The Moon in Hand

 In Preventive Medicine Column

The Moon in Our Hands

My editors at LinkedIN asked me to contribute to a series of articles offering “advice” to the next President of the United States, whomever that may prove to be. Here, slightly abbreviated, is my offering.

Dear Mme./Mr. President: For more than twenty years, across democratic and republican administrations, we have neglected one of the greatest potential advances in the history of public health.

I invite you, and I implore you, to lead us toward that reachable, luminous prize: the addition of years to countless lives, the addition of life to countless years. We can eliminate up to 80% of the total burden of chronic disease- heart disease, cancer, stroke, diabetes, dementia, etc.- by applying knowledge of the root causes of such disease not only now in hand, but in hand already for decades. You could pledge your commitment to this campaign, and lead us. And because you can, you should. Lives- lives we know how to save- are at stake.

I respectfully urge you to make the combination of longevity and vitality, followed more often than not by a timely, swift, and gentle exit into that inevitable night– the new American standard. I ask this of you because it can be done.

Like so many others, I was moved when your predecessor leveraged the imprimatur of his high office, and the State of the Union address, to propound his will against the menace of cancer. I was moved in particular because the enemy was not diffuse and pervasive, but seen through an intimate window. I felt the pain and loss in the resolute set of Joe Biden’s face. This was a nation’s mission, but born of a family’s loss. When a menace invades such private spaces, when it roils the expression of a face we know– we are moved. We are motivated to act. I admire the assertion of will, the pledge to find a way to end all cancer. But alas, it is misguided.

President Obama likened curing “cancer” to reaching the moon, but that analogy falls from the sky. Even those decades ago when President Kennedy committed us to the moon, we had in hand the technologies to get there. We knew where there was; it was a single destination. There was one, clear, achievable mission.

The cure for all cancer is not a single mission, but many. Cancer is not one disease, but many. Ending cancer is not one destination like the moon, but more like the scattershot of stars in the cosmos. Getting there will depend on innovations yet to be conceived. When we know so little of the ultimate ways, we are ill advised to assert that Presidential will reliably presupposes them all.

We should continue to foster and fund the already impressive advances against cancer. But we already know the short list of lifestyle practices- avoiding tobacco, eating optimally, being active routinely, sleeping adequately, dissipating stress effectively, and nurturing our social connections- that can not only help prevent a large percentage of all cancers and an even greater majority of other leading disease killers including dementia, but can even modify the contributions of DNA to our defense. Studies show that lifestyle practices can throw the epigenetic switches that forestall the advent of cancer, and its progression once begun.

I humbly urge you, Madam/Mr. President, to promise us a mission we know can be fulfilled, and lead us in the keeping of it. In those places around the world where longevity, vitality, and peace at the end of life prevail, it is not courtesy of citizens battling against the currents of their culture. It is where the currents of culture lead toward, rather than away from, just such blessings.

Ending cancer is not a moon shot; it is, for now, a pipe dream, sprinkled with stardust. But we could banish tobacco to the ashtray of history’s bad ideas, and you could lead us there. We could end the subordination of what diet could do for the health of people and planet alike to predatory profiteering, and you could lead us there. We could be a culture that doesn’t feel compelled to count our every step, because we consider our native, animal vitality and the chance to exercise it a reason to count our blessings; and you could lead us there.

We have known for two decades and more how to eliminate some 80% of all chronic disease; we have known how to enhance the length and vitality of life. Please, make us the generation that turns what we have long known into what we routinely do to advance the human condition. Lead us, and persuade us, to treasure what’s in hand. Please beware the conflation of will for way. That itch may tempt your hands to clench, those fists to pound the lectern as you proclaim the inclinations of your power, and glare past the horizon. In the hush that follows, you may open your hand to find the ruin of a beautiful, luminous bird that was in your hand all along. As it is, and has long been, in the hands of us all.

-fin Dr. David L. Katz;www.davidkatzmd.com; author, Disease Proof; founder, True Health Initiative

Dr. David L. Katz
DAVID L. KATZ MD, MPH, FACPM, FACP, FACLM, is the founding director (1998) of Yale University's Yale-Griffin Prevention Research Center, and current President of the American College of Lifestyle Medicine. He earned his BA degree from Dartmouth College (1984); his MD from the Albert Einstein College of Medicine (1988); and his MPH from the Yale University School of Public Health (1993). He completed sequential residency training in Internal Medicine, and Preventive Medicine/Public Health. He is a two-time diplomate of the American Board of Internal Medicine, and a board-certified specialist in Preventive Medicine/Public Health. He has received two Honorary Doctorates. Dr. Katz has published roughly 200 scientific articles and textbook chapters, and 15 books to date, including multiple editions of leading textbooks in both Preventive Medicine, and nutrition. Recognized globally for expertise in nutrition, weight management and the prevention of chronic disease, he has a social media following of well over half a million. In 2015, Dr. Katz established the True Health Initiative to help convert what we know about lifestyle as medicine into what we do about it, in the service of adding years to lives and life to years around the globe.
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