Above-Zero Tolerance

Gawande and Williams

Above-Zero Tolerance

Gawande and Williams

Above-Zero Tolerance
An email conversation about the news of the day.
March 18 1999 6:20 PM

Gawande and Williams

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Dear Marjorie,

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Until now, I have had some sympathy for the "zero tolerance" folks simply because the people on the other side seemed so disingenuous. A lot of the advocates for allowing medical uses of marijuana really do see it as an opening to looser restraints on recreational use. The report would not have accomplished all that much if it had just picked one side or another. It succeeds by distinguishing between the useful drug compound in marijuana (the cannabinoids) and the smoking process (with all the tar and other toxins that it delivers) and then showing that you can have one without the other (with inhalers or patches). The beauty of this line of thinking is it takes a big part of the fun out of pot--the whole ritual of smoking--while leaving the medical part. It's the difference between smoking a cigarette and chewing nicotine gum (hey, what about marijuana gum?). Either the "zero tolerance" folks haven't realized this yet, or they really are morally obtuse. I am impressed, however, that the pro-marijuana people see this as a genuine way out of the current impasse. You raise a good point, though. Who knows if drug companies will see enough money to be made from this to develop marijuana gum.

I don't know if you saw the report on the conviction in South Africa of anti-apartheid leader Allan Boesak for embezzling some $400,000 from the charity he was running. When I was in college, I wasn't exactly a firebrand on the issue, but I pitched in with the anti-apartheid crowd, and Boesak was a genuine hero of resistance in those days--one of those wonders of life like the author of the Three Gorges critique. I don't know whether to be depressed or heartened by the news of the conviction. It's depressing because it only reminds us how easily a hero can become a villain--or even be both at one and the same time. But it's heartening because it shows yet more evidence of the maturity of the new South Africa. There were no cover-ups, no riots. Just the simple upholding of the rule of law.

One story puzzled me today: The vote in the House to limit steel imports. Ninety-one Republicans broke with the House leadership and the traditional Republican free-trade stance to put the bill over the top. The major steel companies didn't even support the bill. The papers attributed this surprising showing for blocking imports to a tide of protectionist sentiment and a campaign by the United Steelworkers after cheap imports from abroad led to plant closings here. Could Republicans really have been swayed by union lobbying? And in the midst of the best economic performance we've had in decades, it seems like surprising news that protectionist sentiment is growing. It's not like NAFTA turned out to be the disaster opponents had predicted. Free trade has always been a hard sell on Main Street. But doesn't the idea that it's now a harder sell strike you as something to be explained? The papers say the key swing votes were Rust Belt Republicans. So perhaps this is an isolated tide of protectionism, and these Republicans tending to their home fires will just switch back to the usual free-trade line.

This is it for me. It's been good fun chatting with you this week. I hope the members of your ailing family all turn the corner soon--and without leaving you afflicted.

Salud,

Atul

 

Atul Gawande has written about medicine for The New Yorker and Slate, is a surgical resident in Boston, and is a fellow at the Harvard School of Public Health. Marjorie Williams is a contributing editor at Vanity Fair.