I dag arrangerer Universitetet i Oslo The Per Fugelli Lecture 2015, under overskriften The Patient Earth, Pasienten Jorden, eller Den Tålmodige Jorden. Bakgrunnen er at jeg siden 1993 har inspirert en gruppe medisinstudenter til å engasjere seg i Planetary health som defineres slik: Planetary health is the health of human civilization and the state of the natural systems on which it depends. Hvert år i desember kommer en “verdenslege” til universitetet for å stille diagnose og skrive ut resept på jordens sykdommer. I år skal Sir Andrew Haines forelese om Planetary health – human health and global environmental change.” Første gang var i fjor da Richard Horton og Anthony Costello satte fakta og lys på fordelingen av makt og helse på kloden.
Jeg gleder meg som et barn. Hvorfor? For æren? Nei. For transplantasjon av håp og krigshumør? Ja. Fordi disse krigerne lider ikke av Weltschmertz. De tenker ikke: Verden har det så vondt at vi må bedøve den, eller oss. De har med seg det handlingsmot som alltid har vært medisinens adelsmerke: Her er sykdommen. Vi behandler den. Selv om pasienten heter Jorden.
Jeg skal holde en liten tale til slutt, om hvordan døden kan fremme planetens helse. Ble dere nysgjerrige nå? Her er den:
DEATH AND PLANETARY HEALTH
Short speech given by Per Fugelli at the end of The Per Fugelli Lecture December 15th 2015
I will now present to you: The contribution of death to planetary health.
Strange thing to do. Here is my excuse:
I have lived with the patient Per for six years now, with new cancers coming to the lungs and being carved out every year. Status praesens: Myriads of metastases in both lungs. Dancing with death is not pleasant, but it is a discovery channel. I have used this pre-mortem time to explore the potentials of death – for life.
Andrew Haines lecture provides an opportunity to extend our curiosity to:
HOW CAN DEATH CONTRIBUTE TO PLANETARY HEALTH?
Here is my prescription:
Potential 1. The awareness of being mortal can enhance man’s moral stamina, for example to engage in planetary health.
Potential 2. Memento mori, remember you shall die, may inspire us to use life on essential matters, the force majeure of our time, such as planetary health.
Potential 3. Awareness of death stimulates you to rise your eyes from the microscope to the horizon, from the particle to the whole. Not to be blindfolded for the individual patient, but to oscillate our clinical gaze between the sick person and the salutogenic or pathogenic world he is interconnected with.
Potential 4. Death may help medicine from hubris to humility – from an illusion of being allmighty to a reconciliation with being doctors with boarders. Death demonstrates the fragility of life and the limitations of medicine. We ought to respect, not provoke the Masters of planetary health: Nature – and perhaps gods.
Potential 5. And now we come to the real thing: Death is a sine qua non, a prerequisite for life. Without death planetary health will fall into steep decline. All biological beings must die to create room for new life. Experiment of thought: Death leaves Oslo. Nobody dies. No birds, no flies, no bacteria, no humans, no flowers, no rats – in a short time Oslo will transform into an ecological hell. So death, my friends is an act of solidarity with the future. Timely death is the best doctor for the Patient Earth.
So nature and future demands our bodies to die. But spirits must not die. Hopes, values, dreams – are forever, guarded and conveyed by the ancestors spirits .
As a young medical student, dr. Zhivago, in Boris Pasternaks novel, is comforting his dying aunt: “You in others – this is your soul. You have always been in others and you will remain in others.”
Medicine, the collective body of doctors, do have a soul. It has inspired Andrew Haines lecture here today. A soul expressed by dr. Bernard Lown when he received the Nobel Peace Prize on behalf of International Physicians against Nuclear War: “It may be argued that nuclear war is a social and political issue and we may address is only as concerned citizens. But we physicians have taken a sacred and ancient oath to assuage human misery and preserve life. This commitment imposes social and moral obligations for us to band together to make our collective voices heard.”
Colleagues, I have no God, but I do have Saints, eternal values of medicine:
- Do good
- Be just
- Respect nature
Let us band together then for The Patient Earth – When the Saints go marching on.