How to Deal with Our Current ‘Death Spiral,’ Session 8

Special Topics in One World or None

*The Zoom Link for today’s live session is far below.

Last week, we discussed our decision to form a new organization—Physicians for Global Survival—as a necessary response to the urgent, existential challenges we face today and as a vehicle for implementing Prescription for Survival 2025. I noted that there is historical precedent for such action, and no conversation about precedent would be complete without recognizing the legacy of Dr. Bernard Lown.

Lown was already a towering figure in cardiology, when he perhaps came to save more lives than any other physician. He had co-developed the direct current defibrillator, a life-saving device used to restore normal heart rhythm during cardiac arrest. His use of lidocaine as a treatment for arrhythmias further revolutionized cardiology, and as a professor at Harvard and senior cardiologist at Brigham and Women’s Hospital, he trained generations of physicians in modern cardiac care.

But his true contribution came when he cofounded the International Physicians for the Prevention of Nuclear War (IPPNW) with Soviet cardiologist Dr. Evgeni Chazov. At the height of U.S.-Soviet tensions, they helped doctors on both sides of the Iron Curtain come together and speak of the increasing risk of nuclear war, not as a political issue but a public health emergency that would annihilate human life entirely.

Now, to give a little background, tensions were escalating between former allies, the United States and the Soviet Union, in the decades following World War II—an era marked by ideological confrontation, mistrust, and the race for nuclear supremacy. This period, known as the Cold War, created the conditions for what Lown came to describe as, “nuclear madness.”

In 1945, the United States dropped atomic bombs on Hiroshima and Nagasaki, demonstrating the devastating power of nuclear weapons. Just four years later, in 1949, the Soviet Union successfully tested its own atomic bomb, and America’s nuclear monopoly abruptly ended. What followed was relentless escalation: the U.S. testing the far more powerful hydrogen bomb in 1952, and the Soviets responding in 1953. Each breakthrough deepened the spiral of mutual suspicion and arms accumulation.

The 1950’s and early 1960’s saw the institutionalization of nuclear deterrence under the doctrine of “Mutually Assured Destruction” (“MAD”). This concept held that neither superpower would launch a first strike, knowing that it would result in total annihilation on both sides. Ironically, MAD was seen as a stabilizing force, and yet it required the continuous development and stockpiling of weapons capable of ending civilization.

During this time, proxy wars in Korea and Vietnam, the arms buildup in Europe, and domestic anti-communist fervor—like McCarthyism in the U.S.—all reinforced an atmosphere of paranoia. In the Soviet Union, Joseph Stalin’s authoritarian regime suppressed dissent, further closing off avenues for dialogue. Both superpowers launched massive intercontinental ballistic missile (ICBM) programs and built nuclear submarines, increasing the speed and reach of potential strikes.

The political climax of this period came with the Cuban Missile Crisis in 1962, when the world teetered at the brink of full-scale nuclear war. For thirteen days, the U.S. and the Soviet Union faced off over Soviet missiles installed in Cuba. Although a peaceful resolution was reached, the crisis revealed how close to catastrophe they came.

By the time Lown appeared as an anti-nuclear advocate in 1961, the world had amassed tens of thousands of nuclear weapons, and governments were normalizing their existence. Lown and his Soviet counterpart, Chazov, believed that they could not keep with the Hippocratic oath and stay silent for what they called, “the final epidemic”: nuclear war. They came to be among the first to dissolve the illusions that existed and to reveal nuclear weapons for what they were: weapons of genocide. They warned peoples and governments that, in clinical terms, a nuclear conflict would cause mass casualties and render a medical response virtually impossible.

Lown said in his memoir:

In this danse macabre, [there] could be no victor. Despite the gibberish of the nuclear war planners, there were no strategies for winning, or even for surviving…. Russians and Americans obviously are not different biological species. We share the gift of life as well as a common ancestry shaped by a repertoire of emotions, feelings, and instincts. Governments, however tyrannical, however unsparing in brutality, cannot erase that common legacy.

The group mobilized to educate the public and policymakers about the medical consequences of nuclear war—essentially that few would remain living and that survivors would envy the dead. They conducted research, published in influential journals, and held conferences that brought together experts from across ideological divides. These efforts not only raised awareness but also contributed to a shift in public discourse, moving away from abstract geopolitical strategy toward the tangible, devastating human cost. Lown’s own personal relationship with a Soviet cardiologist embodied the power of humanizing the opponent, overcoming widespread skepticism. He even met with King Hussein of Jordan and Mikhail Gorbachev—on medical grounds during routine examinations or conversations.

Further, knowledge is the precursor to prevention. They recommended a ban on tests of nuclear weapons, a freeze, reduction and eventual elimination of nuclear weapons, non-first-use of nuclear weapons, ending the arms race on earth, and preventing it from spreading to outer space. This, they claimed, would help create an atmosphere of trust between peoples and countries, promoting close international cooperation, and it did.

IPPNW grew to 145,000 physicians worldwide within five years, and their collaboration sent a powerful message: that doctors, bound by a common commitment to life, could transcend political divisions to address a shared existential threat. This helped to reframe the debate and to awaken the globe to the real costs of geopolitical division and to highlight our commonalities.

In this manner, first the atomic scientists—such as Albert Einstein and J.R. Oppenheimer—and then the physicians—such as Lown and Chazov—helped inform and mobilize massive citizens’ movements that highlighted the humanitarian, environmental, and existential threats posed by nuclear warfare. Major successes included the Partial Test Ban Treaty of 1963, which prohibited nuclear testing, and the more comprehensive Nuclear Non-Proliferation Treaty of 1968, which aimed to prevent the spread of nuclear weapons and promote disarmament. Grassroots mobilizations, such as the massive nuclear disarmament protests in the 1980’s, influenced public opinion and pressured governments to act.

IPPNW’s influence contributed to arms reduction agreements, such as the Intermediate-Range Nuclear Forces (INF) Treaty and the Strategic Arms Reduction Treaty (START). The INF Treaty led to the destruction of nearly 2700 missiles and marked a major deescalation of Cold War tensions, while START, further extended with New START, reduced long-range nuclear arms. For their groundbreaking efforts, IPPNW was awarded the Nobel Peace Prize in 1985.

During his speech, Chazov quoted French author Antoine de Saint-Exupéry, who said:

Why should we hate each other? We are all in one, sharing the same planet, a crew of the same ship. It is good when dispute between different civilizations gives birth to something new and mature, but it is outrageous when they devour each other.

I would say it is outrageous still when we destroy each other.

I would like to end with Dr. Bernard Lown’s Nobel Prize acceptance speech:

We physicians who shepherd human life from birth to death have a moral imperative to resist with all our being the drift toward the brink. The threatened inhabitants on this fragile planet must speak out for those yet unborn, for posterity has no lobby with politicians….

Twenty-four nuclear bombs are being added weekly to world arsenals. We physicians protest the outrage of holding the entire world hostage. We protest the moral obscenity that each of us is being continuously targeted for extinction. We protest the ongoing increase in overkill. We protest the expansion of the arms race to space. We protest the diversion of scarce resources from aching human needs. Dialogue without deeds brings the calamity ever closer, as snail-paced diplomacy is outdistanced by missile-propelled technology. We physicians demand deeds to implement further deeds which will lead to the abolition of all nuclear weaponry….

From this world podium we call upon the governments of the United States and the Soviet Union to agree to an immediate mutual moratorium on all nuclear explosions to remain in effect until a comprehensive test ban treaty is concluded. A moratorium is verifiable, free of risk to either party, simple in concept yet substantive, has wide public support, and is conducive to even more dramatic breakthroughs….

We physicians have focused on the nuclear threat as the singular issue of our era. We are not indifferent to other human rights and hard-won civil liberties. But first we must be able to bequeath to our children the most fundamental of all rights, which preconditions all others; the right to survival….

Having achieved peace, in the sonorous phrase of Martin Luther King spoken here twenty-one years ago, human beings will then “rise to the majestic heights of moral maturity.”

Nowadays, nuclear threats are not singular but accompany the dangers of climate destruction, pandemics, and artificial intelligence misuse. Physicians and other health professionals can contribute to their containment through global health collaboration, public health advocacy, raising awareness of climate-related health impacts, disease surveillance, vaccine development, and reducing pandemic risks. However, we realize that mental health is increasingly central in these efforts, such as in helping people to cope, to invest in the prevention and preservation of life, to promote resilience, and to strengthen our guard against the harmful effects of disinformation and psychological manipulation. We have therefore entered a time when human survival and wellbeing depend on moral maturity, certainly, but require attention to psychological maturity to get there. This has become the defining task for the twenty-first century.

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