Editorial: Bioterror Burnout, or Pills to Purge Melancholy

by Harry Goldhagen
First published September 11, 2002 on Medscape Infectious Diseases

The other day the UPS guy dropped off a small box from an address I didn’t recognize, and I must confess that I felt a moment of anxiety as I opened it. It was just a delivery of business cards from a new printer, but it drove home the point that I am a bit more sensitized to the risk of bioterrorism than I was before last fall, and I don’t think I’m alone in this.

With all the reading I’ve done, the lectures and seminars I’ve attended, the interviews I’ve conducted (including a recent discussion about our preparedness 1 year later), and the articles I’ve written and edited, I found that knowledge is not a sufficient answer to the terror of bioterrorism. When I consider the possibility of a bioterrorist attack (as Mike Osterholm, among others, has said, ” it is not a question of if such an event will occur but rather when”),^[1] I experience a sense of helplessness, the thought that no matter how creative we are in preparing for such an attack, someone even more clever out there will figure out how to thwart our defenses.

So I have taken a different approach to preparation. I have begun to prepare my mind.

One way has been by training in kung fu. Now, don’t laugh. Sure, the sight of a balding, middle-aged shrimp with thick glasses in a baggy uniform doesn’t inspire the kind of fear that, say, The Rock or Lenox Lewis induces in his opponents. And I certainly don’t get the kind of respect I’m used to from the strong, flexible, and fast youngsters at the school, who enjoy calling out to “take it easy on the old man” when I step into a sparring match (suitably covered in protective padding, of course).

But the benefits are unmistakable. Besides the obvious improvement in strength and aerobic capacity, I’ve noticed a change in the way I think and feel. There is the relief of stress from all the exercises. Practicing blocks and kicks, visualizing opponents and defeating them, dodging bamboo poles and rubber knives and plastic guns, applying wrist locks and “arm bars” and all the other arcane but practical techniques have, surprisingly, provided a measure of mental peace, an ability to take on the enemy with calmness. The frequent repetition allows me to function more effectively under pressure, to think more clearly when under attack, to prepare for dealing with death. That state of mind the Buddhists tell us about, being “in the moment,” practicing “mindfulness,” comes very easily when facing a 6-foot tall 13-year-old who can kick to my head before I can blink. There’s no other place I can be than in the moment, when to be out of it means certain embarrassment and hooting from the crowd, if not a wake-up kick. Who could have thought that fighting, even the well-controlled and padded sparring we do each Saturday, would have so much in common with meditation?

The benefits, however, are not limited to calmness and clear-headedness in the face of the enemy. There is also the element of teamwork in the training. We often work with a partner, looking out for each other, and thankfully, providing encouragement for even small improvements. We are a team, working to improve our skills, however modest. And teamwork is sure to be vital to our response to any kind of attack.

I think there is also the benefit of a longer and healthier life. Suzuki, Willcox, and colleagues believe that a key factor in the longevity of the Okinawans, the population with the highest percentage of centenarians on earth, is their life-long involvement in exercise, especially in karate and tai chi. (Of course, this older age group also has one of the healthiest diets in the world.)

But the best part of training in the martial arts is how much I enjoy it. Sure, Jet Li has nothing to fear from me, and Jackie Chan’s career is safe. Nevertheless, as I go through the intricate steps of a form, executing this fighting ballet with increasing finesse and intensity, I feel as rewarded as I do from any intellectual pursuit, and maybe more so. It had been years since I worked out this much, and I am loving it.

Another part of my preparation is laughter. With our nerves still raw from last year’s attacks, it is hard to find humor in much of anything, especially terrorism. Can you imagine joking about disaster, murder, even genocide? But how is it that I still roar when I see the elaborately staged “Springtime for Hitler,” Mel Brooks’ painfully funny musical number from “The Producers”? (Perhaps it is not surprising that the revival on Broadway was one of the only shows to draw large audiences after the 9/11 attacks.) There are few events that can match the horror of the Nazi era. But farces like “The Producers” and “To Be or Not to Be” (both the darker 1942 Jack Benny classic and the sillier but still hilarious 1983 Mel Brooks remake) are certain to cure melancholy.

You might as well enjoy the life you have now, instead of worrying about the future that may not come. Just think, you could get lucky and be hit by a car before the next anthrax letter arrives! Take some of the moments remaining to you to do what you enjoy. Go dancing with your sweetheart. See a show on Broadway, or gather the family in the den and watch your favorite old movie. Cook a gourmet meal for your friends, or have them cook one for you. Climb a mountain or solve a crossword. I’m not talking about life-transforming activities, like learning a new language or overcoming your worst habit or character flaw. Use your minutes to do what you enjoy, whatever you find satisfying and rewarding. Whatever it is, go for it.

Preparing for bioterrorism involves more than throwing money at science to find the most effective drugs and vaccines or honing our disaster-training skills. We must work with our minds as well, by living and enjoying the life we have now and by preparing for dealing with death. We must not forget our humanity while contemplating the inhuman. For otherwise, why prepare? We all die eventually, whether from bioterrorist attack or more mundane causes. Even after Tom Perls and colleagues^[2] of the New England Centenarian Study find the genes for longevity, and we exploit them, life will still fly. We might as well enjoy the trip. Or, as the Tentmaker, Omar Khayyam, eloquently wrote nearly 900 years ago in The Rubaiyat^[3]:

Note: The title of this editorial comes from a music book entitled Wit and Mirth: or, Pills to Purge Melancholy by Thomas D’Urfey, an entertaining collection of lewd songs and ballads from 1720.

References

1. Osterholm MT. The medical impact of a bioterrorist attack. Is it all media hype or clearly a potential nightmare? Postgrad Med. 1999;106:121-124,129-130. Abstract.
2. Perls T, Kunkel LM, Puca AA. The genetics of exceptional human longevity. J Am Geriatr Soc. 2002;50:359-368. Abstract.
3. Khayyam O. The Rubaiyat, verse XXIV (Fitzgerald translation). Available at: https://classics.mit.edu/ Khayyam/rubaiyat.html. From The Internet Classics Archive, available at: https://classics.mit.edu/ index.html.