1. Sledge, George W. Jr, MD

Article Content

On a recent Friday night my wife and I took in the Indianapolis Symphony Orchestra's Symphony on the Prairie. This outdoor concert is our local version of the Boston Pops, and is one of those civilizing influences that make a community livable. The evening was devoted to old Broadway standards, sung by talented performers and accompanied by the orchestra.

GEORGE W. SLEDGE JR.... - Click to enlarge in new windowGEORGE W. SLEDGE JR., MD, Ballve-Lantero Professor of Oncology and Professor of Medicine and Pathology at Indiana University Simon Cancer Center, was President of the American Society of Clinical Oncology for the 2010-2011 term.His

And a fine evening it was. We've been in the midst of the Great Drought of 2012, forbidden to water our lawns, with temperatures as high as 105 degrees Fahrenheit. But it had rained the night before, cooling us down, and the skies were a beautiful blue tinged with pink as the sun set behind the hills surrounding Conner Prairie. We haven't had a more pleasant evening this summer. It's a cliche, but it was a great evening to be alive.


I know I'm hopelessly out of date, but I love those old musicals: Cole Porter, Irving Berlin, George Gershwin, Lerner and Lowe, Leonard Bernstein, and Stephen Sondheim songs certainly must rank among our best. Aside from jazz, Broadway musicals are probably America's greatest contribution to world music. I sat back and let the songs wash over me.


The world intrudes on even the most pleasant and the most beautiful of evenings. Earlier in the day I had heard the horrifying news from Aurora, Colorado: the gunman murdering filmgoers at a midnight showing of the latest summer blockbuster.


I had also heard that morning about the great sadness of one of my colleagues, a native of Syria, on learning that the dictator's murderous henchmen had gunned down his cousin and that cousin's 11-year-old son. I thought of this child even as I saw another child-certainly about the same age-doing cartwheels on a nearby hill: I couldn't see her face, but I could feel her joy in life, even from a distance.


And I could imagine the horror of that other child, and of his father, as they faced their killers. I'm told that the child in Syria had a bullet through his hand, a classic defensive wound.


One of the songs that evening was Fantine's lament from Les Miserables, "I Dreamed a Dream," its sad words so appropriate both to Aurora and Syria:


I dreamed a dream in time gone by When hope was high And life worth living I dreamed that love would never die I dreamed that God would be forgiving[horizontal ellipsis]


But the tigers come at nightWith their voices soft as thunderAs they tear your hope apartAs they turn your dream to shame.


When these monstrosities occur, they always seem far away, almost unimaginable, unless you have been to the place or know someone involved. Who would do such things? Who would purchase an assault rifle with the purpose of destroying one's fellow citizens? What madman, what vile creature, would send soldiers out to murder an 11-year-old child? Whether the work of an individual, or the institutionalized violence of a dying regime, such hatefulness is hard to fathom.


That, by the way, is a change, as Harvard's Stephen Pinker pointed out in The Better Angels of Our Nature: Why Violence Has Declined, his 2011 book on the gradual decrease in individual and state violence. Dying a violent death was incredibly common in the past, but has become progressively less so, not because human nature has changed (we all carry the potential for violence within us) but because human institutions have changed.


Violence is a public health issue, and an institutional issue, though our politicians are sometimes oblivious to this fact. The Florida state legislature, in thrall to their NRA masters, passed a law last year making it unlawful for physicians to inquire about gun ownership. It is now illegal for a pediatrician even to talk about gun safety with a parent in Florida: think about that the next time you hear about a child's dying of a gun mishap in Miami.


But the general trend has been for the tigers not to come in the night, or at least less frequently: young children can do cartwheels on a green hill on a pleasant summer's eve, Fantine's sad song being just that, a sad song describing past events rather than a prophecy.


That's no comfort to those who are grieving, any more than knowing that most childhood leukemics are cured makes the parent's of a dying child comfortable with that death. Those deaths-one wants to say, those stupid, unnecessary deaths-remain a challenge and reproach to us all.


These intermittent spasms of violence are rendered more immediate, more frightening, by modern technology. The 24-hour news cycles of cable TV and the instantaneous nature of the Internet thrust these events at us, mash them up against our faces, whether we like it or not. In similar fashion, a deranged young man could purchase high-end SWAT gear and hundreds of rounds of ammo for an assault rifle over the Web without anyone being the wiser.


Technology can propel evil, and speed the news about that evil. And, in the back of our minds, we realize that the stakes have gotten higher as the means for committing violence-both individual and collective-have increased.


But technology can also educate, and, one hopes, provide a check to those savage impulses through the creation of a global consciousness. It is harder for evil to remain hidden when a cell phone can capture and spread images of that terrible, mindful cruelty for all to see, creating a shared revulsion.


So the world intrudes; or both worlds, the world dominated by death and the world striving for a better life, intrude on each other. And, on a beautiful summer's eve, seeing that child doing cartwheels in the distance, I could imagine that the latter might prevail.