Words Create Worlds.6 Doctors Against Fascism

“Words create worlds,” Rabbi Abraham Joshua Heschel.[1]

“Words create worlds.” These are the words of Rabbi Abraham Joshua Heschel, here is the full quote, remembered by his daughter, Susannah Heschel:

“Words, he often wrote, are themselves sacred, God’s tool for creating the universe, and our tools for bringing holiness — or evil — into the world.  He used to remind us that the Holocaust did not begin with the building of crematoria, and Hitler did not come to power with tanks and guns; it all began with uttering evil words, with defamation, with language and propaganda.  Words create worlds he used to tell me when I was a child.  They must be used very carefully.  Some words, once having been uttered, gain eternity and can never be withdrawn.  The Book of Proverbs reminds us, he wrote, that death and life are in the power of the tongue.”[2]

I have been writing this series, Words Create Worlds, based on the words and writing of Rebecca Solnit, Rob Riemen, Timothy Snyder, Madeleine Albright, Jason Stanley, and physicians: Bandy Lee, Robert Jay Lifton, and Judith Herman. I was inspired by these authors and particularly by Riemen’s To Fight Against this Age: On Fascism and Humanism and Rebecca Solnit’s Call Them by Their True Names and their discourse about how words shape our reality. The title for this series of essays comes from Rabbi Heschel who cautions us to be careful with the words we use. I fear that these last four years we have been over-cautious in coming to call the words of the current president of the United States of America fascist. Dr. Bandy Lee’s Twitter profile states, “Uninvolved in politics until politics invaded my area of expertise. I take my professional responsibility to protect society seriously.” Similarly to Dr. Lee, I feel compelled to speak up politically because fascism is a public health crisis. As Foucault wrote, the “first task of the doctor is therefore political: the struggle against disease must begin with a war against bad government.”[3]

The Responsibility of Spiritual Democracy

As I was working on Becoming Medicine: Pathways of Initiation into a Living Spirituality with Joseph Rael, I began to see that while the spiritual path may lead away from society at first, it eventually leads back – one returns after initiation with a new found sense of responsibility for the land and all the creatures that live on it: four-leggeds, two-leggeds, fin-ed and wing-ed. The spiritual path leads to a sense of Oneness, of non-duality. When you start to feel One with creation, you realize that you are responsible for creation. Words create worlds. The etymology of the word “responsible” goes back to a similar word, “answerable.” To be on a spiritual path, which Joseph would say is the same as the path of being a True Human Being, is to be answerable to the Earth. This led me to feel that we had to write a section of the book on the responsibility of the spiritual seeker.

Joseph Campbell taught that the hero’s or heroine’s journey had three stages: separation from the known world, initiation into the new world, and then return to the old world, but now transformed and carrying a responsibility for healing and transforming the world. For our book, this meant writing about our interrelationship with the land; about moving from “other” to “brother and sister;” about Oneness and non-difference; and about the concept of spiritual democracy – the spiritual responsibility we have for all beings. This responsibility led to us losing our publisher as the book turned out to be 500 pages long.

Joseph Rael, in the early 1980s had a vision of men and women sitting in a circular structure, half above ground, half below, singing and chanting for world peace. He followed this vision across the globe, helping to create over 60 Sound Peace Chambers on four different continents. He was recognized by the United Nations for this work on world peace. It is this spirit of peace that leads to my now needing to speak words of peace to counter the 20,005[4] divisive words of fascism.

Circle of Light Sound Chamber

Being Present with Suffering

Words Create Worlds. To be silent or neutral is to take the side of the bully. There are times that one can lose one’s humanity through inaction. Yes, it is true that one can act without humanity as well, that is a definition of fascism: actions without humanity and against humanity. When I was going through medical school in the early 1990s, struggling with the dehumanizing aspects (Perri Klass described medical school as, A Not Entirely Benign Procedure), I was also reading the Chicago Tribune regularly, trying to understand what was happening in the former Yugoslavia and Rwanda. I had read about World War II extensively when I was younger, I knew about fascism and genocide – but I struggled to make sense of what it meant to be a human being in the late 20th Century as I was immersed in learning the language of pathology and despair as I learned to diagnose and treat illness. I was overwhelmed by with the feeling that I was not being taught how to be human and present with either my suffering, my patients’ suffering, of the suffering of the world.

In The Shadow of the Slaughterhouse, D. Kopacz

In the Shadow of the Slaughterhouse: Silence is the Only Real Crime Against Humanity

I brought my friends together to write and to bear witness to the age. I was reading the Beats in those days, Kerouac, Ginsberg, Burroughs, and I loved how they created their own interpretive community and supported each other. The Beats didn’t shy away from suffering or madness, but bore witness to it, as Ginsberg wrote in Howl, “I saw the best minds of my generation destroyed by madness, starving hysterical naked…” Or as William S. Burroughs wrote to Allen Ginsberg, “Whether you like it or not, you are committed to the human endeavor. I cannot ally myself with such a purely negative goal as avoidance of suffering. Suffering is a chance you take by the fact of being alive.”[5] My friends and I put together an unpublishable manuscript that included cut-up art, multiple perspectives, and no coherent theme, other than a bunch of twenty-somethings let loose in the big city and reading a lot of books and trying to find their way in the world. I titled this collection, In the Shadow of the Slaughterhouse: Silence is the Only Real Crime Against Humanity. It included essays I wrote on the Native American genocide (from Dee Brown’s Bury My Heart at Wounded Knee) and an essay on witnessing and the survivor (from reading Terrence des Pres’ The Survivor: An Anatomy of Life in the Death Camps). In a way, these essays on Words Create Worlds are a continuation of In the Shadow of the Slaughterhouse: Silence is the Only Real Crime Against Humanity. I cannot remain silent as the shadow of fascism falls across the country.

This is not the succinct entry into the topic of Doctors Against Fascism that I envisioned – but then, the fight against fascism is not through bullets or bullet points, but through re-humanization. What is more re-humanizing than stories about human beings trying to make sense of suffering and bear witness? It is our humanity, our shared humanity, that protects us against the dehumanization of fascism. All of us, as human beings, are responsible for humanity because we are part of humanity. Similarly, as creatures of the Earth we are all responsible for the Earth, as we are part of Her.

What it Means to be a Professional

I have been thinking about the idea of medical activism and what it means to be a professional.[6] In my work on re-humanizing medicine through the compassion revolution,[7] I have argued that much of what we are taught in contemporary medicine is how to be a technician rather than on how to be a healer. A technician is not a professional, necessarily, but someone who performs a set of route protocols and techniques. A healer, on the other hand, is someone who learns techniques, but who also learns humanity – for it is our human presence that we must bring to suffering. While a technique or protocol might treat a disease, suffering needs humanity and compassion. To this end I have continued to argue that as physicians we should be good technicians, but that we must also be good human beings. To be a good medical technician, we are required to engage in Continuing Medical Education. To be a good human being we have to seek out our own Continuing Human Education – this is what I call the counter-curriculum of re-humanization.[8]

To be a professional means that we answer to a higher calling than just simply doing our jobs or staying in our lanes,[9],[10] it means that we are responsible to humanity. This means that our job does not end at the walls of our exam room – our job as healers is to attend to the public health of humanity.

Witnessing Professionals

In an interview with Bill Moyers, Robert Jay Lifton describes the concept of health care providers as “witnessing professionals” who have a responsibility to confront malignant normality (such as when lies and cruelty become normality). Lifton ends the interview with the following statement:

“I always feel we have to work both outside and inside of our existing institutions, so we have to…examine carefully our institutions and what they’re meant to do and how they’re being violated. I also think we need movements from below that oppose what this administration and administrations like it are doing to ordinary people. And for those of us who contributed to this book [The Dangerous Case of Donald Trump] — well, as I said earlier, we have to be “witnessing professionals” and fulfill our duty to warn.”[11]

As Psychiatrists We Feel Obliged to Express Our Alarm

Robert Jay Lifton is psychiatrist and psychohistorian I greatly admire, he is a living example of a witnessing professional who has worked at both the individual and the societal level for healing. He and Judith Herman (another psychiatrist I respect) wrote a letter to the editor of The New York Times March 8, 2017.[12]

“To the Editor:

“Soon after the election, one of us raised concerns about Donald Trump’s fitness for office, based on the alarming symptoms of mental instability he had shown during his campaign. Since then, this concern has grown. Even within the space of a few weeks, the demands of the presidency have magnified his erratic patterns of behavior.

“In particular, we are struck by his repeated failure to distinguish between reality and fantasy, and his outbursts of rage when his fantasies are contradicted. Without any demonstrable evidence, he repeatedly resorts to paranoid claims of conspiracy.

“Most recently, in response to suggestions of contact between his campaign and agents of the Russian government, he has issued tirades against the press as an “enemy of the people” and accusations without proof that his predecessor, former President Barack Obama, engaged in partisan surveillance against him.

“We are in no way offering a psychiatric diagnosis, which would be unwise to attempt from a distance. Nevertheless, as psychiatrists we feel obliged to express our alarm. We fear that when faced with a crisis, President Trump will lack the judgment to respond rationally.

“The military powers entrusted to him endanger us all. We urge our elected representatives to take the necessary steps to protect us from this dangerous president.” (Robert Jay Lifton & Judith Herman)

A Duty to Warn

Dr. Bandy Lee organized an April 20, 2017 conference at Yale, entitled, “Does Professional Responsibility Include a Duty to Warn?” From this conference grew the first edition of The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President, and then the second edition with 37 experts, The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President. Dr. Lee and colleagues then formed the World Mental Health Coalition and published The World Mental Health Coalition Documents, which collects conference transcripts, media transcripts, letters and statements, a report on the Mueller Report, and a Prescription for Survival. Dr. Lee writes:

“Since society is one of psychiatry’s primary responsibilities, next to that of patients, there is unquestionably a duty not only to warn but to protect and to promote its wellbeing. We are bound by law in most states, as now replicated in multiple countries and even in fields outside of mental health, that we must warn even those who are not our clients in the case of danger. We also have an obligation not only to warn but to take steps to protect potential victims if security personnel will not act; safety is always first priority.”[13]

Agent 488 (aka Dr. Carl Gustav Jung)

There are precedents of psychiatrists using their skills for public health and safety. Robert Jay Lifton’s career as a psychohistorian is an example – understanding dangerous movements such as: Nazi Germany, Chinese thought reform, Aum Shinrikyō, climate deniers, and the current president of the USA. Swiss psychiatrist, Carl G Jung (aka Agent 488)[14] was recruited by the United States during World War II to provide psychological profiles of Hitler. Jung’s descriptions of Hitler’s psychology and behavior are eerily similar to the current president of the United States:

“All these pathological features— complete lack of insight into one’s own character, auto-erotic self-admiration and self-extenuation, denigration and terrorization of one’s fellow men (how contemptuously Hitler spoke of his own people!), projection of the shadow, lying, falsification of reality, determination to impress by fair means or foul, bluffing and double-crossing — all these were united in the man who was diagnosed clinically as an hysteric, and whom a strange fate chose to be the political, moral, and religious spokesman of Germany for twelve years.”[15]

Jung cautioned about Hitler’s systematic lying which he described as pseudologia phantastica. Is our current president’s 20,055 falsehoods (as of 7/9/20) another example of pseudologia phantastica?[16]

“A more accurate diagnosis of Hitler’s condition would be pseudologia phantastica, that form of hysteria which is characterized by a peculiar talent for believing one’s own lies. For a short spell, such people usually meet with astounding success, and for that reason are socially dangerous.”[17]

After World War II, many professionals wondered, “Why would so many apparently rational, even educated people, follow a fascist?”[18] Jung would say that those who do not deal honestly with their own shadow project it on to “others” who are then seen as bad, dangerous, untrustworthy. Jung saw Hitler as an inferior personality who was over-taken by his own shadow, projecting his own darkness on to the world and then trying to destroy his own darkness by destroying others. From that perspective, a fascist movement is a giant psychological experiment and a fight between those who have little self-awareness and do not take responsibility for their own darkness and those who are committed to truth and reality and are willing to introspect. Jung describes the formation of mass psychosis and mob psychology:

“Its leader will soon be found in the individual who has the least resistance, the least sense of responsibility and, because of his inferiority, the greatest will to power. He will let loose everything that is ready to burst forth, and the mob will follow with the irresistible force of an avalanche…[H]e symbolized something in every individual. He was the most prodigious personification of all human inferiorities. He was an utterly incapable, unadapted, irresponsible, psychopathic personality, full of empty, infantile fantasies, but cursed with the keen intuition of a rat or a guttersnipe. He represented the shadow, the inferior part of everybody’s personality, in an overwhelming degree, and this was another reason why they fell for him.”[19]

Untitled, D. Kopacz

The Plague of Fascism

As I have watched this regime unfold over the past four years, my early uneasiness has gradually turned to alarm. I think it is time for the Doctor to make the diagnosis: fascism, prognosis: serious.

In 1947, Albert Camus wrote his allegory on fascism, The Plague. Camus cautioned us, through his indefatigable Dr. Rieux,

“I have no idea what’s awaiting me, or what will happen when all this ends. For the moment I know this: there are sick people and they need curing. Later on, perhaps, they’ll think things over; and so shall I. But what’s wanted now is to make them well. I defend them as best I can, that’s all.”[20]

Dr. Rieux’s commitment to defend sick people as best he can reminds us of the professional commitment of Drs. Lee, Lifton, and Herman, as well as Dr. Fauci and all the frontline health care workers doing the best they can during this pandemic. Just as Lifton encourages us to be witnessing professionals, Rieux’s writing bears witness to the peoples’ suffering:

“It could only be the record of what had had to be done, and what assuredly would have to be done again in the never ending fight against terror and its relentless onslaughts, despite their personal afflictions, by all who while unable to be saints but refusing to bow down to pestilences, strive their utmost to be healers.”[21]

Camus’ choice of a plague as an allegory of fascism resonates with our current situation. We are currently in an actual viral pandemic of Covid-19 and this viral plague has further illuminated the plague of fascism. The president’s deplorable and counter-scientific handling of the pandemic has led to the United States of America, the country with the most expensive health care system in the world, and with 4% of the world population, to account for roughly 25% of the cases of Covid-19 worldwide. The president has contradicted and undermined scientists and physicians, he has encouraged the opposite of public health measures (ridiculing masks and those who wear them), he has preached economy over public health, and has spread over one-third of the global misinformation on the virus.[22] And, as of 10/2/20, the president himself is now infected with Covid-19, a carrier of the plague of the pandemic and the plague of fascism. However, we knew all along that we were electing a sick individual who is a plague – a plague of lies, a plague of bullying, a plague of divisiveness, a plague of crookedness, a plague of Covid-19 and, ultimately, a plague of fascism.

Doctors Against Fascism

The way you learn how to diagnose something in medical school is to see case after case after case – until it becomes automatic. At the first signs or symptoms, you see the incipient signs of a more serious illness. This is why we need Doctors Against Fascism – to diagnose and warn us that the fascist bacillus is starting to dehumanize our population and make it vulnerable to fulminant fascism.

The Doctor is in and has bad news for you – the prognosis of our nation’s health is serious. We are infected with fascism – it has taken hold in the brains of many of our citizens and it is spreading through our institutions. Words Create Worlds and we are surrounded by 20,055 and counting words of fascism. Every lie is an assault on reality and every bit of reality that is eroded weakens the immune system of democracy, making us vulnerable to infection with the unreality of fascism.

The Growing Stack of Books I Keep on My Desk as a Reminder

This series, Words Create Worlds, grows out of my work with Joseph Rael on peace. In Becoming Medicine: Pathways of Initiation into a Living Spirituality, I felt compelled to write about the responsibility of mystical, visionary, and shamanic experience—that we must work toward “Spiritual Democracy.” At its deepest point, mystical experience leads to an awareness that we are all one and this comes with a responsibility to challenge words of separation which ultimately lead to fascism. Mystical experience is a pathway that leads us to question who we are and gives us a responsibility to use our words wisely to create worlds where we are becoming the medicine that our world needs. As Rumi says, “We are pain and what cures the pain.”[23]


[1] Life Between the Trees blog, https://lifebetweenthetrees.wordpress.com/2012/08/06/words-create-worlds-monday-morning-parable/. I first came across a shorter instance of this quote in the Omid Safi reference below.

[2] Ibid.

[3] Michel Foucault, The Birth of the Clinic (New York: Vintage Books, 1994), 38.

[4] “In 1,267 days, President Trump has made 20,055 false or misleading claims,” Updated July 9, 2020. The Washington Post’s Fact Checker’s ongoing database of the false or misleading claims made by President Trump since assuming office. https://www.washingtonpost.com/graphics/politics/trump-claims-database/?utm_term=.27babcd5e58c&itid=lk_inline_manual_2&itid=lk_inline_manual_2

[5] William S. Burroughs, letter to Allen Ginsberg The Letters of William S. Burroughs, Vol. 1: 1945-1959, p. 227.

[6] David Kopacz, “Medical Activism: A Draft Working Paper,” (8/11/20) in the Being Fully Human Blog, https://beingfullyhuman.com/2020/08/11/medical-activism-a-draft-of-a-working-paper/.

[7] David Kopacz, Re-humanizing Medicine: A Holistic Framework for Transforming Your Self, Your Practice, and the Culture of Medicine, Washington DC: Ayni Books, 2014.

[8] Ibid. Also see David Kopacz, “A Proposition for a Counter-Curriculum in Healthcare Education and Practice,” (9/10/16), Being Fully Human blog, https://beingfullyhuman.com/2016/09/10/a-proposition-for-a-counter-curriculum-in-healthcare-education-and-practice/

[9] “Doctors Revolt After N.R.A. Tells Them to ‘Stay in Their Lane’ on Gun Policy,” Matthew Haag, The New York Times, Nov. 13, 2018. The original criticism was in a Tweet from the NRA, “Someone should tell self-important  anti-gun doctors to stay in their lane. Half of the articles in Annals of Internal Medicine are pushing for gun control. Most upsetting, however, the medical community seems to have consulted NO ONE but themselves.” https://twitter.com/NRA/status/1060256567914909702.

[10] “Take Two Aspirin and Call Me by My Pronouns: At ‘woke’ medical schools, curricula are increasingly focused on social justice rather than treating illness,” Stanley Goldfarb, Wall Street Journal, 9/12/19.

[11] http://billmoyers.com/story/dangerous-case-donald-trump-robert-jay-lifton-bill-moyers-duty-warn/

[12] Robert Jay Lifton and Judith Herman, “‘Protect Us From This Dangerous President,’ 2 Psychiatrists Say,” The New York Times, March 8, 2017, https://www.nytimes.com/2017/03/08/opinion/protect-us-from-this-dangerous-president-2-psychiatrists-say.html

[13] Bandy X Lee, “American Psychiatry’s Complicity with the State,” in Bandy Lee (ed) The World Mental Health Coalition Documents, 299.

[14] Jung was recruited by the Office of Strategic Services (OSS), the organization that eventually grew into the CIA and INR, to provide psychological profiles of political leaders, foremost among them Adolf Hitler. Deirdre Bair, Jung: A Biography. New York: Back Bay Books, 2003, pages 481-495.

[15] CG Jung, “After the Catastrophe” (1945) in CW 10 Civilization in Transition, page 203.

[16] The Washington Post Fact Checker, 7/9/20, https://www.washingtonpost.com/graphics/politics/trump-claims-database/?utm_term=.27babcd5e58c&itid=lk_inline_manual_2&itid=lk_inline_manual_2

[17] Ibid., 203-204.

[18] For a recent analysis of this question, see John Dean and Bob Altemeyer’s Authoritarian Nightmare: Trump and His Followers.

[19] CG Jung, “The Fight With the Shadow” (1946) in CW 10 Civilization in Transition, 220-223.

[20] Albert Camus, The Plague, New York: Vintage International, 1991, p. 127.

[21] Ibid., 308.

[22] Sarah Evanega, Mark Lynas ,Jordan Adams, Karinne Smolenyak, “Corona virus misinformation: quantifying sources and themes in the COVID-19 ‘infodemic’”

[23] Rumi, “We are the mirror as well as the face in it,” The Essential Rumi, trans. Coleman Barks, 106.

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