Dr. Sandro Galea is a physician and epidemiologist, and also the dean of Boston University's School of Public Health. He has co-authored and authored more than a dozen books. His latest is titled, "Well: What We Need To Talk About When We Talk About Health." WGBH News' Henry Santoro Interviewed Galea about his new book. The transcript below has been edited for clarity.
Henry Santoro: You begin almost every chapter of "Well" with an anecdote of historical nature that you use to make your case. But it's your passage on blues musician Blind Willie Johnson that starts the book, that has us really wanting to know more. Can you explain?
Dr. Sandro Galea: Blind Willie Johnson is a blues musician — those who know the blues will remember him. He was born at the turn of the 20th century in Texas, and he was born sighted. So, the story is that he became blind after his stepmom threw lye in his face when he was about 7. He grew up poor and blind and black in Texas. He got married, was living in a small house, and his house burned down. He and his wife didn't have any money, so they kept living in the same house.
When he was around 40, he developed malaria. And his wife took him to the hospital, and the story is that he was turned away. It's not clear if he was turned away because he was poor, because he was black, or because he was blind. And then he died. So, the question is, well, what killed Blind Willie Johnson? Now what killed him is malaria, but the reason I tell the story is because anybody who listens to us realizes that it wasn't just malaria that killed him. It was poverty and homelessness and domestic violence and lack of access to care. It's an extreme story, but it still makes the point that medicine and treatment are important — there's no question about that, we want doctors to look after us — but malaria by itself is not enough. We need to deal with all the other factors that create a life.
Santoro: Let's go back. Let's go back to where you were born. Tell us what the conditions were like where you were born and growing up.
Galea: I'm from Malta. Malta is a small island in between north Africa and southern Europe. I come from a blue-collar family where there was nobody who had ever been either a doctor, lawyer or priest, and the family's achievement was if somebody does one of those three. So, I immigrated to Canada to go to college, and then to do medical school. I practiced both in northern Canada — some fairly remote places about 18 hours north of Toronto — as well as in places like Somalia and Papua New Guinea.
Santoro: Doctors Without Borders?
Galea: Yes, with Doctors Without Borders in Somalia. That, I think, gave me this experience of really being in places where, as the doctor, I was making an acute difference — there was no question about that. But, paradoxically, the effect it had on me wasn't as much a sense of the power of medicine as much as it was a sense of the limitations. Because I realized, when I was no longer there, if I wasn't doing what I was doing, nothing was going to change. And the metaphor is, I felt like I was standing at the side of the river pulling people out, but I was never stopping and asking, what's throwing people in the river to begin with? And what this book is about is what throws people in the river to begin with.
Santoro: How much of a problem is it when health gets mixed up with health care?
Galea: I think it's a big problem, because we then think that health care is the solution for everything. So, you know, I said a few minutes ago that we spend more on our health than any other country in the world. It's not true. We don't spend more on our health; we spend more on health care. Once we understand that health is more than health care, it changes how we think about everything. Which is why I call this book, "What We Need To Talk About When We Talk About Health," and it is why I say in the book that this is an explicit effort at changing the conversation.
