America the Beautiful: Rediscovering What Made This Nation Great

by Ben Carson, M. D.

  I realize that some feel that the United States and other world powers with nuclear weapons have no right to declare that others cannot have them. On the surface this seems like a fair argument, but can you imagine how many deaths would occur if everyone were given a handgun? Perhaps it would be fair to give everyone a handgun, but it certainly would not be wise. Although I applaud efforts toward nuclear disarmament, I also realize that if no one had nuclear weapons and one of the madmen of the world acquired them, worldwide tyranny would quickly follow. Therefore, we must be careful in pursuing our goals of an idyllic world.

  The next two wars the United States was involved in were really ideological wars. The Korean War was a proxy war, with the Korean Peninsula becoming the site of the first Cold War conflict. It was the first major intervention in the world by the newly formed United Nations, which took action when communist North Korea, backed by China and Russia, invaded South Korea, backed primarily by the United States. The conflict lasted only three years, and Korea remains a divided nation today. In the case of Vietnam, we were trying to stop the spread of communism, which seems like a noble cause to those who hate communism. However, many people love communism, and certainly everyone should have the right to live under the system of their choosing. The problem occurs when a system of government is forcibly imposed upon unwilling participants. It was our attempt to stop such intrusions that led to our participation in these wars. Although our intentions were noble, I question our methodology.

  A major question, however, remains: what responsibility does the world’s only superpower have when it comes to responding to humanitarian atrocities throughout the world? Should we have intervened in Rwanda to prevent the slaughter of over one million innocent people? Should we have been more concerned about the hundreds of thousands of people Saddam Hussein was slaughtering than the possibility of him possessing weapons of mass destruction? When the United Nations was formed, it was intended to be an international guardian of freedom that would not allow humanitarian atrocities. Like the United States, however, it has become so bogged down in politics that it did virtually nothing to stop these and many other calamities from occurring. Recently, it did vindicate itself to a degree by taking relatively quick action against the ruthless regime of Moammar Gadhafi in Libya, but its overall record leaves something to be desired. These issues become very complex when a nation responds to these atrocities through the lens of such questions as, what’s in it for us? and how does it fit into our global strategic goals? They are much simpler to answer, however, when constrained by the principle of doing what’s right and moral.

  FILLING THE ETHICAL VOID TODAY

  A large void in ethical world leadership has been present for quite a while, and this is a perfect time for the United States to step forward and offer effective, morally consistent policies unconstrained by political correctness. If a bully faction or bully nation is beating up on those with whom it disagrees or simply doesn’t like, we should immediately stop them with brutal force, if necessary, because it is the right thing to do. If that were done consistently, I guarantee that such incidents would cease almost immediately.

  I mention political correctness here because it only hampers effectiveness. For example, a lot of time, effort, and lives were wasted in Fallujah, Iraq, because the terrorists were hiding among the people and using them as shields against the American forces. Political correctness dictates that we cannot kill innocent women and children in the process of destroying the enemy. I certainly agree from a moral perspective, but from a military perspective I would not have played their game. I would have announced via bullhorn and leaflets that in seventy-two hours Fallujah was going to become part of the desert because there were substantial numbers of terrorists hiding there. This would have given people time to flee before the city was destroyed, and is a tactic that would actually save lives not only of women and children, but also men. If the terrorists were foolish enough to choose to remain and to keep people from leaving, any ensuing deaths would clearly be their responsibility. Admittedly these are very bold and definitive steps, but such actions would likely preclude long drawn-out wars, and ultimately decrease the numbers of people killed and injured.

  I can just hear pacifists saying, how horrible and brutal — how could a man of God even think such a thing? But they haven’t thought beyond their initial reaction. You would not have to take this type of action very often before people began to realize that having terrorists among them was not a good thing, and they would act accordingly to either expose such individuals or expel them. On the surface, this kind of action may seem brutal, but I believe the number of innocent lives that ultimately would be spared is substantial, and it seems to me that it would be more morally acceptable to destroy structures than lives. Buildings can always be replaced, but not so for even one life. When political correctness is not introduced into warfare, efficiency and smart economic policies can prevail.

  We have talked about World War I and World War II, but could World War III be in our future? The war on terror has already been declared, and unless we act with courage and decisiveness, there is no question that the terrorists will soon acquire nuclear weapons. Radical Islamic extremists are not satisfied to peacefully coexist with those they consider to be infidels. They feel that such people need to either be converted or destroyed — and there is no middle ground. Although the vast majority of Muslims don’t subscribe to this philosophy, they are not very vocal, just as the vast majority of Germans did not subscribe to Hitler’s insanity, but instead remained silent, paving the way for some of the most monstrous acts against humanity ever committed. We need to actively combat these extremists in every way possible, including economic warfare. The terrorist network derives most of its money through oil revenues, and we, along with most of the rest of the world, have an insatiable appetite for oil. Unlike the rest of the world, however, we have enormous amounts of oil under North and South Dakota, Montana, and Alaska, as well as offshore oil. I am as much of a conservationist as anyone and love the natural beauty that surrounds us, but the pragmatic part of me warns that there will be no beauty at all if the world is consumed in nuclear conflagration. As we intelligently tap our own resources, we must doggedly pursue other energy sources. With appropriate incentives, I have no question that Americans, with all their ingenuity, can come up with new sources of clean energy in a relatively short period of time.

  Providing appropriate incentives to the American people should result in a plethora of ideas and inventions to solve our energy problems. Can you imagine the amount of hydroelectric power alone that is available to us, situated as we are between two oceans? We simply need to invent efficient and inexpensive ways to harness that energy. We also need a way to regulate the way some companies and individuals buy up patents of promising ideas that would threaten their sources of revenue. For instance, petroleum companies should not be allowed to purchase the patent for a new process to harness solar energy. Perhaps no one should be allowed to buy such a patent without demonstrating a clear-cut plan and the capability to bring the plan to fruition. Incorporating such ideas into our society should help America move toward energy independence, leading to greater self-sufficiency and preventing political conflicts over oil.

  We have an awesome military with tremendous leadership, and we wisely have civilian oversight of the military. If our leadership is willing to once again return to the moral high ground and use our power to achieve peace and a chance for all to prosper, I believe we will have fulfilled a most noble purpose in the history of our world.

  — CHAPTER 10 —

  IS HEALTH CARE

  A RIGHT?

  MEDICINE FASCINATED ME AS A CHILD. WHENEVER A MEDICAL STORY was featured on the television or radio, I was drawn to it. Fueled by my love of books on nature, I was captivated by the life-and-death struggle of animals and insects, and I was also extremely curious when one of our older relatives died about what caused the death. I became convinced as a child of t
he evils of tobacco and would try to hide the cigarettes of friends and relatives who smoked. I had an insatiable desire to know how things worked, and I was constantly taking things apart (and sometimes reassembling them successfully!). The chemistry set that I received for Christmas when I was eight years old was an endless source of entertainment and learning. All of these things indicated early on that medicine would be an ideal profession for me.

  I was particularly intrigued, however, by the stories presented each week in Sabbath School that featured missionary doctors who traveled to remote areas of the world at great personal sacrifice, not only to spread the gospel, but to bring physical healing and reform the health habits of the populace. What courageous compassion, I thought, for them to lay down their lives for others. Those missionary doctors seemed to me the most noble people on the face of the earth.

  In fact, my first public speech, at the age of eight, involved the story of a missionary doctor. It was my turn to give the mission story in the primary division (children aged seven to nine) of our church, and when I told my mother about it, she said, “You should present it as if you were the missionary doctor talking to them.”

  To do so, I practiced memorizing the story and presenting it dramatically, until I almost convinced myself that I had been there. My mother helped me create a costume the missionary might have worn, and I tried to emulate the speech of an authoritative but compassionate preacher by raising and lowering my voice at the appropriate times in my delivery.

  On the morning of my presentation, the children chattered away among themselves, distracted as always, until I began reeling them in with my story. “I was quietly tiptoeing through the jungle in the dark of night without a weapon,” I confided to them in a whisper, “knowing that savage warriors had been told to bring me in dead or alive.” I fanned a fly away from my face as I pressed on through the imaginary jungle surrounding me.

  “Suddenly,” I exclaimed, whirling around as I had practiced at home, “a large branch broke behind me.” To my joy and amazement, I realized everyone was drawn into the moment with me, and I had my entire audience hooked from there on.

  When I finished, the teachers were so enthusiastic they asked me to give the same presentation to the adults the following week, which was unheard of. I refined my presentation over the days that followed, growing ever more nervous as the day approached about performing before a whole church auditorium full of adults. My mother told me I should simply pretend that everyone in the audience was naked — but that did nothing to alleviate my anxiety. Imagining everyone in my church naked was not a pleasant thought!

  On Sabbath morning, the stage seemed larger than usual to me. Some of the adults did not look particularly happy to be there, and as I began speaking I initially took refuge behind the large white podium. But as I began to get caught up in the presentation I had practiced so many times, I ventured farther out onto the stage and began whispering and shouting and jumping to the delight of my audience, who applauded loudly when I finished. The adults were incredulous that an eight-year-old could present something so powerfully, and the seed of my public speaking career began to germinate.

  After that experience, my desire to be a missionary doctor continued to grow until I was thirteen. By that time I had a much better understanding of what the life of a missionary doctor was like, and the appeal of its lifestyle had dissipated. Perhaps if I had grown up in an environment of economic privilege, I would have pursued my original goal more vigorously, but the thought of a lifetime of continued poverty was something I had a difficult time facing.

  By then, however, human behavior and the lives of psychiatrists had captured my attention. The psychiatrists I saw depicted on television seemed like such wise individuals who made a real difference in the lives of desperate people — and to top it off, they drove fancy cars, lived in mansions, and had plush offices. My brother, Curtis, knew of my interest in psychiatry and bought me a subscription to Psychology Today for my fourteenth birthday. I really looked forward to receiving my magazine each month, and I became the local amateur psychologist for many of the people around me. I majored in psychology at Yale and took advanced psychiatric courses in medical school at the University of Michigan, fully believing that I was going to become a psychiatrist. However, I was so impressed whenever the neurosurgeons made presentations to our class that I began to have second thoughts about my area of specialization.

  So I asked God to give me wisdom to make a proper decision that would have a lifetime of implications. I truly believe God gives everyone special gifts and talents, and as I began to assess mine, I quickly realized that the talents necessary to be a good neurosurgeon — good eye-hand coordination, steadiness, calmness, and the ability to think in three dimensions — were all things I possessed already. After realizing that, the decision for me was quite easy, and I have never regretted it. When I made that decision to become a neurosurgeon, I did briefly think about the fact that I would have a much smaller impact on the lives of people than I would have had as a missionary doctor, but I felt that God was leading me and that he clearly knew more than I did about his plans for me. As it turns out, because of the amazing career that he orchestrated for me, I have been able to touch more lives through my books, magazine articles, interviews, and a made-for-television movie than perhaps I could have as a missionary doctor. It was that very ability to positively touch lives that attracted me to medicine in the first place — and is the reason that many of our nation’s doctors, nurses, and other health-care professionals are attracted to the field as well.

  PRIVATE DECISIONS, PUBLIC CONSEQUENCES?

  When I was a neurosurgery resident at Johns Hopkins, on numerous occasions my wife and I would be in the car driving and suddenly a motorcyclist with no helmet on would whiz past us, seemingly without a care in the world. I had to fight feelings of anger as I thought about how often I was awakened at two in the morning to respond to a severe head trauma case from a motorcyclist who was not wearing a helmet involved in a motor vehicle accident. Yet that motorcyclist had every right to neglect his own safety, and at that time, that right was protected by law.

  Subsequently, helmet laws were enacted, much to the displeasure of many motorcyclists, but to the great relief of many health-care practitioners. The ramifications of such irresponsible behavior on behalf of the motorcyclists, however, extend far beyond the inconvenience suffered by people like me who had to take care of them. Sometimes the head injuries were very severe, and saving the victims became an extremely expensive process that involved not only acute medical care, but also long-term rehabilitative services, and in some very sad cases, chronic maintenance for those with little or no chance of resuming productive lives. Although doctors sometimes resent having to give up time with their families and the many other sacrifices associated with the medical profession, few people stop to philosophize about whether the victims have a right to consume enormous amounts of medical resources. In our society, we do not discuss the behavior that created the problem, and we generally do not discuss the price of treatment or the significant impact on their family and societal resources (welfare).

  Not many years ago, when I was on call, a fifteen-year-old boy was brought into our pediatric emergency room with a high fever and a decreasing level of consciousness. After a rapid and thorough workup, we discovered that he had multiple intracranial bacterial abscesses. It took several operations and extended time in the intensive care unit to get his health temporarily under control. Saving him cost hundreds of thousands of dollars, and in the end he had no insurance or other means to pay his bill. We subsequently discovered that he was in the country illegally, but that did not change the fact that he was in dire need of medical care.

  We do not like to ask questions in situations such as this that force us to make judgments about who should get care and how much care they should get. It is far easier to simply render whatever treatment is necessary and let someone else worry about the bill. In America, we tend
to have a very negative reaction to the health-care systems of countries such as England that are based on a socialized model. And we particularly abhor the rationing of care based on such factors as age.

  For example, under some socialized systems, kidney transplants are not even considered for individuals over the age of sixty, which means that most of our United States Supreme Court justices would be too old to be considered for such a life-saving treatment in many countries with socialized medicine. Who is right? Those who feel that it is our moral obligation to treat everyone regardless of cost, or those who feel that rationing and other means of cost containment make more sense to our nation’s health-care funding in the long run. As with virtually all controversial issues, the answer usually lies somewhere in between, and compromise can be very helpful. I must admit that in my many years of medicine, I have never witnessed a patient abandoned because of lack of money. In America we suffer much more from a lack of money than we do from a lack of compassion.

  THERE’S NO SUCH THING AS A

  FREE LUNCH HEALTH-CARE POLICY

  One of the by-products of our society’s strong value on compassion is the development of an entitlement mentality among large portions of our populace. I have noticed at Johns Hopkins Hospital that many of the indigent patients — instead of feeling grateful for the fact that people are willing to extend to them sophisticated and expensive care with little or no remuneration — are the most belligerent and the most likely to initiate lawsuits. By no stretch of the imagination are all indigent patients like this — and I shouldn’t even have to make such a disclaimer — but there exists in our society today a vocal and highly sensitive minority who are constantly monitoring every word to try to find fault with the finer points, rather than examining the overall message and attempting to engage in constructive dialogue to help find solutions. The fact that some of these patients become abusive and threatening does nothing to improve their care and actually is destructive to the development of the kinds of relationships with nurses, doctors, and other health-care providers that ensure quality care. No one likes to be around those always looking to pick a fight, which means that a belligerent person or their child might not be checked on and chatted with as frequently as someone who is reasonable and pleasant to be around. That, of course, means something might be missed, which continues to exacerbate the doctor-patient relationship.