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David Katz, M.D.

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One for All: Milling the Grist of Graduation

Posted: 06/19/2012 8:00 am

I was privileged and honored to deliver the keynote address recently at a local high school graduation. I reiterate my congratulations to these -- and all -- graduating members of the class of 2012!

This "keynote" was rather less imposing than its name intimates. My marching orders were to deliver a generally inspiring exhortation on being selfless and giving back in seven minutes or less. For better or worse, I adhered to these parameters quite strictly and spoke for about five minutes.

In contrast, a lineup of dignitaries who had been invited to step up to the mic and say "congratulations" mostly spoke for as long as or longer than I did -- and they spoke before me.

So I rather suspect that by the time my "keynote" rolled around, the audience was stuffed to the point of nausea with sagacious counsel, oratorical wit, and food for thought. I take an apparent lack of induced vomiting as the single most salient measure of the success of my performance under the circumstances.

As for content, I did, indeed, adhere to the marching orders -- but for one thing. I advised selfishness, rather than selflessness. Or, more accurately, I recommended both.

There may, in fact, be no alternative to selfishness. Evolutionary biologists have wrestled most diligently with the topic, endeavoring to account for such apparent tendencies as altruism and cooperation. By and large, their analyses suggest that these behaviors serve the same basic purpose as selfishness, namely, fostering the "interests" of the organism in question.

In the context of evolutionary biology -- nature red in tooth and claw, if you will -- that interest is survival. Parental organisms are protective and altruistic toward their progeny not so much out of "love," but out of dedication to the defense of their genetic lineage. The genes creatures pass on to offspring are their one true hold on the future -- and they fight to preserve it. The more challenging instances of altruism to account for are less directly tethered to personal advantage, but connect back to it nonetheless.

In human context, things of course get more complicated. We have the expanse of culture and conscience to refract the crude intentions of biology into new designs.

But there is a case to be made that even so, we cannot be other than selfish.

While our great altruists -- Mother Teresa springs to mind -- are undeniably giving, that does not obviate selfishness. One may presume that if being generous and altruistic made Mother Teresa feel badly rather than gratified about herself, she might well have done otherwise. And if being altruistic did, indeed, provide her the greatest return in gratification -- well, then, it was... selfish. Doing what makes us feel good is selfish.

This can, I suppose, seem a bleak epistemology. But that's only if "selfish" is bad. There is nothing bleak about it if "selfish" is merely inevitable, with choices about good or bad to follow.

The word as we routinely use it -- "selfish" -- seems to imply greed, or conceit, or neglect of others. But in its parts, it simply means we are to some extent focused on ourselves (my kids routinely use "ish" to indicate "somewhat," as in "hungry-ish"). Since each of us -- our self -- is our only window to the rest of the universe, that we are inescapably a bit focused on self is no great revelation.

But it is important, and I have empirical evidence of that from my routine experience addressing audiences on the topic of public health. Highlighting the power of lifestyle as medicine, I note an incontrovertible body of evidence indicating that knowledge we already have would readily allow for the eradication of 80 percent of all heart disease, 90 percent of all diabetes, and as much as 60 percent of all cancer. I then ask if this verifiable assertion has brought a tear to any eye, or a lump to any throat. And the answer, of course, every time -- is no.

These are stunning statistics -- but they are statistics. Dull, dry, bland, and impersonal. They do not reach out to our selfish selves.

So then I make it personal. I ask my audience members to raise their hand if someone they love has been affected by heart disease, or cancer, or stroke, or diabetes. If so, I ask them to remember the day they got that news, and bring to their mind's eye the face of that person they love. By show of hands, it is rare for any adult member of any audience anywhere in the country to be left out.

I then note that if the knowledge we had of lifestyle as medicine were the power of routine action, 8 out of 10 of us in that very room would not have had cause to raise our hands. Those dreadful days of anguish and pain simply would not occur 80 percent of the time. Reflecting on the private parts of public health, tears do come to eyes, and lumps to throats. We are far too selfish to shed tears very readily for an anonymous "public." We very readily, selfishly shed tears for the trials, tribulations, and tragedies affecting those we love. The conundrum, of course, is that for any one of us to derive the advantages of what we know, all of us must act on it.

My brief comments to the graduates were informed by such ruminations -- but did not, of course, directly address them. A graduation is a time of celebration and triumph (see "If, and but") -- and no time to reflect on tragedy.

But it is a time to admonish, exhort, and advise. And in general, we admonish selflessness. Even as we convene to celebrate the advancement of our son or daughter -- even as we feel a somewhat selfish pride -- we admonish selflessness.

But if there is no such thing, we leave our young people with a choice. Do as we advise, even though it's impossible. Or, renounce our advice and be selfish instead. I don't like these options, and think there is another.

To admonish doing good while denying the influence of selfishness is like endeavoring to fly while ignoring gravity. We can fly, but by overcoming gravity, not by denouncing it. Similarly, we can send young people out to make the world better not by renouncing selfishness, but by reconciling doing well for oneself with doing good for all.

As a culture, we allow for doing well without doing good. In fact, the greatest measures of success are things like landing more 3-pointers than anyone else, and scoring an endorsement deal to peddle soda nobody should be drinking in the first place. What our culture reveres on a daily basis says far more to our young people about what matters than any litany of graduation platitudes.

It is all well and good to speak to young people of selflessness -- but for the fact that everyone wants to do well, and advising to the contrary does little good. The impressions of youth are the barometer of our hypocrisies.

The very best among us are as selfish as the very worst -- it is the sources of gratification that diverge. And the origins of these reside in cultural imperatives we fashion, and propagate.

On a day when a young person is acutely focused on self -- what has been accomplished, what lies ahead -- we should be honest about that. We should validate the legitimacy of selfishness. Further, we should encourage young people to look out for themselves (Who else will do it half so well?), love what they do, and do what they love.

But then it is up to our culture to make clear that the only selves worthy of such selfish devotion are good selves. We should convey, not by annual rhetoric but daily example, that the only ways of doing well that genuinely qualify involve doing good. We should allow for being selfish, while affirming that the self is part of something larger than itself. It is the choice of a culture to reserve its greatest reverence for those who do well only by doing good -- or otherwise.

And so, I was honest with the graduates out of hope, not cynicism. We will not eradicate selfishness any more than we will eradicate gravity. But we manage, nonetheless, to fly.

And so I hope they do -- one, and all.

-fin

Dr. David L. Katz; www.davidkatzmd.com
www.turnthetidefoundation.org

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