Bernard Lown’s Prescription for Survival

The world-renowned cardiologist Bernard Lown won the Nobel Prize for Peace, (outside his field, so to speak) for putting doctors (starting with the Russian Eugene Chazov, above, who was Leonid Brezhnev’s heart doctor in the 1980s) into the fight against nuclear weapons in a global force called International Physicians for the Prevention of Nuclear War (IPPNW). His professional obsession had been sudden death, one by one, by coronary events. As Dr. Lown says, how could he not try to make a healing connection with the real danger of sudden death, in the hundreds and thousands, maybe millions, by nuclear events? The Nobel recognized in Bernard Lown the doctor-as-citizen to the nth degree, the world citizen, a saint of public health.

Many heart doctors (also Bernie’s mother) have said he should have won another Nobel Prize, for Medicine, for developing the defibrillator — the now implantable (and universal) electrical restart button for the heart. That’s the story of Bernard Lown the researcher and innovator, the doctor-as-scientist to the nth degree, an experimenter and inventor in the family of Thomas Edison.

And then there is Bernard Lown the doctor-as-doctor, the patient’s friend, the hands-on healer to the nth degree. If you haven’t had a touch of Bernie’s doctoring, you’re missing something. The finest interviewer in America is not on radio or television – sorry, Terry Gross; sorry, Ted Koppel. The best interviewer in America is Bernie Lown. He examines you inch by inch. And then he sits there with you in what feels like a sealed room. No interruptions, no distractions of any kind. “Half like a general, half like a bishop,” as Henry James writes about a doctor in The Wings of the Dove. Like Henry James’ doctor, Bernie sets on the desk between the two of you “a great empty cup of attention.” Bernie listens and watches.

“You have a unilateral stare,” he said to me a few years ago.

“Meaning what?” I asked.

“Meaning you lead with your right eye. Your right eye does more of the looking than the left.”

“And what does that tell you,” I wanted to know.

“Not easy to say,” he said. “It could be a sign of aggressiveness.”

A year later, I asked him: “Okay, Bernie, where’s the unilateral stare now – which eye?”

“It’s your right eye,” he said.

“How could you be sure?” I asked.

“I looked,” he said.

“Does that cost extra?” I checked.

“No,” he said, “it’s part of my exam.”

Bernie has written in The Lost Art of Healing that the taking of a patient’s history is the most important diagnostic device ever invented; and that touching – the laying on of a doctor’s hands – is the most effective tool in medicine. He is a doctor on the William Carlos Williams model, who is willing and able to become us, to become the patient, for half an hour, or an hour at a stretch. You leave his office, as Henry James’ Milly Theale did in The Wings of the Dove, feeling that you’ve confessed and been absolved.

Best of all: months later I realized that under Bernard Lown’s care, my tachycardia was gone.

Our conversation here is about 87-year-old Benard Lown’s new memoir, Prescription for Survival, about the nuclear obsession that led to his Nobel. I urged him to begin with the revelatory freak happenstance, at a press conference on the eve of the Nobel ceremony, when a Russian journalist had a heart attack and both Lown and his opposite number, Evgeny Chazov, heart doctor to Brezhnev and the Politburo, jumped to the rescue. Lown’s impromptu speech in that moment is a capsule of his life:

We have just witnessed what doctoring is about. When faced with a dire emergency of sudden cardiac arrest, doctors do not inquire whether the patient was a good person or a criminal. We do not delay treatment to learn the politics or character of the victim. We respond not as ideologues, nor as Russians nor Americans, but as doctors. The only thing that matters is saving a human life. We work with colleagues, whater their political persuasion, whether capitalist or Communist. This very culture permeates IPPNW. The world is threatened with sudden nuclear death. We work with doctors whatever their political convictions to save our endangered home. You have just witnessed IPPNW in action.

The patient and the planet survived a while.

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  • In keeping with the theme of the last show, again we have the words of an American president. Reagan tells us that ” a nuclear war can never be won and must never be fought.” I made the point elsewhere that the Hobbesian doctrine that ‘war is a natural state’ is itself a hoax. It serves as an excuse for those who have power to seek it further regardless of the damage it does to others. But let’s talk the talk now. Let’s be as those cynics like to say ‘realistic.’

    The discovery of the ability to destroy all life is both a nightmare and a blessing. While the former is obvious, the latter may not be so straightforward. Limits force changes in growth strategies. The fact of nuclear capabilities forces nations to come to agreements. The alternative is to keep going in the direction we are headed which increases the probability of hitting the reset button.

    If life is somehow an exercise in self-creation — in making ourselves into something worth being — perhaps the nuclear dilemma is a necessary challenge in which we have the opportunity to transform the basis of international relationships in light of the possibility of annihilation. Our binding enemy in which we must overcome is not “them” but “ourselves.”

    I am thinking about Søren Kierkegaard’s “Fear and Trembling,” where he addresses the story of Isaac and Abraham. What I take from Kierkegaard is the idea that one’s lineage is not worth the sacrifice of one’s beliefs. That is, it is not worth going on if one gives up that which it is better to be.

    And here we are. I am also reminded of Richard Rorty’s lecture “Anti-Terrorism and the National Security State” in which he eloquently proposes that the threat of terrorism is not that cities will be destroyed but that in order to protect cities democratic freedoms will be eroded. Cities can be rebuilt, but social justice is a more delicate matter.

    Good show Chris.

  • A few thoughts on the current crisis, and the conditions producing it, as inspired by this radically insightful, delightful conversation!

    What has become of our culture? It is widely recognized that Washington, Wall St., and to a certain degree, “Main St.” is plagued by corruption. What is responsible? What is missing?

    What is missing is Ar! You know, like the pirates say: Arrrrrr. No just kidding. Ar, as in the root of art, as in thou art; the present indicative. Ar as in art, like artist, more like techne; to do something well, to produce something of value.

    But perhaps more importantly, Ar as in aristocracy, an endangered species, seemly very near extinction, that must be restored to its proper niche and population. “Our kingdom for a nobleman,” must be our war cry. A true, genuinely noble man (or woman). More than one would be a real boon.

    Ar as in anarchy, not in the chaotic sense, but rather of the libertarian kind, but this only when our cultural norms depreciate the value of avarice and appreciate the value of virtue. This is the only means to cure our culture of the malignant effects presently manifesting as geo-political, economic and ecological crisis.

    Then will man — and by extension society, civilization — find yet again our true source of vigor and integrity. Vir (“man”) requires virtue (“strength”) to thrive, in its absence we perish and society decays. The solution to our current problems lies not in the public sphere, with government or the financial system, the problem is entrenched in the secret recesses of our psyche (as the Greeks would say), our soul (as the Christians have it), our mind (as translated from the Sanskrit). This is the essential nature of the proposition imposing itself at present: humanity must choose between terror and dissolution, or virtue and integrity. The floggings will continue until morals improve!

    However, the resolution to our conundrum is infused with paradox: what is plaguing us collectively must be resolved personally. The collective is an amplified personification of the dominants of the personal.

    The resolution requires individual participation, an involvement, in the form of self-examination, and a certain measure of personal response-ability to issue forth that which is most noble, most virtuous in the human character to guide our collective evolvement, our evolution. If we prove incapable of transcending the corrosive nature and inherent limitations of our cultural conditioning, we will remain “prisoners here of own device.”

    In the Age of Deregulation, the only re-regulation that will ultimately be effective against our current predicament is a regulation of human motivation. The only government that can correct the current dysfunction of critical systems, is the governance of values. It is true that pride goeth before a fall, it is also true that profuse avarice decomposes societal foundations. If we are to cure the current crisis plaguing our global socio-economic system, we must first make a radical examination of the culture responsible for producing it. We must see clearly that which nourishes the root of our problem. And the prescription must likewise be radical. We can ill-afford to deal only with symptoms at this critical juncture.

  • To correct the typo in the previous post, it should read: “prisoners here of our own device,”

    From the song Hotel California by the Eagles: “We are all just prisoners here, of our own device.”

  • potter

    The eye thing is interesting. I have seen it in you Chris- in photos- Nubar’s and others. I have always interpreted it slightly differently. I see it in myself as I get older. I think we see this more as we get older. I think it represents some sort of battle going on in there. I suppose you could call it leading.

    Anyway- thank you for Bernie Lown. He sounds much younger than his age and not the harsh voice of a radical some may expect but more the gentle loving spirit of one, truer.

    Along with William Carlos Williams- can I add Walker Percy and Anton Chekhov- who went beyond their medical careers… and my cousin Stephen.