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Letter from Michael Learner - May, 2007
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Dear Commonweal Friends:
I hope this letter finds you well. I am well. Bolinas is beautiful in the early Spring. The work at Commonweal is flourishing under Charlotte Brody's skilled leadership.
Elizabeth's Choice: Elizabeth Edwards and Breast Cancer Prevention
During the past week (as I write to you), John and Elizabeth Edwards announced that Elizabeth's breast cancer has returned. The cancer is in her rib. It may be in her lungs.
My thoughts kept coming back to Elizabeth this week. I thought about what she and John have been through since the doctor gave them the news. I thought about the conversations they had before they told their staff of their decision and stepped into the sunlight to make their private grief public before a media-drenched world.
For the past twenty-two years, I have worked closely in the Commonweal Cancer Help Program with hundreds of mothers like Elizabeth Edwards who are facing metastatic breast cancer while their children are still young.
I know Elizabeth hopes for many years of life. I imagine she also decided that if she has less time, making John president would be the greatest gift she could give to the man she loves. I imagine she wants to go out fighting for the things she believes in and taking care of her family.
The one thing Elizabeth Edwards' new diagnosis—and John's and her shared decision to stay in the race—makes almost certain is that breast cancer will be front and center in the presidential campaign. The predictable course of media coverage will be stories about her courage, about new treatments, about the need for more research, and about living with recurrent breast cancer as a chronic disease.
What interests me is the possibility a new story might be told. It is a story about the need to prevent breast cancer. It is a story that a number of us across America have been telling for some time. It is not an easy story to reduce to a sound bite. But here are the basics. There is an epidemic of breast cancer. The causes of the epidemic are clearly environmental. We do not know which environmental factors contribute how much to the epidemic.
More important, we may never know which environmental factors contribute how much to the breast cancer epidemic. Because breast cancer is a disease that is amplified in industrial civilizations by an infinitely complex interaction of many factors. Diet, exercise, and chemical exposures make some contribution. There are many other possible contributors.
If it were "just" a breast cancer epidemic that is amplified by industrial civilization, maybe we would throw up our hands and say: "This is a tragedy but it is too hard to deal with all the complexities to try to do something." But the breast cancer epidemic is not the only epidemic. And it is not separable from the other epidemics of our time. How many of our children struggle for breath? How many cannot read, or write, or pay attention to what is happening around them? How many are autistic? How many have birth defects that you can see? How many have birth defects that you cannot see at birth — defects of the heart, the immune system, or the mind? How many have childhood cancers?
How many young girls have premature puberty? How many develop endometriosis How many young couples struggle with infertility? And, as we get older, how many of us develop cancers—like Elizabeth Edwards—in the prime of life? How many develop allergies, chemical sensitivities, or autoimmune diseases? How many develop early onset Parkinson's Disease, or ALS, or early onset Alzheimer's? And how many are subtly altered, in ways that do not manifest as frank disease, but shift the experience of what it is like to be human?
It may be too much to ask Elizabeth and John Edwards to talk about breast cancer prevention. It seems indecent to intrude on their private and public tragedy and to tell Elizabeth Edwards what her message about breast cancer should be. We cannot decently ask Elizabeth Edwards to make the link between preventing breast cancer and preventing many of the epidemic diseases of our time.
But it may be that some of the rest of us can say a word or two on the subject. Because—after over 20 years of working with hundreds of young mothers with metastatic breast cancer—there is only one thing I am sure of.
I know Elizabeth Edwards is strong enough to face life and death with metastatic breast cancer. But I also know, deep in her heart, Elizabeth Edwards absolutely does not want her two daughters, one adult and one eight years old, to face the same disease. She does not want her daughters, when they have young children, to face what she is facing now. She has lost one son already, claimed by a car accident at age 16 in 1996. She has no need, whether she is alive or dead, to lose another.
Elizabeth Edwards is now among the thousands of mothers with stage IV breast cancer who know in their bones what it means that their young children may lose their mother. But what is even harder for Elizabeth, and all those like her, is the thought that her daughters, who may lose their mother at an early age, might face the same disease when their children are young. It is this tragic lineage of preventable grief that stands at the heart of the breast cancer prevention movement.
That thought may lead Elizabeth Edwards where many of the courageous women with breast cancer I have known have been ineluctably led. They know how difficult a cure for breast cancer has proven to find. Billions of dollars and decades of research have not found one. They know what living with breast cancer is like. The surgeries, the chemotherapies, the radiation. They know about living from one check-up to the next with the ever-present fear of recurrence. And when recurrence comes, they know what it means for them and the ones they love.
Many of these courageous women have come to understand that the only sensible thing to do is to make the kind of investment in breast cancer prevention that we have made in breast cancer treatment research. And they understand that this investment in prevention should be not only investment in a research agenda but investment in public policies that protect public health as well.
These courageous women have come to understand that the breast cancer epidemic is essentially inseparable from the other epidemics of environmentally related disease in our time. And so they have decided to fight for a world where every major contributor to breast cancer and other chronic diseases is minimized.
That means a return to some basic public health values. It means clean air, clean water, and safe foods. It means schools where children eat nutritious meals and exercise vigorously every day. It means eating the foods our grandparents and their parents for thousands of generations before them ate. It means reducing the terrible gap between rich and poor which is the largest single contributor to the burden of all disease in this country and every other country. It means health care for all. And it means a systematic and thorough approach to reducing our body burdens of thousands of toxic chemicals and radiation exposures that were not in our grandparents' bodies and should not be in ours.
Politics completely aside, from a public health perspective John Edwards is talking about the real issues. He talks of universal health care. He talks of narrowing the gap between rich and poor. That yawning gap in the distribution of wealth is the single greatest cause of ill health. It is also the single thing we could most readily change with a simple vote in Congress and the stroke of a pen. Edwards talks of the need to spend at home the billions we are now spending in the Middle East. It is not a political statement to say that it is a good thing that at least one candidate is talking about the real issues in public health.
Will Elizabeth Edwards' new cancer diagnosis lead her to do the kind of thinking so many thousands of women across the country have done? Will it lead her to think about breast cancer prevention? Will she do the research and come to understand how complicated breast cancer prevention is? Will she go deep enough to recognize breast cancer as an ecological disease that is part of the whole fabric of ecological diseases we face today? Will she see the need to do what the Europeans are doing and what people are doing in states across the country — to work for clean air, clean water, and safe foods, and to systematically reduce the thousands of untested toxic chemicals building up in our bodies? And if she makes the connection, will she discuss it with John Edwards? And if he agrees, will Elizabeth and John Edwards be the ones who finally bring breast cancer prevention into the American mainstream?
I don't know the answer. I only know that if Elizabeth doesn't do it, we need to continue to do it. We need to tell the simple truth that breast cancer prevention is part and parcel of preventing most of the major diseases of our time. It is only complicated if we get caught up in the game of trying to figure out which specific stresses are responsible for what proportion of what disease. It is simple if we just say we need to make our country safer for our children and for all of us again. We know how to do that. It is common sense. That is our choice, and Elizabeth's choice.
The New School: Supporting the Shift in Ecology, Culture and Consciousness
I wrote you in my last letter about the New School, our newest project at Commonweal. There is more news about TNS in the Commonweal Letter. We started the New School because we believe that all the changes we want and need to see in the world really do require a shift in ecology, culture and consciousness. The work at Commonweal has been contributing to that shift in many ways for three decades. But we have never previously addressed the need for that shift directly.
The New School supports this shift in ecology, culture and the inner life in three ways—through conversations, convenings, and collaboratives. We are talking with a wide range of thought and action leaders in teleconference conversations that you are most welcome to join by emailing us at thenewschool@commonweal.org . Likewise we have initiated wonderful convenings at Commonweal that you will be invited to if you join the New School. Finally, we have begun to explore the strategic collaborations that we hope will help us leverage some of the most promising movements toward the shift in culture and consciousness that we seek.
For me personally, I find that engaging with the New School deepens and enriches my work and my inner life in many ways. This learning community refreshes the way I work in the Cancer Help Program and the Collaborative on Health and the Environment. I feel strengthened in my hope by the example of the remarkable people who join in the conversations. As Ram Dass said when Rachel Naomi Remen and I interviewed him, "this is the kind of school I wish I had gone to." Please join us in the New School. It is a whole new way to engage with the wider Commonweal community. It is a great antidote to the culture of despair.
Steve Lerner Steps Down as Commonweal Research Director
And now, some sad news. My brother, Steve Lerner, Commonweal Research Director for 31 years, will be transitioning from a salaried position to a contract relationship with Commonweal starting July 1st, 2007. Steve has been a strong partner in Commonweal since its founding. Steve writes:
It's been a great ride at Commonweal over the last three decades. I got in on the ground floor at Commonweal when we started building a barbwire fence around the watershed in 1976 so Commonweal could have clean water. Then I was designated the first director of the Residential Community, which was a great honor except that there was no residential community to run.
Instead I started Common Knowledge, a quarterly journal on environmental threats to public health, which was the first product of Commonweal's Research Institute. Using CETA money to hire researchers, we published in-depth articles about the dangers of pesticide contamination, microwave pollution, food additives, radioactive dumping at the Farallon Islands, indoor air pollution and noise pollution among other perils of the Chemical Age. We made maps of where toxic chemicals were handled in large quantities in California. We also helped educate the public about government plans to drill for oil off the northern California coast.
After being jailed for demonstrating against the construction of the Diablo Canyon nuclear power plant, I became interested in the institutional environment and how it affects health and behavior. I began writing about conditions of life at the California Youth Authority and juvenile facilities in five other states, adult prisons, as well as group homes for acting out adolescents in New York and foster-care facilities for troubled youth in Brooklyn.
With a grant from the Institute for Health Policy Studies I spent six months researching and writing about the ways in which toxic chemical and heavy metal wastes were regulated in the Philippines, Thailand, Malaysia and India. I then began working with a small group of non-profit activists in Washington, D.C. who were creating a network of non-profits interested in the negotiations leading up to the Earth Summit. I followed these negotiations for two years and published two paperback books about individuals doing sustainability work around the world. Earth Summit: Conversations with Architects of an Ecologically Sustainable Future and its sister volume, Beyond the Earth Summit: Conversations with Advocates of Sustainable Development, were circulated at the Earth Summit in Rio in 1992.
American state department officials at the Earth Summit argued that the U.S. didn't need to practice sustainable development because our nation had the best environmental regulatory regime on the planet and we were already developed. My own view was that this was nonsense and that the United States was the heart-of-the-beast and had a disproportionately large negative ecological footprint. Clearly, if humans were to avoid ecological collapse, it was essential that America join the effort to create sustainable technologies and practices. With this in mind I spent five years combing the country for cutting-edge sustainable practices. What came out of this work was my book, Eco-Pioneers: Practical Visionaries Solving Today's Environmental Problems.
Since then I have been writing about environmental justice and land use issues. Early on I wrote about the connection between cleaning up contaminated "brownfield" abandoned industrial sites in poor neighborhoods as a way of creating the conditions for community development. This introduced me to a number of the key players in the environmental justice movement and the impact that land use policy has on low-income and heavily-minority neighborhoods. My forthcoming book, Fair Growth: Building Mixed-Income Communities, deals with the interrelated issues of sprawl, racism, and poverty.
My current work, about low-income and minority residential populations on the fenceline with heavy industry and military bases, is a follow-up project that came out of writing Diamond: A Struggle for Environmental Justice in Louisiana's Chemical Corridor. My goal is to highlight the special vulnerabilities of fenceline residents and suggest that there needs to be a buffer zone around highly-polluting facilities and intensive environmental monitoring and health studies done of fenceline residents. There are thousands of fenceline communities around the nation. My efforts to tell the stories of fenceline residents and educate the public about the intolerable conditions and injustices that prevail in these neighborhoods is aimed at strengthening the hand of environmental justice activists so they have a series of case studies they can point to when arguing for funding and regulatory change. It is my hope that eventually fenceline communities will become a buzzword that denotes a public problem that needs to be solved in the same way that a decade ago the concept of "brownfields" focused new public funding and regulations to deal with abandoned, contaminated, inner-city industrial sites that required clean-up before development could take place.
Working at Commonweal has been a great privilege. Through Commonweal I met and collaborated with a number of committed and talented people who are motivated to be of service. These are people who care about preventing contamination and the disease it causes, creating a sustainable way of meeting our legitimate needs without damaging the web of life, and correcting injustices that cause untold suffering in vulnerable populations. I will continue to hold dear this community of colleagues and friends; I wish them well and I look forward to finding future projects that can be channeled through Commonweal.
Steve does not say how central he was to the heart of the Commonweal community during the first decade of Commonweal's work, when he was living in Bolinas. He also does not say what an irreplaceable source of support and counsel he has been for me for the three decades we have worked together. When we realized this transition had to take place, and were reflecting on what it meant to us both, Steve quietly observed to me that for thirty years we had felt safer working together. That is true.
Steve's shift from a salaried to a contract relationship with Commonweal reflects how very difficult it has become to find sustained support for the kind of in-depth environmental health and justice reporting that Steve does. Every program position at Commonweal must be supported by grants or other contributions. Over the past few years, foundation support for this kind of in-depth investigative reporting work has proven exceedingly difficult to find.
Steve hopes — and I share this hope — that he can find resources to enable him to continue the in-depth investigative reports on fenceline communities around the United States, whether through Commonweal or under other auspices. We have been posting these reports on the Collaborative on Health and the Environment website — www.healthandenvironment.org — if you want to read them.
Here is a poem by Marge Percy that captures what I have loved about working with Steve.
To Be of Use
The people I love the best
jump into work head first
without dallying in the shallows
and swim off with sure strokes almost out of sight.
They seem to become natives of that element,
the black sleek heads of seals
bouncing like half submerged balls.
I love people who harness themselves, an ox to a heavy cart,
who pull like water buffalo, with massive patience,
who strain in the mud and the muck to move things forward,
who do what has to be done, again and again.
I want to be with people who submerge
in the task, who go into the fields to harvest
and work in a row and pass the bags along,
who stand in the line and haul in their places,
who are not parlor generals and field deserters
but move in a common rhythm
when the food must come in or the fire be put out.
The work of the world is common as mud.
Botched, it smears the hands, crumbles to dust.
But the thing worth doing well done
has a shape that satisfies, clean and evident.
Greek amphoras for wine or oil,
Hopi vases that held corn, are put in museums
but you know they were made to be used.
The pitcher cries for water to carry
and a person for work that is real.
Thank you, Steve. I will miss working together.
Last Thoughts
I end this letter to you in the precious silence of the early morning. I feel the silence around me is also within me. It is the fertile silence out of which creation comes.
To grow older in good health is a great blessing. A dog, a cat, my wife Sharyle Patton and I, her mother Marianne, now 95, next door. Our old house on an acre of land with twenty fruit trees in blossom. Soon I will ride my bicycle through the crisp morning light two miles to an astonishing community of work and friendship. The wisdom traditions commend gratitude for our portion in life. Patanjali in the Yoga Sutras called this gratitude santosha. The Hebrew sages praised gratitude in The Ethics of the Fathers. Plato's Socrates embodied this gratitude. They all knew this gratitude is rooted in restraint. They also knew that restraint is anchored in alignment with a greater purpose. Jacob Needleman quotes the Roman stoic Marcus Aurelius in his elegant new book, Why Can't We Be Good:
For the philosophers of antiquity...for Pythagoras, Socrates, Plato, Aristotle and, in fact, for almost all other great thinkers up until our modern era, it was obvious that the universe is a vast, living organism permeated by an all-knowing conscious intelligence. "Always think of the universe as one living organism," writes Marcus [Aurelius], "with a single substance and a single soul; and observe how all things are submitted to the single perceptivity of this one whole, all are moved by its single impulse...According to Marcus, what he called the "single perceptivity" that permeates and governs the cosmos has been placed also within the soul of man in order to permeate and govern his mortal body in all its functions and actions. Unique in all the world, man is the creature who is endowed with an individual portion of the very flame of conscious attention that defines the power of the gods themselves — that is, the unchanging forces and laws that watch over and ultimately direct the universal world in which all things come into being, have their existence, and die. Only those of our actions that emanate directly and consciously from this portion of perceptivity or attention that is placed within ourselves have ultimate meaning and genuine moral force in our lives. And therefore, according to Marcus and the tradition which he represents, the aim of our lives must be to strive always to allow this inner, immortal flame of divine attention to illuminate and govern our actions and intentions...and to become available to its intentions day by day.
These ancient wisdom traditions, which experienced the universe as alive and taught that we can align ourselves with that ultimate Oneness, seem to me invaluable today. They can guide us toward ways of living our personal lives and contributing to the Great Work of return — of returning our tragic world to the path of the peaceable kingdom. The journey ahead is filled with perils. But dedicated and courageous friends walk with us. And we share a commitment to the greatest calling humanity has ever received. What greater joy can life hold than dedication to service to life? It is not given to us to know the outcome. It is only given to us to serve life until we breathe our last breath. All the great traditions have pointed this way. We need only follow.
Thank you for being part of the Commonweal community. We need your thoughts, your support, and your prayers. And do consider joining us in the New School. All you need to do is email thenewschool@commonweal.org. We learn and heal and find courage in community. We can walk this road together.
With warm best wishes,
Michael Lerner
President