A Life Worth Living

Dr. Bernard Lown is a cardiology professor and practicing cardiologist in his seventies who lives and works in the Boston area. Years ago, Lown had a patient who was an artist, a painter, who Lown felt needed an operation. The operation was extremely successful, and Lown considered the case resolved. However, when his patient came in for a follow-up appointment, it turned out that, as a result of his surgery, this man had lost the use of his right hand. He could no longer paint, and now “life wasn’t worth living.” Years later, Lown remembered the painter when he met with another patient who had been told by her other doctors that she needed a risky heart operation Lown asked her what she wanted to do with the rest of her life; she was a professor, and she quickly responded that she wanted to summarize her life’s work. He encouraged her to pursue her writing in the time she had left, and to avoid the operation. She lived six more years, and completed her writing in that time. 

Dr. Bernard Lown is in his seventies, and is a cardiology professor and practicing cardiologist. Born in Lithuania, Lown moved to the United States with his family in the 1930s. Lown has had a very distinguished career, though he says he “got into a lot of trouble everywhere” in his life because of his radical approach to social justice and social change. For example, during graduate school, he worked in a blood bank, where he was appalled to discover that the blood was kept segregated by race: blood donated by white people was labeled with a “W” blood donated by African-Americans was labeled with a “C,” for colored. Lown decided he wanted to do something about this, “I decided to wage my own guerilla warfare, and what I did is when we’d run low on white blood, I would take a crayon to convert the C into a W.” This went on for some time before the blood bank staff figured out what Lown was doing. He was kicked out of medical school, though fortunately he was reinstated after members of the staff went to bat for him. Lown says he does not regret his actions in the least: 

“[Y]ou make the decision that … there are more important things than academic advancement. So, I advanced academically. But it was far later than I would have done, had I not been active, radical in my social activities. Would I do it differently? No. Never. Because the rewards were so enormous— there is nothing quite comparable.”

In fact, his penchant for radical social activism does not seem to have slowed him down too much: Lown is the winner of a Nobel Peace Prize on behalf of International Physicians for the Prevention of Nuclear War, an organization he co-founded. He is also the recipient of a United Nations Educational Scientific and Cultural Organization Peace Education Prize, a George F. Kennan Award, a Ghandi Peace Prize, and the first Cardinal Medeiros Peace Award. He co-founded Physicians for Social Responsibility and was a founding member of the Ad Hoc Committee to Defend Health Care. In addition, he invented the cardioverter, a defibrillator that helps to prevent heart attacks, and he published a book, The Lost Art of Healing. 

Lown says that he chose medicine because he “wanted to do good” and he saw medicine as one way to do so. Even so, he has had experiences during his practice after which he has questioned whether he did the right thing. Lown speaks of one particular situation he faced in his practice that deeply disturbed him, and has since made him more cautious as a practitioner. One of his patients was a visual artist, a painter, who suffered from angina, a condition that prevented him from being able to eat. This man’s angina was extremely bad, so bad that Lown had “never seen the likes of it.” Lown could tell that this man needed an operation, and fast. At the time, he viewed the situation as “an open-and-shut case.” He sent the man in for an operation, which was extremely successful, and Lown thought the case was resolved. 

However, when his patient came in for a follow-up, he “cursed” Lown, and accused him of being a bad doctor. “He was so distraught. He said, ‘You’re not a good doctor; you’ve done me the greatest evil you can do to a person. You’ve destroyed me as a human being.’” It turned out that, as a result of his surgery, the man had had a small stroke and had lost the use of his right hand. The result was that he could no longer paint:

“With the angina, he could paint; he wouldn’t have angina when he painted. Couldn’t eat, but he could paint. Now he couldn’t [paint]. And life wasn’t worth living.”

Lown reflects that, faced with the same situation again, he would be “much more careful in outlining … risks” to his patient. As it turned out, he had another patient a few years later who was facing the prospect of a risky heart operation, without which, her other doctors told her, she would die “within three months.” When she came to see Lown for a consultation, he approached her case from a different angle. “I said to her, ‘What do you want to do with the rest of your life?’” The patient was a prominent professor at a Boston university, and she quickly responded, “I want to summarize my life’s work.” Lown asked her how long she thought that would take, and she said that she thought it would take her a year. He told her he thought she had that much time to live. He advised her to not undergo the operation, and instead to pursue her writing in the time that she had left:

“And, she did. She lived six years and she wrote up all the things she needed. But I knew if she’s operated on, it’s too uncertain. She may have a little stroke, and that experience [with the painter] helped guide me.”

As accomplished as Lown was, he still needed to take the time to reflect on his approach to work and consider the speed with which he was making decisions about other people’s lives.

What do you think about Dr. Lown’ s decisions? In going forward, do you think there are additional factors he should take into consideration in his work? How would you suggest he advise young surgeons, who are just starting out in the field?