Cope Lecture on the Effects of Nuclear Proliferation

by John E. Mack, M.D.

Oliver Cope Memorial Lecture,
Massachusetts General Hospital,
January 18, 1983

Dr. Mack [to Dr. Alex Leaf]: Thank you Alex. This is a great privilege for me to be able to be here and give this lecture, and I want to thank Dr. Cope and those of you for this opportunity and also for your courage in being willing to undertake, to have this be the subject — this serious matter of the threat of nuclear war — to be the subject of the Oliver Cope lecture. I think it is characteristic of Dr. Cope’s courage and willingness to look ahead and to stretch the boundaries of what we generally undertake in his willingness and his interest in having this matter addressed today.

INTRODUCTION

In four decades since World War II, the world has witnessed an obscene proliferation of instruments of mass destruction which threaten the survival of life on this planet. Like a metastasizing cancer, the nuclear arms race, led by the United States and the Soviet Union, is sapping the physical, emotional and moral health of our population. Unlike a cancer, a nuclear war, whose occurrence appears ever more imminent, may by man’s own hand bring in a few minutes the deaths of hundreds of millions of people, unimaginable suffering to as many others, and obliterate the cherished creations of thousands of years of human effort.

In my talk this afternoon I will look at some of the psychological effects of nuclear weapons without their ever being used, and then will consider the contributions that psychology and psychiatry may make to our understanding of the arms race itself and, potentially to reducing the threat of nuclear war.

II. MEDICAL ASPECTS – GENERAL/PSYCHIATRY

One Poseidon submarine holds enough nuclear missiles to destroy the major cities of the Soviet Union. And we have over 30 such submarines and they are simply one element in the arsenal of nuclear devices — weapons — that we have.

One of the most impressive experiences I had was to see John Constable, of this hospital, go through what one severe burn case can do to tie up the Shiners Burn Center. But can we imagine hundreds of thousands of such cases in this country, perhaps millions in the case of a nuclear exchange. How do we imagine 1 million Hiroshimas which is what there now are enough nuclear devices to create. There is the sheer horror and it s avoidance which inspires helplessness and apathy and withdrawal, and then there is a special one that we psychiatrists have which is kind of our expert tease of resistance which is that we have a way of explaining things. Something means something else; it doesn’t mean itself. We have difficulty with reality. On December 17th, just past there was a panel at the American Psychoanalytic Association entitled “Perspectives on the Nature of Psychic Reality”. External reality was referred to as the outside world. The true reality was the inner world but that the actualities of that outside world may affect the ways the mind looks upon reality was not the focus. The nuclear threat was not mentioned.

There is a corollary to this which is I think is more applicable to psychologists then to psychiatrists, but another motive for avoiding this issue has to do with the fact that it is not professional useful to get involved. A young psychologist, who is now doing a study of childrens’ responses to the arms race was discouraged from writing his Ph.D. thesis on the subject because he was told it was too subjective, it was too emotional, too value laden; he would have difficulty approaching it scientifically, so he had to leave his university to come to the Massachusetts Mental Health Center to do this work.

These resistances are beginning to be overcome. Partly as a result of work of physicians and other groups in breaking through the psychological barriers, and also as a consequence of actions and words on the part of leaders, which so obviously appear to increase the likelihood of nuclear war and seem to reflect a failure to grasp the raw essentials of what the use of nuclear weapons would actually bring about.

III. EFFECTS OF BOMB BEING USED: PSYCHOLOGICAL AND MORAL

The nuclear arms race has had disturbing effects on the physical and emotional health of our society – The increased rates of leukemia and cancer in parts of the Southwest, where atmospheric testing took place between 1951 and 1958, is an obvious example. (Last Aid, p. 251). There is increasing evidence that the arms race and the experience of living with the threat of imminent annihilation is having a destructive impact on the emotional well being and personality development of children and ado1escents.

Milton Schwebel and Sybylle Escalona conducted surveys around the time of the Cuban missile crisis of the perception of adolescents of the nuclear threat. These young people expressed doubts about the future and Escalona concluded, “The profound uncertainty about whether or not mankind has a foreseeable future exerts a corrosive and malignant influence upon important developmental processes in normal and well functioning children.” (1965, p. 201)

There was virtually no work on this subject for the next 12 years until the appointment of a task force of the American Psychiatric Association in 1977 to look at the psychosocial impact of what they called then “nuclear advances”. The euphemism was recognized and the title was changed to “nuclear developments”. The chapter that I was involved in confirmed the Escalona and Schwebel findings.

We demonstrated through questionnaires that were given to a thousand children in the Los Angeles, Baltimore and Boston areas that indeed there was profound fear on the part of children, a fear of the future doubt about whether they were going to grow up, encouragement of impulsivity, a sense of live for now, a sense of betrayal on the part of their parent’s generation and we raised questions about the impact on personality development that this sense of betrayal might have. We wondered particularly about the formation of serviceable ideals. If the formation of the vision of the future of how one would want to live one’s life, how one sets ahead the notion of what one values. If that depends on 2 elements, one is that the people that you look to are creating something you value in the world and secondly depends on your sense that there will be a future, then what happens to the formation of the ego ideal when that generation is not preserving the future and the future itself seems in doubt.

In the past few months we are hearing from younger and younger children and the parents and teachers of younger children about the threat and the fear of nuclear war. It is common now to get calls from parents of 9 year olds who are expressing fear that they will now grow up. The fear of dying in the nuclear war is now increasingly being expressed as a clinical complaint among child psychiatry patients and adult-patients as well. I was approached by the parents of an 11 year old girl, and the chief complaint was “My daughter wants to know if there will be time to commit suicide in the interval between when the warning that the bombs are coming and the actual explosion of the bombs occurs.”

Scott Haas, a psychology Ph.D. candidate administered questionnaires to 60 public high school students in Connecticut, and he found that the highest number of all their concerns, the highest number listed nuclear war among several issues that he listed. But there were many who did not list it, and there was an expression of apathy among q u it e a few which has not been our experience in interviewing kids, but it may be that when we interviewed them to give them an opportunity to say what they think and what they feel.

Lisa Goodman, a senior at Wesleyan, and I have been doing a study of 31 boys and girls that she interviewed in the Boston- Metropolitan area. They come various socio-economic backgrounds. When given the opportunity to talk with her and she is near their age, and they do speak freely and openly to her, they talk about the pervasiveness of the threat in their lives. They describe the double-edged attitude toward the future. On the one hand they doubt that there will be a future. They believe that nuclear war is likely or inevitable in their lifetime. At the same time they go ahead and make plans as if there would be a future. They feel unsafe in relation to our weapons or Soviet weapons. They feel equally insecure in relation to all nuclear weapons. Again, there is this impulsivity, the sense of live for now; a number of them attribute their increased drug use to efforts to blot out their experience and the threat of dying in a nuclear war. They describe the sense of things being out of control. As if the world were being run by technology and not by people. None of them believe in the possibility of a limited nuclear war. And they regard civil defense as a cruel hoax. The media now is increasingly filled with similar reports that confirm this general picture. The addiction of young people to these television electronic games in which the object is to increasingly run up a high score of keeping out the missiles that come in until eventually their defenses are overwhelmed is surely related to this threat and some effort to master it.

There are a number of survey studies that also confirm this picture. Psychiatrist Daniel Offer who has developed a highly respected self-evaluation test for adolescents has compared the findings from the early 1960’s with the sample from 1979-1980-1981. In the earlier samples, the young people were hopeful and had more belief in the future. Gerald Bachman at the Institute for Social Research at the University of Michigan has given questionnaire to 16,000 to 19,000 high school seniors and finds a fourfold increase from 1975 to 1982 among those who worry of t e n about the chance of nuclear war. Daniel Yankelovich summarizing survey data from the United States and Europe describes an intense experience of despair in Western Europe among young people. In a speech at the Harvard Medical School in December, Yankelovich described a pervasive attitude of gloom among young people throughout Western Europe and the United States which he related to the threat of nuclear war and the arms race; and I quote him:

“A sense of the future as being very threatening, as perhaps there not being a future, a future of grimness, of shortages, a closing of horizons.”

There is a slogan which is widespread in West Germany now, “No future.” The Roman Catholic Bishops have taken the leadership in confronting society with the immorality of the arms race. What is of central importance here for my discussion was: identified by Archbishop Joseph L. Bernardin of Chicago, since nominated to become a Cardinal. “It is,” and I quote him, “the intention to do what is morally evil” which is intolerable. But it is our intention as represented by our elected leaders. This after all, is the basis of a credible deterrent. It means you intend to use the weapons should the appropriate occasion arise. Now what effect can the intention to murder millions upon millions of innocent people in the pursuit of political aims which cannot possibly provide sufficient justification for such intentions have upon the moral development of young people who must draw upon examples offered by their parents generation.

In the remaining portions of this lecture I wish to consider some of the psychological forces which contribute to the perpetuation of the nuclear arms race. Einstein’s famous quote, “the unleashed power of the atom has changed everything, save our modes of thinking”, points to anachronisms of thought. I will identify several of the most prevalent in the hope by so doing they can gradually be made to lose their influence in the national debate now beginning to take place about nuclear weapons policy. First is the notion that nuclear weapons are like old weapons. Only bigger. Or really are weapons at all in the sense that they can be used militarily. Our language is anachronistic. We use words like “ahead,” “advantage.” You have read a lot in the papers of recent Russian proposals give them the “advantage” as if this has meaning in the nuclear context when there is such an excess of destruction. “Window of vulnerability”. “Winning”, “protracted nuclear war”, “prevailing”. All of these terms which have no appropriate meaning in the current context. They reflect a profound misunderstanding of the nature of nuclear weapons. As Panofsky and Keeny ask in a recent article in Foreign Affairs, they wonder how deeply has the reality of nuclear weapons penetrated the public consciousness. This defalcation of language Russell Baker calls Flegatongue.

A related rigidity of thinking is that new wars will be like old wars. You may have read the Pearl Harborizing of the MX debate over dense pack basing system, which took place between December 6th and December 8th. Defenders and opponents alike used images of surprise attack. The former, including the President, to stress the need for preparedness in order to avoid it, the latter , like Representative Jack Addabo a Democrat of Queens to point out the danger of “putting all of our missiles in one basket in one location.”

But there was no hint that any of these men grasped fundamental differences between missile systems and battle ships. This sort of thinking might be called the psychology of a false analogy. There are other areas of rigidified or distorted thinking that seem also to grow out of the inability to grasp the threatening impact upon a potential adversary of the development and planned deployment of advanced systems. Like the Trident II submarine, the Cruise and Pershing 2 missiles and the MX. These are created ostensibly as “bargaining chips” or for “defensive” purposes. But inasmuch as they can like the Pershing 2 reach the Soviet cities in 6 minutes or are undetectable like the Cruise Missile, or are of use only as first strike weapons like the MX, and are matched by no comparable technology, which is true of all of them in the Soviet Union. The other side can hardly and does not see these as primarily for defensive purposes.

Interestingly, the adolescents that we have questioned grasp clearly how unwise it is to frighten the Soviets with destabilizing weapons, to make them, as one girl put it, all “jittery,” thinking that we may be contemplating a first strike. A number of these adolescents question the defensive nature of our intentions. Admiral Noel Gayler reports that in simulated war games in which both sides are American, nuclear weapons moves, which one side makes for defensive purposes are inevitably seen as threatening and aggressive by the other. Sometimes the involvement with nuclear weapons leads to actual loss of touch with reality This appears to be the case in the dense pack basing mode plan. And here I have to rely on Kosta Tsipis, an M.I.T. physicist who studied it carefully. And this is from an article which he wrote on this subject:

“In the dense pack, 100 MX’s would be placed in silos 1,800 feet apart in alternating rows of twos and threes that would stretch in a nearly 14-mile north-south column. The Air Force expects that protection would be provided by “fratricide.”

Again, this desiccated, dehumanized language. To talk about a human matter in this way.

“By this, it means that a Soviet weapon detonating over one MX silo would be expected to destroy other incoming nuclear weapons before they reach their targets. Unfortunately,” he concludes, “physical reality does not support this theory of protection.”

No where does this loss of touch with reality seem more complete than in Civil Defense planning and there are many examples. General Daniel Graham, former Chairman of Coalition of Peach Through Strength in a meeting last fall said that ” if a one megaton bomb is on the way, all you have to do is run for an hour,” he said, “and hide under a bush.” My son, my second son, Kenny, realizing that the Brookline, Massachusetts plan was to evacuate to Laconia, New Hampshire became so incensed that he went around the town whipping up support for a Selectmen’s Meeting in which the townspeople showed up and the Selectmen voted to reject the Civil Defense Plan for the town which they up until that point didn’t even know we had.

Lewis G. Giufrida, head of the Federal Emergency Management Agency said, and I quote: “Nuke war would be a terrible mess, but it wouldn’t be unmanageable.” (p. 3) Most famous of all are the bizarre utterances of Thomas J. T. K. Jones. Now you are familiar with “the dirt that does it,” but there is more. Robert Scheer in his book With Enough Shovels: Reagan, Bush and Nuclear War, which I recommend to all of you describes his interview with Jones:

“Stabbing at his living-room carpet with an imaginary spade, he showed me how to dig a hole in even the hardest Siberian tundra so that a man could crawl in to it and protect himself from radiation by placing doors over the hole and three feet of dirt on top of the doors.”

Imagine, 6 feet of frozen tundra. Scheer asked him about radiation. He said, “Stay out of that area… go in to another area where it is not so hot, clean off the topsoil, scrape away the radioactive particles from the top of the dirt, go in to an area where there’s some surviving housing or something like that. .. Radioactive particles can attach to dust which sits there on top of the ground. If you go in with a power shovel or hand shovel and clean of f the top inch of dirt, mound it off somewhere out of the way, you’ve gotten rid of the radiation in that area.” Unquote. This is not atypical of the thinking t h at goes on about Civil Defense. T. K.’s mistake, Scheer said, was that he talked about shovels and dirt. He should have talked about intensive programs.” He made the madness palpable.

Limited nuclear war is another example of what Robert J. Lifton calls nuclear illusions. Sam Keen of Sausalito, California summed up this absurdity succinctly in a letter to the New York Times on November 30th.

“We have no evidence from history,” he write, “or human psychology to suggest that, under the insane conditions of a modern war, we would suddenly develop nuclear chivalry – a polite exchange of blows by the military.”

There is the positive attraction to the bomb. A certain attraction to its power. You may recall the Life Magazine issue in which the whole magazine was devoted to these beautifully colored missiles rising out of the sea, sweetly in rows or towering above smaller human beings and not one word about what their destructive purposes really were. According to Thomas Merton at Almagordo there was an atmosphere of devotion. These weapons spawn procreative images. Edward Teller asked after Trinity: “Is it a boy or a girl?” The Hiroshima device is called “Little Boy.” The Japanese called it “original child.” Poetess Denise Levertof believes the attraction to the bomb is deeply erotic, especially in males. Bertrand Russell said, “Our world has sprouted a weird conception of security and a warped sense of morality. Weapons are sheltered like treasures, while children are exposed to incineration.”

Perhaps the most dangerously outmoded way of thinking is our tendency to polarize perceptions of the world and to divide nations into friends and enemies, or to perceive countries as extreme representations of good and evil. In the first year of life the infant begins to divide the world into safe and threatened beings, protectors and strangers. Perceptual representations of these beings are internalized and structured in the mind. Which divides the world in to those who comfort and love us and make us feel good and objects which frustrate and frighten us. The polarization and pairing is embodied in our language good and evil, light and dark, God-loving and God-less. Further, the child is taught to distinguish our family, our group, our people from those who are different, alien and foreign, threatening.

Charles Pinderhughes, the psychoanalyst in Boston has developed the concept of paired differential bonding. Pinderhughes points out and documents that all bonds have a double element – all human attachments. Affiliative and connecting on the one hand, differentiating and aggressive on the other. According to Pinderhughes every society shows the result of differential bonding in belief, ideologies, religions, castes, classes and other divisions in to opposing camps. Each adversary hold idealizing illusions about self and devaluing about opponents. Nations form out of complex historical process. I said recently that the word “nation” in the Latin, natio, means “to be born” – not killed. The formation of nations relates to the in security of groups in primitive circumstances with limited resources. Nations serve fundamental, psychological functions. Belonging, of giving a sense of value. Ideology is structure, rigidly the assignment of values to one political system or another. And above all nations serve security and survival. When a people feel insecure they cling to the identity of their nation and its interests. The idea of the enemy grows out of historical experience. But the enemy is also an object onto which one can displace negative, unwanted aspects of oneself. All good resides in one’s nation, all evil in the adversary’s. Religion has its double-edge power to amplify these concepts. Religion can further polarize as in the Manichean division of the world into good and evil, between different religions; the alien, our own and the alien group. Or religion can serve to transcend or to connect. Gerome Frank has gone over Gallup surveys over the past several decades. He notes the qualities of we and they, in adversarial relationships do not change, only the names of the countries who are seen as friends or enemies. In 1966 when Gallup surveyed the responses to mainland China, predictably, the Chinese were seen as “warlike,” “treacherous,” and, being Orientals, “sly.” After President Nixon’s visit to China, however, almost immediately these adjectives disappeared about the Chinese, and they are now characterized as “hard-working,” “intelligent,” “artistic,” “progressive,” and “practical.” In short, “we” and our allies are “peace-loving and honorable,” “well-meaning and humane;” “they” are “treacherous and cruel,” and thus “evil.” He gives an illustration from Doonesbury by Gary Trudeau: “In one sequence BD went to Vietnam and was captured by a communist named Phred. At one point Phred gets a letter and BD asks, “Who’s that letter from?” And Phred says, “It’s from my mother.” BD looks at the reader with a puzzled expression and says, “I never knew commies had mothers.”

In its extreme form this division of the world as friends and enemies can become dehumanization which is particularly dangerous because when the enemy is deprived of all human qualities then one gives one’s self permission to wage war to destroy them and in this case it means suicide as well as destruction of the other side.

Erikson’s notion of pseudospeciation is another way of saying the same thing. That is the division of the human species in to different biologically separated groups. Again, attaching one’s sense of what is worthwhile to it s own group and what is alien to another. Once the polarity, the fear and evil are perceived in the other group, then anything goes. Lies, making up of statistics, become a lesser evil once the greater evil of the threatening other nations is defined. You can include the data that you choose. Leave out what is inconvenient to the argument.

The current justification for the arms race, for the entire mortal peril in which we now find ourselves, is “The Russians.” There are alternative explanations. Herbert York writes that the U.S. is mainly responsible for the momentum of the arms race because and I quote him, “Our science and technology are more dynamic. And we have less at virtually every stage of the arms rage. The Russians are now fitted in to the role of the enemy. And there is a reality. Soviet history, oppression of it s people and of Eastern Europe, of its Jewish population, the events of Poland and Afghanistan. But there is a caution in order here. Fact finders now coming back describe with horror a policy that we are supporting of genocide in Guatamalla and a systematic suicide in Nicaragua. But lets allow the worst possibility. Let’s assume the Soviet aggressive intent. Is the escalating production of unusable, sophisticated, destabilizing, suicidal weapons. “What else but suicide is that terrible mu1tip1ication of atomic missiles that our war department is up to in its secret dungeons,” Karl Menninger wrote to one of my colleagues just before Christmas. I s this the most effective way to deter the Soviet Union or change its behavior? Is there any evidence that our nuclear weapon overkill counted as strength has had any positive impact on deterring effect on Soviet behavior? At the very least one may agree with Mr. George McBundy, who after reciting a list of Soviet crimes and evils and omitting all of our own, concluded in a Washington Post article on Thursday (January 13, 1983),

“But it is a long wholly unjustified jump from these realities to the conclusion that we cannot do business with such men. They govern a great nation, and we must never assign to the Soviet people as a whole the offenses of their rulers. We are stuck on the same small planet, sharing the same thermonuclear danger. This reality alone is enough to require a strong and persistent effort to do most serious business with this unappealing regime.”

But we cannot stop here. For it is possible that our view of the Soviet Union is deeply affected by American ignorance of Soviet reality. Lisa Goodman’s adolescents acknowledged this ignorance and expressed a desire to learn more about the Soviet Union in their school. John Stremlow, Associate Director of International Relations for the Rockefeller Foundation in an address to American foundations and fund raisers in July bemoaned the abysmal state of Soviet studies in American colleges and universities. It seems as if such ignorance were serving the purpose of maintaining intact our hostile perceptions of the Soviet Union. The work of Marshall Shulman, Ralph White, Gregory Guroff, of the United States International Communications Agency has shown how each country maintains distorted images of the other.

The need to demonize the enemy, in the present instance the Soviet Union, has reached an extreme form, among many of the men now in leadership positions in our government. In Robert Scheer’s words, they seem “committed… to… a world in which all evil resided in the bosom of one’s enemy while all was virtuous at home.”

The most dangerous form of demonization and dehumanization is the equation of the Soviet Union with Nazi Germany and its leaders with Hitler. Seweryn Bialer, a Soviet expert and Polish émigré who has experienced both Nazi and Russian oppression, considers the comparison of the Soviet system and Nazism a most pernicious argument – erroneous and crippling. I have an example of this from a young state department friend of mine who was asked to brief a southern senator about Andropov just after he came here, so he – being a psychologically minded – one of the few – and reasonable analyst, he proceeded to go through Andropov’s K.B.G. experience and then he talked about how some aspects of him in some ways he was not so aggressive – that he was cautious and it was important that we look for common ground and throughout all of this the young staffer, clearly wanting to earn his spurs as a Soviet hater sat there with his teeth clenched and when the presentation was over he raised h is hand when he was called upon and he said, “That’s what they said about Himmler.” Once the mind has surrendered to this way of thinking, another example of the false analogy, then all efforts to find areas of common interest become appeasement. The President of Boston University arguing against the nuclear freeze and a debate just before the election raised the specter of Munich in 1938 in order to defeat his opponent.

I receive a lot of letters about the work that I do in this area, and most of them are supportive. But sometimes I receive ones that have to do with this Soviet-Nazi analogy. I’ll read you one of them which is in some ways characteristic. This is from a psychiatrist in Kansas. He writes, “Your effort to psychologize away the Soviet Union’s intent flies in the face of reality. In fact, it represents one aspect of a general trend toward denying the overall reality of the expansionist, hegemonic evils of that awful regime, just as did Mr. Chamberlain’s 1939 hegira to Adolph Hitler represent a denial of the same intent among the Nazi murderers. Will we never learn? I might invite you to spend some time out here in the Great Plains, where people are close to the soil and not immersed in the pseudo intellectuality and identity diffuseness and typifies so much of the Eastern megalopolis, including Greater Boston and Hyannisport. The Soviet Nazis don’t fool these people.” Out here in Kansas. Interestingly, this stereotyping and demonization of the Soviet Union has not been in evidence among the adolescents’ questions. They say, we are supposed to stereotype (their word) the Russians. The Russians are “supposed to be our enemy.” they say, “they must be as scared as we are.” Responsibility of the arms race is assigned evenly by them.

The work of physicians, scientists, psychologists and others to call the public’s attention to the nuclear peril, to rouse us from our apathy, and to identify the irrational assumptions which drive the arms race have, to a large extent, been successful. Yet the arms race continues. Why? I have no answer but I have some ideas about where to look.

I am taking part now in a seminar of the American Association for the Advancement of Science whose aim is to question assumptions, and in the group are strategic arms experts, historians, political scientists, Soviet experts, students of American politics – economists, psychiatrists – a number have had experience in the Department of Defense. Each person seems quick to object when somebody says what they really think the arms race is about, or what is causing it. Its not technology, it s not economics, it s not political. There seems an isolation of the parts. A fragmentation of the problem. I recently had the opportunity to interview a former high ranking member of the official from the Department of Defense, because I am curious about this matter. And this person described his philosophy of the Department of Defense. “We don’t interpret. We see what they have. That is the enemy. And what the enemy is capable of. We assume what they have they will use. And we recommend accordingly. We don’t know about intent. Someone else looks at that.” Now surely this is a prescription for mindless escalation and disaster. It is the pattern of forces, I think , the economic, political, technological, military, psychological forces which interlock. Domestically and in turn with some of their counterparts in the Soviet Union that I think must be looked at. A physicist, I think it was Bernie Feld, coming back from his Pugwash experience said that the American – so-called hawks, seemed to get along better with their Soviet hawk counterparts than they did with the Americans who thought differently than themselves. There are patterns of resistance to change which need to be looked at as whole and then in their totality, I think, there are deep vested interests in keeping things the same way. The most obvious of these is economic. The problem of conversion of our whole economy which depend so much on the arms race and our munitions production and all the related industries. But this is not the only vested interest. My own view. This is a vested interest of mine is that the greatest conservatism. The most intense vested interest is psychological and emotional. Driven by fear and lying in the ways we think in our attachment to old ways of thinking about relations among nations. The habit of settling differences by war and the readiness in which we divide national groups in to friends and enemies. If this zero sum world of we versus they could be transformed it might then become possible to see that the U.S. and the Soviet Union has far greater common interests than differences than bringing the arms race under control. I n preventing for example conflicts such as those occurring in the Middle East or the one that recently took place in the South Atlantic from escalating in to a nuclear holocaust.

A common interest in safeguarding the world against nuclear accidents and preventing the spread of nuclear weapons technology and finally in reversing the direction of weapons development and production. We would see that the profound distrust which exists between us and the Soviet Union is mutually created. We would realize that the actions on one side activate the responses on the other. We could discover that in this nuclear age we are yoked together. Indeed two apes on the same treadmill as Paul Warnke wrote in 1975. We would see our interconnectedness in that we have a vested interest in each other’s security. And that increasing Soviet security increases our own. We would not need to reject the Soviet overture as propaganda as the media and our leaders so regularly do. As History Professor Edward Pressen of City University of New York wrote last week in the New York Times:

“That an arms proposal is good propaganda does not mean that it is lacking in merit.” (January 11, 1983)

What is to be done?

What are our prescriptions?

First of all, if you haven’t already joined Physicians for Social Responsibility… Take responsibility for the problem. This is everyone’s problem. The arms race is not just a technological matter. It is a human problem created by human beings out of ingenuity, hostility and fear and will be solved by them. A nation’s health does affect its security. Howard Hiatt quotes Benjamin Disraeli:

“The health of the people is really the foundation upon which all their happiness and all their powers as a state depend.”

Arnold Relman, in the New England Journal of Medicine questions whether physicians have any special professional competence when it comes to political matters, such as the secretary of defense’s assertion which came from Mr. Weinberg had talked here at Boston. The Secretary of Defense’s assertion that U.S. nuclear forces are “inadequate” and the U.S. must build up it s strategic forces since “the road to peace is marked with preparations for war.” (NEJM, 9/16/82, p.745)

But what if we believe such policies endanger the health, well being, and lives of all peoples? What if as physicians, who treat the mind as well as the body, we identify the anachronisms, distortions of language, false assumptions, and irrational thinking contained in nuclear policies and programs of our own and other governments? Is it not our responsibility as physicians and citizens to be sure our voices are heard? How else are we to regain control of our destinies and reverse the present course?

Next we must confront the reality – somehow each of us must find his or her own way to come to grips with the nuclear horror to make it real so effective action can be taken. We need to support education in all matters relating to the nuclear age at the college, high school, and junior high levels.

We need to employ every possible avenue of approach to the Soviet Union. To overcome the stereotyping and demonization, to establish communication, to find areas of common interest, to support scientific and educational exchanges, support plans for teenagers to travel to the Soviet Union and for Soviet youth to come here to object and fight against Soviet wrongs but maintain our ties. We must seek to sort out Soviet realities and perspectives and distinguish them from our own participation in the need to divide the world into sub-species of friends and enemies.

I will end with two quotations. The first is from Karen Nelson, a sixteen year old girl from West Roxbury, Massachusetts:

“I just accept the world as a whole, she says, “and think of people as a whole force, not having divisions. Now its like, we just gotta join together, stand together, cause we’re all feeling the same way. We all need each other. We can’t do it alone.”

And the second is from Voltaire, who wrote in 1771:

“One should regard all human beings as one’s brothers, a Turk, a Chinaman, and a Siamese. We are all children of the same father, and creatures of the same God, who did not give us hearts to hate one another, nor hands to slay one another. Do not let trifling differences in language, religious customs, imperfect laws be signals for hatred and persecution among the puny atoms called mankind.”

Thank you.

  • John E. Mack, M.D. was a Pulitzer Prize-winning author and professor of psychiatry at Harvard Medical School.

© 1983 John E. Mack, M.D.
A tour-de-force lecture by John E. Mack, who was invited to speak on the subject of the nuclear arms race and physicians’ social responsibility, per Dr. Oliver Cope’s “great concern with the effects of nuclear proliferation”. One of Dr. Mack’s most acclaimed presentations, and a precursor to the awarding in 1985 of the Nobel Peace Prize to Physicians for Social Responsibility (PSR, then Directed by Dr. Mack) and International Physicians for the Prevention of Nuclear War (IPPNW) “for spreading authoritative information and by creating an awareness of the catastrophic consequences of atomic warfare.”

This text used OCR to convert paper pages into electronic form. Some minor errors may therefore be present.