Human health: return of the four horsemen?

The Four Horsemen of the Apocalypse

The Four Horsemen of the Apocalypse, Woodcut ca. 1497–98. Albrecht Dürer (German, 1471–1528).

In the arena of human health, living in the post-industrial Stone Age will force us to deal with the biblical Four Horsemen of the Apocalypse. And I’m not thinking metaphorically.

During the time of Christ, in the Mediterranean region, the population of humans was viewed through the same lens as other populations. As such, human deaths often occurred in large numbers, as a result of war, conquest, famine, and pestilence — these are the Four Horsemen of the Apocalypse, as described in the gospel of John.

The Four Horsemen of the New Testament are reminiscent of much of the Old Testament. Among the many exemplary passages in the Old Testament is this one from Deuteronomy:

The Lord shall smite thee with a consumption, and with a fever, and with an inflammation, and with an extreme burning.

Yikes!

A quick review of the Old Testament suggests the Lord was partial to quite a bit of smiting. Strange and often fatal diseases were attributed to Divine Retribution. They still are, by some people. Not so long ago, President Ronald Reagan declared AIDS to be “God’s revenge” on homosexuals. That was after he ripped the solar panels off the White House, but before he oversaw the military conquest of Grenada, a tiny island-country in the Caribbean most readers hadn’t heard of, until then.

Until very recently, large-scale die-offs were viewed as normal in much the same way we view as normal our K-12 system of education, or weekly shopping trips to the big-box grocery store, or cellular telephones.

The description and management of human populations during the days of the Greek Cynics was oriented along population lines, with relatively little societal regard for individuals. Contrast that perspective with today’s laser-like focus on individuals.

A chaise and four

Let’s take a quick look at the Four Horsemen, one at a time.

Famine’s as good a place to start as any, considering that my limited understanding of human health tends toward eating. Or, rather, eating less, as we enter a time of poverty and starvation.

The years ahead will see a dramatic rise in deaths from starvation, as we become unable to transport vegetables from the Central Valley of California to anyplace in the country. The inability to retrieve high-fructose corn syrup in the form of cheese doodles and soda pop from the vending machine down the hall won’t hurt us a bit, individually or collectively, but it’s symptomatic of far greater problems. At the population level, starvation is called famine. And famine looms large, right here in the richest country in the history of humanity.

We’ll also see pestilence — what we call disease, when it happens one person at a time — making a big comeback.

Cheap oil allows us to sanitize our water, lethally cook harmful organisms, sterilize the surfaces on which we prepare and eat food, and manage many potentially catastrophic diseases. Contemporary American healthcare is completely dependent on ready supplies of cheap oil for grid-based electrical power, backup generators, and thousands of pieces of equipment we all take for granted, from IVs and syringes to disposable gloves and plastic containers for tossing out contaminated needles and other sharp objects.

When the trucks stop running, we won’t even be able to deliver antibiotics, unless gigantic numbers of non-apocalyptic horsemen suddenly appear. I hope society will retain some understanding of germ theory, so our children are able to live at least half as long as their grandparents.

Famine and pestilence are two of the Four Horsemen; war and conquest are the other two.

Already, resource wars have begun, and they are likely to ratchet up in the near future. The so-called bipartisan Iraqi study group concluded that Operation Iraqi Freedom was conducted in pursuit of black gold. In fact, just to make the acronym transparent, the invasion should have been called Operation Iraqi Liberty, as it apparently was during the early days of the conquest.

Regardless of the name of the invasion, it truly was “mission accomplished” for George W. Bush: We ensured ourselves a spot at the OPEC table, while also privatizing the oil fields of Iraq for American companies.

Although the oilman in the oval office correctly pointed out, in his 2006 State of the Union Address, “America is addicted to oil,” his solution is absurd. Rather than stressing conservation, as a conservative might do, his goal is to find more oil by any means necessary. Is that how to deal with an addiction? By finding more substance for the addict?

I fear Oil War III is just getting started. Nobel Laureate President Obama has a war record even worse than his predecessor.

And conquest is just another name for war, albeit without a fight from the vanquished. We’ve done that throughout our history, as have many other nations. I’ve no doubt we’ll continue as long as the industrial age allows.

From many, one!

The Four Horsemen are lurking in the background, obscured by the never-ending, irrelevant chatter of the corporate media. The corporate media’s weapons of mass distraction notwithstanding, soon enough the Four Horsemen will be riding tall enough for everyone to see. Population-scale rules from two millennia ago will re-assert themselves.

Socrates understood the importance of maintaining societal norms in the name of the law, even when justice failed at the level of the individual. And human-health practitioners back in Socrates’ day undoubtedly understood that the good of the one, or of the few, sometimes must be sacrificed for the good of the many.

A lot has changed in the two thousand years that have transpired since Socrates drank from that fatal cup.

Many, and perhaps most, of the changes that have transpired during the last two millennia have occurred during the last century. We can trace many of those changes to the convoluted notion of American exceptionalism and our focus on the individual.

In this country, we too infrequently take a population approach to human health. We decree every life worth saving, including the one-pound baby born 12 weeks premature, the 95-year-old with cancer in all the major organs, and everybody between. To a great extent, we’ve traded in a perspective on the population for an obsession with the individual.

Never mind human dignity. Our doctors are the best. They — meaning we — can save anybody. The costs, which are enormous, have been ignored in the name of vanity. These costs include economic, environmental, political, social, and moral.

Alternatives

Some countries have looked back to move forward.

Ireland purportedly uses medical generalists in their communities to advance the public health. They preserve the good of the many at the occasional expense of the one, or of the few. Yet babies and old people die at the about the same annual rate in Ireland as in the United States.

No, Ireland’s public-health practitioners don’t get to write articles about saving the lives of babies with no statistical chance of living. They don’t get to bask in the reflected glory — or maybe it’s the hubris — of their seven-figure salaries while their peers enviously wonder when they’ll have a chance to break the new record.

But perhaps, in focusing on communities and therefore letting go of some individual lives, Ireland has preserved something we’ve lost: something economic, environmental, political, social, or moral.

–Guy McPherson, Transition Voice

This essay is excerpted and modified from McPherson’s latest book, Walking Away from Empire.

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Comments

  1. Auntiegrav says

    I think it falls under two things: net usefulness (our useful contribution to our own future minus our consumption of resources), and moderation. Focus on the high dollar individual health activities (especially those who have at least enough money to drive to the hospital…so the hospitals are built in suburbia) is a lack of moderation of health care activities. The most common application of Moderation in today’s money-oriented business world is the 80/20 rule. If we applied the 80/20 rule to health care, those special cases would go untreated. In the terms of Pearl S. Buck, however, “All things in moderation, including moderation.”, we should treat at least 20% of those special cases for the sake of diversity and learning.
    How do we know which ones to treat and which ones not to treat? We don’t. Like most things in life, it’s a crap shoot, but we’ve forgotten this in most other situations, and we’ve forgotten how to accept it. We used to say things like “que sera sera” or “God works in mysterious ways” and then move on, but in today’s world, if one person doesn’t get what another person got, there is a que of lawyers ready to start a fight.
    The military knows how to triage things, but apparently the socialized medicine that the troops get is too good (or not good enough) for everyone else.

    • Auntiegrav says

      Why is it ‘patriotic’ to pay taxes to ‘support the troops’, but not patriotic to pay taxes for health care to provide physically fit kids for the army?
      Because people don’t pay to die in the Army, but they are willing to pay damn good money for insurance or religion to die in private resort hospitals away from the poor people in cities.

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