I became fascinated with rivers and streams as a child, seeing them on maps and wondering how they worked. Regardless of their size, they have rhythms like the different settings on a metronome. Streams can be ‘ephemeral,’ and rivers can be filled with whitewater rapids in spring but can barely float a raft a few months later. Mountain lakes with natural or manmade earthen dams can be more dramatic if they fill to the brim in late spring. A rivulet may escape over the top of the dam, eroding a small channel. The channel will deepen and release more water until the dam breaks, sending a tsunami of water, soil, and rocks downhill.
The same is true, it seems, for the flow of allegations unleashed by the #MeToo movement. They have flowed and ebbed, dominating the news sometimes, followed by periods of quiet. The release of the Epstein files seems to be a mountain lake of incriminating documents: a flood of redacted documents, followed by renewed pressure for more.
Hugh Panero wrote an excellent column in the Talbot Spy on one celebrity caught in the flood. It focused on Dr. Peter Attia, the best-selling author of “Outlive,” a treatise on longevity and a new paradigm for health care. I recommend Hugh’s column to all Spy readers. He parsed the people named in the released files into (1) those who should face legal consequences, either for crimes they committed, damages they’ve done to their victims, or knowingly withheld information about crimes they witnessed or knew of; (2) those not guilty of any illegal acts, but who committed amoral acts of commission (e.g., profiting by their association with Epstein) or omission (having indirect knowledge through hearsay of illegal acts, but not speaking out); or (3) those who were connected with Epstein for reasons unrelated to his crimes.
My focus here is on the second group. How do we, as a society, respond to these people? Dr. Attia’s case provides a suitable example. Press coverage included examples of his crude banter with and about Epstein, while also noting the absence of connections to any illegal activity, either as a participant or observer. In my view, this would place his behavior in the ‘lawful but awful’ category of group 2.
I was horrified and felt duped by the news of Attia’s connection with and apparent fascination with Epstein. A friend had recommended Outlive to me at a time when I was dealing with several medical issues. I gleaned many specific ideas about my health from the book, and it changed my attitude toward my medical care and relationships with doctors. I followed Attia’s advice and recommended his book to many friends and associates.
Outlive paints a revealing picture of how medicine was and is practiced, dividing it into three phases. ‘Medicine 1.0’ spans the time from Ancient Greece to the discovery of how cells can be infected by microbes. ‘Medicine 2.0’ has been the norm since WW II, according to Attia, and I recognized it as the approach my primary care physicians had been using. I would undergo standard annual tests, discuss the results with the doctor, only to have him brush off abnormal test results, almost without exception, as “something we’ll keep an eye on”. As Attia put it, Medicine 2.0 doesn’t take action without symptoms and test results showing a serious illness advancing or possible death within a ten-year period.
A significant part of the book was devoted to the four deadliest diseases and recently developed indicators of their developing presence. They are cardiovascular disease, cancer, Type 2 diabetes, and Alzheimer’s and other neurodegenerative diseases. The book describes the progression of these diseases and the specific, measurable markers that indicate their early development. ‘Medicine 3.0’ uses these markers to identify potential diseases early; 3.0 practitioners use these canaries in the coal mine to discover the presence of disease, and immediately focus on managing and slowing the progression of disease.
One chapter focuses on strength, fitness, and balance, because injuries from falls like broken hips often start the final decline in health and wellness among the elderly. Our strength and balance decline as we age, but with effort we can slow the process significantly. How strong would I have to be at my age to still be able to enjoy life in 10, 20, or 30 years? Which exercises would I need to start doing now to slow the aging process and reach my goals?
These chapters really caught my attention and led me to new habits of self-care and fitness. I reviewed all my test results going back ten years and compared them to the recently developed tests described in the book. Most of the recently discovered early disease indicators were absent from my medical files. I made a list of the additional tests that I wanted done. I had recently replaced my Bethesda primary care doc with someone on the shore, and I wondered how he would react. Would he be offended by a new patient telling him how to do his job, or would he see me as his collaborator and an informed advocate for my own health? Luckily, he was enthusiastic about my list and exploring the 3.0 approach.
The final chapter took me by surprise. It focused on emotional health and it included Attia’s recounting of his own emotional disorders and struggles. It was extremely confessional and filled with expressions of his feelings of guilt and shame, as well as his treatment and self-improvement. He didn’t mention his specific transgressions or any connections to Epstein, but having read this chapter I was not surprised by his presence in Epstein’s files.
That’s the basis for my focus on Group 2. My experiences after reading Outlive (twice) may prove to be life-changing (and death-changing, I hope.) I don’t know the exact nature and extent of Attia’s wrongdoing, beyond his boorish, misogynistic, and offensive remarks in the most recent release of Epstein files. I’m repelled and disappointed, but I’m also conscious of the great good he is doing for medical care and did for me. I don’t know whether his treatment and recovery from emotional problems came before or after his Epstein association, but I’d like to know.
Attia is one of many celebrities who have made significant contributions, while also showing failures of judgment and character. Al Franken of Minnesota comes to mind. He was an effective and well-regarded Senator hounded out of office early in the #MeToo Movement. ‘Cancel Culture’ was near its high point at that time.
The outlook for Attia, Franken, and others in Group 2 is that they will live under an inescapable cloud, even if they engage the best damage control experts, as Panero’s column predicted. We will be poorer as a society if there contributions have ended.
There is an alternative. “Truth and Reconciliation” processes have brought wrong-doers and their victims together in a public forum. The goal is to allow each side to express their truths – their confessions, remorse, pain, and anger – to bring closure to them and provide lessons to the rest of us. I hope it has the potential to make our society more just and compassionate.
It’s a big topic – too big to address here. I hope my research will lead to a second column on this topic and I invite your reactions in the comment section.
Should I drop the subject, or do you find it worth exploring?