Pearls and Irritations

We have all been abandoned by our “leaders”, a pathetic coterie of self-focused, ignorant and immature individuals who lack courage, compassion and the capacity to recognize an impending catastrophe, with likely societal collapse and massive loss of life (already beginning). There is no possibility of technological salvation.

I’ve been a medical oncologist for 40 years, treating patients with advanced cancer. What can I say about the intractable COVID 19 and Climate Crises? Perhaps, “The human civilization now confronts the challenging interconnected crises of COVID 19 and Climate Change, (not to mention the crises of health inequity, racism, poverty and child abuse, each exacerbated by all the others)”?

As the great 20th-century philosopher, John Lennon sang:

“I’m sick and tired of hearin’ things
From uptight, short-sighted, narrow-minded, hypocrites
All I want is the truth
Just gimme some truth”.

In oncology, we often see multiple crises. A previously well patient may present with a serious refractory infection, say pneumonia, in itself a crisis for patient and family alike. Weeks of treatment go by. There is no improvement. Further testing reveals the Big Crisis, underlying cancer. Now life itself is threatened. But there is more. This 50-year-old woman, Joan, lives in an abusive relationship, a third crisis.

In oncology, following the discovery of a cancer, there are often two consultations. In the first, I would spend much time with Joan by herself, and then with the family, obtaining as much information as possible about her past, even from early life, and other important factors, including aspects of the ongoing lung infection, her personal strengths and supports, and her emotional response when told of the cancer and its clear threat to life. Further investigations would be necessary to characterise the cancer in detail and thus plan the best treatment.

So too with COVID 19 and Climate Change, I will approach these crises gently in this Part 1, with a presentation of the “further investigation” and stark reality in Part 2.

In the second meeting with Joan, I would discuss the further results with Joan. Over the years I have had to “break bad news” to so many patients, essentially telling an anxious and desperate patient that their cancer is treatable but not curable. They will thus die sooner than they expected. Some patients indicate early that they do not want to hear this news. Sometimes a family member intervenes to ask me not to break this bad news, that is not to tell the truth, even indirectly or in stages. Clearly, there are ethical issues here. A person generally has a right to know the truth about their own life.

Over the years, despite informing hundreds of patients of their shortened lives, I find that this important duty never gets easier, and nor should it, since I am relating deeply with one person, this particular patient, whose name is Joan, with her own life, that she has kindly shared with me, including details never shared with anyone else. So, I share and feel the reality of her shortened life, with the knowledge that so many dreams will not be fulfilled. Eyes moisten. I can only really be truly present for Joan if I have already become familiar with my own eventual demise, although always necessarily beyond comprehension. I reassure Joan that she will be cared for with compassion right through until the end.

Unfortunately, because of the pneumonia, Joan was never able to receive treatment for her cancer, and died some weeks later, still in hospital.

As with this second consultation, confronting intolerable realities, so in Part 2 I will present current data indicating the truly perilous status of the Climate Emergency.

Just as the pneumonia and lung cancer are related to each other in many complex ways, so too with COVID 19 and Climate Change, reflecting man’s inexorable destructive exploitation of our precious planet. The great majority of indicators of ecosystem health and biodiversity now show rapid decline. The Sixth Great Extinction on this planet has begun. The population sizes of vertebrate species have fallen 68% since 1970. Around 1 million species of all life forms already face impending extinction.

Whilst we are rightly focused on the immediacy of COVID 19, we should not forget the evolving malignancy of Climate Change. Indeed, as with Joan, this malignant process can rapidly become irreversible, possibly amenable to minor mitigation, but ultimately following a trajectory determined by physical laws oblivious to human preferences.

Despite decades of alarming scientific data and witnessing and experiencing directly the catastrophic consequences of the Climate Emergency (wildfires and alarming record temperatures on many continents, unprecedented flooding in Europe and increasing Atlantic hurricane intensity and so on), very little action has been taken.

The reasons for this dangerously inadequate activity by governments in the face of increasing existential risk are not well understood but likely include:

1. “Scientific reticence” (a self-censoring process when dealing with truly unpalatable data); and also here;
2. The recent “under-presentation” of opinion and risk (based knowingly on incomplete data for political acceptability); for example, the IPCC 2018 statement that zero greenhouse gas emissions by 2050 would restrict a global temperature rise to 1.5⁰C; when in fact there was only a 50% chance of doing so, but this also excluded other adverse factors – notably tipping points, so we are now actually at the undesirable 2⁰C, with an urgent need to reach zero by 2030 (not 2050);
3. “Psychic numbing” and the “nothing response” (noted by the courageous psychiatrist, the late Beverly Raphael, during the nuclear threats of last century);
4. Significantly, most politicians have limited cognitive and emotional maturity, mostly residing in level 3 of 8 possible levels in Grave’s Model of Human Development. In level 3, (Egocentric Power) the principles include:

• Living in a world of haves and have-nots, where it’s good to be a have;
• Avoiding shame, defending reputation, seeking revenge, being respected; remaining self-focused with no awareness of the world;
• Gratifying impulses immediately; exploiting the world;
• Fighting remorselessly and without guilt to break constraints;
• Not worrying about consequences that may not come.

Higher levels of maturation in our “leadership” would allow: the finding of meaning and purpose in life (spiritual progress), a sense of self-sacrifice, seeking order, stability and peace, controlling impulsivity, responding to guilt, promoting righteous living, enabling others to flourish, becoming aware of the world as a complex, sensitive, interactive, interconnected biosphere (Gaia).

In the world of oncology, patients (like Joan) are often faced with an existential threat, the equivalent of their own internal “climate emergency”, (a terminal illness). They would then receive meticulous care, guided by compassion and honesty, remaining fully informed about changing circumstances, with their loved ones also supported. Importantly, there would be a commitment by the caring team to maintain this deep engagement to the end of life, with no possibility of abandonment.

In the very real world of Climate Emergency, as tipping points are passed, with a rapidly worsening prognosis, we have all been abandoned by our “leaders”, a pathetic coterie of self-focused, ignorant and immature individuals who lack courage, compassion and the capacity to recognize an impending catastrophe, with likely societal collapse and massive loss of life (already beginning). There is no possibility of technological salvation.

Furthermore, they have abrogated their fundamental duty to protect the vulnerable, particularly children, who are already aware of the crisis (note Greta Thunberg), and experience eco-anxiety and grief, and internationally, participate in “SS4C” (School Strikes for Climate) demonstrations in large numbers. A major recent Australian protest by children took place on May 21^st 20021 against the bizarre plan for our federal government to fund a $600m gas-fired plant.

Not surprisingly adult eco-anxiety and solastalgia (climate grief) are also high, or often internalized, (and thus to manifest as other disturbances of mood and behaviour).

Since our leaders have access to the best climatological and psychological advice, their bewildering inaction over decades now represents a major crime, not only against humanity but against all life. There are now new categories of crime to consider: Ecocide, Auto-Speciescide, Eídocide (killing of an entire species) and Gaicide.

More evidence and analysis in Part 2.

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