LIFE: A MIXTURE OF THINGS WELL DONE AND NOT WELL DONE-A BIOGRAPHY OF GEORGE W. BUSH

Jean Edwards Smith’s, Bush, the newly published biography of George W. Bush, demonstrates the reality I’ve come to appreciate more and more: each of our lives is made up of things well-done and not well-done; “ups” and “downs.”  We recognize some of these contradictory experiences; some we don’t.  Some are invisible to us, but they are realities nonetheless. 

Happily, over time this realization has provided me with a deeper sense of humility and peace. 

 

In Bush’s tenure as President, there was, above all, the imprudent and, in hindsight, all too clearly irresponsible decision to invade Iraq.  The decision to do this in the name of bringing “freedom and democracy” to countries that didn’t have it and to rid the world of Hussein was in President Bush’s mind even before 9/11.  Contrary to evidence that was being provided by the CIA and the UN Inspection team he insisted we needed to invade Iraq and depose Hussein to avoid the risk of his proceeding with the use of weapons of mass destruction.  

 

The decision ignored the lessons of history and the on- the- ground realities as to what the consequences would likely be (e.g., the historical animosity between the Sunnis and Shiites and Kurds ).  Bush’s decision supported strongly by Cheney went against the advice of almost all of his counselors.  

 

There was not only the decision to begin the war, but then the execution of what to do after Hussein was driven out of power.  The total dissolution of the Baathist government and the Iraqi military preordained massive Sunni unrest and, in important measure, laid the foundation for what became ISIL and then ISIS.

 

There was also Bush’s decision to cut income taxes massively, which led to major deficits, especially with the significant cost of war.  

 

Smith’s book does do a good job of illuminating the many courageous acts and programs which President Bush led.  Many I had not adequately appreciated.  

 

His personal leadership in the attack on HIV/AIDS was singularly important in the sharply reduced incidence of that disease.   His courageous reaction in 2008 to the economic crisis following the advice of Secretary of Treasury Paulson and bailing out financial institutions stopped what could have become a truly great depression from happening.  

 

His “No Child Left Behind” program, while flawed in some areas (too much testing) advanced the recognition of the huge racial disparities in our children’s educational outcomes. That has been and will continue to be a driving force in attacking those disparities.  

His expansion of prescription drugs for seniors, while a costly improvement, was a greatly needed initiative even as it was controversial among many Republicans.

 

President Bush's strong advocacy of sensible immigration reform, while not ultimately successful, was a brave and correct undertaking which displayed President Bush’s courage and genuine compassion. 

 

There is no question of Bush’s single-minded and brave pursuit of what he thought was right.  I believe his ideology and faith-based fervor led him to see himself and the nation's being able to do more than it practically could or should try to do in terms of improving what he perceived to be the desired outcome in people’s lives.  This I say with particular reference to the invasion of Iraq and his overall “Freedom” agenda.  

I find the conclusion of Smith’s book to be “too cute by half,” as he writes:  ”Whether George W. Bush was the worst President in American history will be long debated, but his decision to invade Iraq is easily the worst foreign policy decision ever made by an American President.”

 

First of all, I can’t imagine history regarding Bush as the “worst” President in history. No way!  He has lots of winning competition on that front . I would place Buchanan and Pierce at the head of the list. 

When it comes to foreign policy decisions, while I can’t think of one worse than invading Iraq,  I regard our entry into and expansion of the war in Viet Nam as being at least at the same level.  As Iraq represents for Bush, Vietnam represents the chapter in Lyndon Johnson’s tenure as president which will likely forever overshadow his many accomplishments.  Chief among them was the passage of the Civil Rights Act of 1964, something that never would have happened if it were not for him.

These Presidents’ lives illustrate what’s true in all of our lives, and certainly in my life.  Some things I’ve done well and some I haven’t.  Some I take pride in; others I look back on with regret. We do the best we can; we try to do what we think is right--what, at least in some measure, can make the world and other people’s lives a bit better.

 Smith’s biography of George W. Bush (like most biographies) doesn't attempt to probe other differences George Bush’s life made in ways that perhaps count the most. These are the differences which will be manifested in the lives of his and Laura Bush’s children, and their children.  Nor the positive influence he brought to others with whom he was associated closely during his life.  

For many, if not most of our lives, these will be the biggest differences we make,  for the better or for the worse.  We should never forget that.

 

THE U.S.AND RUSSIA AND THE OVERHANGING THREAT OF NUCLEAR WAR

THE U.S. AND RUSSIA AND THE OVERHANGING RISK OF NUCLEAR WAR

 It is difficult for an individual or indeed a Nation to view a particular situation through the eyes of another person or nation.

I have never seen this more true or more dangerous than what is transpiring now in the relationships between the United States and Russia.

As a former CEO of Procter & Gamble and a student  of history, I have followed the relationship between the U.S and Russia (and before that the former Soviet Union) for half a century. From a peak of hope in the early 1990's in the possibility of our joining together in the vision of a Greater Europe, 

I have become increasingly and alarmingly concerned by the deeply polarized perceptions  of the intentions of  our two nations. 

Fueled by Russia's annexation of Crimea and its (as well as our own) involvement in Syria, this fever has boiled and become intensely personal  as  the President of  Russia, Vladimir Putin has become demonized. 

The situation has become further politicized as Donald Trump, whose views I disagree with on almost all counts, advocates , rightly,  cooperation with Russia in fighting ISIS, even as he outlandishly (facetiously or not ) calls on Russia to hack the DNC's and Secretary Clinton's e-mail accounts. For me, Trump is the apposite of someone you want to be advocating your point of view because he encourages his opponents to reflexively adopt or double down on contrary views. 

Why am I so concerned about this situation?  Because  I believe the failure of Russia and the U.S. and West to work together threatens the  security and indeed

 the very existence of the world because of the overhanging and very related risks of nuclear annihilation and terrorism. 

There is a great and common danger in the affairs of humans and of nations in self-fulfilling expectations.  These self-fulfilling expectations can be for the better or they can be for the worse.  The expectations held by Russia toward the United States and those the United States holds toward Russia today are all “for the worse.”

Contrary to what was promised as Germany was reunited and became part of  NATO as we entered the 1990's, NATO  continued to expand to Russia's doorsteps. The belief that Ukraine might be next, was a precipitating cause of the  Ukrainian crisis. As a colleague of mine has said, whether NATO is a benign or a malign force is irrelevant from a geopolitical perspective if one of Europe's great powers (Russia, a country which has been subject to multiple invasions over the course of history) considers it a threat. The dismissal of these concerns  has deeply exacerbated Russia's mistrust. 

And that mistrust has been matched on our end by the impact of Russia's annexation of Crimea and presence in Eastern Ukraine,  entry into Syria supporting Assad and the alleged (though unproven) involvement in our electoral process.  

We hear veiled and sometimes bald assertions that Russia intends to enter countries previously part of the Soviet empire--the Baltics, Poland and all of Ukraine.  Putin describes such a notion as “insane.”   He is right.  

Can you imagine the suicidal idiocy of Russia's undertaking to move into those countries?  Why would they do this?  They don't need land. They would find very few friends there.  They would become the pariah of the world. There is no driving ideology as there was in the days  of Soviet Communism.  

Of course, there are legitimate concerns about President Putin,  just as there about many leaders with whom it is in our interest to work. Some of them are serious. In terms of encouraging a positive relationship with the United States, he is in some ways his own worst enemy. His distrust of our motives now borders on paranoia. 

 However, we should not forget that he was the very first President to call President Bush to offer his nation's unbounded support following "9-11". 

Whatever, my concerns are existential. 

I worry deeply that most people are so far removed from the reality of war today that we have forgotten its horror. We should all go back and look at the film showing the instantaneous annihilating devastation resulting from the atomic bomb  at Hiroshima. It won't be pleasant but we should watch movies  like “Platoon” or “Saving Private Ryan”. We should read Michael Herr's devastating front line reports on the war in Vietnam. We dare not forget the horrific cost of war on human life and civilization.  

We cannot address this overhanging threat unless we are working with Russia. That is the plain and simple truth. 

We are at a historical precipice.  I am extremely worried by the unfettered “propaganda,” and that’s what it is, on both sides of the issue.  This has had the insidious effect of bringing the people of Russia and of the United States to view the “other” as “evil.”  And in fact they are not.  They are committed to their own national interests.  The concerns of the Russian and American people are fundamentally the same. . They yearn for a peaceful, economically stable life for their children and themselves

Every nation, every person, wants to be treated with respect.  There is no way that will happen if we are not able to view the current situation through each other’s eyes.  That doesn’t mean we will compromise and tolerate people taking away the freedom of another nation or people.  We need to draw a bright line on the support we will provide to countries to which we pledge support--and mean it. 

 However  we should not make the mistake of attributing motivations and nefarious intent to other nations which, in fact, they disclaim and which, as we examine the reality of the situation,  we see no persuasive  reason to assume.  

We need to stop carrying out diplomacy and negotiations through the media and "anonymous" third parties, seeking sharp headlines that show we “mean business” and are "tough".  We need to establish what the bright lines and  bases for cooperation  are.  We need to rebuild trust-based relationships. This will be very hard; many will say there is no point in trying.  It will require courage and stamina, but it is what we must do. We should do so privately through credible leaders, starting with our Presidents and foreign service secretaries, just  as we did in the later years of the Reagan Administration and that of George H.W. Bush.  

I pray for the wisdom and courage of these leaders. 

I  believe the future of our Nation and the world depends on it. 

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UNDERSTANDING PUTIN'S INTENTIONS AND THE RIGHT COURSE OF ACTION IN DEALING WITH RUSSIA

“The New Czar:  The Rise and Reign of Vladimir Putin” by Steven Lee Myers

This was a deeply informing and mind-opening book for me in trying to understand President Putin's true intentions and how we in the United States and the West should deal with Russia and him to advance our own and the world's interests. Here are my perspectives: 

1.     It becomes even clearer to me that Putin’s ascendency and with it his frame of mind changed event-by-event, yet inexorably over the course of his life and especially over the 15 years, 2000-2015 during which he has held power.

So much of his history grew from his earliest background, as it does for all of us.  Having been born into a war-ravaged country, with his father at one point left for dead and two of his siblings dying during World War II, having seen a movie in his teens that led him to want to join the KGB and become a “spy,” having been bullied as a kid, and later pursuing martial arts, learning that one has to fight for oneself, seeing the West as a historic potential threat (witness the Cold War), with a life driven by a pragmatic, “put your nose to the grindstone” commitment, while loyally serving those in power (e.g. Sobchak) and being ready to make the most of what comes next (I can relate to that).

In that regard, nothing could have surprised him more looking back than Yeltsin’s asking him in 1999 to take his place as President.

2.     I believe Putin truly started out with one overwhelming goal – to restore Russia’s stability and return it to greatness.  He had experienced the ravages not only of the war but of the 1990s as the economy disintegrated.  

Just before he assumed the Presidency entering the year 2000, Putin spoke at the Kremlin on New Year’s Eve saying, “unfortunately, not everyone in Western nations understood this, but we will not tolerate any humiliation to the national pride of Russia or any threat to the integrity of the country.”

Those fears were to build incident by incident during the coming 15 years.

Still, he began his Presidency wanting to become part of the West.  This was reflected in his being the first leader to reach out to President Bush right after the 9-11 terrorist attack.  This manifested not only his desire to reach out to the West but, above all, his fear of terrorism, of unrest, of chaos, which he had experienced in many forms.

There is no mistaking Putin’s passion or genuineness as he reacted to the news of the 9/11 bombing.  He went on television and expressed his condolences to the victims of what he called “an unprecedented act of aggression..the event that occurred in the United States today goes beyond national borders.  It is a brazen challenge to the whole of humanity, at least to civilized humanity.”  As Myers says in his book, Putin made it clear that the tragedy was an opportunity to refashion into national relations--to fight, in Putin’s words ‘the plague of the 21^st century..Russia knows first-hand what terrorism is, so we understand as well as anyone the feelings of the American people.  Addressing the people of the United States on behalf of Russia,” Putin continued.  “I would like to say that we are with you, we entirely and fully share and experience your pain.”

In a later conversation with President Bush, Putin said it simply, “Good will triumph over evil.  I want you to know that in this struggle, we will stand together.”  Words like these were not contrived.

There is no overestimating in my view the impact on Putin of the multiple terrorist attacks in Moscow, Beslan, Volgograd and other cities of Russia and then the brutal Chechnya war.  Maintaining the strength of the state, including fighting off terrorism, in all its forms, became Putin’s principal goal and that goal continues to this very day in Syria.  

Putin’s view of the importance of having a strong state, ensuring order over chaos, was manifested clearly in a statement he made in 2003 referring to democracy:  “If by Democracy, one means the dissolution of the state, then we do not need such democracy.  Why is democracy needed?  To make people’s lives better, to make them free.  I don’t there are people in the world who want democracy that can lead to chaos.”

Clearly this line of thinking was to find affirmation, as Putin saw in it, the tragic results growing from the move toward what was hoped to be “democratization” in Iraq, Egypt, Iraq and Libya.

Putin’s desire to work constructively with the West had other manifestations.  Putin invested heavily in developing a personal relationship with Bush.  Already the first Russian or Soviet leader since Lenin to speak a foreign language, he took lessons in English for an hour a day, learning the language of American diplomacy and commerce, and he used his rudimentary skill to speak privately with Bush to break the ice.  In private, he felt he could be candid with Bush about their differences, Myers writes, trying to make him understand the difficulties that Russia—that he—faced in the transition from the Soviet ruins.  He sought some kind of accommodation with the United States, even with NATO, Myers continues.

Against this background, it is easy to understand how frustrated and disappointed Putin was in Bush’s abandonment of the anti-missile defense treaty.

3.     Putin’s disenchantment with the West and his increasing view that the U.S. and the West were “out to humble” Russia and exercise a unilateral commitment to hegemony progressed through several stages.  And so did the importance he attached to the “nation state” and his deep abhorrence of what he saw as the unilateral moves by the United States and the West to overthrow national leaders.

The expansion of NATO into Central Europe, including the Balkans, and then to the Baltic states, was not vigorously opposed, but it certainly was resented and came despite the understanding (disputed by many in the West) that there had been an understanding reached at the time of the unification of Germany that NATO would not extend in the borders of what had been the German Democratic Republic.  What tipped the scales far more was the consideration given in 2007-08  to bring Georgia and Ukraine into the European Union and, following that, even NATO.

The conflict in Georgia precipitated by Georgia’s move into South Ossetia in 2008 was another point of demarcation.  Putin clearly saw the U.S. having encouraged this initiative.  And if it could happen in Georgia, it could happen in Ukraine and maybe even Moscow.  Another nail had been put in the mindset he was building.

Prior to that, at the close of 2004, we had what became known as the “orange revolution” in Ukraine.  It was treated in Russia as a humiliating defeat and as an ominous warning.  Putin was convinced then, eight years before the Ukraine crisis of 2013, that Western leaders had encouraged the mass protests in the streets of Kiev.  “We must not make it an international practice to resolve disputes of this kind from street riots.”

The first runoff of the Presidential election in Ukraine had given the victory to Yanukowych, a leader clearly committed to Russia.  Marked by a high degree of fraud, Ukraine’s highest court ordered a runoff and Yushenko, strongly supportive of the West, won the election.

This coincided with President Bush’s now advancing what he described as “the freedom agenda” as he cheered the popular uprisings in Georgia and Ukraine.  To recent elections in Iraq, Bush said, “we are part of the inevitable march of democracy that had begun with the Velvet Revolution in the then unified Czechoslovakia in 1989.”  Without mentioning Russia, Bush declared that “eventually the call of liberty comes to every mind and every soul.  And one day, freedom’s promise will reach every people in every nation.”  Without intending to, I’m sure, Bush’s words led Putin to believe that similar efforts might even be undertaken in Russia.

Ukraine’s election came amidst the week of terrorist attacks in Russia and, in Myers view, “proved to be a turning point for Putin and for Russia.”  Putin’s initial instinct to bring Russia into closer cooperation with the West, if not an actual alliance, had faded as steadily as his political and economic power had grown.

In 2007, at Davos, he spoke without, as he said, “excessive politeness and the need to speak in roundabout, pleasant but empty diplomatic terms.  Today, we are witnessing in a most uncontained, hyper use of force—military force—into international relations, a force that is plunging the world into an abyss of permanent conflicts.”  He singled out the United States which had “overstepped its national borders in every way.  This is visible in the economic, political, cultural and educational politics it imposes on other nations.  Well, who likes this?”  The dye had been cast.

And then you had the Ukraine crisis itself which I needn’t go through here.  Putin viewed the riots which led to Yanukovych’s departure and the entry of the new provisional government as having been advanced by the U.S. and the West and indeed it had been.  By now, Putin’s review of the history of the past decade had become a fixation, and in many ways a paranoia.

4.     Syria—Russia’s position on Syria and what is happening right now was totally predictable.  Here again Putin saw the U.S. and the West setting out to overthrow a national leader.  As Myers writes, “Putin had little personal sympathy for Assad; what he vehemently opposed was another American-led attack in the Middle East.  He was convinced that from the beginning the United States had been waiting for any pretext to attack and topple Assad.”

By now, Putin had the evidence that he could point to as confirming his belief.  I refer to the actions taken to intervene in Serbia (Milosevic), Iraq (overturning Hussein), Egypt (Mubarak), Libya (Khadafi) and Tunisia.  Each had unleashed sectarian violence.

Adding to his motivation in Syria, perhaps the most important element was Putin’s deep concern about ISIS terrorism that could flow over into Russia.  Here, in Syria, Putin had the melding of all that was needed to undertake a righteous mission:  the maintenance of the rule of law, national sovereignty and a fight against terrorism of a kind he had fought against almost non-stop and with the very integrity of Russia at stake as he looked back for over 15 years.  Increasingly, President Putin saw himself upholding a value system being compromised by the West.  

In 2013, fresh from his diplomatic triumph in reaching an agreement to remove Syria’s chemical weapons without warfare, Putin described the “Euro-Atlantic countries” as dangerously adrift from their Christian roots.  “They are denying moral principles and all traditional identities:  national, cultural, religious and even sexual.  Worse, he said, these nations want to export these dangerous ideas.”  It was “a direct path to degradation and primitivism, resulting in a profound demographic and moral crisis.”

5.     Stepping back, there is no question that for Russia to have a healthy, growing economy, and for the entire world to be safe, Russia needs constructive, non-adversarial relationships with the U.S. and the West.  

At a minimum, we need to:

·      Avoid a further breakdown the relationships between Russia and the U.S.  This means that we must work together to resolve what are the open wounds now in Ukraine and Syria; both require a political settlement which requires Russia and the U.S. (and others) to be at the table, and the defeat of ISIS.

·      Come together to identify what are the common interests which Russia and the U.S. and others must work to achieve.  Interests so important and so requiring Russia and the U.S. to work together that we must form a common goal and plan.  Those for me are two-fold:

o   Avoiding the risk of nuclear proliferation and disaster.

o   Combatting terrorism, starting with but not exclusively combatting ISIS

We are going to need to accept the fact that values as they relate to the mode of democracy and cultural issues such as same-sex marriage will be different in Russia than the U.S., just as they are different in parts of our own country and have differed over time.  We must avoid seeming to or actually working to impose our values on Russia.  We must acknowledge Russia as a major global power, with a history and status that deserve and demand respect.  We must dial down the rhetoric which vilifies the other party when what they are doing is essentially expressing their own national interest and pride as we do.  Such rhetoric runs the grave risk of creating “self-fulfilling” negative outcomes—“mythical enemies”—distracting us from the real enemies in front of us.   

At the same time, we should make it clear that we will not stand by and allow Russia or any country to infringe upon the integrity of another national state like Ukraine.  Indeed, that position on our part mirrors that which has been driving Putin and Russia as they express it.

We should be under no illusion that Putin’s mindset and deeply entrenched attitudes will change quickly.  They are the product of decades of experience.  To the degree they change—and I for one believe they can--they will change based on actions and behaviors on both our parts as we work together on objectives of common interest.  Most importantly, at this moment, combatting ISIS and reaching political settlement that brings greater stability and peace to Ukraine and Syria and other countries of the Middle East.

Yes, Putin’s mindset had evolved, slowly but surely, block on block.  As Myers writes, “each step against Russia, he now believed to be a cynical, calculated attack against him.  His actions belied a deep sense of grievance and betrayal, sharpened by the crisis that unfolded (in Ukraine) at the very moment Russia had achieved its Olympic dream (referring to the Sochi Olympics).  It was as if a political upheaval in Ukraine affected Putin deeply and personally, like a taunt on the schoolyard that forced him to lash out.  For 14 years, Myers continues, Putin had focused on restoring Russia to its place among the world’s powers by integrating into a globalized economy (and), profiting from…the financial institutions of the free market.  Now, Myers continues, “he would reassert Russia’s power with or without the recognition of the West, shunning its ‘universal’ values, its democracy and rule of law, as something alien to Russia, something intended not to include Russia but to subjugate it.”

As he winds to his conclusion, Myers greatly simplifies and overstates matters and, most importantly, I believe, misconstrues Putin’s pragmatic mindset and willingness to be flexible in order to achieve what in the end is his main goal:  a successful, economically thriving, respected Russian state, looked at and treated as a partner in critical world matters.

I believe Putin understands that it will only be through a coalition of forces, prominently including the United States, that terrorism can be beaten, nuclear proliferation avoided and economic progress optimized.

I am convinced that if we were able to bring leaders together, to undertake specific goals, including combatting terrorism and taking steps to control the threat of nuclear annihilation, we can progress.  It has always been human nature that we come together best when we face a common enemy.  Unlike the past, we do not have ideological differences with Russia (as we do with ISIS) that should lead to war or that by their very nature lead to competing commitments to global expansion.

                                                                                    J. E. Pepper

WE HAVE TO WALK AWAY FROM THIS ROAD SHOW

I AM REPOSTING THIS BLOG FROM 5 MONTHS AGO WITHOUT CHANGING A WORD

“We Have to Walk Away From This Road Show”

These are among the words with which Pulitzer Prize-winning author Marilynne Robinson concludes her book, “Mother Country.”  It was published in 1989.  She was writing about a somewhat different challenge then.  She described it as a “decline in national self-esteem.”  But in a way, it wasn’t different.  In a way, we are facing much the same challenge today.  I describe it as a “decline in confidence in our institutions.”  

Because of this, we are witnessing a campaign by a candidate for the presidency of the United States by Donald Trump unlike any other we have witnessed in my lifetime.  A campaign that relishes in sweeping, categorical defamation of other people, such as Muslims and immigrants.  A campaign that takes delight in pushing the boundaries of outrageous pronouncements, whether that be in vilifying an entire group of people or accusing a former president of the United States of “lying.”  We are perversely taken by Trump’s authenticity, his fearlessness and his complete and utter rejection of political correctness.

Trump is feeding off a space filled with the potent mixture of boredom, frustration, hopelessness and anger and the all-too-present human attraction to witness, and indeed even revel, in the bizarre.  His impact is fueled by a media frenzy producing unending coverage and the inability of even the most seasoned, tough-minded interviewer to overcome his steamrolling, self-guided verbosity.

Without articulating any policy much beyond “building a big wall, which we’ll have Mexico pay for” and “making America great again” in ways weakly defined, he emphatically says, “Trust me.  I’m great at making deals.”  

He has the insidious talent of demeaning, indeed trashing, “others,” while making those he is addressing feel special, valued, even “loved.”  He gets away with this in no small measure because he is so obviously delivering what he says with gay abandon.  He is really enjoying himself.  

All of what I’ve written here has been easy to write.  But what is not easy and has never been easy in times of challenge of the kind we face today is to find and support the leader who can bring us together, who can offer a vision for the future and plans to support it that realistically offer an improved life for all and to find a role for our country in the world which advances as far as possible the peace we need while avoiding nuclear disaster and the threat of terrorism.

Returning to Ms. Robinson, she closes her book with words I resonate to:  “My greatest hope is that we will at last find the courage to make ourselves rational and morally autonomous adults, secure enough in the faith that life is good and to be preserved, and to recognize the greatest forms of evil and name them and confront them.”  

Paraphrasing her conclusion, we have to walk away from this road show which Donald Trump’s campaign represents.  We need to “consult with our souls, and find the courage in ourselves, to see and perceive and hear and understand.”

DonaldTrumpCampaign022516

A PERSPECTIVE ON REDUCING GUN CARNAGE IN OUR NATION

July 18, 2016

 

GUNS, CANCER, TOBACCO AND AUTOMOBILES – WHAT DO THEY HAVE IN COMMON?; WHAT CAN WE LEARN ON HOW TO REDUCE THE CARNAGE CAUSED BY GUNS IN OUR NATION,

My reading of an outstanding “biography of cancer” titled The Emperor of all Maladies by Siddhartha Mukherjee has stimulated a line of thinking that I am finding to be very mind-opening.

Put simply, I believe we should re-frame and attack the issue of the enormous number of gun caused deaths in our nation as an issue of PUBLIC HEALTH. 

 

One thing guns, cancer, tobacco and automobiles have in common is their association with high rates of mortality, actual and potential.  And with their association with morbidity, automobiles, guns and tobacco have, to different degrees and at different points in time, raised the question of how “causal” the relationship is.

 

The struggle, or more precisely the “fight” (for indeed industry did fight) against the ever more evident and deadly linkage between cigarette and cigar smoking and cancer was brutal.  I won’t try to tell that chilling story here.  It’s done brilliantly in the aforementioned book. 

 

Cigarette smoking skyrocketed during the first half of the 20^th century.  In 1870, the per capita consumption of cigarettes in America was less than one cigarette per year.  By 1953, the average adult American was smoking ten cigarettes every day.  (Sadly, as we went into the 1960s, I was smoking at four times that level!)  Not surprisingly, in this same period—the 1950s—a meteoric increase in lung cancer was being observed in the U.K. and the United States.  But was it being caused by the increase in cigarette smoking?  At first, that notion was greeted with more than skepticism. It was disbelief.  One evidence of this: even medical journals were routinely carrying cigarette advertisements.  At the annual conferences of the American Medical Association in the early 1950s, cigarettes were distributed free of charge to doctors who lined up outside the tobacco booths.  When I joined Procter & Gamble in 1963, there was an ashtray placed in front of every member of the Executive Committee, with no thought it was carrying a danger (though by then research was amply available to demonstrate that).  Almost everyone smoked, many nonstop. 

 

Ironically but profoundly, and this has great significance to the issue we face on the causal relationship of the availability of guns to increased morbidity,  as Mukherjee writes, it was the “rapid, viral ascendency of tobacco that made its medical hazards virtually invisible.”  He points out that our intuitive appreciation of statistical correlations “performs best at the margins.”  When rare events are superposed against rare events, the association between them can be striking.  That had been seen in drawing a link between scrotal cancer and chimney sweeping in the U.K. Both the profession and the disease were uncommon enough that the juxtaposition of the two stood out starkly like a lunar eclipse; two unusual occurrences in precise overlap.

 

However, as cigarette consumption escalated into a national addiction, and the documented incidence of cancer also sky rocketed,  it became harder to discern an association  of smoking with cancer. 

 

Similarly, with guns today, with their penetration growing at a rate which like cigarettes in the past can only be described as an “addiction”—over 300 million in homes in the United States, twice the level of 1968—and, sadly, with deaths involving guns also becoming more prevalent day to day, it becomes harder to make direct associations.

 

In time (measured in decades)  and with great difficulty, the causal relationship of cancer and smoking, was irrefutably established.  It happened only thanks to the perseverance and courage of scientists and academics.  Prospective trials were carried out among (ironically, at first doctors) matching those who smoked and those who didn’t and then documenting the prevalence of lung cancer over many years. The results were unarguable. But even then getting clear warnings on packages and banning televison advertising was resisted by the industry-- and by legislators committed to the industry, just as is the case today with guns.   It took decades to bring regulations which recognized and grew from the knowledge that cigarette smoking is a “public health issue” of the highest magnitude. And it came through the Public Health Administration, not Congress which was beholden to special interests just as  is the influence of the NRA on legislators today.  

I do not believe the type of "prospective", irrefutable research has been carried out to establish the causal relationship of guns and various forms of deaths caused by guns that would match the research which eventually underpinned the causal relationship of cigarette smoking and cancer.  It would be very hard to model that. 

But there is powerful "retrospective" and "associative" evidence to show the correlation between gun penetration and deaths caused by fire arms. The facts are staggering. Based on 2010 research reported in the Journal of American Medicine, deaths caused by fire arms are (per 100,000):

U.S. 10.2

Canada 2.3

France 2.8

Germany 1.1

UK 0.2

Gun penetration per 100 people:

U.S. 112.6

Germany 30

UK 6.6

Russia  8.9

The instant death which a gun can cause in a domestic dispute or suicide attempt (compared to other "weapons") makes it altogether more lethal just by the very fact that it is on hand. Just being there is a "public health" risk of a greater dimension than alternative implements which can cause great injury and even death.

 

Today, no one who can read can mistake the danger that they are embarked on in smoking.  This is not being done with the usage of guns.

So what about automobiles?  How do they come into the picture?

 

On a per capita basis, automobiles used to place far higher in the ranking of the causes of death (and injuries) in this country than they do today.  In this case, it was easy to establish the causal relationship.  There was no mistaking that, when a car crashed and there were no seatbelts, and the passengers flew through the windshield and died, that the cause of death was irrevocably related to the car accident.  And in time, for this and other reasons, sharp regulations have been brought to driving a car.   You need to have a license and you have to have that license renewed regularly.   You have to pass a driver’s test to show that you know what you’re doing when you drive the car.  Surely we should insist on nothing less than that when one buys a gun.  We don’t insist on that today.  I can find no logical explanation for that.

 

Many will raise the familiar argument that guns don’t cause death, people do. It is their choice.  Of course, that could have been said about tobacco—and it indeed was, literally, vehemently, repeatedly.  It wasn’t the tobacco that caused cancer, it was the smoker.  And it could be said about automobiles, too.  It wasn’t the car; it was the driver or the weather or the road.  Yes, but…we have identified a causal relationship of such importance that we ought to be certain that proper steps are being taken to regulate its use so that not only harm to the “owner” but harm to others who are not the owner can be constrained.  That is certainly the case with guns.  Sometimes, it is the harm to the “owner” in the case of accidentally shooting oneself and suicides, which happen all too often.  But even more, it is the danger to people who don’t “own” the gun.  To not require a license and training on how to use the gun is absolutely irresponsible. 

 

Which brings me to my last point where the relationship of tobacco and cancer, and of automobiles and guns, has something to teach.  It come under the heading of prevention.  It was decades before the medical community was prepared to really address the issue of “prevention” when it comes to cancer.  There were those who favored surgery; others, oncology; of course, many, both. But it was only later, and it’s still a movement underway, that the issue of “prevention” in terms of diet and living habits, especially smoking and alcohol,  as they relate to the risk of cancer was addressed.  It manifested itself especially in the focus on not smoking, and this has had a major effect in reducing lung cancer. 

 

“Prevention” has played a big role in the reduction of deaths through automobile accidents too.  The requirement for seatbelts, speed limits (no matter how inadequately enforced) and other safety devices, have all come into play, under the mantra of “public health”.

 

I don’t think we have thought deeply enough, or taken action, on what can be done to prevent needless deaths from widespread gun ownership much as we have done on smoking and driving a car.

 

There will be many, certainly the NRA, that retreat to the familiar citation of the “rights” conferred by the 2^nd Amendment.  This argument should carry no weight when it comes to making intelligent modifications on the requirement for gun ownership dictated by learnings from history.  Certainly, the authors of the 2^nd Amendment did not contemplate that it would confer the right to have semi-automatic and automatic military-style weapons in the hands of millions of people; weapons capable of killing dozens and dozens of people in a matter of seconds.  Just as with automobiles, or now with tobacco, I cannot believe the authors of this Amendment would object to there being strict rules dictated by the well documented knowledge  of the risks these guns pose to public health and life which would  require clearance and registration before they could be purchased and training before they could be used to be as sure as we could that they were going into responsible hands that are capable of resposnsible use.   

 

This is a short treatment of a complicated subject.  I hope it sheds a light on what it took to understand, document and then control the causal impact of cigarette smoking on cancer and the impact of automobiles on highway deaths in a way that provides insight on what we should do about the tragic loss of life from the broad and inadequately regulated penetration of guns in this country today. Put simply, I believe we need to frame and approach this as a "public health" issue, which it surely is. 

 

"THE WARMTH OF OTHER SUNS" -AN OUTSTANDING BOOK

THE WARMTH OF OTHER SUNS:  THE EPIC STORY OF AMERICA’S GREATEST MIGRATION BY ISABEL WILKERSON

 

As Toni Morrison writes, this is a “profound, necessary and an absolute delight to read.  It is at once mind-opening, sobering, inspiring and, above all, truthful.”  It tells the story with great academic depth of the migration of black Americans from the south to the north during the period 1915-70.  It does so with data-based perspectives which show that contrary to much of the written history, the men and women making this journey tended to be better educated, better employed and have stronger family formations than blacks who had been born in the north. 

 

The story comes alive through the tracing of the journey of three individuals over a period of 50 and 60 years who traveled from Florida, Louisiana and Mississippi to New York, Chicago and Los Angeles.  Each of these stories is worthy (and indeed is represented here) by its own “book.”

 

The book brings to life in an unforgettable way the horrible treatment, whether in orange groves or cotton fields, that led these individuals to make the courageous decision to leave and then the discrimination they faced as the “lowest of the lowly” new immigrants in cities in the north.  Substantively, none of this is really surprising to someone who has lived as long as I have, but in the details it is brutal as it documents in the most personal way, the denigration of blacks requiring that they not associate with whites, not only in schools, use of water fountains, bathroooms, bar rooms  and theatres, but in something as trivial and mundane as betting windows at a horse track. 

 

Wilkerson never trivializes or idealizes the lives of these men and women.  They all made mistakes, as they themselves admitted; they all gave up something vital which, to varying degrees, was hard for them to leave behind in the south.  They had disappointments in their children; deaths in their extended families; these were lives that I only wonder: how I could have possibly managed?

 

The common denominator, of course, is they were all looking for Freedom.  As James Baldwin wrote in Notes of a Native Son:

 

 “Most of them care nothing whatever about race. 

They want only their proper place in the sun.

And the right to be left alone, like any other citizen of the republic.”

 

The challenges were legion.  We look at the horrors going on around us today, and “horrors” they are.  But this history reminds one that there were 58 bombings of houses that blacks moved into or were about to move into between 1917 and 1921 alone on the south shore of Chicago.  As Wilkerson writes, “No laws could make frightened white Northerners care about blacks enough to permit them full access to the system they dominated.”

 

The terrible harm reaped on the children of these immigrants by the drug-infested culture around them is spared no detail. 

 

Again, James Baldwin in Notes of a Native Son:

“I can conceive of no Negro native to this country

Who has not, by the age of puberty, been irreparably scarred

By the conditions of his life…

The wonder is not that so many are ruined

But that so many survive.”

 

As these immigrants from the south were the first to say, that provides no excuse to their youth but it does describe circumstances that need to be understood as one draws judgments and particularly draws conclusions on what we need to do now.

 

The all-pervasive presence of “Implicit Bias” is revealed again and again in this book.  For example, the “expectation that any colored woman walking in the white section of town was available to scrub floors and wash windows” continued into the 1960s.  The author’s mother had a woman call out to her in the late 1950s when she was on her way to decorate and fit slipcovers in Cleveland Park, a wealthy neighborhood in Washington, D.C.: “Say girl, could you come up here and clean my bathroom?”  “I’m looking for someone to clean mine,” my mother yelled back to the woman.

 

*****************

 

There is wonderful contemporary joy to be taken from the joy which these immigrants to the north felt as they were able to vote, as they were not in the south.  And their votes mattered Ida Mae’s (one of the three lives Wilkerson illuminates) first vote and that of her husband’s in Chicago was one of those tens of thousands of other colored migrants’ votes that helped Roosevelt carry the State of Illinois by two percentage points in the reelection of 1936.We continue to face repression of voting by African-Americans (and others) today, especially in Ohio.

 

**********

 

Wilkerson records an amazing galaxy of African-American leaders in every field—black mayors (including Lou Stokes in Cleveland), sports stars like Bill Russell, artists like Duke Ellington—who were children of parents who fled from the south. 

 

This history, showing the embedded systemic impact of racism that existed both as a driver to this great migration and in the reality which those who moved to the north found themselves in has lessened today, but it is far from gone.

 

 And one should not forget that the children, and the grandchildren, of the men and women who made this brave journey and incurred all of the insults and discrimination they did along the way,  while feeling being of a different generation and, in many ways, wanting to distance themselves from their forefathers and mother’s generation, still inevitably carry the varying combination of fears, resentments, ambitions, and of determination that every one of us draw, knowingly or not from the road which prior members of our family traveled.