Catastrophe and survival


By George F. Will
Thursday, December 31, 2009

Already 99.9 (and about 58 more 9s) percent of the universe -- it is expanding lickety-split -- is beyond Earth's atmosphere.

Into what is it expanding? Hard to say. We can say there is lots of stuff in space: Hold up a penny at arm's length and you block three galaxies from your field of vision -- billions of stars and other things -- 350 million light-years away, which is right next door in our wee corner of the universe.

But there is much more space than there is stuff in space: If there were only three bees in America, the air would be more crowded with bees than space is with stars. But there is much stuff besides stars whizzing around, and 65 million years ago -- the day before yesterday on the calendar of the 14-billion-year-old universe -- big bits of stuff entered Earth's atmosphere traveling faster than a high-caliber-rifle bullet.

One result was a 16,000-foot mountain, Bombay High, that has never been climbed because it is underwater off India's west coast. Another result was the "worldwide collapse of the climate and ecosystems" leading to the mass extinctions of the dinosaurs and two-thirds of marine animals, and the destruction of much of the planet's flora. So surmises Sankar Chatterjee of Texas Tech University.

"Catastrophism," the study of calamitous episodes in Earth's geological history, has long postulated a cosmic collision that resulted in sudden extinctions. There are "iridium anomalies" -- concentrations of that material that suggest extraterrestrial origins. There also is 10,000 times more carbon than normal in the geologic time zone 65 million years ago, a worldwide layer of soot from fires kindled by the impact of a gigantic asteroid.

A consensus developed that it created Mexico's 110-mile-wide Chicxulub crater. But Chatterjee says there is a crater, Shiva, more than 300 miles wide, off western India, probably formed by an asteroid or a part of one, 25 miles in diameter.

He thinks it possible that Shiva and Chicxulub were created by portions of different asteroids that fragmented when they hit the atmosphere. The energy from the fragment that produced Chicxulub is estimated to have been equivalent to the explosion of 100 trillion tons of TNT -- 10,000 times the explosive potential of the world's arsenal of nuclear weapons. The much bigger fragment that created Shiva may have shoved India north. India was then an island moving three to five centimeters a year. Then came what has been a mystery to students of plate tectonics -- the surge of the Indian plate to the astonishing rate of 15 to 20 centimeters a year.

Dinosaurs, which were thriving in India, had lived a thousand times longer than humans have yet lived. Then they and more than 75 percent of Earth's plant and animal species died. Perhaps the two collisions, combined with a lot of volcanic activity in that era (some of it perhaps caused by the collisions), tossed up enough dust to block sunlight, creating perpetual night and acid rain, impeding photosynthesis and causing the starvation of many creatures. Or perhaps by screening sunlight, the dust caused a glacial episode.

Or perhaps dust and water vapor had a "greenhouse effect," holding in heat and cooking much life out of Earth. The discovery, two decades ago, of a bed of dinosaur fossils on Alaska's North Slope suggests that temperatures may have been warmer long ago, before there were human beings to blame for that.

Before Darwin, many people believed that no species could become extinct because this would mean there had been an imperfection in God's original handiwork. Yet 104 years before publication of "On the Origin of Species," the Lisbon earthquake of 1755 had caused some people to doubt that God has ordained a benevolently ordered universe. Nevertheless, in 1787 other people -- Americans call them the Founding Fathers -- who were influenced by Newtonian physics and the deist idea of God as cosmic clockmaker, devised a constitutional system of separated powers, checking and balancing one another, mimicking what they considered our solar system's clocklike mechanics.

Today, we know there is a lot of play in the joints of the Constitution and that every 40 million years or so asteroids more than half a mile in diameter strike Earth. Yet the Constitution still constitutes, and the fact that flora and fauna have survived Earth's episodes of extreme violence testifies to the extraordinary imperative of life.

I don't need a war to fight my cancer. I need empowering as a patient
Using the martial metaphor for something as complex as cancer makes the disease ripe for political and financial exploitation

Obituaries routinely inform us that so-and-so has died "after a brave battle against cancer". Of course, we will never read that so-and-so has died "after a pathetically feeble battle against cancer". But one thing that I have come to appreciate since being diagnosed with multiple myeloma (a cancer of the blood) two years ago is how unreal both notions are. It's just not like that.
The stress on cancer patients' "bravery" and "courage" implies that if you can't "conquer" your cancer, there's something wrong with you, some weakness or flaw. If your cancer progresses rapidly, is it your fault? Does it reflect some failure of willpower?
In blaming the victim, the ideology attached to cancer mirrors the bootstrap individualism of the neoliberal order, in which the poor are poor because of their own weaknesses – and "failure" and "success" become the ultimate duality, dished out according to individual merit.
It also reinforces the demand on patients for uncomplaining stoicism, which in many cases is why they are in bad shape in the first place. Late diagnosis leads to tens of thousands of avoidable deaths in the UK each year. For those who have been diagnosed it remains a barrier to effective treatment. The free flow of information between patient and doctor is a scientific necessity, and a reluctance to complain inhibits it.
Earlier this year Barack Obama vowed to "launch a new effort to conquer a disease that has touched the life of nearly every American". In so doing, he was intensifying and expanding a "war on cancer" first declared by Richard Nixon in 1971. But this "war" is as mislabelled and misconceived as the "war on terror" or the "war on drugs".
For a start, why must every concerted effort be likened to warfare? Is this the only way we are able to describe human co-operation in pursuit of a common goal? And who are the enemies in this war? Cancer cells may be "malignant" but they are not malevolent. Like the wars on "drugs" and "terror", the war on cancer misapplies the martial metaphor to dangerous effect. It simplifies a complex and daunting phenomenon – making it ripe for political and financial exploitation.
In the war on cancer, the search for the ultimate weapon, the magic bullet that will "cure" cancer, overshadows other tactics. Nixon promised "a cure for cancer" in 10 years; Obama promises one "in our times". But there is unlikely to be a single cure for cancer. There are more than 200 recognised types, and their causes are myriad. As a strategic objective, the search for the ultimate weapon distorts research and investment, drawing resources away from prevention and treatment, areas where progress has been and can be made.
Like other wars, real and imagined, the "war on cancer" is a gift to opportunists of all stripes. Among the circling vultures are travel insurers who charge people with cancer 10 times the rate charged to others; the publishers of self-help books; and the promoters of miracle cures, vitamin supplements and various "alternative therapies" of no efficacy whatsoever.
But most of all, there's the pharmaceutical industry, which manipulates research, prices and availability of drugs in pursuit of profit. And with considerable success. The industry enjoys a steady return on sales of some 17%, three times the median return for other industries. Prices do not reflect the actual costs of developing or making the drug but are pushed up to whatever the market can bear.
Exorbitant drug prices are at the root of recent controversies over the approval by the National Institute for Clinical Excellence (Nice) of "expensive" cancer drugs – notably Revlimid, a therapy used in the later stages of a number of cancers, including mine – and top-up or "co-payments" (allowing those who can afford it to buy medicines deemed too expensive by the NHS). "We are told we are being mean all the time, but what nobody mentions is why the drugs are so expensive," said the Nice chairman, Professor Michael Rawlins. "Pharmaceutical companies have enjoyed double-digit growth year on year, and they are out to sustain that, not least because their senior management's earnings are related to the share price."
Many cancer therapies are blunt instruments. They attack not only cancer cells but everything else in sight. This is one reason people fear cancer: the treatment can be brutal. Making it less brutal would be a huge stride forwards for people with cancer. And that requires not a top-down military strategy, with its win or lose approach, but greater access to information, wider participation in decision-making (across hierarchies and disciplines) and empowerment of the patient.
Because I live in the catchment area for Barts hospital in central London, I find myself a winner in the NHS post code lottery. The treatment is cutting-edge and the staff are efficient, caring and respectful. What's more, I live close enough so that I can undergo most of my treatment as an outpatient – a huge boon.
Cancer treatment involves extensive interaction with institutions (hospitals, clinics, social services, the NHS itself). Even in the best hospitals, the loss of freedom and dependence on anonymous forces can be oppressive. Many cancer patients find themselves involved in a long and taxing struggle for autonomy – a rarely acknowledged reality of the war on cancer, in which the generals call the shots from afar.
As Susan Sontag noted, in the course of the 20th century cancer came to play the role that tuberculosis played in the 19th century – as a totem of suffering and mortality, the dark shadow that can blight the sunniest day. But the ubiquitousness of cancer in our culture is of dubious value to those living with the disease. The media love cancer scares and cancer cures; they dwell on heroic survivors (Lance Armstrong) and celebrity martyrs (Jade Goody). But as Ben Goldacre has shown in his Bad Science column, they routinely misrepresent research findings, conjuring breakthroughs from nothing and leaving the public panicked, confused or complacent.
What we need is not a war on cancer but a recognition that cancer is a social and environmental issue, requiring profound social and environmental changes.
---Mike Marqusee, The Guardian (UK), 12/30/09