538
Commentary
Physician, Heal Thy Planet WILLIAM B. STEWART, MD, San Francisco, California
In developing a theory of the earth as a living organism, James Lovelock, in his book 77Te Ages ofGaia: A Biography of Our Living Earth, suggests the need for a new profession-planetary medicine.' He credits James Hutton, the 18th-century physician and geologist, with first introducing the idea of planetary physiology. Is it not, after all, the health of the planet that matters most, not the health of one species among millions? And is not the survival of the earth's many life forms intimately entwined? We have been reminded again and again by philosophers of both Eastern and Western orientation that our attitude toward the world has often led us to paths excessively anthropocentric. Yet we remain oblivious to the consequences of our actions, consequences that often distance us from our natural world. The insightful Chief Seattle of the Duwamish (Suquamish) tribe poignantly described the connection between humans and the earth. In a letter to President Franklin Pierce in 1854, marking the transfer of Indian lands to the United States government, he wrote, The President in Washington sends word he wishes to buy our land. But how can you buy or sell the sky? The warmth of the land? The idea is strange to us. If we do not own the freshness of the air and the sparkle of the water, how can you buy them? . . This we know. The Earth does not belong to man. Man belongs to the Earth. This we know. All things are connected like the blood which unites all in one family. Will you teach your children what we have taught our children? That the Earth is our mother? Whatever befalls the Earth befalls the sons of the Earth. Man did not weave the web of life, he is merely a strand in it. Whatever he does to the web, he does to himself . (reprinted in Solstice, December-January 1989, issue 34, p 72).
Considering the pace ofhuman population growth, industrial and technologic "progress," and our exploitation and consumption of the earth's resources, the words of Chief Seattle seem prophetic and timely, for our actions have served to "soil our nest." Now we are faced with many examples of environmental degradation that directly affects human health. The media daily remind us of the implications of global warming, ozone depletion, air pollution, water contamination, topsoil erosion, rain forest destruction, species extinction, human overpopulation, waste disposal, threat of nuclear disaster-the list seems endless. The tabulation of our environmental problems is analogous to the table of contents of a medical textbook describing human disease. Congenital deformities, infection and infestations, degenerative changes, fluid and electrolyte imbalances, nutritional deficiencies, respiratory distress, mental illness, and cancers plague our bodies like the maladies of our environment. The effect of our presence and actions on the health of the planet is difficult to deny. We must recognize our intimate relationship to the earth and our responsibility in creating the planet's health. Although our scientific training and reliance on rational proofs
and empirical data can often separate us from wisdom otherwise gained, scientific inquiry has taught us about our elemental relationship with our world. We know that our atomic structure-protons, neutrons, electrons-is identical to that of all organic and inorganic substances. The chemical components of carbon, hydrogen, and oxygen are the same in humans as in "nature." From the "Big Bang" on, the scientific story of evolution confirms the common origin of all that is present on the planet. Nor are the similarities merely anatomic or microscopic. Physiologic relationships further define our interrelatedness. The proportion of water in our bodies is the same as on the earth's surface. The concentration of salt in the oceans is similar to that in human blood. The proportion of oxygen in the atmosphere allows aerobic reactions without uncontrollable combustion. The universe is expanding fast enough so the force of gravity does not draw all back to implode but slowly enough so that we do not fly off unrestrained into distant space. The microscopic and macroscopic relationships between humans and the natural world and the maintenance ofthe delicate life-sustaining proportions remind us of the intimate interconnectedness and dependency between humans and the planet. They remind us also of the possibility of looking at the earth as a whole, as if it were a living organism. Before the advent of contemporary scientific thinking, many peoples gained the wisdom to live in harmony with the earth. Our 20th-century population explosion and life-styles have separated us from the kind of relationships our forebears had with their habitats. Nonetheless, we need to accept that all of us need to be as fully a part of our surroundings as are the Native Americans, Eskimos, tribes of Africa, nomads of the Sinai, herders of Tibet, and others who live close to the land and sea. Our health and our planet's survival may be in jeopardy until we can care for our environment with more compassion. With the recognition of our planetary heritage and interdependency, we can begin to accept the responsibility to heal the planet by first healing ourselves. As a journey of a thousand miles begins with one step, so, too, must our practice of planetary medicine begin with the creation of human health in the fullest sense. Health creation includes not only treating diseased states but also establishing physical, mental, emotional, spiritual, and societal well-being. It acknowledges the importance and balance of nutrition, work and play, rest and relaxation, as part of "wellness." It is a practice that recognizes the effect of our behavior on our surroundings and how environmental influences affect our health. It is an approach that learns not only from science and technology but also from the wisdom and traditions of the past and accepts ways of knowing and understanding that are not always "rational."
(Stewart WB: Physician, heal thy planet. West J Med 1991 Nov; 155:538-539) Dr Stewart is the Executive Director, Program in Medicine and Philosophy, California Pacific Medical Center, San Francisco, and is in private practice. Reprint requests to William B. Stewart, MD, 2100 Webster St, Suite 214, San Francisco, CA 94115.
THE WESTERN JOURNAL OF MEDICINE
THl
o
NOVEMBER 1991
o
155
0
It is a practice that is mindful of the brain and the heart, the earthly and the astral, the minute and the monumental. As with the practice of species-specific medicine, the practice of planetary medicine requires careful diagnoses based on an accurate assessment of signs and symptoms and pertinent laboratory studies. Treatment ranges from dietary adjustments and behavior modifications to extensive surgical procedures. Organ transplants save lives just as recycling preserves precious and finite resources. While each of us must recognize the web of life in our own way, our practices must reflect a planetary view, acknowledging that our health is intimately linked to the survival of the planet. Our needs must be seen in the context of the needs of the planet, not just
539
5
for today but for the future. We must accept our humble position in the global hierarchy. Resisting the temptation to be overwhelmed by the enormity of global problems, we must demonstrate an individual resolve to the "rightness" of each of our actions. "Whatever befalls the Earth befalls the sons of the Earth" (Chief Seattle, Solstice, 1989; [34]: 72). We are tenants, not landlords, of this earth, and we must all practice planetary medicine in the living of our lives. REFERENCE 1. Lovelock J: The Ages of Gaia: A Biography of Our Living Earth. New York, NY, WW Norton, 1988
OLDER BROTHER August afternoons when the sky darkened with storms we'd climb the old silver maple high as its limbs could hold us and ride that wind that rocked the wren house and turned grape leaves to their white undersides down on the arbor. He'd lean into it like a prow, his hair cowlicked back seeming to stare at something beyond our hills of sheep and junk yards, unflinching even when rain spattered his glasses. That's how I think he looks now, walking on silent shoes through the wards delivering news to families too stunned to question the voice that pronounces so surely still birth or the names of cancers. But I wonder if there is ever a father, a mill worker with large, blackened fists who grabs the narrow lapels of his lab coat and pounds on my brother's chest, demanding that he take it back. JULIA KASDORF© Brooklyn, New York
Commentary
Physician, Heal Thy Planet WILLIAM B. STEWART, MD, San Francisco, California
In developing a theory of the earth as a living organism, James Lovelock, in his book 77Te Ages ofGaia: A Biography of Our Living Earth, suggests the need for a new profession-planetary medicine.' He credits James Hutton, the 18th-century physician and geologist, with first introducing the idea of planetary physiology. Is it not, after all, the health of the planet that matters most, not the health of one species among millions? And is not the survival of the earth's many life forms intimately entwined? We have been reminded again and again by philosophers of both Eastern and Western orientation that our attitude toward the world has often led us to paths excessively anthropocentric. Yet we remain oblivious to the consequences of our actions, consequences that often distance us from our natural world. The insightful Chief Seattle of the Duwamish (Suquamish) tribe poignantly described the connection between humans and the earth. In a letter to President Franklin Pierce in 1854, marking the transfer of Indian lands to the United States government, he wrote, The President in Washington sends word he wishes to buy our land. But how can you buy or sell the sky? The warmth of the land? The idea is strange to us. If we do not own the freshness of the air and the sparkle of the water, how can you buy them? . . This we know. The Earth does not belong to man. Man belongs to the Earth. This we know. All things are connected like the blood which unites all in one family. Will you teach your children what we have taught our children? That the Earth is our mother? Whatever befalls the Earth befalls the sons of the Earth. Man did not weave the web of life, he is merely a strand in it. Whatever he does to the web, he does to himself . (reprinted in Solstice, December-January 1989, issue 34, p 72).
Considering the pace ofhuman population growth, industrial and technologic "progress," and our exploitation and consumption of the earth's resources, the words of Chief Seattle seem prophetic and timely, for our actions have served to "soil our nest." Now we are faced with many examples of environmental degradation that directly affects human health. The media daily remind us of the implications of global warming, ozone depletion, air pollution, water contamination, topsoil erosion, rain forest destruction, species extinction, human overpopulation, waste disposal, threat of nuclear disaster-the list seems endless. The tabulation of our environmental problems is analogous to the table of contents of a medical textbook describing human disease. Congenital deformities, infection and infestations, degenerative changes, fluid and electrolyte imbalances, nutritional deficiencies, respiratory distress, mental illness, and cancers plague our bodies like the maladies of our environment. The effect of our presence and actions on the health of the planet is difficult to deny. We must recognize our intimate relationship to the earth and our responsibility in creating the planet's health. Although our scientific training and reliance on rational proofs
and empirical data can often separate us from wisdom otherwise gained, scientific inquiry has taught us about our elemental relationship with our world. We know that our atomic structure-protons, neutrons, electrons-is identical to that of all organic and inorganic substances. The chemical components of carbon, hydrogen, and oxygen are the same in humans as in "nature." From the "Big Bang" on, the scientific story of evolution confirms the common origin of all that is present on the planet. Nor are the similarities merely anatomic or microscopic. Physiologic relationships further define our interrelatedness. The proportion of water in our bodies is the same as on the earth's surface. The concentration of salt in the oceans is similar to that in human blood. The proportion of oxygen in the atmosphere allows aerobic reactions without uncontrollable combustion. The universe is expanding fast enough so the force of gravity does not draw all back to implode but slowly enough so that we do not fly off unrestrained into distant space. The microscopic and macroscopic relationships between humans and the natural world and the maintenance ofthe delicate life-sustaining proportions remind us of the intimate interconnectedness and dependency between humans and the planet. They remind us also of the possibility of looking at the earth as a whole, as if it were a living organism. Before the advent of contemporary scientific thinking, many peoples gained the wisdom to live in harmony with the earth. Our 20th-century population explosion and life-styles have separated us from the kind of relationships our forebears had with their habitats. Nonetheless, we need to accept that all of us need to be as fully a part of our surroundings as are the Native Americans, Eskimos, tribes of Africa, nomads of the Sinai, herders of Tibet, and others who live close to the land and sea. Our health and our planet's survival may be in jeopardy until we can care for our environment with more compassion. With the recognition of our planetary heritage and interdependency, we can begin to accept the responsibility to heal the planet by first healing ourselves. As a journey of a thousand miles begins with one step, so, too, must our practice of planetary medicine begin with the creation of human health in the fullest sense. Health creation includes not only treating diseased states but also establishing physical, mental, emotional, spiritual, and societal well-being. It acknowledges the importance and balance of nutrition, work and play, rest and relaxation, as part of "wellness." It is a practice that recognizes the effect of our behavior on our surroundings and how environmental influences affect our health. It is an approach that learns not only from science and technology but also from the wisdom and traditions of the past and accepts ways of knowing and understanding that are not always "rational."
(Stewart WB: Physician, heal thy planet. West J Med 1991 Nov; 155:538-539) Dr Stewart is the Executive Director, Program in Medicine and Philosophy, California Pacific Medical Center, San Francisco, and is in private practice. Reprint requests to William B. Stewart, MD, 2100 Webster St, Suite 214, San Francisco, CA 94115.
THE WESTERN JOURNAL OF MEDICINE
THl
o
NOVEMBER 1991
o
155
0
It is a practice that is mindful of the brain and the heart, the earthly and the astral, the minute and the monumental. As with the practice of species-specific medicine, the practice of planetary medicine requires careful diagnoses based on an accurate assessment of signs and symptoms and pertinent laboratory studies. Treatment ranges from dietary adjustments and behavior modifications to extensive surgical procedures. Organ transplants save lives just as recycling preserves precious and finite resources. While each of us must recognize the web of life in our own way, our practices must reflect a planetary view, acknowledging that our health is intimately linked to the survival of the planet. Our needs must be seen in the context of the needs of the planet, not just
539
5
for today but for the future. We must accept our humble position in the global hierarchy. Resisting the temptation to be overwhelmed by the enormity of global problems, we must demonstrate an individual resolve to the "rightness" of each of our actions. "Whatever befalls the Earth befalls the sons of the Earth" (Chief Seattle, Solstice, 1989; [34]: 72). We are tenants, not landlords, of this earth, and we must all practice planetary medicine in the living of our lives. REFERENCE 1. Lovelock J: The Ages of Gaia: A Biography of Our Living Earth. New York, NY, WW Norton, 1988
OLDER BROTHER August afternoons when the sky darkened with storms we'd climb the old silver maple high as its limbs could hold us and ride that wind that rocked the wren house and turned grape leaves to their white undersides down on the arbor. He'd lean into it like a prow, his hair cowlicked back seeming to stare at something beyond our hills of sheep and junk yards, unflinching even when rain spattered his glasses. That's how I think he looks now, walking on silent shoes through the wards delivering news to families too stunned to question the voice that pronounces so surely still birth or the names of cancers. But I wonder if there is ever a father, a mill worker with large, blackened fists who grabs the narrow lapels of his lab coat and pounds on my brother's chest, demanding that he take it back. JULIA KASDORF© Brooklyn, New York
