"Upgrade the West, Manage the East"

Brzezinski's Strategic Vision

“Balancing the East, Upgrading the West”—that’s the most succinct summation of Zbigniew Brzezinski’s new articulation of U.S. grand strategy, Strategic Vision.  In a wide-ranging 192 pages expounding on U.S. interests in the world’s most strategically relevant nations, Brzezinski seeks to present a new blueprint for continued American relevance in a world whose center of gravity is shifting toward the east. Eastern Europe and Asia Minor are the fulcrum of this new center of world power, and strengthening Western power here will provide us the leverage to ensure that democracy, human rights, and rule of law remain vital to the liberal international order. In this essay I’ll show why the Western relationship with Russia and Turkey will perhaps be the defining arena for the global politics in the next decade.

Brzezinski recalls the early 20^th century geopolitical strategist Halford Mackinder, who argued in a 1904 paper before Britain’s Royal Geographic Society that Eurasia would constitute the crucial “pivot area” of geostrategy, an emerging discipline of world politics as defined by control of economic resources.  By 1919, Mackinder would summarize his theory thus:

"Who rules East Europe commands the Heartland;

who rules the Heartland commands the World-Island;

who rules the World-Island controls the world."

Granted the father of modern geopolitics could not have predicted the primacy of Middle East oil, the rise of China, and the emergence of asymmetric warfare as key alternatives to his favored “pivot” point in geostrategy, but it’s nonetheless difficult not to acknowledge his prescience in emphasizing Eurasia which extends to even contemporary policy-making.

Eastern Europe is crucial not only to Mackinder in the early 20^th century and Brzezinski today, but also in Napoleon’s attempts to take Russia in the early 19^th century. Also, in the 1930s and 1940s Mackinder’s theories influenced a generation of “organic state” geo-strategists upon which were based Nazi expansionist efforts to move into Eastern Europe and eventually take Russia. The emphasis on Eastern Europe also dominated much of Cold War containment policy, and Brzezinski has devoted much of his career to realizing Mackinder’s original vision that whoever controls Eastern Europe can essentially make a claim on world hegemony. His 1950 Masters thesis at McGill University focused on nationalities within the Soviet Union. As President Carter’s National Security Advisor, Brzezinski highlighted the importance of bolstering Soviet dissidents in Eastern Europe, many of them leading nationalist movements. In 1988, Brzezinski correctly argued that the Soviet Union would eventually fracture in Eastern Europe along lines of nationality, directly recalling his original Masters thesis nearly forty years before and his work as Carter’s National Security Advisor.

As Mackinder did, Brzezinski strongly emphasized Eurasia in his more broad and well-known 1997 book The Grand Chessboard. With the more programmatic Strategic Vision of 2012, Brzezinski gives country-by-country instructions for continued American influence during the next 25 years. With little emphasis on South America, Africa, or Australia, Strategic Vision focuses in on Europe and Asia, but even Europe is mostly assumed away as part of the West. The true focus, aside from how to repair America domestically, is almost exclusively on Asia. This is naturally in step with much of current American policy, as exemplified, for instance, in Secretary of State Hillary Clinton’s recent essay in Foreign Policy, “America’s Pacific Century:”

The Asia-Pacific has become a key driver of global politics. Stretching from the Indian subcontinent to the western shores of the Americas, the region spans two oceans -- the Pacific and the Indian -- that are increasingly linked by shipping and strategy. It boasts almost half the world's population. It includes many of the key engines of the global economy, as well as the largest emitters of greenhouse gases. It is home to several of our key allies and important emerging powers like China, India, and Indonesia.

In order for our Asia policy to succeed, however, we’ll need to focus much of our resources on “upgrading the West” in order that we may “manage the East.” Brzezinski devotes many pages to how America can repair itself domestically (by addressing issues like income inequality, gridlocked politics, decaying infrastructure, and national debt), but those can be addressed in another essay. Likewise, much weight can also be put on partnering with China in a strategic dialogue and fostering pro-American values of human rights, free and fair elections, and the rule of law there. However, that too is a subject for another essay-length examination needed to tease out the many complexities lying in store in Brzezinski’s thin, but dense volume.

The point I want to make here is that we cannot ignore the degree to which we still live in Mackinder’s world, and that in order for America’s example and values to have worldwide power, we must focus on the region of the world that early scholar termed the “heartland.” Eastern Europe has been essential to geostrategy for a century and much of it (the Russian half, at least) remains fiercely independent, ambivalently nostalgic for the grandeur of its Soviet past, reluctant to embrace rule of law and free elections, and somewhat inclined toward a Russo-Sino alliance. Cultivating Russia as a crucial member of the upgraded West is a vital piece of American strategy. Likewise, Turkey is another key nation of the upgrading West, and though it’s not technically part of Eastern Europe, it’s directly adjacent to it. Turkey’s long history of secular modernization in a predominantly Muslim nation makes it as important a member of the greater West as ever before in light of the recent Arab Spring. It began secularization per the European model in 1924 under its first president, Mustafa Kemal Ataturk, and we should support efforts for Turkey to satisfy requirements to accede into the European Union within the next decade.

Because Russia and Turkey are vital members of the new West, I want to devote the remainder of the essay to showing how they represent the crucial pivot point in America’s efforts to upgrade the West, manage the East, and to remain the world’s foremost beacon of stability and human prosperity. I’ll look first at Russia, examining the challenges and obstacles for democracy before outlining a plan for American influence there per Brzezinski’s prescription. I’ll then do the same for Turkey, first highlighting the problems we face before showing how we can make the most of the situation.

Russia presents a major long-term strategic challenge over the next quarter-century. Its problems are many. First Brzezinski notes, “Russia’s demographic crisis, political corruption, outdated and resource-driven economic model, and social retardation” are among its greatest issues. However even worse is the “persisting disregard…for the rule of law” which is “perhaps its greatest impediment to a philosophical embrace with the West” (Brzezinski 140). While the strongest inclination toward Europe exists in the Russian business elite, the political elites have expressed more of an inclination toward separation from America or to be an outright rival to America. Other Russian elites eye the vast continental expanse of the nation’s Eurasian breadth as a potential source of power (though the land is largely undeveloped and barren). Still others want to see Russia project its power into a greater “Slavic Union” that gives preferred treatment to the Ukraine and Belarus. And most potent are those who dream of the past Soviet strength, those who don’t question why “Lenin’s embalmed remains continue to be honored in a mausoleum that overlooks the Red Square.” In short, the jury is still out on whether Russia has any desire to even be a part of the West.

            Though there is much reason to fret, we can also be encouraged by the surprising, if short-lived, presidency of Dmitri Medvedev. Brzezinski’s book was released in January, shortly before Putin unsurprisingly won the presidential elections. Therefore Strategic Vision at least held out the possibility that Putin might not regain his authoritarian and anti-Western hold on the country. Yet although Medvedev had been hand-picked for the presidency by Putin, Medvedev had surprised many with his outspoken advocacy for democracy and human rights. His online statements at the official Web portal for the President of Russia impressed Brzezinski so much that the author singled them out for spotlighting in a rare offset text box in the book:

Democracy needs to be protected. The fundamental rights and freedoms of our citizens must be as well. They need to be protected from the sort of corruption the breeds tyranny, lack of freedom, and injustice…Nostalgia should not guide our foreign policy and our strategic long-term goal is Russia’s modernization. [One can only wonder whom Medvedev had in mind when making his pointed reference to “nostalgia in foreign policy.]

              The fact that such sentiments can exist at the top level of Russian government proves that democratic dreams have strong presence in modern post-Soviet Russia even though at present internal chaos breeds the popular notion that Putin’s strongman tactics are necessary for now to hold the nation together. Yet the necessity for short-term authoritarianism does not mean Putinism is a reliable long-term project. Indeed Brzezinski points out major flaws in each of the alternative long-term visions for Russia’s strategic interests that I outlined above. Each approach that does not advocate unity with the West is either unrealistic and unsustainable. Brezisnki argues, as Medvedev does, that Russia’s “only real option” for future prosperity is a future partnership with Europe, Asia, and yes, America.

             Though the obstacles for near-term philosophical affinity with Russia appear bleak, Brzezinski offers an important ray of hope, “it is useful to bear in mind the dramatic transformation of global geopolitical realities that has occurred in just the last forty years and the fact that we live in a time characterized by the dramatic acceleration of history.” As new technologies help spur new revolutions in information availability and consequently in political consciousness (with examples from the Gutenberg printing press all the way to the al-Jazeera and the Arab Spring), the progress of strengthening democratic values in Russia might occur far quicker than we might think.

            While Russia is at best ambivalent about joining the West, there is no question that Turkey has already long harbored aspirations of Europeanization. A more European Turkey is as much in the Turkish interest as it is the Western interest. “It is a geopolitical reality,” Brzezinski writes, “that a genuinely Western-type Turkish democracy, if solidly anchored in the West through more than just NATO, could be Europe’s shield protecting it from the restless Middle East” (Brzezinski 128). We can also assume that the demonstration effect of Turkey’s secularization and democratization could influence political consciousness in Tunisia, Egypt, and the rest of the Arab world in a more pro-Western direction. Bolstering Turkey as a regional power and a reliable counterweight to Iranian theocracy is a long-term strategic interest.

While there is a risk of Turkey backsliding toward Islamic theocracy, the nation’s long traditions of modern secular democracy and its affinity for the West make courting it far easier than Russia. The challenges in the Turkish case are much fewer: “some persisting retardation in some social aspects including press freedom, education, and human development” (Brzezinski 137).  The most pressing challenge Brzezinski highlights is Turkey’s continued exclusion from Europe per European anti-immigrant and anti-Muslim sentiment as well as EU fears of embracing a poorer country particularly while in the grips of the debt crisis. Add to this the fact that 18 of the 35 chapters of negotiation on Turkey’s accommodation to EU law are currently frozen by France, the EU, or Cyprus, and we see major impediments to bringing Turkey into the fold. If we perpetuate this exclusion, we could be grappling with an increasingly bitter and anti-Western class of poorly educated people for whom Islam will gain credence.

Although Brzezinski’s Strategic Vision is light on programmatic details for how we can include Turkey in the wider West, the recipe is widely available elsewhere. While Turkey has largely expressed an historical desire to become more European and is already a NATO member, the progress of talks to help it gain access to the EU has been stalled for the last several years. By contrast, while Brzezinski could only outline the alignment of interests that might occur for Russia to simply want to one day join NATO or the EU, the biggest issue right now for Turkey is how to progress through the messy negotiation process to actually join the EU. Our embrace with Turkey now only faces practical issues, while with Russia it is still in philosophical doubt. By 2013 it is highly unlikely Turkey will satisfy all 35 areas of EU law that it needs to satisfy for the next round of evaluations. However, 2021 is more realistic target to work through the current stalemate.

Though most commentators and strategists will continue to emphasize China as the most intimidating power rising today, we are wise to remember that China’s rise is not as sure as some make it out to be. The Chinese experience is fraught with many problems, particularly the rising political consciousness in its new middle class and its problem squelching dissidents in the information age. While China is being forced to sort out its internal problems, no one doubts the need for a long-term strategic dialogue between our two countries. But perhaps even more crucial in increasing the American stake in the new global power balance is to focus on Turkey and Russia. Strengthening Western democratic values in these nations will actually directly strengthen democratic values in China. We’ll be wise to remember the world that Mackinder saw more than a century ago.

But even further back than Mackinder’s observations are Brzezinski’s exhortations about the Byzantine experience following the fall of Rome in 476. One of his prevailing themes is that, while Byzantine could insulate itself geographically and politically from the failing Roman Empire, such lucky diplomatic finesse is impossible in the globally interconnected world of 2012. Brzezinski uses this motif as synecdoche for his overall vision of the book that America must carefully manage its relations throughout all of Eurasia because it is impossible to remain a world power in an isolationist context. But the Byzantine example is especially powerful and it’s worth taking the metaphor a couple steps further. Accepting Brzezinski’s point of global interdependence, Byzantium can be a brighter bellwether of modern geostrategy. Whereas 1,500 years ago it was a model of isolation, today the descendents of Byzantium which make up Turkey and parts of Russia could be the perfect symbol for the global appeal of democratic values in the 21^st century. 

John F. Kennedy's Two Fathers

Kennedy’s Two Fathers

            In my first essay I explored how Obama’s foreign policy instincts are deeply Neibuhrian, in that they embody the tension between the cynic and the idealist, between the children of darkness and the children of light. In Chris Matthew’s recent biography Jack Kennedy: Elusive Hero, there is also that similar lifelong tension between conservatism and liberalism . While Barack Obama was a lifelong liberal for whom Neibuhr would add a sharp biting edge, John F. Kennedy lived most of his life as a conservative or a moderate and would only proudly label himself a “liberal” a couple years before he ran for president. As a youth, Kennedy was weaned on the great stories of Arthurian literature, and this deep identification with heroism and eloquence eventually projected itself onto Winston Churchill, the great conservative leader who would define a generation and become his personal idol. Yet, just as he admired Churchill from afar, the young Jack was well aware that his own father, the American ambassador to Britain, was a staunch supporter of Neville Chamberlain’s good-intentioned but ill-fated appeasement policies which Churchill vehemently opposed. The tension between his biological father and his metaphorical or intellectual father would define Kennedy’s life, from his senior thesis at Harvard, Why England Slept, all the way up through his presidency in which he strived to construct a Churchillian foreign policy.

            Matthew’s primary goal in Elusive Hero is to portray Jack Kennedy as a “hero” and as an independent thinker, not truly beholden to any counselor but himself. Kennedy’s story, therefore, truly begins in his prep school years at Choate, where as a sickly youth he found himself often in the infirmary with nothing to do other than to read. In these long hours of solitude, the boy would read the New York Times daily and close his eyes after reading each article to recall its every detail. The boy who had loved King Arthur and His Knights picked up biographies of the great men of British and American history: Lord Melbourne and Henry Clay, Lord Byron and John Quincy Adams. Of course there were also the many histories penned by Winston Churchill. “And it wasn’t knowledge for its own sake, it was the grander world he glimpsed through it,” Matthews notes. “Such habits of mind as thinking about Churchillian views of history were the glimmerings of the man he was shaping himself to become.” The young Jack’s best conversations were not with his fellow peers, but with the great heroes of history, and in engaging with these grand lives he began to realize his life too could become one of these stories.

            His fascination for Churchill’s pen in the history books soon translated into rapt attention for the man’s silver tongue in parliamentary debates, but as Jack matured and the specter of world war grew closer, his loyalties would be split between both sides of the political aisle. Kennedy’s 1940 thesis to complete his international affairs B.A. at Harvard was titled “Appeasement in Munich” and went on to be published as the bestselling book Why England Slept. It is a nuanced defense of appeasement, while at the same time a subversive critique of his father’s views. While his father Joseph Kennedy opposed fighting Hitler under any circumstance, Jack’s hero Winston Churchill had been steadily sounding the alarm against Hitler for years. Jack argued that the 1938 Munich Agreement was wise in the face of Britain, France, and America’s weak Depression-era militaries and industrial output. Fighting the Nazis so early would have been disastrous, and putting off the war a little longer through appeasement would give Britain time to re-arm and eventually properly fight the menace.  Kennedy’s thesis was a skillful political compromise between two poles, and much of Matthews’ book teases out this critical theme. “His career,” Matthews wrote, “would go on to be a similar balancing act between the nobility of valiant death on the battlefield, so admired by Churchill, and the horror of war itself, so understood by Chamberlain and his supporter Joseph Kennedy, Sr” (Matthews 38).

            After the war, Kennedy won the Massachusetts 11^th district Congressional seat in 1946, successfully defending it in 1948 and 1950. He then won a seat in the U.S. Senate in 1952, which he would hold until he became president in 1960. In most of the campaigns, particularly in the first decade of his career in politics, Kennedy would define himself exclusively as a “conservative” or as a “moderate.” Running relentless door-to-door campaigns to the right of his opponents as a “fighting conservative,” he channeled his heroism in the war into repeated victories at the polls.

In those days of ethnic politics before the parties organized themselves along ideological lines, Kennedy could easily exist as conservative within the Democrat Party. His Irish Catholicism and staunch anti-Communism would make him and his family political allies of the infamous Senator Joseph McCarthy. Jack’s brother Bobby had been a staffer in the Republican senator’s office and the boys’ father Joe had helped finance McCarthy’s campaign. Jack had danced at the Senator’s wedding. As McCarthyism and the Red Scare heated up in the early 1950s, Jack avoided the McCarthy issue at every juncture. Ken O’Donnell, who was running the Kennedy office in Boston, advised the Senator that voting to censure McCarthy would end his career. The Irish in Massachusetts, for better or worse, were standing by a fellow Irish Catholic: McCarthy. “The passions of that historic moment created strange alliances,” Matthews writes. And Jack understood the populist rage. “A part of him, the stubborn part—the part then still dominant—cheered just about anyone liberals loved to hate” (Matthews 181). Because he was not a liberal, Jack was relatively unmoved by McCarthy’s accusations of liberals. And because he was such a Cold Warrior—Jack had criticized FDR’s concessions at Yalta and Truman’s loss of territory in Asia—he was even less compelled to censure McCarthy. He coincidentally had scheduled a life-or-death surgery at the same time as this life-or-death vote, and was able to escape being pinned down on one side of the issue or other. Every Democrat and half the Republicans had voted for censure. Voting against censure, had Kennedy done it, may have saved his career in Massachusetts but would have ruined his national ambitions.

Much of Matthews’ thesis rests on the idea that Jack was an independent-minded thinker, but it’s hard not to acknowledge that events like McCarthyism showcase a young politician beholden to his greatest financial backer—his father. Betraying his father and his family would have been a far more grave offense than going against his constituents. Yet although it’s tempting to use this example to counter Matthews’ thesis, we can’t help but remember that Kennedy’s position on McCarthy (one he was very lucky not to have to express publicly) was perhaps not so different than what his other “father” Churchill would have believed. Irishness may have been the rare occasion in 1954 for the two poles of Joseph Kennedy and Winston Churchill to more easily converge in Jack’s life.

Not long later, Jack was researching and writing Profiles in Courage with his counsel and speechwriter Ted Sorenson. The book, which would win the 1957 Pulitzer Prize, highlighted eight key legislators in American history who had taken positions against their constituents in order to make votes of national importance. Could the boldly ambitious Kennedy have counted his position on McCarthy’s censure as his own “profile in courage?” History will never know, but we are left with the words of Kennedy friend and British conservative politician David Ormsby-Gore, which Matthews quotes at length on Kennedy’s moral lessons from the research on Profiles in Courage:

“He said that one of the rather sad things about life, particularly if you were a politician, was that you discovered that the other side really had a good case. He was most unpartisan in that way…. He wondered whether he was really cut out to be a politician because he was so impressed by the other side’s arguments when he really examined them in detail. When he thought there was a valid case against his position, he was always rather impressed by the arguments advanced.” (Matthews 192-193)

            It was not until this period that Kennedy began to consciously court liberal support. Between the years of 1956 and 1960, Kennedy crisscrossed the nation, shoring up support among party leaders in every state. Where before Kennedy had used the Democrat Party to help him win elections, now he was actually seeking to lead it. As a merely state-wide politician, he’d never needed to court the liberals in the party. The Massachusetts Democrats were not “as liberal as the national party. The reputation that Massachusetts would gain for liberalism, never fully on the mark, was not the case even then. In 1956, it was Joe McCarthy country” (Matthews 200). One such instance of Kennedy increasing his liberal appeal was his July 1957 Senate speech calling for a total revision of the Eisenhower Administration’s Eurocentric foreign policy of holding fast to World War II alliances and not recognizing the aspirations of developing countries. The speech was a necessary debut as an important voice of principled dissent. As the London Observer noted, his words “introduced Kennedy the statesman.” But even more importantly, the speech was a deft political calculation. Kennedy’s pollster noted that the speech had been “customized to appeal to the wing of the party whose backing his client needed. It was meant to show the liberals just how far Joe Kennedy’s boy had come. The irony, the pollster noted, like everyone else who knew Jack, was that his boss probably read more and was a good deal more informed than those on the Democratic left into whose political bed he was trying to climb.” His speech had been precisely steeped in Cold War logic but had also made the leap to connect anti-Communism with the yearnings for sovereignty present in America’s founding. “Whatever maneuvers he was slyly executing in order to win over the liberals,” Matthews writes, “he wanted, at the same time, to keep himself positioned as the best hope of moderate and conservative Democrats.”

            This ongoing paradox between conservatism and liberalism, war and peace, would immediately manifest itself in Kennedy’s presidency, beginning with his inaugural speech in January 1961. On a freezing day with eight inches of fresh snow on the ground, the new president called from the Capitol steps in his Boston accent, “We dare not tempt them with weakness. For only when our arms are sufficient beyond doubt can we be certain beyond doubt that they will never be employed.” It was a statement that could have been printed in the history books he read in the Choate infirmary as a boy, and the concept was still ingrained in his mind decades later. Matthews tells us, “The Churchillian notion of peace through strength had echoed throughout Jack’s adult life” (Matthews 325).  But the bumper sticker slogan wasn’t deployable in every international showdown. He would soon realize that while it was one thing to talk in such ringing and eloquent tones from the podium, living such blustery confidence would be much more complicated.

            The president learned heavy lessons about the brutality of nuclear realpolitik when he met Russian premier Nikita Kruschev at a summit in Vienna in 1961. Marvelling at how the Russian leader seemed nonplussed about a nuclear exchange killing 70 million people in ten minutes, he later told a close friend he’d “never come face to face with such evil” (Matthews 344). The crucial discussion at the meeting had been Berlin, with the Russians pressing for total control of West Berlin and a willingness to go to war over it. With only 11,000 Allied troops in West Berlin to face the Soviets’ 350,000 based in East Berlin, the president who had argued in campaign speeches that Berlin was the crucial front of the Cold War was faced with a massive dilemma:

“So, he knew how to talk like a war hawk. But what did it actually mean—words like that, all the threats and gun-cocking—if you’re the first American president to come into office aware of your enemy’s nuclear stockpile? It’s one thing to use words such as appeasement and surrender and vital principle with regard to Berlin when someone else is making the decisions. It was the Munich argument—the one that had so obsessed him that he’d written a book about it—adapted to the nuclear age. (Matthews 344)

            The stalemate at Berlin would extend throughout the summer of 1961, and in a pivotal July speech, the president announced that although he planned to stand firm on West Berlin, he would be prepared to give the Soviets other concessions. Eventually the stand-off ended when the Soviets constructed the Berlin Wall that August, making it impossible for either side to make quick claims on the other half of the city, and symbolizing a boundary settled for the time being. Kennedy wouldn’t have to find out whether Krushchev was bluffing about going to war over Berlin. His decision resonated with his own careful big-picture argument for appeasement two decades before. In the face of the overwhelming defeat of the Soviets taking West Berlin, then Germany and Europe, and then Asia (as he argued would happen in his campaign speeches, at least), he had kept peace. But was it peace through strength or peace through concessions? Did Jack’s steady hand in 1961 give the world a better result than Joe Kennedy or Winston Churchill would have yielded? Would Joe Kennedy have argued not to fight, to let the massively stronger Soviet army have West Berlin…in order to prevent the far, far greater horror of a nuclear war? Would Winston Churchill have called the “evil” premier’s bluff, if it really was a bluff? These are the impossible questions of trying to understand why rational men make the decisions they do, of trying to understand the unique psychology of being an fallible human being charged with making earth-shattering decisions.

            We would do well to remember Neibuhr’s words in The Ironies of American History:

  We take, and must continue to take, morally hazardous actions to preserve our civilization. We must exercise our power. But we ought neither to believe that a nation is capable of perfect disinterestedness in its exercise, nor become complacent about a particular degree of interest and passion which corrupt the justice by which the exercise of power is legitimatized.

            Obama and Kennedy represent two different sides of “the business of taking morally hazardous actions to preserve our civilization.” The Obama we know was the anti-war candidate who renewed the Patriot Act and increased drone strikes in the Middle East. Kennedy was the lifelong Cold Warrior who campaigned on strength, but would stare the prospect of nuclear war in the face many times and consider his greatest foreign policy achievement the Nuclear Test Ban Treaty. Rather than the mainstream Niebuhrian idea of recognizing evil in the world and taking up arms against it, Kennedy turned the notion inside out: the Churchillian who believed in peace through strength would learn that the most morally hazardous action he could take to preserve civilization would be to take steps to disarm.

My Unorthodox Treatment for Chronic Fatigue Syndrome (ME/CFS)

I first got sick six years ago, in late 2006. I was a junior in high school: captain of the cross country team, varsity soccer player, president of the student council. I was a go-getter, I had no time for this strange and unforgiving illness.

I checked all the familiar boxes on the way toward diagnosis: six months of being too exhausted to attend school, the all too many visits to doctors and specialists, none of whom understood what was wrong with me.

In that, I think my story will be similar to most others. I saw about 15 doctors before I found one that thoroughly and holistically understood my condition. One of the doctors diagnosed me with depression: he did not receive a follow-up visit.

Today I am not necessarily “well,” but I’m living a nearly fully functional life. Aside from my pre-illness goal of becoming an Army Ranger, I’m more or less capable of doing anything I want: skydiving, bungee jumping, horseback safaris in Africa. I’m now training for a half-marathon.

I know that every CFS patient has a distinctly different version of the illness. I myself have had what feels like different versions of it. So I know there is no one-size-fits-all formula for beating it. What I want to do, though, is say something that few doctors will be able to tell you. I hope that I can explain how to think about the illness, and how to contextualize the experience of living with it into a larger worldview. By re-thinking our way of interacting with it, we can deprive CFS of much of its power over us.

I say this because I have only a layman’s medical background. I recently graduated from the University of Georgia with degrees in international affairs and in English literature. My perspective is steeped in those fields, and I think they both provide as good a way of grappling with these horrible questions as any background ever could.

My friends in medical school tell me that they are trained to look for “horses” and not for “zebras.” CFS/ME, unfortunately, is the ultimate zebra. Zebras are rare and odd; they fall through the cracks. Doctors are trained to look for the simplest answer. CFS/ME, however, either has a complex answer, as I believe, or no answer (yet), as others will contend.

To me, though, the good news is that CFS/ME is really only a zebra to the current Western bio-medical establishment. I will outline four different approaches to thinking about the illness that either critique or transcend biomedicine. One is a literary approach. The second can be considered an anthropological or philosophical approach. The third is medical, based on what my CFS/ME specialist provides. The fourth is a practical, do-it-yourself method. The DIY method is speculative, but I do strongly contend that in the information age, well-read patients can often be more knowledgeable about their own cases than many specialists. When I was seventeen, I diagnosed myself with CFS via the Internet three months before a medical doctor did. I’m sure many other patients have done the same thing.

I can’t guarantee any of these methods will work for everyone. But at the very least, they should help deconstruct the idea that there’s nothing we can do for CFS/ME.

Literary Method

When I first got sick, I started writing. My horror had no name, the pain had no label. It was much larger than a medical illness. I had an existential philosophical problem. Rendering my troubles verbally was one of the few things I could do to get better. I had to do it. Writing was, and still is, one of the best ways for me to quiet my mind and rest my soul.

I wanted to get better so bad. I remember very distinctly the moment when I went back over the words on the page and thought to myself that the phrasing, the spirit of the words, felt startlingly similar. After thinking about it awhile, I realized that something in what I was writing felt very similar to an essay I’d read the year before in my American literature class: “Civil Disobedience,” by Henry David Thoreau. “Let your life be a counter-friction to stop the machine,” he had written in 1849.

I quickly re-read that whole essay and then moved on to Thoreau’s larger work Walden, the story of how he lived for two years in the woods in a cabin he built himself in an experiment to try and separate himself from modernity. He wanted to re-learn how to live. In the pits of a debilitating illness, so did I.

That book, and my experience of reading its slow, thoughtful sentences, is a metaphor for how to deal with CFS/ME, which medical specialists tell us is a “disease of modernity,” like heart disease, cancer, diabetes, anorexia, and others. These illnesses appear with far greater frequency in modern, developed countries than in poorer countries. If our illness is one of modernity, it follows that we should be able to separate ourselves from modernity as a way to stop it. We can make our lives a counter-friction to stop the machine. We must construct our own Walden.

The first way I constructed my own Walden was through reading.

Left for hours each day alone to contemplate my illness, I often had nothing to do other than to read. I was mostly interested in literature and philosophy (aside from books or articles about health). However, I started becoming more interested in biographies.

To this day, I am still taken with the lives of Theodore Roosevelt and John F. Kennedy. Roosevelt, as a boy, was puny and weak. Larger boys could easily beat him up. He had what we’d now call a severe case of asthma, which was dramatically less treatable then than it is now. He was confined indoors for a large part of his childhood. Eventually his father built an indoor gym for him, and the young Teddy began lifting weights daily. He would essentially re-build his stricken body into a robust force of nature. The weak boy became the vigorous champion hunter, rancher, and outdoorsman that we know him to be today. Through sheer force of will, Teddy overcame an illness that could have sidelined him for most of his life, and for this reason our 26^th president, our most energetic president, remains my CFS role model.

John F. Kennedy, another great American president, was also a sickly teenager. He was constantly in the infirmary of his prep school with some odd ailment or another. In bed with little to do, he spent much of his time reading. He devoured history and biography, becoming a great admirer of Winston Churchill. It is no mistake to say that during his sick days at the Choate School in Wallingford, Connecticut, our 35^th president began to develop a sense of who he was and of his place in history. His illness forced him to become that man, to develop that deeper part of himself. In Kennedy’s sickbed reading, I can see something of myself. It is the same process by which I formed my own self through reading when I was too sick to do anything else.

When I was a sophomore in college, I took a class called “Literature and Medicine.” The professor contended that literature is the best form of preventative medicine, for both physical and mental ailments. “You can either read literature or you can take Prozac,” she told us more than once. I remember the teacher reading a note from a former student to our class, “In my house I now have two medicine shelves in my house. One holds the normal pills like aspirin and Benadryl. The other has the books from your class.”

The book titles on that course’s syllabus were not as important as the process and perspective we learned for contending with the existential horrors and joys of living. The great classics of literature are the titles that build stronger souls. My own tastes range from Plato to Thoreau to Yeats, none of whom were featured in that class but all of whom constitute the most sublime form of medicine. They are an integral part of my therapy when my illness inevitably flares up.

Reading takes us to a higher, better place. And reading stories of human resilience in the face of seemingly insurmountable challenges is the best way for us to prepare to meet our own seemingly insurmountable challenges.

Soon we realize that the process of embracing those challenges makes us who we are. John Solomon, in his Pulitzer Prize-winning exploration of depression The Noonday Demon, puts it this way:

''Curiously enough, I love my depression. I do not love experiencing my depression, but I love the depression itself. I love who I am in the wake of it. . . . I have discovered what I would have to call a soul, a part of myself I could never have imagined until one day, seven years ago, when hell came to pay me a surprise visit. It's a precious discovery.''

Life gave me the sourest lemons, but I thought it was all the more reason to make sweet, sweet lemonade.

The Anthropological or Philosophical Approach

Getting sick set off a long and unending process of constant research to try and understand the historical, cultural, and philosophical reasons why I was ill. At times I was lucky when this great quest dovetailed with my own school assignments. For a high school project, I embarked on a 25-page tour of alternative medicines that was an excuse to do as much work as I could to find an alternative treatment that could work for me.

I did find some relief through acupuncture, Chinese herbs, massage, and other practices. Intellectually, however, I found traditional Chinese medicine (TCM) and Indian Ayurvedic medicine to be much more satisfying than studying homeopathy or aromatherapy. Ayurveda and TCM are appealing because they present totally different systems that compete with Western biomedicine. Patients with CFS/ME are “zebras” to biomedical doctors. However I suspected that other health traditions, themselves having had more millennia of continued historical practice, could be more useful in re-conceptualizing CFS/ME.  I fought for funding for a summer research fellowship after my sophomore year of college and made this line of inquiry my next subject.

My purpose in this essay is not give a full accounting of Ayurveda or TCM, but rather to explain their place in how I’ve learned to re-think CFS/ME. Any number of books or articles are available on these subjects, one of the most useful, for instance, being The Web That Has No Weaver: Understanding Chinese Medicine by Ted Kaptchuk.

Western bio-medical science is largely based on anatomy, and stems from a materialist belief that we can find illness inside the body. My understanding of the ancient Indian health tradition, Ayurveda (literally “science of life”), tells me that illness derives from a set of patterns and forces outside ourselves with which our lives intersect. Another way of explaining this would be to say that Western society trends individualistic, while Eastern cultures generally trend collectivistic, or toward holistic thinking: they see the individual in the context of his society and his surroundings.

Without delving into Ayurveda’s complex Sanskrit vocabulary, I do want to point out that the system is similar to the Greek system of the four humors that dominated Western medicine well past the Renaissance. It is based on the notion that there are overall forces that contribute to illness and that if we re-balance these forces we can cause wellness.

This core concept has some vital reverberations in terms of treatment modality. Rather than a headlong project of trying to discover some pathogen, some virus, of some genetic flaw, the individual healer’s search for the cause of unbalance can be much more out in the open. It is not shrouded in the arcane mysteries of science. It far more oriented toward individual lifestyle, family situation, the society, and the individual’s moral and philosophical outlook. Each of these weighs on health as much as a particular virus might. If we change these aspects of the patient, we can change him such that an illness is much less likely to take hold.

In her 1995 study of Ayurvedic practitioners in India, the anthropologist Jean Langford described healers interviewing patients with the patient’s whole family present at the appointment. It should be obvious that when a patient’s whole family is invested in the process, the diagnosis is more likely to be correct and the treatment regime is more likely to be enforced.

Langford also discussed the case of a patient who returned to his healer saying that he had cured himself of his insomnia such that he no longer needed to take sleeping pills. He attributes the change to feeling “more philosophical,” of having a more cosmic perspective on his problems. The healer encourages the lifestyle change. “Try to be like the Buddha,” he says. “Not that you have to be a Buddha, but follow what Buddha has said.”

Langford boils down one practitioner’s health philosophy in this way:

For Vaidya Sharma the maintenance of health implies also the persistence of joy,

not only in one's organs but in one's mind and soul, the most transpersonal

facet of one's self… Thus the aim of medicine seems to encompass longevity,

happiness, and the good life generally, not only in Vaidya Sharma's perspective,

but in one of the most respected Ayurvedic texts.

Medical Method

I saw about 15 doctors after becoming ill: five different primary care physicians, two rheumatologists, a neurologist, psychiatrist, endocrinologist, dermatologist, infectious disease specialist, a chiropractor, and an acupunturist. I admired their intellect, their passion, and their sincerity. But I saw marginal results from all of them. The dominant image in my mind is of the very last one, a rheumatologist whom I’d been told was a specialist in CFS, putting her face in her hands after an hour-long interview. “I really don’t know what’s wrong with you,” she said.

That’s why February 9, 2008 was such a major turning point in my life. It was my first appointment with Karen Bullington in Marietta, Georgia, in a clinic that was part of the Fibro and Fatigue Centers, a network of twelve fatigue clinics nation-wide, co-founded by Jacob Tietelbaum, a doctor who was hit by CFS in medical school in the 1970s. My physician at the Atlanta clinic was Dr. Bullington, a former Christian missionary, who was also a victim of CFS when she was in medical school. She has dealt with the syndrome to some degree or another for all of her practicing years.

My memory of Dr. Bullington essentially completing my sentences for me contrasts sharply with the previous parade of specialists who had no idea what was wrong with me.

Another major contrast was the first blood test she ordered. The lab tech drained 26 tubes of blood from me, or about one-third of a pint. It was significantly more than any of the previous 15 doctors had ever ordered. She was gathering in-depth data about my whole system, not just one organ system.

A month later, we spent an entire appointment going over the results, which also was a revelation in customized care. Whereas most doctors would shrink from treating me if my blood levels were in the defined “acceptable” range, Dr. Bullington had no problem prescribing a supplement to address a nutrient level that was simply on the lower level of the acceptable range. Also, for instance, she was willing to diagnose me with Lyme disease per the iGenics Labs definition rather than the CDC definition. For anyone who’s dealt with the complexities and controversies surrounding Lyme, getting that diagnosis from a doctor and a long-term antibiotic treatment to address it, should come as no small feat.

All in all, the method succeeds because it takes an gigantic amount of data from the patient and has a pre-existing framework for understanding how each strand of the puzzle is connected in a massive and imposing knot of fatigue. By meticulously unraveling each string in the knot over a period of months and years, many patients, myself included, get their lives back. Most MDs and most specialists fail in treating CFS because they mistake it for a single problem or double problem, perhaps sleep apnea or thyroid issues. They treat the problems they find, but because they cannot or aren’t willing to treat ten or twelve underlying issues simultaneously and in an organized manner, they often can do nothing more than throw up their hands. They often cannot even discover underlying issues worth treating, and that’s why dramatically more subtler and nuanced diagnostic criteria are the first step toward effectively treating CFS/ME.

In the six years I’ve been sick, I’ve had two major flare-ups, one in 2009 and one in 2012. During the 2009 flare-up, Dr. Bullington ordered that same massive blood work-up and revealed a set of several new problems that had somehow cropped up and caused the fatigue crash that had nearly forced me to drop out of college. In particular, one of the problems was a new magnesium deficiency, and she prescribed a magnesium supplement to address it. CFS/ME becomes a dramatically less frightening illness when every twist and turn in one’s case can be traced to a scientifically verifiable piece of data.

The prevailing message from the overwhelming majority of government officials and medical professionals is that nothing can be done about CFS/ME. That’s simply not true. Since being treated, my experience of living with the illness is actually that it is highly understandable and even predictable.

The quest to find a doctor who understands the illness requires much endurance, but it is without a doubt the most important thing anyone with CFS/ME must do to get his or her life back.

The problem, as I’m painfully aware, is that my treatment modality is out of reach for most patients: most, particularly those in foreign countries, don’t live close enough to a proper facility. Even among those who do live nearby, many can’t afford the treatments because they aren’t covered by insurance. Among those who live close enough and who have enough money, it’s still possible that their bodies might not even respond to the treatment.

Practical, Do-It-Yourself Method

Without a doctor in whom you are confident, there are still ways of taking matters into your own hands. And even with the best possible doctor, CFS/ME is never totally solved. However, there are ways forward.

In today’s WebMD world, people have access to an unprecedented amount of medical information, which enables us to make dramatically more informed choices. Our information age allows us to truly hold our doctors accountable.

One of the great fallacies I had to overcome was the belief that a doctor amounts to some kind of “Superman” in a lab coat. Most, smart as they are, are not as smart as you are about yourself. You should never outsource your critical thinking to someone simply because he has a medical degree and is telling you what to do.

Patients can and should engage intellectually with their doctors; indeed, doctors enjoy the rigorous discussion with a well-informed patient.

But no medical doctor and no government bureaucrat should stand in the way of the fact that we, ourselves, are the ones who are most empowered to change our lives and to move forward.

Reading the great stories of heroes who overcame high odds was a wonderful education in the process of improving my own life. In a similar way, reading deeply and broadly about the fundamentals of health and wellness has also been a great engagement in a process toward a goal. Although every new idea I explored might not have borne fruit in my particular situation, I can say with confidence that there was something deeply important about simply taking ownership of my situation and taking it upon myself to solve it myself.

One of the books that bore fruit and continues to transform my life is William Dement’s The Promise of Sleep. Dement was a founder of the field of sleep science and has been a pioneer in the field for half a century. Sleep occupies about one-third of all human existence and it’s a shame people know so little about it. We can all dramatically change our lives for the better if we simply improve the way we sleep.

For CFS patients, I generally believe that about 20% of our problem can be fixed simply by addressing the underlying sleep disorder(s). Patients with a sound understanding of the science are well on their way to part of this solution.

For me, the most revolutionary concept in Dement’s book was sleep debt. We all have a set point of sleep (roughly eight hours) that our bodies need each night. Every minute shy of that set point can be made up. If a person slept for six hours one night, he or she would have accumulated two hours of sleep debt. The good news is that we can simply re-pay the debt by sleeping more the next night.

At the end of each semester of school, I began my sleep vacation. Sleeping for ten hours a day for two weeks, I could make up almost 30 hours of missed sleep. It makes for a vital rejuvenation twice a year. I feel much more at peace after it.

I know that others may find other parts of Dement’s book equally important, particularly those suffering from sleep apnea, narcolepsy, insomnia, or a general inability to get refreshing sleep.

By understanding and correcting part of the sleep puzzle, we should then wonder how much of our life situation we can improve by similarly addressing diet, stress, even posture, and other aspects of our lifestyles.

I would never dream of saying that we could totally fix CFS through this do-it-yourself method, but I do believe we can have a positive improvement in quality of life by embarking on robust scientific studies of each fundamental aspect of our health. This knowledge can teach us easy, common sense fixes to improve energy.

Again, even more important than the actual improvements in quality of life is the belief in our own ability to make improvements. Perhaps the most important psychological approach to my recovery has been to not define myself as sick; rather, however slowly and imperceptibly, I think of myself as always getting better.

We should remember that there is a reason that the Roman Catholic Church deemed despair a mortal sin. Despair is unlikely to lift one out of misery. It is not a path to redemption.

We should better remember Henry David Thoreau’s admonition that “I know of no more encouraging fact than the unquestioned ability of a man to elevate his life by conscious endeavor.”

How to Keep Your Dream Job

 1. Live closer to your workplace.

 2. Befriend and know about the children of your office manager/secretary. (Understand that I don't say this to make the secretary feel better. The secretary in my office gave me advice on which airports to use, where the cheap buses were--and if  I could the ball rolling by listening to a story about her daughter's Peace Corps experience, which was fascinating by the way, then all the better. It makes me wish I had talked to her double the amount of time that I did.)

3. Get to know the janitor and maintenance staff (You'll be a better worker if all your stuff is working, particularly *every* lightbulb. Brightness is key to being alert and focused.)

4. Use a desktop computer and a good keyboard.

 5. Take a walk and get sunlight every day at lunch.

6. Join a gym. Work out regularly.

7. Aggressively network and cultivate relationships with people in your office over coffee/beer/lunch or any common activity that they or their family enjoy:
  Ask:
What's your background?
How's your family?
How'd you get into this job?
Made any major decisions lately? (Warren Buffett's wife always asked this to people she met; it was part of her remarkable ability to get to understand people at their core very quickly.)

8. Find two or three solid mentors, whom you look up to.

 9. Remember people's birthdays (you can find them on Facebook). Leave at least a physical note; take them out to lunch if you can. Bring a simple gift.

10. Get info on using the fax/scanner/copier on the first day.

11. Bring your own nutritional snacks, meals, and drinks for work so that you can make yourself at home as soon as possible.

12. Get there ten minutes early.

13. Read things in paper form whenever possible; get away from the screen! Be human.

14. Know your role and why you matter to the operation: if this is unclear, be assertive in finding someone who can clarify; trade publications and choice Twitter feeds/podcasts are often better explanations for the societal role of your vocation than people in the office. However, they should never be a substitute to getting working definitions or explanations from people you work with.

15. Start betting pools in the office.

16. Go on a monthly adventure.

17. Get a good look at the stars every two weeks. And have a conversation with someone you care about while you're doing it.

 Remember what the renowned political scientist and economist Robert Putnam says: "Social networks are a kind of capital."

About Me