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Tuesday, November 24, 2009


Written by: Rick Staggenborg, MD on May 25, 2009 9:07 AM PDT

What motivates people to work for change is the awareness that we have the power to make the world a better place if we put our minds to it and spend our time working for the betterment of everyone. The most effective agents of this change realize our interconnectedness and try to order our efforts to maximize the effectiveness of our labor. 

The Internet has been a powerful tool in this regard. It can serve to isolate those who do not recognize that the only real purpose worth valuing is to work for the benefit of mankind, but overall its effect has been positive. Our attitude is not altruism, but the simple recognition that since we are all connected, our actions ultimately benefit ourselves and those who we love. 

If we take the time to care for each other, it is not only satisfying but multiplies our own pleasure as we see the effects of our efforts making the lives of both ourselves and others easier and less painful. Our intent is to do the same for those who do not see the caring for of others as their duty and even if they do not appreciate that it is our intent to make their lives better. It is important that we keep this in mind and respect those who disagree with us as we strive to open their minds to new possibilities. 

We must listen to those who see the world differently as well. It is important to emphasize our common goals as we discuss how to move forward together into a more just and secure future for our children. We must respect the ideas and values of others even if we disagree if we want them to be  more receptive to our own ideas. It is critical to remember that we are all more alike than otherwise and it is these commonalities that make us human. 

By approaching the task of healing America with respect and civility, we accelerate the process. We cannot afford to continue to use a conflict model to resolve what has become a very uncivil war if we want to solve the problems while there is still time to save the United States from economic and moral destruction. While our Congress excuses its every failure to put the interests of the People of the United States over those of their corporate patrons, other problems threaten the survival of human civilization as we know it.

Effective doctors have many essential qualities. They must have empathy, analytic ability, willingness to listen, good communication skills and above all, a single minded dedication to the patient. To apply these skills, doctors must be willing to dedicate themselves to the task of becoming familiar with the scientific evidence for the causes and treatments of the ills to which humans are subject. 

It takes all of the energy of the effective doctor to help our increasingly ill and undertreated patients. When the problem outstrips our knowledge of proper treatment, the doctor must apply skillful listening and active observation, then apply deductive skills to use their knowledge base to solve the problems of the individual patient.

At some point the question becomes, who is the patient? To be most effective, the doctor must be physically and psychologically healthy to withstand the pressures of the job. Like the familiar warning that adults must put on their own oxygen masks in an airplane decompression before attempting to assist others, we must first attend to our own needs, whatever they may be. 

Fortunately, this is easy when the doctor enjoys the work. When this happens it does not seem like work at all, but becomes pure pleasure. This does not mean that we are indifferent to the pain and suffering of our charges. The doctor must learn early on that at this stage in the history of medicine, we cannot save every individual patient. The heartache of our failures spurs us on to ever greater efforts to improve the effectiveness of our methods.

Once we understand how to prepare ourselves for this awesome responsibility, we turn our attention fully to the patient before us. In the case of non-physicians, the patient is mankind. To address the illnesses of contemporary society, we must become lay doctors who can apply the art and science of modern medicine to social ills. 

The first step is to develop a problem list. The doctor then attempts to narrow this list to a set of likely diagnoses. This requires deciding which problems are manifestations of the same underlying cause, and formulating a treatment plan to address each of the derangements of the body’s systems. The treatment approach needs to be carefully considered so that its elements complement each other, rather than causing so many side effects that the treatment is worse than the illness.

With all this in mind, we are now prepared to formulate an action plan to maximize the good we can accomplish for our patient, who is all of us. I will now share with you my proposed treatment plan, developed in consultation with hundreds of other doctors, physicians and non-physicians alike. It is based on an understanding that the sequence of treatment interventions is critically important when operating on such a sick patient, all of whose problems are interrelated. Only by utilizing a holistic approach can we hope to be most effective in the daunting task of treating our critically ill patient.

I propose that we use a system based approach. We must treat the most life threatening problems first, while simultaneously supporting the patient by strengthening its defenses against disease. I suggest that we begin by focusing on restoring to health the democratic system that our Revolutionary forefathers gave birth to so long ago. 

In those days, birth was a very dangerous experience. The life expectancy of nascent democracies was limited, most previous attempts having died young. While our Republic has survived to adolescence, it is like the cystic fibrosis patient who is not expected to live beyond young adulthood despite our best efforts, due to a genetic defect which we have not learned to cure.

Eventually, cystic fibrosis patients must be maintained on oxygen as their lungs succumb to the ravages of the disease. It is tragic, and one of modern medicine's greatest challenges. What a breakthrough it would be if these patients could be made to breathe life-giving fresh air and live healthy, full lives for the allotted fourscore and ten or more that most of us take for granted.

I can only outline the basic treatment approach in this brief progress note. I will try to summarize its elements here and expand upon them in future entries. Remember, this is only a preliminary treatment plan, subject to revision after careful consideration of the effects of the initial interventions. The rational physician must always take into account that we are only humans, and sometimes we must trust in forces greater than ourselves to help us save the patient.

If we succeed in restoring the democratic system to health, our patient will be able to withstand the stressful and sometimes dangerous interventions we must make in our attempts at cure. The treatment consists of cutting out the corruption by corporate money of our increasingly partisan Congress. The process will be painful to politicians and their partisan supporters who do not accept this as an inescapable part of the treatment. Like a pregnant patient terrified of the birth process, they will find that the rebirth of democracy will only be made more painful to them if they struggle against the inevitable.

Once the patient that is America is stabilized by a transfusion of democracy we can turn our attention to the critical problem of maintaining thermoregulatory homeostasis. In layman’s terms, this means that we have to address global climate instability. In doing so, we must intervene on a global level that some fear may require shock treatment to restore the healthy pulse of the global economy. However, more holistic thinkers realize that transforming our energy economy to a more stable system of sustainable, nonpolluting and decentralized production and distribution is the optimal course of treatment for this problem.

The heart of the economy has been damaged by the viral illness of unrestrained greed, amplified by the inhuman growth factor of globalization and a market that is anything but free. The heart of the global economy has been weakened by this virus and will never return to its former functioning. 

Like the patient who has survived viral cardiomyopathy, the only cure is transplant. This is futile however, if the virus cannot be held in check. There does not seem to be a cure in sight for viral infections, but we have learned to control them. The senseless suffering and premature deaths of early AIDS patients was not entirely in vain, for we began to address our societal homophobia and developed treatment to address this scourge, which was initially thought to only affect gays. 

As we carry out our treatment, we must not neglect to assure that it is available to everyone, through a system of truly universal health care which is the only treatment for our ailing health care system that the weakened heart of the global economy can tolerate. The prescription is single payer health care. This treatment must be made available to all nations. As in the case of the decompressing airplane on which we all travel, the US must assume the role of the adult and put its own oxygen mask on before it can help others.

With the heart of democracy healthy, we will be free to address the underlying cancer that will make all our efforts in vain if not addressed. Humans cannot continue to reproduce exponentially without destroying the source of their sustenance as a cancer eventually outgrows its blood supply. It is clear that this will require radical intervention. 

The surgical treatment is brutal, cutting out large parts of the body to save the rest, while leaving a scarred and functionally damaged patient. The scalpel used would be war, famine, pestilence and disease. If this is the only treatment that we have to offer, then the patient should be informed of his right to euthanasia. The only alternative is to find an effective medical treatment. This is a problem whose solution merits intensive research to find an early cure, before millions more succumb to the disease of unrestrained greed.

Shalom, salaam, peace.

Rick Staggenborg, MD

Physicians for a National Health Plan

Soldiers For Peace International

1 comment:

  1. This essay essentially wrote itself. I had in mind illustrating with a medical metaphor how I thought about the social changes I believe are necessary to heal the ills of modern society. The idea of describing how one can approach social advancement as diagnosing and treating a patient naturally followed from the basic premise.

    I had thought about writing an essay on my belief that altruism is a myth, as the apparently altruistic person is in fact satisfying a very real desire to make themselves happy in a world too often filled with sadness and pain. Once I introduced the idea in this essay, it seemed redundant. People take for granted that a doctor who enters the profession for traditional reasons finds their work rewarding. I can vouch for that in my case.


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