When I was a fourth-year student in medical school, I had the good fortune to be named a winner of an essay competition sponsored by the John Conley Foundation. I was further honored by the subsequent publication of my winning essay in the Journal of the American Medical Association (JAMA). Here is a part of the introduction:

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“It takes time to understand that some microbes will continue to mutate more quickly than antimicrobials can be developed to treat them or that manufactured infant formula is not an improvement over the real thing.” Here I was making the point that the technological explosion of the 20th century, as fantastic as it was, would have its limits, and that the patient-physician relationship transcends technology.

When I think about an overarching theme for the 20th century, I think about how large things got. Skyscrapers, phone companies, fast food supply chains. The bigger the better, we used to say. Growing up in the second half of the 20th century, I don’t think we really thought about how big might be big enough. Too big had not yet occurred to us. Yet here we are in the 21st century, thinking about solutions to enormous problems that have resulted from unlimited bigness.

At the time I wrote that winning essay, I did not yet see that manufactured infant formula was just one among many types of edible compromises available for sale. [Note, as an aside, the scientific allusion in the word “formula.”] In the 20th century, technology was thought to be the solution, and the solutions were assumed to be absolute.

I didn’t realize what I know now, that there are thousands and thousands of edible compromises on the market. Food is a little bit different from formula, I know, because there are certainly some moms and babies who will be unable to nurse. I’m glad we have manufactured formula, like medication, for them. But the rest of us, as well as our pets, for that matter, will never need formula, or partially hydrogenated vegetable oil, or maltodextrin, or corn syrup, or any of the thousands of other sources of manufactured calories that fill miles and miles of super-duper-market shelves across this nation. Not just that, but these manufactured calories have played a major role in one of the greatest pandemics in human history.

So you tell me: Was justice done?  [Name that movie reference.]

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