It was such a pleasure talking with Dr. Dick Jackson, a truly pivotal figure in Children’s Environmental Health (CEH). With Dr. Lynn Goldman, he helped found the Children’s Environmental Health Network (CEHN) in California before they both moved to the Federal Government, Lynn to EPA as an Assistant Administrator, and Dick to CDC as a Center Director. In California, Jackson led the Office of Environmental Health Hazard Assessment, which became a full department when the California EPA was established in 1990. He then went on to lead the CDC’s National Center for Environmental Health (NCEH). He advanced CDC’s influential Biomonitoring Project analyzing representative and statistically robust samples of blood and urine in American people: in a way, it was like a doctor checking the chemistry and cells of your body in order to evaluate your health using data from NHANES. He has gone on to write and speak extensively about the importance of looking at what is in the bodies of the people, and then to look at how their near environments, the built environments where we live and work, are affecting human health. In later years, he was a professor at UCLA.
We had more in common than, perhaps, either of us suspected at the beginning, both brought up in a Catholic ethos, his Jesuit, mine Benedictine. In my last book, I argued that we need better, more holistic metaphors, gained from various traditions and perspectives, including Dante’s Communion of Saints, a vision of a community joined throughout time – from the past and into the future – multivarious, whole, many in one. Dr. Jackson described making the shift from “personal” physician to public health expert as shifting from thinking of his patient as one individual to one corporate body, made up of 330 million cells, all flourishing together as one organism. What a beautiful metaphor, and as we discuss below, a metaphor that is needed to counter the corrosive cynicism that has evolved from the selfish and greedy behavior of public figures. Like many scientists and physicians I have interviewed, Dr. Jackson describes an origin story that heightened his awareness of the essentials of health, that gave him the values that have supported his unusual career, and that lent insight into the bigger picture of how we can achieve greater health and happiness as a community, as a whole human society.
This interview has been lightly edited for length and clarity.
JMK: Hello, Dr. Jackson! Such a pleasure to meet you!
RJJ: It's my pleasure to meet you, Jean-Marie.
JMK: Well, let us get right down to business, because I know your time is valuable, and I greatly appreciate speaking to you. I have a list of questions, but really, I just want to hear your stories – because I know you are a pivotal figure in children's environmental health. I first want to know about how you ended up getting where you are. Was there some story from your childhood or your early training, or how did you get here?
RJJ: I sent you that talk I gave at Saint Peter's College, the small Jesuit college in Jersey City that I attended during the Vietnam era. I did that in part because I put more work into that talk than I would normally; I wanted to convey the arc of a life in health and in service. It wasn't a technical talk; it was a humble reflection at age 77. I really wanted to speak about what I learned were the most important things in life. My college was very working-class. I was first-generation college, and most of these kids were then and still are. And the business about having a vision, about where you're going and looking within your own life experiences is essential – because your own life experiences, good and bad, will shape your own sense of what is important in life.
And I talked about suddenly losing my father to polio when I was three years old, my mother being a widow with three babies. I didn't realize it, but it embedded in my DNA what was important – it was about life; it was about family. It was about not being sick, about the lethality of disease. I thought that health was feeling good and playing sports, but I didn’t know – it’s the lifespan as well. And I do now know how much these experiences had shaped me.
When I was little, we had been living near Portland, Maine where my father was running air traffic control at the airport. Robert Jackson was an Army Air Corps pilot in the South Pacific, and I was later told that half his squadron had not survived. After Bob’s death, we moved back to Newark. New Jersey is called the Garden State, but it’s actually, sadly, the densest, richest state per capita with an immense number of petrochemical industries. Many of the chemistry, fragrance, and pharmaceutical manufacturers were right there along the NJ Turnpike and Garden State Parkway. My mother would tell me about her growing up in East Orange and seeing women with their jaws rotted off because they had been painting radium dials in a nearby (well lit) production facility. A good portion of the work was originally for aircraft because when flying at night, pilots needed their night vision but also needed to see the dials on the control panel. Environment contamination and worker poisoning – in this case of diligent young women – were a palpable reality in my growing up.
I tell the story that Hoffman La Roche was right there in my little town of Nutley – we would go and play in the creek that came out of there, and we would see how many deformed tadpoles we could find. My youngest brother – brilliant, a good athlete, and the father of two college sons – died of what was basically mesothelioma at age 60. So the importance of environmental threats was very real in my life. I also underestimated the social, economic, and political power of the petrochemical and the pharmaceutical industries. They are joined, including with interlocked directorates.
JMK: Yes, absolutely. My former husband worked for BP, and when he wasn’t working on oil refineries, he would just switch over to plastics. And I know New Jersey has a much higher rate of autism spectrum disorder (ASD) than most other states.
RJJ: I didn’t know that. But among faculty at UC Berkeley, UCSF, and UCLA, it seems that about a third have children on the spectrum. It’s more prevalent among highly educated people, but also the obsessive portion of ASD can be an asset in many disciplines. In medicine, we sometimes joke that we all have “obsessive-compulsive advantage.”
JMK: Yes – I have friends whose kids are on the spectrum. One of my friends has a son who is hyperlexic. So perhaps there is something to that – but also, educated people might have a higher proportion of older fathers, which is correlated to ASD.
You've done so many things, and I especially think it's wonderful that you and Lynn Goldman helped to originate CEHN (Children’s Environmental Health Network). I talked to Nse Witherspoon just a few weeks ago and heard a lot of the history about that. You've done a lot of research. And you're a healthcare practitioner. Is there one thing, or maybe a few things, of which you are proudest?
RJJ: I’m most proud of my children and grandchildren and my family. And I'm not making that up. You know, after all is said and done, that's the most important thing.
Secondly, I am very proud of the work we did around farm worker health and getting the laws passed in California. Lynn Goldman worked on one of the cancer clusters down in the Central Valley. What came out of that was we were able politically to put in place full reporting of all pesticide use in California. We are the only state now, for 20 years, that has all the record keeping, which has led to important information around Parkinson's and other disorders.
You probably will along the way talk to Irva Hertz-Picciotto at UC Davis. This second example is very important. It was outrageous that the pesticide residues in food were based on the diets of 70kg men on a couch rather than on highly exposed children. Children eat, drink, and breathe three as much as an adult. I wasn’t allowed to do politics, so it all had to be through the back channel and through the American Academy of Pediatrics (AAP) to get the National Academies of Sciences, Engineering and Medicine (NASEM) report on Pesticides in the Diets of Infants and Children. Phil Landrigan was the lead on that, but I did a lot of the technical stuff on that report. That led to the Food Quality Protection Act, which Lynn was very influential on because she was then the Assistant Administrator at EPA for Pesticides and Toxics. And then, when I got to the CDC, I empowered and got funded biomonitoring because an endless frustration in my life was learning of appalling exposures to farmworkers, other workers, and children – and products brought high and hazardous chemical exposure. When I learned that children’s pacifiers were 50% phthalates, I could not help feeling outrage. Plastic baby bottles had phthalates, and food containers had bisphenol A, and cans were soldered closed with lead. With lead, we could measure how much of it was in a child, but for many of the other chemicals, we had no useful data about human exposures.
Recently, the National Childhood Lead Poisoning Prevention Program found children in North Carolina with elevated lead levels, and it took research to track it back to these pouches of applesauce being brought in from Ecuador. We rightly look at the food, but we need to look at what is happening to people. Having biomonitoring and the ability to accurately measure what was in people was important to individuals, but also to populations, and ultimately to policy.
That was one of the most important aspects of the movement against tobacco harms. The tobacco industry was claiming that non-smokers weren’t really being exposed. It was the CDC data when I was the center director that measured cotinine levels in the U.S. population. It could show even kids living in a house with a smoker had elevated cotinine levels. By the way, the tobacco industry said, oh, that’s from eating plants in the Solanumfamily like tomatoes and eggplant, and in truth, you do get a little cotinine from eating those plants – because they are in the same family as tobacco. But the levels are much less than you get sitting in a car with grandpa when he’s smoking. The biomonitoring was very important.
In the early 2000’s, I had the insight that we are building America in ways that are fundamentally unhealthy, and I began to talk a lot more about architecture and urban planning, and that was fun because it was more forward-focused rather than going back and trying to undo past harms. And I learned so much doing this work.
JMK: Yes – I loved that section of your talk – and the idea of this all being part of a syndemic. And how many of our health problems are related to the way that we have built modern society? It’s amazing that you are the one who stood up CDC Biomonitoring Project using NHANES data – I teach that to my class every year. I particularly liked the report that included successes – like lead and secondhand smoking – as well as new challenges. I point out to my students that cotinine levels in children went down as a result of changed policies.
RJJ: You know the first step in all that was to measure cotinine levels in flight attendants.And there’s a lesson in this – can you imagine – what could be worse than having to run back and forth on an airplane filled with smokers, working very hard in a lower-oxygen atmosphere? My predecessors at CDC were able to measure the cotinine levels in the blood and urine of the flight attendants, and the lesson for the students I use is that this was a very sympathetic group. They are not doing something stupid – they are trying to earn a living, and they are being victimized by an absurd policy of allowing smoking in pressurized aluminum tubes.
JMK: Right? I'm old enough to remember when the tide turned against tobacco, and I know that what made the difference was the second-hand smokers – because they didn't choose that. And the same is true for so many of the chemical exposures we have – that we don't choose those exposures.
RJJ: There is a kernel in this that you will appreciate, which is, and it’s a little embarrassing to say – when we started the childhood lead poisoning work in the early 80’s, Newsweekmagazine put a picture of a child living in an environment that was lead-contaminated with paint and other things. It was a beautiful white child – not a poor black child. And I know that sounds cynical, but we see this same thing elsewhere. Rich people here on the coast of California love fresh organic food but don’t think much about poor farmworkers who are working twelve-hour days in the brutal heat, with literally 1000 times more pesticide exposure than a food consumer.
JMK: Absolutely. There was a paper (Lu et al. 2006) that convinced me that I was benefiting my children by buying organic food. But before that, I did it for the farmworkers’ children because they're exposed at much higher levels.
RJJ: And you know, the loop closes because the number of farm worker poisonings has gone down dramatically because the surveillance for chemicals in the food production system is much better, and so the growers don't want to have box cars full of apples condemned. So they are much more scrupulous now than they were at the beginning.
JMK: Too bad they weren't inspired by human health.
RJJ: Yes – it’s money.
JMK: Absolutely. So you're a physician. You must have conversations with parents at times about your work on exposures, and I think it can be difficult to frame that, because it's a topic that is essential to communicate about, but that can be productive of anxiety and guilt among parents, or at least there's a perception that that could be the case. Do you have a take on that?
RJJ: I will confess, Jean-Marie, that as my career became more and more technical, political advocacy, travel, and speeches, I became less and less of a clinician, although I kept those friendships, and I read my pediatric journal every month, and all the rest. But where I'm going with that is – and actually, you'll appreciate this in your own teaching – you shift from thinking about your patient as one person to thinking about your patient as the population – an organism of my country with 330 million cells. It's a reframing. And by the way – you teach at Benedictine University; I was totally prepared for this spiritually and emotionally because in my Jesuit training, we thought a lot about the mystical body of Christ, and how we were all part of the body of Christ. In some ways, there’s a real transferability over to thinking about public health.
The hardest thing we have to do in medicine, of course, is to tell parents that their child has been killed in a car crash or something else. It’s just awful, at least for me, and I think it was true for everybody. You become very attached to some of these children who were dying. There were days I could barely talk when I got home. But you know this because you’ve been through it.
That first meeting when the child is diagnosed with, for example, leukemia – you have to both be very sensitive – and also very direct because that family likely must confront surgery, chemo, perhaps radiation, and maybe amputation. So you have to be very serious at that point and say, this is going to be very difficult, and it pains me to tell you all this. But then you never end the conversation that way. You go on from there: here are the options; here is the success rate. The point of this is the importance of being truthful, and yes, you have to raise anxiety, but not leave them there. As Pope Francis would say, despair is not an option. We need to face our pain and then work through it.
JMK: Absolutely. That’s also very Catholic. It’s so funny what you said about the corporate body – that is something I wrote about in my book, that we sometimes need to think using religious models like the Communion of Saints, to understand that we have connections to people from the past who are gone, and connections to people in the future we may never meet. We're all part of one whole, and a lot of very different religions do have a way of conceptualizing that. I love that you think that's your patient. It just makes a lot of sense.
RJJ: In medicine – the patient comes in, and the chief complaint is, perhaps, a sore toe, but then you discover that they have lupus or diabetes and early gangrene. The analogy in public health is that so often, those who are in the most pain are warning us of systemic disease, and those who are disenfranchised poor, maybe environmentally poisoned or impacted, are alerting us to systemic illness in the body politic.
I was once on a radio show with a Rush Limbaugh wannabee. He said to me at the beginning of the show, this is Richard Jackson. He’s a doctor with the State Health Department. He’s from the government. He says he’s going to help us, and we all know that government is worthless and that they don’t really care about us. And I said no – the purpose of Public Health is to assure the conditions where people can be healthy, and I’m not going to order people to do things, but I sure want them to know how they can be healthy. I want to assure that how systems are set up – whether it's transportation or food, or you name it – should make it easier for people to be healthy, not harder.
JMK: Yes – absolutely. I also wanted to follow up on what you said about that conversation with the parents. I am actually going to reach out to my daughter’s oncologists. They were just beloved figures in our lives, and I remember, even at the hardest moments, having a little bit of feeling for them, that they had to tell us this terrible news. And they loved her, too. They got to know her over years. I think there's a lot of compassion there.
RJJ: I couldn't do it. I am embarrassed to say – it may be from my own childhood loss – that I am a little too vulnerable, and I needed to think and work at more of a meta level – that of the population rather than the individual. You know what I’m saying.
JMK: Yes – I do know. It's just tough. One thing: Public Health sorts out some of the best people. And I will tell you, pediatric oncology sorts out some of the best people, right? No one goes into that for the money.
RJJ: They are saints.
JMK: Absolutely – I just love those people.
RJJ: Where was she treated?
JMK: She was diagnosed here in the Chicago region. We went to Christ Hospital – Hope Hospital is the associated Children's Hospital. When she relapsed and needed a bone marrow transplant, we went to Children's Hospital of Wisconsin and received excellent care. She had two bone marrow transplants, and they bought us precious time with her. You know, a year is really important when you are only seven years old. So I remain eternally grateful.
The next question is about policy, because I think you're right. We see individuals suffering, but a lot of times, it's from the larger structure of how things are made in society. If you suddenly had the power to do whatever you thought right, what would you do with U.S. policy regulating environmental chemicals? What would that look like?
RJJ: Well, I'm glad you asked. We should not be producing chemicals that are indestructible like PFAS. We don't synthesize lead; it’s an element, an atom that is not destructible by biological systems. We should not be sticking halogens like bromine and fluorine to organic molecules because Mother Nature has not yet figured out how to degrade them. It’s one of the reasons they are manufactured; they work well and are tough; they last a long time. Why can’t our clothes be made, if not from natural fibers, then from synthetics that could be valuably reused or turned into compost, unlike polyester, which degrades over many decades? And many non-destructible chemicals are released into the environment and bioaccumulate right up to whales and polar bears. Whales have enough flame retardant in them to make them almost non-flammable.
Our first effort should be getting rid of the worst chemicals before production, not after. We know the chemicals that don't break down –It’s part of the sales pitch. We use them because they are nearly indestructible: for firefighting foam, and other such things. We are learning more and more what the structures are that confer cancer risks, whether it’s epigenetic or other kinds of structural activities. We must develop the ability to do this: it is unforgivable not to do this. By the way, the neonicotinoid insecticides and fungicides that are used on corn – huge amounts – end up in the drinking water of virtually every child in the Midwestern United States, very low levels. But they're there.
Three is that we ought to do sensible cost-benefit calculations incorporating health benefits into it. So something like 30% of all the corn planted in the United States is being used to produce ethanol. It’s only being continued now because growers are one of six big corporations with huge political power. It’s not doing anyone much good. We ought to be supporting families as much as we support corporations. The greatest gift in your daughter’s life was her family, I am sure.
I think some of the crazy angry “acting out” in the United States, where people are outraged and inflamed, is because it’s so damn hard for people – it’s fearful and lonely. I know a lot of immigrants who come to the U.S. say, yes, it’s better than being in a war zone, but it’s not an easy place to live. It’s a very lonely and challenging place.
JMK: Yes. We are in the top ten for per capita income, but number 15 to 20 for happiness. It’s very clear we’re not at the top for happiness.
RJJ: We live six to seven years less than people in other wealthy countries. My son is now a physician at CDC. But when he was in college, he did a study in the rainforest of Costa Rica, and he sent me a note one day and said, “Dad, Costa Rica spends seven times less per capita on medical care than the U.S., and they live five years longer.”
JMK: My goodness!
RJJ: I put it at the end of the talk – you know, that was more effective than any speech I could have given them.
JMK: Yes, we spend so much for so little. It doesn't have to be this way, but of course, medicine is now for-profit.
RJJ: You said it so well. The medical community has succumbed to the disease of greed as much as anybody else has.
JMK: I'll take it from you – you know better than I. I always like to think the best of people. But I have a friend who's a theologian who talks about structural sin. I remember hearing a former head of the AMA say places like Cleveland Clinic, where physicians are salaried,tend to spend less per patient. They don't do unnecessary procedures, and it is truly unfortunate that anyone does.
RJJ: Do you know about the Lown Institute’s Shkreli Awards for the biggest crooks in medicine? One of the first people was the head of a Catholic healthcare system who was making 11 million dollars a year working in a non-profit.
JMK: That is criminal.
The next question is the central question of both the last book I wrote and the next book project: if we know we're poisoning our children and destroying our climate, and we know there are solutions ready at hand, why are we not implementing them? Or broadly said, how is it that we are being so stupid? Earnestly said, how is it this is happening?
RJJ: I would argue that the vested interests have become so powerful; take, for example Monsanto, which makes Round-Up (glyphosate). Now, when government tries to move on a bunch of these things, industry has bought off so many experts that they make the argument that you have to look at the preponderance of evidence, and then they flood the government agencies that are trying to look at this with many of their studies.
And you know, if you're paying a million dollars for researchers to do a study on this, and the meta message is, we really want to disprove that this causes cancer or this or that harm. It's very easy to do negative studies. And then they literally flood the political process, the legal and the regulatory process with a lot of half-baked, often bogus data, and it takes real courage to stand up to them. A dear friend of mine was on the IARC Committee (International Agency for Research on Cancer). They were the ones who said glyphosate is a probable human carcinogen. And she was sued. Here's this good, honest PhD scientist, Harvard trained, and suddenly she is subject to a huge lawsuit. She was a California employee, but she had done it pro bono for the United Nation’s IARC. And now she's being harassed and threatened by this powerful corporation. It reminds me a little bit of Rudy Giuliani picking on the two African American election workers in Atlanta. Nobody can stand up to this kind of stuff, and so the power imbalance is profound, and it's one of the reasons a book like yours calling out these issues is so important. My colleague Tracey Woodruff in the group at UCSF is much more deeply informed on this than I am, and she talks about how the system is designed not to identify problems. There’s an ugly quote that I don’t think I will quite get, “never try and convince a man….” What is it?
JMK: It’s Upton Sinclair: “it is difficult to get a man to understand something when his salary depends on his not understanding it.” [We both laugh.]
RJJ: That will be on the flyleaf of your book.
JMK: I'm writing an article right now. Mark Miller said I should try to get some of these stories into The New Yorker or The Atlantic in the near future. It's a long shot. But I'm going to try because he told me to. And I’ve used that quote because it does seem like that is what is happening. People are greedy, and even if they're not fully aware of it themselves, I think they are influenced.
RJJ: It's always like this, but it seems much worse, and the power is now reinforced because the directorates are so interlocking. The meeting Tracey’s group ran was about how the food industry has used the original tobacco strategies. The lead industry used the tobacco strategies, and over and over again, this method was deployed.
For example, the message is that certain colors are more important to some populations – that’s all been segmented. They are able to say that this is the fragrance to get 17-year-olds to use this kind of smoke-free cigarette. And this is how you get them to want this kind of Kool-Aid or other kinds of food. The sophistication level is astounding. Read Laura Schmidt’s work around the stacking of incentives that created the obesity epidemic. The obesity epidemic has multiple causes, one of which is that we’ve designed exercise out of people’s lives. But the other part of this is these hyperpalatable, tasty, but extremely processed foods that move into your bloodstream very rapidly. And they taste really good – I still love potato chips – I’m not proud of it. It's almost irresistible, especially if there are five ads an hour at every football game you watch.
JMK: Is she among those showing that highly processed food, compared to equivalent food that is not highly processed, is so much worse on all those measures we care about? I will look her up for sure. You know I worry about NAMs (New Approach Methodologies), too. I'm concerned that you said that the system is designed to not find problems. And it seems like they are designing systems that are very sophisticated to not find problems, and yes, to laden into us as many of these calories and chemicals as they can.
RJJ: You know who Lily Tomlin is, right? Her best quote, in my opinion, is, “no matter how cynical I get, I just can’t keep up.” It’s OK to be stoic, but I think it’s wrong to be a cynic. Cheap cynicism is a totally useless emotion.
JMK: Yes – but especially the work of Naomi Oreskes, Merchants of Doubt, has shown what you are saying. I teach that all the time, and it’s hard. I advise students that their mental health may take a blow in my class.
RJJ: I tread carefully. I don’t want students to think that it's all hopeless and become sour – that would be the wrong message in a Benedictine school.
JMK: Yes – I end with solutions every time.
Okay, I'm going to try to respect your time and just have two more questions. One question is, what do you see happening with children's health by the year 2050?
RJJ: I don’t know. I had a physician salary in government, so I was able to educate my children and buy a house, and people who have decent incomes and support systems stay married, and people who stay married with a steady income do better – I'm not saying this from a moral standpoint. It is so hard to be poor in this country. Many people have such meagre support systems, and those becoming a single parent on top of that have it that much harder. And you've said this. Having a child with cancer is a big predictor of marital dissolution. In fact, I took care of the child whose mother started Candlelighters in the Bay area. The stress in a family with support systems is extreme. Family and community are not luxuries; they are life essential.
Unless we reform our economy, unless we reform our legal system, unless we get back to, in my opinion, the fundamental democratic principles that undergird Canada and the U.S., I don't see it getting any better. I love that Canada has “peace, liberty, and good government” rather than “life, liberty, and the pursuit of happiness.”
A number of articles coming out foresee this massive decrease in population by 2050. But it’s economists talking about how it’s bad, not sociologists. We know that in my children's lifetime, probably all the physical work will be done by immigrants. It's already happening. But in the 1950s, there were about six workers for every retiree, and now it's down to almost one to one, and it's going to become a point where there's more retirees than workers.
JMK: There is a lot of reason not to feel hopeful. I really love how The Lancet frames it. They say there are two pathways, and it depends on what we choose right now.
My last question is if you would like to ask anything about my project or about my experiences.
RJJ: I got a kick out of the fact that you were from a Benedictine school. After my dad died, and we moved to Jersey, my mother's first cousin, who she grew up next to and was very close to, was Stephen Findlay, OSB, who started Delbarton, a Benedictine school in Jersey. Father Stephen introduced my mother to Richard Hughes, a widower with three or four kids who was on the Supreme Court of New Jersey at the time. My mother said, no, I don't want that public a life. He ended up being governor for eight years. But she did remarry and have four more wonderful children, and I had a good stepdad. But where I'm going with that is, I have such mixed feelings about the Catholic Church. I was a Jesuit novice, you know, for a couple of years. But when I read Humanae Vitae, and I read it in Latin, I'm thinking, this is stupid to be against contraception. I really had a very hard time with it, and so I don't know if you agree with me on that. But I'd be interested to hear how you navigate those conflicts. Because I found the Benedictines to be more doctrinaire than the Jesuits.
JMK: That is a good question. We recently separated from our sponsoring community. Some unfortunate things happened – but we still feel very influenced by them. We're still very close to many of those monks. Since the Order of St. Benedict was our sponsoring abbey, previously, the Abbot had been our Chancellor, and it wasn't working very well as the community shrank. We've lost so many of our monks; two of my best friends among the monks have just died in the last few months. I will say that there was sometimes a little bit of pressure over certain issues, and especially around LGBTQ issues. Overall, I would say we're very welcoming to a broad array of people. Honestly, I have read an argument that the position on contraception is a teaching that has not been received by the people of the Catholic Church, and therefore it is no teaching at all. Something like 97% of practicing Catholic women have used contraception at some point.
We are also extremely religiously diverse, which is so interesting. Among students who identify a religion, we’re 25% Muslim. And our previous President embraced that and said, one of our values is hospitality, and we will welcome all people as Christ. Also, my Muslim students and their parents feel more comfortable with us because we have stated values and are hospitable to people who are religious. So I would say that, if anything, I have felt more free teaching at Benedictine than I did when I taught at University of Michigan as a grad student. I'm not hyper religious. I'm very much an academic, though I am a cradle Catholic, but I think it's just that sense of shared values, values that are shared with many different religions and with people who are non-religious. We believe in respect for persons; we believe in the common good. And that is quite counter to a lot of our secular society in ways that we've just been talking about.
RJJ: This is silly, but you might get a laugh about it – if you look me up at the University of California, Berkeley School of Public Health, when they had their seventy-fifth anniversary, they named 75 of their graduates that they were proud of, and so they call me up to interview me. And they said, Well, who are the people you'd like to have dinner with, and I said if I could pick whoever I want, I think I'd want Jesus, Mohammed, the Buddha, and Chuck Darwin, and they thought I was being a wiseass, but I wasn’t. I think that Jesus wouldn't be sitting there arguing with Mohammed and Buddha; it would have been fine, and Darwin was simply describing the world as he saw it. But I love what you just said, because so many of us humans approach others with preexisting prejudices that don't allow us to be fully alive and don't accept the reality of other people adequately. As I say this, I realize it's exhausting to be so hunkered down and closed. And I don’t know if I should say it this way, but one of the joys in life is to be accepting of others and of the reality we are in, rather than fighting it all the time.
JMK: Yes – I agree. I have personally benefited so much from teaching in this very diverse community. When I first came to Benedictine, every class had maybe one Muslim student, some Catholics, some other Christians, and some non-religious people. Now that every class I teach has about 25% Muslims, as well as a good number of Hindu students, I can say, does anybody from another faith tradition have this perspective? And I'm not picking on anyone. And we and the students learn from each other in such a rich way. We have pretty decent ethnic diversity, but our religious diversity is top of the nation for Catholic and Muslim dialogue. Student groups do interfaith dialogue. I have to say, I landed in a great place for me.
I love talking to you, but it is over time.
RJJ: We can talk again if that works for you at some point. I’ve enjoyed this very much, although I talked too much. But I guess you called me.
JMK: I called you and am looking for your words of wisdom. I’m going to write the book and will have my say, but I’ve really relished hearing your stories. We have gotten a lot of really wonderful insights.
RJJ: I will look for this stuff on vested interest, and I'm going to send you the Shkreli Awards about the worst gangster profiteers in health. It’s awful. The reason I bring it up is medicine, teaching, and research are honorable professions – and to be corrupted in that process is sinful – it’s bearing false witness.
JMK: Absolutely. As a professor, I don't make a lot of money, but you couldn't pay me to be that person who is a sell-out to industry. I literally had a nightmare about being that person – doing such harm. And in my dream, somehow, I just couldn't help but be a bad person. I don't know how people do it. I encourage my students to not believe that physicians are in on this kind of corruption and profiteering, and I think most are not. Would you say that's true?
RJJ: I would say most are not. But I've also been pretty selective with the people I respect and I'm friends with. I'm also a member of the National Academies and some of these big shot docs at Rockefeller University in New York, Boston – they did not disclose big support fees they were getting from the drug industry and others, sometimes in the range of a million dollars and more. And these are the Presidents of Universities and are paid very well. Why are they doing this?
JMK: That's terrible. It erodes trust. Trust is not doing well in the United States.
RJJ: And it promotes cynicism, just as we were talking about. Maybe think about this in your book, that cynicism eats the soul. And someone has said that more elegantly than I am. But it is corrosive.
JMK: Yes. I think you're right. I will have to think what Buddha and Mohammed and Jesus would say about that. “Turn the other cheek,” probably.
RJJ: The Old Testament is probably full of it as well.
JMK: It is hard not to get cynical. But I've got my students and we both have our children.
RJJ: It's really been a pleasure to meet you. I hope to continue the dialogue, and you are the kind of person I want to have as a friend.
JMK: Well, of course you are right up there for me. Like I said, nobody goes into children's environmental health who is not something of a hero and a little bit of a Quixotic one maybe.
RJJ: Yes – we should put that in the job description. On these advisory committees, they balance them out with industry – there was no choice.
JMK: I will just have to speak up on the CHPAC – and have my say.
RJJ: Did you know Melanie Marty? She was on that committee for years. Oh, Melanie was fabulous – another Catholic girl, one of eight kids. She just recently died, and that's why I saw Mark was at her memorial service. And she could skewer somebody, and they would say thank you when she was done – she would do it so well.
JMK: Yes – I will try to be polite about it.
RJJ: I’m delighted you are there. Nse is a hero.
JMK: Yes, I love Nse – she is just wonderful. And I just blogged my conversation with her. Thank you so much. I really appreciate the time, and I'd love to talk to you again.
RJJ: Okay and tell Nse that we had a lot of fun – and Mark – and I will send you a bunch of stuff.
JMK: Thank you so much, so good to talk to you!
