I was trying to imagine what the world would look like without Western medicine. Gone would be primary care physicians, surgeons, psychiatry—all the various medical specialties. There would be no treatment for trauma, nor fractures. Sufferers from the common cold would need to recover without their physician’s help. There would be no blood transfusions or organ transplants, nor would there be emergency or critical care of any sort. Pharmaceutical companies would be gone, as would the drugs they manufacture—as would the placebo effects from those drugs!

Perhaps it was the wine—a favorite bottle from the Rhone Valley— that stimulated my question. Or maybe it was the spring air. Fran and I were just finishing a lovely pasta and homemade pesto dinner on our deck, our table framed by pots of bright red geraniums. As though on cue, a huge heron had flown by moments ago, its wings pumping air in slow motion. In the dusky eve, tree frogs began their noisy chant. Less poetically, it might have been an editorial in the New England Journal of Medicine.

Argues convincingly, if counterintuitively, that modern medicine has little impact on longevity or mortality.