Interview by Tom Peterson
Heather Wood Ion is a cultural anthropologist who works on the transformation of organizations, projects and grassroots initiatives. For the last eight years of his life, Jonas Salk shared with Heather his dreams of establishing a science of hope, and his diaries of reflections. Prior to meeting Dr. Salk, Heather studied cultural recovery and resilience following natural disasters and applied her work to turnarounds in health care and community development. She has taught ethics and medical humanities, and is a frequent keynote speaker on health and care in the future. Heather holds degrees from McGill University, Claremont Graduate University, and Oxford University. Her first novel, Third-class Ticket is being made into feature film. Her latest book, Making Doctors, A Century of Lessons on the Practice of Healing, describes the process by which great doctors are formed.
This year will mark the hundredth birthday of Jonas Salk. He was a very important person, yet most young people don’t know who he was, what difference he made.
Jonas Salk was the physician who discovered and oversaw the testing of the first effective vaccine against polio. Consequently, he founded the Salk Institute for Biological Studies, which is now ranked as the most cited private research institute in the world. At the time—in the fifties and in the epidemic of the thirties and forties—more than 50,000 children per year were being affected by polio. Many of them were compromised—either paralyzed or had breathing problems for the rest of their life.
Polio was an urban epidemic, and the emotion most associated with it was fear. In fact, one of the best books about it is called A Paralyzing Fear. One reason I don’t feel confident as a swimmer is we’d have one week of swimming lessons, and the pool would be closed. There was an epidemic of polio every summer from the turn of the century until 1955, when the vaccine was proven effective.
At the end of the day, he decided not to patent the vaccine.
One of his memorable statements is: The answers exist in nature; our job is to discover the appropriate questions. So he felt that the answers about the vaccine and what to do about stopping the virus were evident in nature and were for the public good and you couldn’t patent anything in nature. He said that the way he began thinking about the vaccine was to imagine himself as a virus. What would he need as a virus to thrive? And what would he need to limit that thriving.
You came on the scene years later.
I was introduced to Jonas in 1988. I was a sounding board and was asked to read his stream of consciousness “night notes.” He wrote about 150 pages a month, and he asked me to try and figure out the patterns or operational aspects of what he was thinking about.
Is that how you came across the Epidemic of Health concept?
The day I met Jonas, he asked me three questions: What is your vision of the world? What is your place in that vision? Have you ever met anyone who thinks the way you do? And in the course of his response to what I was saying, he said two things. You want to be the Johnny Appleseed of positive thoughts about health. And I, of course, said yes. He said that he had written about if it is possible for us to create negative epidemics, then it is surely possible for us to create positive epidemics.
Jonas first used the phrase it is possible to create an epidemic of health in about 1974. But he never expanded publically on those ideas. The next stage of those ideas is when Bill Moyers was interviewing Jonas for his book The World of Ideas. As he listened to Jonas talk about conscious evolution, Moyers said, “then what you want to discover is the science of hope.” As soon as I heard that, I knew that was what I wanted to work on.
It was a way of distilling all the things I’d been trying to do to that point in my career. One thing that makes Jonas stand out as a natural philosopher or a twentieth-century thinker was his attitude that everything is an experiment. So if you have that perspective, there’s no such thing as failure, there’s just an experiment that gave you new information. He is well known for a statement: We are an error-making species, therefore we can become an error-correcting species.
What does Epidemic of Health mean?
It means a new perspective in which health is indicative of or equivalent to vitality. This is substantially different from our current attitude that health is merely the absence of disease. If we change our perspectives, the way we think about our own heath and contribute to the health of others, then we’re talking about vitality and capacity. We’re not only talking about care after disease or after trauma.
Jonas said life is dynamic. Each encounter evokes potential from every participant and each environment evokes new possibilities within the dynamics of each encounter.
He seemed to like the word evoke.
In clinical scientific terms that might be potentiate. Evoke, to draw out of, give voice to, make real. When we talk about the interactions of drugs or clinical conditions we use the term potentiate. One makes the other greater.
It is a big theme. He was very strong believer in what Henri Bergson called mutuality. We discover ourselves in human relationships. No one is able to become truly themself without becoming so in relationship with a whole lot of other people, ideas, environments.
Why is epidemic of health relevant today?
As a population, we’re sicker than we’ve ever been in terms of the clinical measures—with no excuse. We have all the knowledge and tools necessary to prevent most of the clinical burdens today, just as we have solved most of the problems of infectious diseases. But we believe and act as if our health depends on external experts. In fact, our health depends on our own choices and behaviors. So to me, in 2014 that’s very exciting; instead of focusing on the health crisis, we can focus on the health potential.
What would that look like?
When someone came to Jonas with a problem, he would ask them three questions: Describe a time when you felt truly alive or vital. Who was part of that experience, contributed or shared that experience? What of that experience would you like to pass on to the future?
Now if you contrast that to a current medical focus, the interaction with a medical professional begins with the immediate “presenting complaint.” If that’s the focus, if that’s how we interact what medical care, we never move away from the idea of complaint and a temporary fix of the complaint.
So Jonas’s focus and what I would like to disseminate as a change in perspective is this vitality, that we are capable of living and thriving as vital—he would finish my sentence as vital partners in evolution. I would finish it as partners for each other and for community.
What would Salk think about our epidemic of eating bad food and inactivity?
He would make it as clear as it was made that cigarettes were bad for your health that becoming dependent on screened realities—video games, television, texting—is equally bad for your heath. And he would be very worried by our dependence on those tools.
Are there places where someone would see this epidemic of health?
We all think of the “Blue Zones,” certain areas of the world where people live the longest and live actively—for example, the 98 year old who is still climbing mountains. In addition to traditional communities that are dedicated to sustaining their vitality, there are growing groups who recognize that their wellbeing is what they want to focus on. Look at senior citizen communities as they’re being designed now. They’re no longer being designed as skilled nursing homes but for very engaged and active adults.
Since Jonas’s death with the development of our ability to analyze big data with computers, we now know that health is contagious. James Fowler, the co-author of the book Connected, has done most of that work. The fact that health is every bit as contagious as an infection should give us great hope. Fowler has done retrospective analysis of the Framingham Heart Study data for 60 or 70 years. He was able to show that people who have chosen health, don’t smoke, and eat a healthy diet, influence far more people than the person who is sick and withdraws from connection because they’re sick.
One of the most profound questions Jonas asked is, “What must we do to evoke the greatest potential in ourselves and in others?” I feel strongly that he wanted us to see that answering that question was the way to save the world.
At one point there were 1.3 million polio pioneers, the children, who were part of the vaccine trials. Over the years, people would flip out their card saying, “I am a polio pioneer.” The March of Dimes estimated that seven million people—doctors, nurses and the public—had volunteered their time to be part of the study. What would it be like if seven million people volunteered to be part of the epidemic of heath?
Reference David M. Oshinsky, Polio, An American Story, p.188. Photos: Salk, Yousuf Karsh; card, Smithsonian Institute.