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A GOOD TRUTH Is Hard to Find
Mary G. Barry, MD
Louisville Medicine Editor
[email protected]
F
acts seem to be quite fluidly de-
fined up there in DC, and some-
times right here in the Com-
monwealth. Climate change, for
instance, is a real and devastating
force, hurling vicious hurricanes and flood-
ing at the coastal Carolinas just last month.
But, the EPA has been forced to comply
with executive orders that have gutted the
information available on its website. A few
years ago, I found a wealth of data there
on the Clean Air Act. In April, the EPA
announced that it was “removing outdat-
ed language on content related to climate.”
Currently the website says, “We are updating
our website to reflect EPA’s priorities under
the leadership of President Trump.” (It used
to read, “and Administrator Pruitt,” but he
gave up his phone booth in July).
The National Oceanic and Atmospher-
ic Administration (NOAA), however, still
honors scientific facts. NOAA has pub-
licized the work of Dr. Kieran Bhatia of
Princeton and the NOAA lab. His group
demonstrated, via modeling fluid dynamics
on supercomputers, that the incidence of
far more powerful hurricanes has gone up
by 20 percent in the past three decades. He
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showed that storm speed and intensity are
both related to oceanic warming to a now
far more considerable depth. Even though
the words “global warming” and “fossil fu-
els” and “greenhouse gases” have all been
purged from the EPA website, the truth of
the matter is that we humans bear respon-
sibility, even Mr. Pruitt and his allies, who
deny that scientific realities matter.
Last week, the nation was mesmerized by
the riveting events of the SCOTUS nominee
hearings. On the one hand, “truth” for the
victim was regarded as relative, not carved
in stone, for such is the nature of memories
of terrible, sudden sexual assault. On the
other hand, the nominee’s denials were giv-
en credence by the committee Majority. The
Majority also had access to written materials
authored by the nominee even though he
had denied such authorship, but refused to
give credence to the Minority’s statements
that this constituted perjury. Truth seem-
ingly was being chased around the room,
caught, held down and silenced.
The fierce outcry that resulted, the waves
of demonstrators, and the fury of women
whose suffering was thus dismissed released
a tsunami of questioning. Why, always why,
is the victim blamed? Why, always why, is
the victim punished? The accused cries,
“Why me?” And the accuser cries, “Why,
because it was you.”
“Why me” is a question that doctors
must answer, over and over. “Why me?” asks
the 34-year-old with cancer. “I have barely
lived yet.” “Why me?” asks the 80-year-old
smoker with small cell. “The other guys got
away with it.” “Why me?” asks the woman
with the rare complication, the one that you
mentioned only briefly beforehand. “Why
me?” asks the guy who fell off the cliff. “Why
did you hurt me? Why did you abandon me?
Why did you stop my pain medicine? Why
didn’t you call me right back?”
Navigating the truth – for physicians, it
amounts to that – is a skill born of experi-
ence. When we know how awful something
can be, but know not how it may yet affect a
particular patient, how much of the awful-
ness must we warn them about at the outset?
We have in our heads a litany of complica-
tions, treatment failures, and potentially
disabling side effects. We have in our words
the power of suggestion, which we must use
with delicacy always to avoid leading the
witness. We have in our hearts the tears and