Thursday, November 25, 2010

On the Eve of Cancun

Every sphere of intellectual endeavour calls forth individuals who make it their task to assimilate, interpret and transmit an evolved understanding to those who may share their interests. This can happen at many levels. Some may choose to address groups of specialists through the pages of learned journals or through professional conferences. Others, such as the many dedicated teachers everywhere who daily pass on the light of learning to their charges, work less visibly. And there are certain projective individuals who will skillfully make use of the dominant media, whether print or electronic, to transmit their message as widely as they can. A few seem to be capable of spanning all levels, thereby making substantive contributions to the collective understanding of their times.

One such individual is Canadian environmentalist David Suzuki who has spent much of his life projecting his formed ideas through many theaters using a range of media. His far-reaching and enduring influence continues, even as he enters his eighth decade. Although recently retired from academic life, Suzuki remains relentless in his quest to identify and disseminate what he understands to be core ecological principles by which humanity can live during a time when many former certainties begin to progressively collapse.

Ironically, while Suzuki continues to spread his message, the present Canadian government remains obstinately obstructive in its refusal to reform or abandon environmentally destructive practices. The saying uttered so long ago, "a prophet is not without honour except in his own country" still holds true.

In a snap vote taken without notice and without debate on 16th November 2010, the Canadian senate defeated Bill C-311, the Climate Change Accountability Act, a modest piece of legislation developed over the past 5 years which aimed for a 25% reduction in Canadian greenhouse gas emissions by 2020 and an 80% reduction by 2050. One cannot accuse the Canadian government of inconsistency. This is a perfectly timed statement aimed at delivering an unequivocal message to the UN Climate Change Conference Summit which will begin in Cancun, Mexico on November 29.

Canada has for some years been widely perceived as engaging in a systematic sabotage of climate change negotiations. Even while campaigning for office in 2006, Stephen Harper had made it clear that he would terminate Canada's commitment to the Kyoto Protocol which had been signed in 1998. One of Harper's first acts upon election was to withdraw Canada's financial support for developing countries seeking to reduce their greenhouse gas emissions. Soon after, environment minister John Baird brazenly described Canada's Kyoto commitment as a "risky, reckless scheme."

These actions and rhetoric are largely driven by the Harper Government's commitment to the exploitation of the immense reserves of tar sands that are held in Canada, particularly in Alberta. Canada exports over one million barrels of oil derived from tar sands to the United States every day.

The extraction process is both energy intensive and resource intensive and requires two to three times as much energy as that required for refining crude oil. It consumes three barrels of water and lays waste two tons of earth for each barrel of oil produced. The tar sands project, which has been pursued in Canada since 1967, has been extremely damaging to the environment, contaminating both groundwaters and local river systems. It has already caused significant health problems, including an increased incidence of cancers and immune disorders, in communities living downstream from the mining operations.

Processing Facility, Athabasca River, Alberta
Tar sands operations in Canada result in the production of 400 million gallons of toxic sludge daily, most of which is stored in numerous tailings dams. Polycyclic aromatic compounds are beginning to appear not only in nearby river systems, but in winter snow gathered 50 kilometers away from the mining operations.

The Alberta tar sands project has already claimed an area the size of England and has been described as the largest industrial source of carbon emissions in the world. In addition to the production of toxic sludge, an estimated 40 million tons of greenhouse gases are spewed forth into the atmosphere every year as a result of these operations. Little wonder that those who support such activities on "economic grounds" do whatever they can to destroy such pieces of legislation as the recently emasculated Climate Change Accountability Act.

Aside from the lobbying and disinformation campaigns of the mining and energy industries, Obama's unilateral demands, China's recalcitrance and Canada's obstructionism did much to effectively torpedo the Copenhagen Climate Summit in 2009. At the conclusion of the inconclusive and largely inconsequential climate talks last year, former UN Climate Chief Evo de Boer quipped: "Everything will be sorted out in Mexico next year." In a video interview with George Monbiot in December 2008, de Boer had presciently stated: "Copenhagen, for me, is a very clear deadline that I think we need to meet, and I'm afraid that if we don't . . . one deadline after the other will not be met, and we sort of become the little orchestra on the Titanic." A perfectly apt metaphor for the sad denouement of Copenhagen.

Unlike the Copenhagen Climate Summit which helped to mobilise the hopes and expectations of millions of people throughout the world in the preceding weeks and months, there has been an empty silence surrounding the coming Cancun talks. One has to look really hard to find any mention of it in the dominant media. Perhaps there has been a growing realisation that the governments of the world are incapable of mobilising the will to alter the patterns of production and consumption that have brought us to the present impasse. Canada continues to plunder its bituminous reserves regardless of the environmental cost. And Australia continues to export 250 million tons of coal and 10,000 tons of uranium oxide to whoever will pay for it.

While Ignatian methods call us to imagine the events from Gethsemene to Golgotha, and Vajrayanist methods instruct us to imagine one's lama seated upon ever-more-elaborate lotus thrones, David Suzuki urges us to imagine a future based on community and long-term sustainability and not on economic determinism and technocratic manipulation. In a talk given at the Kitsilano High School auditorium in Vancouver on September 17th, 2010, Suzuki demonstrates that he has lost neither the passion nor the clarity that have been his hallmark for many decades. He urges us to imagine a future where we live work and play in the same neighbourhood, where buildings and roads capture and store the energy transmitted in sunlight, where town and city roofs capture water for fruit and vegetable gardens, where asthma rates plummet because the air is clean, where cancer rates decline because the air, water and soil no longer carry numerous toxins. He concludes: "We have to get to know each other because we're all in it together. I believe communities are going to be the unit of survival."

The most important thing to emerge from Copenhagen last year was an understanding that the only change we could realistically hope for in the short term was that which emanated from the sustained commitment of ecologically conscious individuals, groups and communities.

Suzuki's wide-ranging and energising lecture was recently broadcast on Radio Ecoshock and can be heard here.

Vincent Di Stefano D.O., M.H.Sc.
November 2010

Saturday, November 13, 2010

While the Hegemon Caves from Within

The results of the US mid-term elections reflect a return of cynicism and ennui among those who were moved by the visionary promises of Barack Obama as he campaigned for the presidency a short 2 years ago. In May 2008, when campaigning in North Carolina, he described the core message of his campaign in the following terms: "It's not enough just to replace the party in the White House. We've got to change our politics as well." Our collective memories are too short. Our expectations too easily side-stepped.

The past two years have shown that in US politics, it is still business as usual. The problem, of course, is that US business continues to affect us all.

While Obama, shadowed by 250 US business executives, was meeting with high dignitaries in India on his 10 day tour through Southeast Asia, his erstwhile opponent-become-Secretary-of-State Hillary Clinton, accompanied by her Defense Secretary Robert Gates, were meeting with Julia Gillard and her new coterie in Australia.

And while Obama was busily negotiating new arms deals which included securing a $3.5 billion contract for 10 Boeing C-17 cargo planes - the sixth biggest arms deal in US history - and lining up an additional $11 billion order for 126 combat fighter jets for the Indian air force, Clinton and Gates were meeting with Australian politicians and military planners in order to secure an increased US military presence in Australia.

It was therefore both politic and pragmatic that Obama was met by Jim McNerney, CEO of Boeing, and Jeffrey Imelt, CEO of General Electric, when Air Force One touched down on the Tarmac of Mumbai airport on 7th November. General Electric have recently contracted to supply 107 F414 engines for the new Tejas lightweight jet fighter presently being constructed in India. And for the past 2 years, GE-Hitachi have been jockeying for the construction of new nuclear power stations in India.

It would seem that the US presidency has more decidedly become an office to promote the sale of US arms in a world already ravaged by the effects of too many wars and too much deadly weaponry.

Good for Business
There is no shortage of irony. In a speech given at a joint sitting of both houses of Parliament in New Delhi on 8th November, Obama invoked the spirits of both Gandhi and Martin Luther King: "I've always found inspiration in the life of Ghandiji and his simple and profound lesson to be the change we seek in the world." He went on to say: "After making his pilgrimage to India half a century ago, Dr. King called Ghandi's philosophy of nonviolent resistance 'the only logical and moral approach' in the struggle for justice and progress."

Words have ever been cheap in the theatre of politics. The contradiction between the rhetoric and the action in his speech in New Delhi is as sharp as it was in his acceptance speech for the 2010 Nobel Peace Prize at Oslo a year ago.

Despite the hopes and the promises that brought Obama to the US presidency, American pragmatism continues to rule. If the US does not sell its jets and its weapons to India, then the Russians or the Europeans will. The Indian military remains one of the largest importers of military hardware on the planet despite the fact that tens of millions of Indian men, women and children continue to live in deep poverty.

But the whole game plan has now changed. Many who were of the view that Barack Obama shared their insight into what was necessary during this time of escalating planetary difficulties have been left wondering what peculiar deception was at play.

Obama took office at a pivotal point in history. The Bush era had brought the theory and practice of political self-interest to a high pitch. The rich got richer, the already powerful got more power, the belligerent were given greater scope for the exercise of their belligerence. As independent journalist Robert Freeman has so astutely pointed out, nothing really changed when Obama entered the White House.

Mammon's rule was confirmed by Obama's selection of the unholy trinity of Larry Summers, Timothy Geithner and Ben Bernanke to run the country's finances. Under Clinton, Larry Summers had single-mindedly driven the deregulation of banks that enabled the rape of national economies around the globe. He was appointed Head of the National Economic Council. Under George W. Bush, Timothy Geithner had already funneled trillions of dollars of public moneys to his old buddies on Wall Street in the guise of "saving the system". He was appointed Secretary of the Treasury. And as Chairman of the Federal Reserve since 2006, Ben Bernanke had presided over a series of monstrous excesses that fattened the already rich and flayed the poor of what little skin they had left. Bernanke was re-appointed in his role by Obama.

And able economists like Joseph Stiglitz, Paul Krugman and David Korten continue to remain on the margins awaiting the inevitable.

Methane burning in the Arctic Circle
Most of Obama's choices have followed this pattern. Despite his promise to renew and to reform US politics, little has changed. According to Robert Freeman, US banks "are making the largest profits in their history and paying themselves the biggest bonuses on record." Meanwhile, both the Pentagon and the US armaments industry are as busy as ever. Oil and energy companies have demonstrated who is really calling the tune through their scuttling of the Copenhagen Climate Summit last year. Their activities continue unabated. While tar sands continue to be mined in Canada at enormous cost to the environment and enormous expenditure of energy, methane gas begins to pour out of the entire Siberian permafrost region and the Arctic seabed itself. The inexorable receding of immense continental glaciers bodes poorly for those populations dependent on the great river systems issuing from ancient glaciers for their drinking water and for the irrigation waters that enable food production.  

The 2008 financial crisis offered an opportunity to clean up the dirty practices that bankrupted literally millions of householders by recklessly enabling unserviceable mortgages and that emptied untold numbers of pension funds and retirement savings by exploiting newly created financial instruments such as derivatives.

The unconditional multi-billion bailout of General Motors, Ford and Chrysler at that time similarly squandered an opportunity to completely redesign transport systems and to transform an obsolete industrial infrastructure.

These opportunities came and went while politicians argued, bankers schemed, oil companies colluded and armaments manufacturers planned.

It would seem we are a refractory species. Not until the situation has become irremediably dire do we begin to take the necessary collective action we could have taken and should have taken long before to prevent widespread collapse and progressive dissolution.

Let us never lose sight of the potencies available to us in familial and community awareness and action during these times of political dereliction and moral abandonment.

Vincent Di Stefano D.O., M.H.Sc.
November 2010

Wednesday, November 3, 2010

The Poetics of Medicine



One of the perceived deficiencies in the practice of reductionist medicine and in busy clinics generally is the small amount of time usually allocated to patients in any given consultation. A brief history will be taken, diagnostic tests may be organised, and a prescription may be supplied. The process is often over and done with in a few minutes.

Much medical diagnosis is dependent on technology - blood tests, X-rays, scans, fibre-optic examination, neurological and electrophysiological measurements and so forth. This work is usually performed by technicians and the reports are later presented to the doctor who will in turn discuss them with the patient. 

However, this has not always been the case, nor will it necessarily remain so in the near or distant future. These methods are peculiar to a scientific medicine developed in a technological civilisation which, as we are increasingly coming to realise, is beginning to strain on many fronts. So how were things done before so many machines were available?

Former surgeon and professor of medicine at Yale University, Richard Selzer tells a remarkable story of an encounter with Yeshi Dhonden, personal physician to the Dalai Lama. While visiting the US in the 1970s, Yeshi Dhonden was invited to demonstrate his method of diagnosis at a teaching hospital. Determined not to miss the opportunity, Richard Selzer joined the group of doctors who would observe Yeshi Dhonden in action. They would accompany the Tibetan doctor on his visit to a chronically ill patient in the hospital. The nature of her condition was withheld from both Yeshi Dhonden and the physicians who accompanied him.

The Tibetan doctor asked that a sample of her morning urine be made available. Before joining the hospital doctors on their morning round, Yeshi Dhonden had spent two hours in prayer and meditation. He was then brought to the room of a woman who was obviously unwell. He spent some time gently gazing at her. He then approached her, and leaning towards her, tenderly lifted one of her hands from the bed and cradled it between his own hands. Having found her pulse, Yeshi Dhonden then closed his eyes and remained in that position. He neither opened his eyes nor spoke a word.

The woman was clearly comfortable, occasionally lifting her head to look at the robed doctor/monk feeling her pulse before relaxing back into her pillow. After about half an hour, Yeshi Dhonden opened his eyes, smiled gently at the woman, released her hand and stepped back from the bed. He then placed a small amount of her urine which had been earlier collected into a small wooden bowl and briskly whipped it into a froth with two small wooden sticks.

He raised the bowl to his nose and inhaled the odour carefully three times. He then placed the bowl on the nearby table, smiled once again and turned to leave the room. Not a word had been spoken. As he was about to depart, the woman lifted her head from the pillow and said in a serene yet strong voice, "Thank you doctor."

Speaking through an interpreter in the conference room, Yeshi Dhonden gave his diagnosis. Richard Selzer reports: "He speaks of winds coursing through the body of the woman, currents that break against barriers, eddying. These vortices are in her blood, he says. The last spendings of an imperfect heart. Between the chambers of the heart, long before she was born, a wind had come and blown open a deep gate that must never be opened. Through it charge the full waters of the river, as a mountain stream cascades in the springtime, battering, knocking loose the land, and flooding her breath. Thus he speaks, and now he is silent."

A professor in the group, impatient to know what all this could mean, asked the doctor who had arranged the visit for the formal diagnosis. The group was then told that the woman had suffered from a congenital heart defect present since birth. She had an intraventricular septal defect - a hole between the two lower chambers of the heart - and was in an advanced state of heart failure.

No scanner, no catheter, not even a stethoscope. Just a highly attentive presence, a refined palpatory sensitivity, a consciousness more familiar with metaphor than with measurement, and an empathic mind both sharpened and softened by decades of intense interior practice.

Three decades ago, Fritjof Capra wryly observed: "Ever since Galileo, Descartes and Newton our culture has been so obsessed with rational knowledge, objectivity and quantification, that we have become very insecure in dealing with human values and human experience. In medicine, intuition and subjective knowledge are used by every good physician, but this is not acknowledged in the professional literature, nor is it taught in our medical schools. On the contrary, the criteria for admission to most medical schools screen out those who have the greatest talents for practicing medicine intuitively."

We have the science. The task ahead is to recover the art of medicine.

Vincent Di Stefano D.O., N.D., M.H.Sc.
November 2010


RELATED POSTS

1. On Ivan Illich and the Limits to Medicine
 
Reading Ivan Illich is not easy, though in a different way to reading Continental philosophers or quantum physicists. Illich's language is demanding and requires a certain suspension of judgement if one is to penetrate the systemic meaning behind his often challenging - if not vehement - rhetoric. But it is worth the effort.


On Ivan Illich and the Limits of Medicine offers a reflection on the life and work of Illich. The post also carries a link to a collation of selected excerpts from his Medical Nemesis: The Expropriation of Health in PDF form.  



2. Of Love and Medicine

Although there has been some small movement to incorporate more humanistic elements into medical education, it remains rigorously scientific in its orientation. American physician Rachel Naomi Remen commented in 1996: "In some ways a medical training is like a disease. It would be years before I would fully recover from mine." Mercifully, there are many practitioners of biomedicine who do survive their training and who quietly rediscover the perennial art of the physician as they work within their respective communities.