Damming the Yangtze; Unleashing Cannabis

Gawande and Williams

Damming the Yangtze; Unleashing Cannabis

Gawande and Williams

Damming the Yangtze; Unleashing Cannabis
An email conversation about the news of the day.
March 18 1999 10:19 AM

Gawande and Williams

VIEW ALL ENTRIES

Dear Marjorie,

Advertisement

I can see that you and I come from different conversational planets when it comes to politics. It's the vision side of politicians that intrigues me more than the dark rumblings of their psychology. I'm always looking for the people, Rhino or no, who seem to know where they're going and it's someplace we'd like to be. Insofar as character interests me, it's not so much whether they have What It Takes to win but whether they have What It Takes to actually get things done. So, as for Gore, I worked for him going back to 1988 and found him to be unquestionably thoughtful, intelligent, wry, plain-spoken, and, yes, perhaps ambivalent about his role in politics. But none of that was what drew me to him. What impressed me about him was the same thing that impressed me about Bill Clinton. They both took their Ivy League educations back home and won committed followings for progressive, even liberal, policies and values in a deeply conservative South. We don't see much of that maverick character and vision in Gore today. But as you intimated, the mushy subordinate role of vice-presidency doesn't really allow for it.

The first story that caught my attention today was the one about the publication in China of a devastating systematic critique of the Chinese government's inhumane Three Gorges Dam project--a project that will displace over one million residents along the Yangtze and leave them even more poor and hungry than they already are. The substantive interest of the story is that there must be a deep rift in the government for such bald criticism to get published. But I was drawn in by the sheer bravery of the scholar who wrote the report and the editor of the journal that published it.

I didn't think it could ever happen, but the news of the latest report on the medical role of marijuana makes me think that pot might actually find respectable usage. The report from the Institute of Medicine appears to be a remarkable accomplishment simply by being impartial and hardheaded about the science. And its findings are bound to be uncomfortable for both sides of the legalization debate. On the one hand, the report debunked the claims that smoking marijuana is safe (it has higher tar levels than cigarettes and can cause cancer, lung damage, and harm in pregnant women) or effective in treating conditions like glaucoma or Parkinson's disease. On the other hand, the scientists did find that the cannabinoids in marijuana could be effective in treating unremitting nausea, in increasing appetite, and in providing modest pain relief for patients with cancer or AIDS. Also, they found no evidence that marijuana was a "gateway drug" to other drugs. So a doorway is open to a sensible solution: developing patches or inhalers that can deliver cannabinoids more quickly and effectively than the current pill form does and more safely than smoking does; and regulating those drugs just as we regulate codeine, morphine, and cocaine for medical use.

Here's my vote for favorite headline of the day: "Four Amish Teenagers Are Arrested in a Rampage." It seems that they smashed 44 windows and overturned buggies in retaliation against a farmer who the teens thought had turned them in for drinking. It's somehow comforting to hear that even the Amish have their problems with teenagers, isn't it?

Yours,

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.