Excerpt from Prescription for Survival: A Doctor’s Journey to End Nuclear Madness, by Nobel Laureate Bernard Lown (Berrett-Koehler Publishers, 2008). Reprinted with permission from the author.
Chapter 26: Epilogue: From Communism to Terrorism
As I reflect on these events now, twenty years later, pride wells up considering what we, a small band of doctors, achieved. We contributed to a profound historic transformation, none too soon, and stopped a gallop toward the brink. This book offers a tale of how doctors formed an organization that helped rein in the nuclear threat. IPPNW embraced a minority of health professionals, rarely exceeding 5 percent of the physicians in any one country. What IPPNW lacked in numbers was more than compensated for by the commitment of its members.
The fundamental problem we faced was the subhuman stereotyping of Russians and Americans by each other. It demeaned entire peoples with complex differences between their social systems, reducing them to martial combat between the forces of good and evil.
The aim of IPPNW was to promote citizen diplomacy to cut through the fog of dehumanization that blocked an awareness of our shared plight and threatened to bring about our mutual extinction. We focused on growing arsenals of nuclear weapons as the common enemy of both nations. Our role as health professionals lent credibility to our message.
We opened a wide window for dialogue and cooperation. As a result, IPPNW was held suspect by the ruling establishments of both sides. In the West, we were accused of fraternizing with evil and being KGB dupes. In the East, we were suspected of serving as clever decoys for the CIA. An ancient tradition of professional cooperation among physicians buffered those assaults and allowed us to overcome the ideological nostrums of the day.
From the outset we hammered away at a fundamental thesis—in a nuclear age, security is indivisible; it is either common or nonexistent. We maintained that the two superpowers either lived together or died together.
We insisted that confrontational politics was a prologue to tragedy. We contended that military force was not the equivalent of national strength. Democratic values could not be protected by amassing nuclear overkill. Reliance on nuclear weapons was politically and morally corrupt, as well as economically catastrophic. We believed that there was no greater force in modern society than an educated public, activated and angered, to effect change.
Stopping the nuclear arms race did not demand technical expertise in military hardware. It required educating people on the shared danger and involving millions in the struggle for global sanity and human survival. We insisted that there were no conceivable circumstances to warrant the use of genocidal weapons. We were nuclear abolitionists.
We set an example. Physicians from hostile camps worked together despite stark political and cultural differences. We focused on the single issue of “preventing the final epidemic.” We exposed the litany of horrors that would result from a nuclear blast, fire, and radiation. Our message made arrant nonsense of political pontificating about fighting a limited nuclear war and surviving and winning such a conflict. Being awarded the Nobel Peace Prize was a resounding affirmation that our message was heard.
The experiences I describe in this book took place over a brief five-year period a quarter of a century ago, yet they are full of lessons for today. Foremost is that an advance on any political front does not come as a gift from governing establishments. It needs to be wrested by an unrelenting, well-organized struggle. Politicians do not respond to the insistent beckoning of history. They rise to a challenge only when confronted by a public clamoring for change—which, if ignored, threatens the politicians’ hold on power.
I became aware of an astonishing fact. IPPNW could penetrate the iron curtain far more readily than it could enter the free halls of power of a democratic society. Leaders in the highest echelons of the Soviet Union were ready to meet and converse as well as listen. Such consistent access was denied to us in the West. Not only were we ignored by the political establishment in the United States and other NATO countries, but the western media shut us out as well. When our activities were reported, they were cast as one-sided and soft on Communism.
For me, the experience was an intense postgraduate education. I learned how my government gained public consent to policies that were utterly mad. Moral safeguards against human savagery were jettisoned as computers simulated total war—a war unprincipled in method, unlimited in violence, indiscriminate in its victims, uncontrolled in the devastation it wrought, and certain to lead to a tragic outcome.
These plans had few precedents in moral depravity. How could threatening a “final solution” by nuclear annihilation be the guarantor of human survival? How could stockpiling instruments of genocide be offered as the means to maintain democratic values? What gave any group or nation the right to engage in a game of Russian roulette with the lives of generations yet unborn? Yet the public did not question a policy of mutual assured destruction, the appropriate acronym of which is MAD.
If this appears as the overblown rhetoric of an emotional peacenik, let me buttress my position with the words of an unsentimental architect of Cold War strategies, Robert McNamara, the defense secretary during President Johnson’s years in office.
McNamara recently wrote, “The whole situation [amassing nuclear weapons] seems so bizarre as to be beyond belief. On any given day, as we go about our business, the president prepares to make a decision that within about 20 minutes could launch one of the most devastating weapons in the world. To declare war requires an act of Congress, but to launch a nuclear holocaust requires 20 minutes of deliberation by the president and his advisors.”
The Soviet Union was consistently portrayed as a colossus on the military front. Indeed, it possessed a nuclear capacity to destroy us many times over. We never lagged behind. On the contrary, we were far ahead in every aspect of the technologies of warfare. The Pentagon proclaimed all types of gaps. These were fabrications. There had never been a bomber gap, a missile gap, a nuclear gap, a spending gap, or a civil defense gap. The Americans were ahead on these fronts. In fact, we set the tempo of the arms race. With the advent of the computer age, the divide between us and the Russians widened from a moat to an ocean.
I learned in numerous visits to Russia that the Soviets were a backward society, characterized by the West German chancellor Helmut Schmidt as “Upper Volta with missiles.” In an attempt to keep up with the Americans, who were setting the pace of the Cold War, the Russians shortchanged every need of civil society. I saw this in the health care sector, where hospitals lacked flush toilets, running water, and adequate sterilizing equipment.
The fabrications about the Cold War have not ceased to the present moment, as Americans proclaim that we were the victors. We did not win the Cold War; the Soviet Union imploded from within. The Cold War had no victors, only victims. Left behind were mountains of wreckage that will take generations to clear.
In the first place, the most securely hidden secret of all relates to the proxy wars the United States waged during the Cold War era. Concealed from Congress as well as the public, these clandestine wars were commanded and funded by American intelligence services. Their geographic sweep was global, from Afghanistan to the Middle East to Angola.
Their objective was dual: to dislodge the Soviet Union’s foothold in the developing world and to set in motion a counterforce against rampant militant Islamic nationalism. In a self-destructive phantasmagoria, we stoked the embers of Islamic fundamentalists, such as the Taliban and al-Qaeda. The blowback consequences have been playing out since, and they are likely to continue to cost us blood and treasure far into the unforeseen future.
Better known than the machinations of the CIA were the precious resources we wasted in forty-five years of superpower confrontation. From 1945 to 1992 US military expenditures exceeded $11 trillion. To provide some grasp of a sum with 12 zeros, one can compare it to the cost of the entire US manufacturing and social infrastructure, which amounts to 67 percent of our national wealth, squandered by the military. A fraction of that sum would have met multiple human needs at home and abroad. It could have alleviated most global health problems, including AIDS, malaria, tuberculosis, and tropical diseases; enough funds would have been left over to end world hunger, arrest population growth, and reverse global warming. The world would have been far safer as a result.
The Cold War left visible scars on every facet of American society. It is reflected in our deteriorating schools and the fact that our children are far behind the children of other industrialized societies in the basics of math, science, and even reading. It is evidenced in rotting inner cities, with their rising crime rates, and in burgeoning prison populations; the United States is now second only to China in its rate of incarceration. It is to be found in a shamefully dysfunctional health care system that is among the worst among industrialized countries. It is exemplified by the smoldering race problem that we never allocated the resources or exercised the political will to resolve.
Though we are technologically the most advanced country in the world, we lack public transport systems to save commuters from choking traffic. The national infrastructure is deteriorating in roads, bridges, water resources, electric utilities, libraries, public playgrounds, and parks. The list goes on and on. All of these issues have suffered decades of neglect from the lack of federal funds that were plowed into “winning” the Cold War. The mammoth squandering of wealth by the Pentagon was deficit financed. The debt incurred will be shouldered by generations that are yet unborn.
If the US experiences discomfort as a result of the Cold War, it has nonetheless had a soft landing. This has not been the case with Russia. One dismaying fact highlights the price exacted from Russia by the Cold War. Since 1992 the average Russian life expectancy has fallen materially and now is on par with sub-Saharan Africa; infant mortality is the highest in any industrialized country. Suicides, homicides, and alcoholic deaths are at record highs. Russian population numbers are dwindling, as declining birthrates are outdistanced by a rising mortality.
That December day in 1985, as I left the Kremlin after the long conversation with Gorbachev, I was brimming with hope and a sense of possibility. At last there was a statesman ready to liquidate the Cold War and eliminate nuclear weapons. His words have not left me: “Nuclearism is the greatest challenge confronting humankind. We either eradicate it or witness its spread.”
We did not address the abiding nuclear threat. Gorbachev’s challenge was largely rebuffed. The United States remained committed to keeping a nuclear arsenal as the mainstay of its power. America deploys approximately 4,500 strategic offensive nuclear missiles, while the Russians have about 3,800. Of the operational US warheads, 2,000 are on hair-trigger alert, ready for a fifteen-minute launch. Robert McNamara has characterized the present US nuclear policies “as immoral, illegal, militarily unnecessary and dreadfully dangerous.”
America’s nuclear posture, unquestioned by its own people, has been supported by two other malign legacies of the Cold War: the national security state (or old-fashioned militarism), and the paralysis of public opposition—both due to the fear of real or imagined enemies.
American nuclear policies stem from the growing power of the military in every walk of life and the increasing role of the Department of Defense (DoD) to shape foreign policy. Never before in human history has any nation possessed so much military power. An appreciation of the seminal role of the Pentagon in American life is reflected in the military budget.
Military spending for 2007 was officially acknowledged as a whopping $626 billion, or about $100 per global inhabitant. By contrast, the budget of the United Nations and all its agencies is $20 billion annually, or about $3 per world inhabitant. The United States is responsible for half of the total global military expenditures, distantly followed by the UK, France, Japan, and China, each spending 4 percent.
Not included in the American military budget are hidden costs for the multifarious intelligence agencies, and for military spending by the Energy Department, State Department, and Homeland Security Department. It does not include the cost of the Veterans Administration, or interest on the national debt from past and current wars. When the figures are summed up, the total exceeds $1 trillion annually. This is equivalent to $71 million hourly, around the clock, day in and day out.
The military budget is sacrosanct. It is not questioned by the tribunes of the people. The vote for the DoD budget in Congress is consistently bipartisan and invariably unanimous. The institutional might of the Pentagon was demonstrated in 1990 when the Soviet Union and Eastern bloc countries collapsed. The Cold War was over, a genuine military threat to national security had disappeared, yet there was no pressure in Congress, nor public agitation for reducing military spending. DoD procurement for Cold War weapons continued as though the colossal historic transformation had not occurred. Neither the pundits who dig into every crevice of political life nor the vociferous media found this fact astonishing or deserving of attention.
Conservatives, who wrap themselves in the American flag, perceive their support for a strong military as deriving from the writ of the founding fathers. The reality is that the drafters of the Constitution regarded standing armies with distaste and fear. Uneasiness about the military finds expression in the Constitution, which limits the appropriation of funds for the army to no more than two years at a time. President James Madison, who drafted the US Constitution, long anticipated President Dwight Eisenhower’s warning about the dominance of the military. Madison wrote in 1795,
Of all the enemies to public liberty war is, perhaps, the most to be dreaded because it comprises and develops the germ of every other. War is the parent of armies; . . . known instruments for bringing the many under the domination of the few. . . . No nation could preserve its freedom in the midst of continual warfare.
Notwithstanding the king’s ransom of resources appropriated annually to the military, it has performed poorly during the past forty years. The Pentagon failed in Vietnam though it dropped more ordnance on that impoverished third-world country than was delivered against Germany and Japan in WWII by all Allied forces. The current failure in Iraq is no longer disputed even by adherents of that preemptive war. Yet, the most colossal failure remains largely unspoken, namely, the inability of the military to protect the US homeland. The Pentagon failed to anticipate the tragedy of 9/11, to intercept and defeat a mere nineteen hijackers armed with box cutters.
America’s military establishment has remained nonetheless immune from criticism. IPPNW and other peace groups loudly spoke out against nuclear weapons but remained subdued in criticizing those who acquired these infernal weapons and were ready to use them. How is one to explain why Americans had abrogated their economic self-interest and, more incredibly, had become numb to the most basic of all biologic instincts, that of self preservation—the survival of oneself, the survival of one’s family, the survival of one’s community, the survival of one’s nation? How is it possible for this madness to have continued this long?
In grappling with an answer I am mindful of H. L. Mencken’s observation that “for every complex problem, there is a simple solution, and it is always wrong.” In pondering this issue for about half a century, I have concluded that the American persona is molded by the culture of consumerism. The goal of life is material self-enrichment. In the process of accumulating, one denatures what is unique about human life, namely, the bonding relationships with others in a shared community.
This comes at a cost of impersonality, passivity, isolation, selfdiminishment, and a growing sense of irrelevance. The vital nexus with other human beings, lending vision and courage to effect social change, is sundered. No longer buttressed by community, the isolated individual grows increasingly susceptible to a host of terrors.
The activities described in this memoir took place during the Reagan era, a period of paralyzing dread. A great deal of it was stoked by government policies that stemmed from the confrontation with the Soviets and an unstable nuclear arms race. We in the doctors’ movement soon learned that the best immunization against the pervading fear of our era was to join with others in social opposition to policies that threatened human survival.
Once again, the US government is ratcheting up fear. Terrorism has been substituted for Communism. The government policies described in the book have turned against a new enemy. The intellectual elite has failed to explain why the threat of a relative handful of terrorists should evoke a military buildup comparable to that of the Reagan administration during the height of the Cold War.
At that time thousands of Soviet missiles were targeted at the United States. Instead of a police action in cooperation with other nations, we are now alone in an aggressive, unprovoked war. Once again, we are inviting boomeranging consequences. The indiscriminate “collateral damage” inflicted on civilian bystanders is a most powerful recruiting inducement to fight the mighty Satan.
The American people may be momentarily dumbed down, but they are not stupid. Sooner or later, the fictions become transparent. There is growing indication that an awakening process is under way. The most important tool in fighting fear is ridding ourselves of historical amnesia. The lessons of the past offer an instructive guideline for the future.
Without the experience of the crucial years described in this memoir, I would have been in a nadir of depression. I learned to respect the plasticity of human beings and be awed by the ability of human societies to evolve immune responses to malignant viruses. The Israeli statesman Abba Eban counseled, “When all else fails, men turn to reason.” The power of the military has failed miserably to bring peace or justice to the world. Increasingly people are recognizing that a new world order is possible.
Great as the present danger is, far greater is the opportunity. While science and technology have catapulted us to the brink of extinction, the same ingenuity has brought humankind to the frontier of an age of abundance. Never before was it possible to feed all the hungry, to shelter all the homeless, to teach all the illiterates, to assuage many afflictions. Science and medicine can liberate us from drudgery and pain.
For science and technology to yield their fullest bounty, people must not wait until they have all the answers. But it is critical not to ignore the lessons of the past. This memoir is ultimately a call to action. Only those who see the invisible can do the impossible. This book makes visible a wide terrain wherein action for another world fit for human beings becomes both challenging and possible.
 Lown, B, and E Chazov. Physician responsibility in the nuclear age. Journal of the American Medical Association 274 (August 2, 1995), 416–419.
 McNamara, RS. Apocalypse soon. Foreign Policy, May–June 2005; available at http://www.foreignpolicy.com/story/cms.php?story_id=2829.
 Mamdani, M. Good Muslim, bad Muslim: America, the Cold War and the roots of terror (New York: Pantheon Books, 2004).
 Green, W. Cold War costs. Boston Globe, May 6, 1992, op-ed, A-13.
 Lown and Chazov, Physician responsibility.
 Specter, M. Russia’s declining health: Rising illness, shorter lives. New York Times, February 19, 1995, 1, 4.
 McNamara, Apocalypse soon.
 US Office of Management and Budget. The Budget for Fiscal Year 2007. Historical Tables 59–60, 77–78. http://origin.www.gpoaccess.gov. Invaluable is the annual report from the Stockholm Research Institute Year Book (SIPRI). Especially for global armament expenditures, see chapter 8 in SIPRI Yearbook 2006: Armaments, Disarmament and International Security, http://yearbook2006.sipri.org/.
 SIPRI Yearbook 2006.
 Garwin, RL. The military-industrial complex. Speech presented at public symposium “Eisenhower’s Legacy for the Nation,” Gettysburg College, Gettysburg, PA, October 13, 1990.
Excerpted from Prescription for Survival by Nobel Laureate Bernard Lown. Copyright © Bernard Lown, 2008. All rights reserved.
Dr. Bernard Lown: A Documentary (Part I)
Dr. Bernard Lown: A Documentary (Part II)
Dr Ira Helfand (International Physicians for the Prevention of Nuclear War)
Five Days in Spring: Short Historical Documentary
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