Introduction to Sustainable Medicine
Part II
by Elizabeth R. Mackenzie, PhD
The Industrial Age and Its Products
One of the chief characteristics of the current era is that we keep coming up against limitations inherent in the products and systems of the Industrial Age. What seems to have worked well for so long, is no longer working for us. The exploitation of fossil fuels is the prime example of this phenomenon. Tapping into this source of stored solar energy has allowed humanity to conquer the planet in
a relatively short period. The human population has experienced explosive growth, handily beating out all other species in our competition for resources and habitats.
What we are now recognizing, however, is that not only has the use of fossil fuels done significant damage to the earth (our only home), but it is a nonrenewable resource. In other words, it is both toxic and finite. Even if we wanted to keep polluting our ecosystems, one day we will run out of these substances. Fundamental changes in how we fuel our civilization are inevitable. These changes will also radically alter how we design virtually every social system: our cities, our transportation, our military, our communications, our entertainment, our agriculture, our food production, our manufacturing, and our health care system.
Biomedicine is industrial medicine. It is a product of the Industrial Age; as such, it is based on an outmoded and mechanistic understanding of the world. As a society, we have begun to discover the limits of biomedicine. For one thing, biomedicine is much too costly to be sustained in its current form. The single factor most responsible for driving up costs: medical technology. 
Advances in medical technology account “for at least 50% of the increase in health care spending between 1940 and 1990” (Keenan, Commonwealth Issue Brief, 2004). It is the single most important factor, eclipsing all other contributing factors (such as aging populations, inefficiency, physicians’ salaries, and malpractice insurance).
Biomedicine, although unmatched in its ability to save lives in the face of traumatic injury and acute illness, has not been effective at preventing disease or treating chronic conditions. There are the unintended side effects of many, if not most, pharmaceutical drugs, along with other common iatrogenic (or doctor caused) diseases. Finally, biomedicine has ignored the role of mind and spirit in maintaining health and healing from illness, and has been blind to environmental causes of disease. All of these issues stem from an essentially mechanistic view of the human body and a reductionism approach to understanding of life.
There is a direct parallel between our creation of industries that harm the environment and an industrial medicine that does not resonate with the way nature actually works.
Like industrial agriculture, industrial medicine has depended increasingly on specialist methodology, mechanical technology and chemicals; thus its own point of reference has become more and more its own technical prowess and less and less the health of creatures and habitats (Wendell Berry).
Luckily, we have a ready-made model that can serve as a staging ground for sustainable medicine for the post-Industrial Age – holistic medicine.
Holistic Medicine and Sustainability
Holistic medicine as a popular movement in the U.S. emerged in the 1970s and grew increasingly visible and mainstream over the next three decades. Characterized by its focus on the integration of mind and body, it arose in response to peoples’ experiences of the limitations of conventional (or industrial) medicine. Holistic medicine researchers, practitioners and patients sought out new
approaches to health by exploring ancient systems, indigenous practices and East Asian philosophies. Holistic medicine also embraced such modalities as chiropractic, osteopathy, homeopathy and naturopathy, all 19th century Euro-American inventions.
Conceptually, what ties all these disparate paths together is the conviction that proceeding in harmony with nature is better than opposing nature, as well as the desire to heal the fragmentation between mind and body, humanity and nature, and matter and spirit. The same underlying impulse toward whole systems thinking that produced environmental awareness (and activism), has led to the formation of the holistic health movement. However, to date there has been relatively little discussion about how the two movements influence and support one another, nor about what we can learn from an analysis of this relationship.
The Gaia Hypothesis
It seems to me that environmental realities increasingly force us to admit that there are limits to mechanistic models and material reductionism in our scientific explorations, limits to the ability of technological fixes to solve our problems, and limits to humanity’s ability to override natural systems without adverse consequences. One good aspect of our current environmental crisis, is that we must recognize that we are a part of nature in very real, concrete terms. What happens to the Earth has a direct affect on all her inhabitants, and what we do to our environment, we do to ourselves. We have begun to move away from a simple materialist understanding of the Earth.
The Gaia hypothesis is an ecological hypothesis proposing that the biosphere and the physical components of the Earth form a complex interacting system. This coordinated system of living organisms maintains the climatic and biogeochemical conditions on Earth in a preferred homeostasis. Named after the Greek goddess of the Earth, proponents of the hypothesis frequently advocate viewing the Earth as a single organism (adapted from the Wikipedia entry for Gaia Hypothesis: http://en.wikipedia.org/wiki/Gaia_Hypothesis)
Many in the scientific community now refer to the Gaia Theory, on the basis of growing evidence in support of this view. Interestingly, long before James Lovelock proposed the Gaia Hypothesis (in the 1960s), Plato wrote of the anima mundi or “world soul."
Therefore, we may consequently state that: this world is indeed a living being endowed with a soul and intelligence ... a single visible living entity containing all other living entities, which by their nature are all related” (Plato, Timeus, 29/30).
Perceiving – even experiencing – the Earth as a living being is an important part of comprehending the connection between ecology and medicine. Once we can perceive the earth as a living entity of some kind, we can easily sense how a diseased planet is a breeding ground for human illness of all sorts. We need the Earth to be
healthy, if we are to be healthy. Conversely, a sick planet produces sick creatures. Seen from this perspective, the entire ecological movement is about health – healing our ecosystems to preserve healthy human habitats.
We have grown accustomed to thinking about environmental concerns as “saving the planet.” It is far more accurate to say that we are saving ourselves. The planet will be fine. The earth will recover from virtually any form of destruction we can devise. Even the biosphere will probably survive all but the most devastating human-made catastrophes. What hangs in the balance, is not the earth, but the human species. People who are paying attention (such as biologists and environmentalists) are now reporting massive species extinction. In addition to the highly visible endangered species such as polar bears and tigers, huge numbers of more obscure animal and plant species are rapidly growing extinct due to the destruction of ecosystems through human development, climate change, and deforestation (Suzuki, The Sacred Balance 2007). When our fellow creatures begin to die off, we must interpret this as a wake-up call about our own viability as a species. To put in another way, extinction is the ultimate public health threat.
Conclusion
But let’s not end on such a gloomy note! There are many reasons for optimism. First, there is already a strong trend toward “green medicine” and “green design.” Pioneers in both areas have already created feasible models that can be easily implemented on a widespread basis. Second, there is a virtuous cycle that looks like this:
? Holistic health practices and interventions help individuals integrate body, mind, and soul.
? Healthier individuals are more likely to look beyond the outmoded Industrial Age model and release the addictive and maladaptive behaviors associated with living in a materialistic and mechanistic society.
? Healthier individuals ease the transition from one age to the next for themselves and others through their actions and choices.
? Healthier individuals are more likely to contribute to creating a sustainable society.
? Sustainable systems and whole systems thinking support a holistic approach to health.
Sustainable medicine is but one facet of an entirely new approach to designing human society, one that is being born as the Industrial Age passes away and a new era emerges. This new era will not be a return to pre-Industrial Age primitivism, but will borrow from those cultures to design a post-Industrial Age technology. We are already seeing this process take place in the formation of holistic -- and more sustainable -- medicine. One of the most interesting things about sustainable medicine, in my view, is the way in which it forces us to consider the parallels between healing ourselves and healing the earth, and the ways in which individual health is linked to societal health, which is in turn linked to the health of ecosystems and the biosphere. Once we step out of the confines of Industrial Age thinking, we begin to see how the concepts of balance, connection, and integrity are central to health at every level and that leads us to a very different view of individual health, societal health and the health of the biosphere.
About the Author
Elizabeth R. Mackenzie, PhD is a scholar and author whose academic work has centered on holistic and humanistic medicine. She is a lecturer at the University of Pennsylvania, where she teaches an undergraduate course on complementary and alternative medicine and another on sustainable medicine.