Sixtytwo people and their "wealth" -- are they really better off than the rest of us?

Several news media including BBC World, the NY Times and the Guardian, have reported the interesting fact that sixtytwo (62) people own half the wealth in the world. The rest of us, more than 7.4 billion now, own the other half. Within this other half of the human population, the distribution of wealth is very uneven. I am fortunate, comfortably off, with an income and a net worth in the top 5 percentile in Canada. In an absent-minded sort of way, I've worked very hard to get into this position. I've never consciously set out to get wealthy. I've just done my job as a university tenured professor, teaching (I describe my 'teaching' as corrupting the minds of innocent medical students with subversive ideas, like the notion that it's preferable to keep people as healthy as possible rather than wait for them to get sick and try to treat their ailments one at a time). I've also done some research, much of it rather trivial and ephemeral, a small part of it highly relevant and of perennial importance. And I've advised governments at local, regional, national and international levels about general and specific actions that can be taken to control diseases, injuries and premature deaths; I've consulted on aspects of medical education and on assessing educational approaches and methods. I've written and edited about 25 weighty technical books, chapters in more than 50 books, and several hundred articles and editorials in medical journals that deal with these topics. None of these activities pay as well as writing sexy books, for instance, or hitting a hard rubber disk about on a smooth icy surface, but over a long professional lifetime that hasn't been encumbered by costly bad habits other than buying a great many books, I've ended well off enough to subsidize the youngest of my three kids and to provide large loans to my other two.

I feel competent to comment on the shockingly uneven distribution of wealth in the world. I do so after long experience of observing and studying the relationship between health and wealth. My beloved wife Wendy and I talked about this relationship as we ate our lunch on the day we met. As a nurse, she'd had enough interaction with sick infants and children (and sick parents) to have ideas of her own about this. She was near tears as she talked about this, and that conversation when we'd known each other for 4-5 hours went a long way towards convincing me that she was the maid for me.

But I digress. What is wealth? It's not money in the bank, land from which food or other resources are extracted, it's not gross national product or other arcane economic indicator. Those of us who treat populations rather than individual persons have conceived new notions about wealth that have less to do with the amount of money, land, servants or dwelling places we possess than with other tangible factors. Our notion is closer to that of people in the Himalayan nation of Bhutan, who speak of Gross National Happiness. Our indicator of national well being is called the Genuine Progress Indicator. In the Dictionary of Public Health (2007) I described it as a composite measure of economic wellbeing. It takes into account much more than the pay packet brought home by the wage or salary earner(s) in the household. It considers more than 20 social and environmental factors and distinguishes between economic transactions that enhance wellbeing and those that diminish it. The per capita gross domestic product (GDP) in the USA and similar nations more than doubled from 1950 to 1990 and the GPI increased from 1950 to 1969; but it declined from then until and after 1990, for instance because much national wealth had to be diverted into fixing problems caused by earlier errors, such as cleaning up industrial wastelands. Since about 1970, the costs of the economic trajectory of the USA and similar nations have begun to outweigh the benefits.  This cost to benefit ratio is rapidly increasing the costs, notable the costs associated with climate change, while the benefits are getting smaller, sometimes virtually imperceptible. Just one component of costs, the cost of climatic extremes and catastrophes (droughts, food shortages, massive wild fires, hurricanes, floods that follow torrential rainstorms) far outweigh the often imperceptible benefits of longer and warmer growing seasons.  

The "value" of the investments that pay my pension has gone down considerably in the current stock market crisis, which seems to be getting worse. Even those 62 families who own half the world's wealth are feeling this reduction of their wealth. I manage to feel a little schadenfreude as I reflect on this. I can't take it with me and I'm a great deal closer to the end than the beginning of my life span. That thought contributes to my personal gross domestic happiness.

I'll say more about the genuine progress indicator and about other measurements, including the interesting scale of gross national happiness, in a future post. Here I will just add that there is a close correlation between health and wealth, not quite such a close correlation between wealth and happiness. 

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Seasonal letter and Annual Report

For the record, here's this year's Seasonal Greeting e-letter, which went out in batches of 20-30 to several hundred friends scattered about the planet. Because I relied mainly on the electronic memory of my iMac to identify the targets, some people got several copies and others didn't get one. If you are in the last group, you can read it here if you are interested.

Dear Family and Friends

Am I lazy, or super-efficient? Whichever, this e-letter is going to relations and friends in New Zealand and Australia. I’ve pasted my ‘Annual Report’ in this email.

Are all you Kiwis excited or perplexed about choosing  a new flag?  Too bad Janet Wendy isn’t still here to weigh in with her views! I remember talking about flags with her, her brother John Wendelken, and several others years ago, long before you got as far as choosing between several alternative designs. Way back then we would have preferred flags for both NZ and Oz without the union jack but with well known and easily recognized symbols like a boomerang for Oz and a silver fern for NZ

Winter is heading our way, but so far it hasn’t been too bad: no snow, but cold enough to make me wish I was back in Sunny South Australia.

Seasonal greetings, and Love and best wishes to you all,

John

Annual Report, 2015

I’ve had a quiet year of vicarious pleasure, enjoying my progeny’s experiences.  Jonathan advanced the plans for his ecologically sustainable off-grid home; David and Desre traveled most recently to Finland, and will be in Adelaide over Christmas; Rebecca and Richard continue to make delectable jams and pickles, and Rebecca’s garden draws praise from everyone.  My three grandsons are all doing well, Charles in Victoria BC, Peter in Toronto, and John in Halifax, Nova Scotia - scattered literally from coast to coast. 

I prefer to avert my eyes from the wider world. Looking back from my 90^th year, I don’t think there’s been a day of my life when the whole world has been at peace. Terrorist atrocities have lacerated Paris, glorious city of some of my happiest memories; and the Middle East is a festering mess. In Canada a bright spot is replacement of the dreadful Harper by young Justin Trudeau and a government that shows promise of being enlightened and progressive. 

These days I seldom venture beyond the city limits of Ottawa, this year just twice, a flying visit to Karen and Pradeep Kumar in Hamilton, with an excursion to the Shaw Festival Theatre where we saw a splendid production of Pygmalion; and I attended a stimulating writers’ workshop at Arnprior, where I fine-tuned the story described below. 

Writing has been my main activity.  I’ve been writing a story for children in the 9-12 year old age range. This departure from all my previous literary efforts has been great fun.  The story is derived from one I made up in 1962 when we were on a cargo ship carrying 12 passengers, returning to Australia after a year in London. About halfway between the Red Sea and the Western Australian coast we ran out of books to read to our two toddlers, Rebecca and David. They didn’t want Wendy and me to read yet again from Winnie the Pooh, Wind in the Willows, Charlotte’s Web, or The Magic Pudding. They said they were tired of all these. Wendy and I were fed up rereading these books too. So I made up a story to tell them. I’d forgotten this until I was reminded by reading Wendy’s diary for 1962. When I began to write the story down, the characters came to life in my head and took over. The heroine is the parrot who once sat on the shoulder of Long John Silver, the villainous pirate in Robert Louis Stephenson’s adventure story, Treasure Island. She is a brilliantly coloured Australian rosella. I named her, and the story, Gloriana, the poets’ name for Queen Elizabeth, Good Queen Bess, and gave her a very long life span: in the early 1930s, time of my earliest memories, she is rescued from a pawnshop at Port Adelaide by 9-year old twins. Gloriana is old enough to have learnt human speech, and tells the twins she knows where the pirates’ treasure is buried.  There’s a road trip through interesting parts of eastern Australia to a little island off the Great Barrier Reef. Gloriana and the twins are pursued by 3 villains who had tried to extract directions to the treasure by getting Gloriana drunk, and want to try again. Writing this has been more fun than anything else I’ve ever written.  About a dozen children have read a first draft of the story. One said he thought it was boring, but all the others said they enjoyed it, several said it’s exciting and they want to read it again after I’ve polished it a bit. I’ve spent the last few months polishing.

I’ve kept my blog going too, writing about once a week on whatever catches my fancy.  You can see this at http://lastswords.blogspot.com

I hope it’s been a good year for you, that you enjoy Christmas, Hannukah, Diwali, the solstice, your own private festival, whatever, and that your future is happy and bright.  

Yours ever, 

John

Fifteen Dogs

One evening the Olympian gods Apollo and Hermes were quaffing ale at the Wheatsheaf Tavern in Toronto.  They were chatting about the nature of humanity. Apollo argued that humans were neither better nor worse than other creatures such as fleas or elephants. Hermes spoke in favour of human languages and wondered what it would be like if animals had human intelligence. Apollo wagered a year’s servitude to Hermes that animals – any animals – would be even unhappier than humans if they had human intelligence. The gods were near a veterinary clinic, so they chose 15 dogs who happened to be there overnight as subjects of their experiment, the means to the end of settling their wager.

The dogs ranged in size and breed from Atticus, a Neapolitan mastiff to Athena, a teacup poodle; large dogs also included Bella, a great Dane, Rosie, a German shepherd, Frick and Frack, nasty-natured littermate Labradors – a nice touch, that, to make friendly, lovable Labs the dogs with the most unpleasant dispositions – and Majnoun, a spayed black poodle. Benjy, a smart beagle who kept his wits about him, survived where others fell by the wayside. Later, Benjy described the brutal violence and murder among the dogs when they fell out with one another, and between dogs and humans, when talking about it with Majnoun.  The violence, murder and other unpleasant deaths take place mostly “off camera” so to say. There were several mutts, notably Prince who was the deepest thinker in the original pack, composed poetry, and continued to think, reflect, and compose poetry after he was expelled from the pack.

If I were to enter such a wager as that of Apollo and Hermes I would choose to demonstrate or refute it on a species less diversified than dogs, which have been selectively bred by their human companions to produce a truly astonishing range of visible variation within the species classified as Canis, the dog. Cattle would serve the purpose quite well and are much less diversified. There is equally or greater variation in personality and prevailing mood even among dogs of the same breed, which I suppose we could legitimately liken to races of mankind – although the visible differences among breeds of dogs are orders of magnitude greater than those between human races. Such a diverse collection as the fifteen dogs in the veterinary clinic that night the story begins could never form a cohesive pack and the prospects for this were further eroded by the sharp personality differences among the dogs.  Andre Alexis implies that these differences followed their adoption of human characteristics.  From what I know about dogs and their diversity, I think Alexis is wrong about this, but it’s a picky point and I wouldn’t argue about it.  The difference soon led to exile for Prince and a brutal death for several others, leaving only Atticus, Bella, Rosie, Benjy and Frick and Frack as survivors. Then Rosie was attacked and killed by another pack of dogs. The murderous gang led by Atticus thought they had killed Majnoun too, left him for dead on a road in High Park, but he was rescued by a kind human couple, Miguel and Nira, and nursed back to health and strength.  Nira renamed Majnoun Lord Jim, or just Jim, and a close bond soon developed between the woman (who worked at home as a copy-editor) and the dog. All dog lovers will recognize this bond, a spiritual, philosophical, emotional bond that is indescribable and incomprehensible to those who do not love dogs.  I had such a bond for some years with Helen, a gentle dachshund bitch and still look back on that loving relationship (which I had good evidence was mutual) with strong feelings of abiding affection bordering on love.

Most of the dogs who survived the early blood-letting died off from other causes such as taking poisonous baits, and the final sections of the book describe the fate of the longest lived and most “human” – the clever and cunning beagle Benjy,  the poodle Majnoun, and the poet-mutt Prince, who all have long and in the case of Majnoun and Prince, largely happy lives.  But did they die happy? Majnoun surely didn’t, alone, starving in a locked empty house after his humans failed to return from a weekend excursion, killed in a traffic crash presumably; the fate of Prince is more equivocal; probably he was happy, even though blind and deaf. Certainly he was loved and cared for until he was gently put to sleep in a veterinary clinic.  But Prince, and Benjy, and even Majnoun to an extent, survived for varying periods on their own, without human companions with whom they bonded and formed mutually supportive relationships. Andre Alexis meditates a little on the nature of the mutually supportive relationship between humans and dogs, but wisely stays clear of in-depth discussion: had he gone into this in depth, his book would have grown to twice its size, or more.

There is much more in this small novel. There are reflections on the nature of bonding between dog and human, on the differences – essential survival traits – between human and canine sentiments; and casual remarks about the ways in which Toronto is such a ‘livable’ city.  So far I’ve read it only once.  It’s a book that cries out to be reread, an easy task because it is such a small book.   I’m looking forward to rereading it.  

This is a truly worthwhile novel, a beautifully crafted little story written with great empathy by a dog lover.  It richly deserved the Giller and Writers’ Trust awards it has already received.  I think it will win more awards before its day is done.

Taking stock

Looking back over a long life I continue to be thankful that I've lived through such an exciting era of discoveries and improvements to the human condition. But it's also been a time of bloody wars in which increasing proportions of those killed and maimed have been infants, small children, and the elderly -- innocent bystanders. We face huge environmental challenges, notably from climate change. The UN Conference in Paris offers hope, if the world's nations and their leaders keep their promises.

Forget gloom and doom. It's the first day of a new year, a time for optimism, time to reflect on all the good things that have happened in my lifetime. I summarized the medical and health-related good things in the Epilogue to the second edition of my book, Public Health and Human Ecology (1997). We can prevent or cure many diseases that were invariably fatal when I was a medical student almost 70 years ago. Financial barriers between sick people and the care they need have been obliterated in most advanced nations. Even in the USA where fierce resistance to tax-supported medical care persists, the barriers have been reduced. The medical profession which was almost exclusively restricted to white men in suits until almost half a century ago, has been feminized and has become culturally diverse; students are admitted to medical school on the basis of talent, not connections to the rich and powerful. Perhaps related to this new diversity, there is increasing concern about the moral and ethical foundations of the health care system. I view this with particular interest.  Of my various contributions to advances of medical science and practice in my lifetime, I am especially pleased and proud about this. 

Beyond medical practice and its scholarly aspects wherein I've spent the past half century and more, advances and changes for the better are even more spectacular. The device I use to tap out these posts on my blog is an excellent example. When I post it, it instantly enters the public domain, and the facts about readers that I glance at occasionally, tell me the readers reside all over the world. (This fact pleases me immensely. Occasionally I get feedback from readers and this pleases me even more, especially when they disagree with my dogmatic statements). So I am grateful for the spectacular advances in information technology in recent years. Faxes and photocopiers were briefly exciting but soon superseded by email, scanning, Skype, and the mysterious cloud about which I'm still  mildly suspicious. What will come next, I wonder? Holograms, 3-dimensional facsimiles? Smellograms? The "Feelies" that Aldous Huxley creepily mentioned in Brave New World? Or  something as incomprehensible to me, and as unpredictable, as the first photocopiers were when I saw them in 1960. 

Air travel has improved too, despite the discontents of heightened security, inedible plasticized food, being herded like cattle in abattoirs (a deliberately unsettling simile) and airline schedules that are often a suggestion rather than a factual statement. David and Desre left Sydney on New Years Eve and thanks to longer-haul intercontinental aircraft than in 2006 when Wendy and I last flew that route, and the International Date Line, arrived in Vancouver before they'd left Sydney. The 747 on which Wendy and I flew in 2006 had to refuel in Honolulu, which meant undergoing the torture and endurance trials of Homeland Security for a couple hours in the middle of the local night when we were worse afflicted by jet lag than any other time in my memory. 

Some advances in technology haven't yet entirely caught up with each other. For instance, CBC hasn't resolved the issue of content between its on-air channels. Yes, I'm aware of the great variety available on line, but even with a top-of-the-line iMac I'm reluctant to load one part of it with opera or classical music while I type my literary masterpieces (or whatever they are) on another part. The better, pragmatic reason  for reluctance is that the avaricious accountants in Bell Canada would charge an arm and leg and several pounds of flesh for the doubtful privilege of listening to the obscure opera their scholarly announcers seem to enjoy. I've gone back a few "generations" in music technology, back beyond on-line on-demand music, beyond CDs, to vinyl LPs.  I'm so happy I kept my collection of LPs, despite the temptation to put them out in a garage sale. I have classical music, opera, jazz, blues, and voice recordings, some quite rare and hard to get, perhaps not obtainable at all now.  I had to invest in a new turntable, which has a CD player and USB drive slot as well as the hardware to play my beloved LPs. My cup doesn't quite runneth over: I need to wire it up to a pair of auxilliary speakers. When I've done this, my turntable -- old technology to be sure -- might turn out to be the best investment I've made for many years.

I could go on. There's much more. But you get the picture. Happy New Year, Felice anno nuovo, et cetera.