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Those of us who go public with our perspectives must accept the principal liability that ensues: we are very prone to hear what people think about what we think, and not all of that commentary is, well, nice. Let’s just call it an occupational hazard of communication at scale.
View of the earth from miles above

Some of the not-so-nice commentary is invitation to dialogue, which at times can be very rewarding – for one party, or both. I have greatly appreciated an education received in exchanges that followed an initial provocation; I have been gratified by those times I was able to persuade. We are only apt to learn when exposed to points of view we don’t already own, so given the requisite civility, I welcome these exchanges.

The requisite civility, however, is not a given- and absent that, dialogue is forestalled by dogma and diatribe. These are postures of no intrinsic value, and they are far too prevalent.

Amidst the clamor of such insult-for-insult’s-sake there is a recurring, thematic admonishment: mind your own business. This one-size-fits-all rejoinder seemingly applies to all that roils the Zeitgeist, from guns, to climate, to dietary practices.

The confirmation of Dr. Vivek Murthy (a friend, and long-ago student of mine) as U.S. Surgeon General was imperiled and delayed -both times- because of his commentary (when a private citizen) on the matter of guns. The Congressional rebuke was along the lines of: “this is a policy matter, and none of your business.”

But whether or not ‘guns’ are the business of medicine, bullet holes in people most assuredly are. And in this case, the ‘correlation’ between the two does, indeed, equal causality.

Bullet holes through bodies would not occur without guns, any more than heart attacks would occur without atherosclerotic plaque. The pathologists might tell the cardiologists that plaque is none of their business, because it resides in the purview of pathologists. That would be absurd. If the effect is your business, then so is the cause. Cardiologists- please keep doing all you can to prevent, control, and regress heart-attack causing plaque. If you encounter a pathologist who objects, the problem is theirs, not yours.

And yes, it follows logically: doctors, public health officials- please keep doing all you can to mitigate the harms of bullet holes in people by addressing the source. As the Biden Administration considers policy approaches to advance gun safety in our nation, the AMA is quite right to voice support from the House of Medicine. This is, indeed, our business.

And there is, of course more: injury or death of any among our friends, family, neighbors is our business if anything is. Those are the losses to guns as cause, bullet holes as effect- and so we all have a rightful voice in this dialogue. Let no one persuade you otherwise.

The nearly 30 years I provided direct patient care, I tried always to remember to say the following: you are the boss!  When providing dietary counseling, as I so often did, I doubled down: if you want to choose a way of eating that makes you ill rather than well, that’s your decision. My job is simply to ensure it is a well-informed decision, that you know your options, and the stakes. I stand by that. In a world where our insurance benefits and premiums derive from pooled risk, one might quibble over it- but I stand by it.

But that conversation changes, and radically, when we look beyond the bounds of our own skin. Just as it would be our business to intervene if we saw someone else abusing a child, so we all have the right, if not the obligation, to protest when our food derives from the torture and abuse of animals with much the same sensibilities as the family dog. Torture a dog, and you face prison. Torture a pig or calf, and it’s just another day of factory farming. All you face is profits. I protest- and you can, too.

2 Katz dogs lie together on a rug

My dogs, Barli and Yona…

 

Dr. Katz riding his horse, Troubador

…and my horse, Troubadour. Best friends, all.

Much the same is true of climate change and planetary degradations. On any number of occasions, from podiums pre-COVID and via Zoom since, I have railed to audiences: “you cannot rightly call yourself a ‘health’ professional any longer if you don’t advocate frequently, and fervently, for the health of the planet.” This is because indirectly, there are no healthy people on a ruined, inhospitable planet; and because of the many direct effects of climate stability, biodiversity, and environmental integrity on human health. Stated beautifully by French astronaut, Thomas Pesquet, the Earth is our space ship- we, all, passengers aboard. Of course assaults upon it are our business.

I note that generally, my clinical colleagues have thanked me for stating publicly this “license” to address professionally what plagued them personally. That this has recurred so many times tells me that something in our culture keeps murmuring to health professionals worried about the plight of our planet: “don’t talk about this, because it’s not your business.” Of course it is.

My right to swing a stick ends where your nose begins. When effects are our business, so too are causes.

Bleeding bodies are the business of medicine. Lost loved ones are the business of every aggrieved family- and all those at risk. Torture of our fellow creatures- human and non-human alike- is the business of anyone with a conscience. Degradations of this planet are much akin to burning down our homes- and sometimes, result in exactly that. If we live here, that is our business.

If you speak out, you are apt to be told- by someone- to mind your business. If you mind business as usual as much as I do, then answer that you agree – and that you are doing exactly that. Keep speaking truth to the obstreperous power of the status quo.

-fin

Dr. David L. Katz is a board-certified specialist in Preventive Medicine/Public Health and author, most recently, with Mark Bittman of How to Eat: All Your Food and Diet Questions Answered. He is the founder and CEO of Diet ID.

COVID Pandemic:

Click here to access the one-page summary of #TotalHarmMinimization

Click here to access the total harm minimization resource library 

Click here to access a library of Dr. Katz’ “reality check” videos on the pandemic

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