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Mr. Public Health

Dr. Lester Breslow

Dr. Lester Breslow's research in the 1960s showed the value of following simple steps to a healthy life. Now, at 82, he's living proof.

October 13, 1997|JULIE MARQUIS | TIMES STAFF WRITER

But he has not always been admired. In fact, he had some trouble talking the California health department into hiring him. After delivering half of a planned 15-minute speech to the department chief in 1946 about the increasing importance of chronic diseases such as cancer and heart disease, he was told, rather bluntly, to go back to Minnesota and try his ideas there. He was hired only after a friend got him an interview with someone else.

By Breslow's own reckoning, his early work was received with a shrug by some of his physician colleagues.

"I don't think they were very interested. They were taught, and I was taught, that we approach things through what we call biomedical science. We receive your complaints--you have a pain or an ache here, and then I [give] an exam. I respond to your complaint, and then I arrive at a diagnosis--say, 'You've got cancer of the right kidney,' and I treat you for it, or, 'You've got a mild upper-respiratory infection. Take two aspirin! . . .'

"We have what I call a complaint-response system of medicine [focusing] on the individual to the extent that they do not have a perspective on what has happened in the whole of a population."

This is only beginning to change. One colleague remarked that for all the awards and acknowledgments that Breslow has received in the field of public health, many physicians still are not well versed in his work.

"I'm still astounded by the extent to which he and his contribution is not known in the medical sector," said Dr. Roz Lasker of the New York Academy of Medicine, a fellow researcher of Breslow's. "In public health, everyone knows him--he's one of the most eminent people . . . in the country. It would behoove the medical sector to become more aware [of him]."

To some clinicians, struggling to treat increasing numbers of sick patients efficiently, Breslow's notions of healthy living may seem overly broad, even unrealistic. Violence, child abuse, teen pregnancy? How does Breslow's approach address these social scourges?

Breslow does not back down: Social conditions, he says, help define a society's health.

"How are we going to maintain people's ability to perform, to do the ordinary things of life, and hopefully even to enjoy those things? . . . That is increasingly becoming what I see as the [emerging] health problem."

Breslow may wax diplomatic, but he calls it the way he sees it. And that, from time to time, has not pleased the powers-that-be. For example, he and two other smoking opponents earlier this year were ousted from a state tobacco oversight committee by then-Assembly Speaker Curt Pringle (R-Garden Grove), and replaced by more moderate types.

Breslow, especially, had gained a reputation for asking pointed questions of the state health department. Some, his critics evidently believed, were too pointed.

In spite of Breslow's self-assessment as a man of moderation, his wife says that he has long been fired up about social causes.

"My husband was a radical when he was in college," confides Devra Breslow, married to Breslow for 30 years. As far back as the 1930s, she said, he was leading an antiwar demonstration to "get the Marines out of Nicaragua."

*

For one so outspoken, Breslow had humble beginnings. In fact, as a youth growing up in Bismarck, N.D., the son of a pharmacist, he had trouble speaking at all. He had a severe stammer that all but condemned him to silence. His mother took care of that. She hooked him up with a nurse who put him on a strict program that involved reading aloud, writing, and relaxation exercises.

He's too much of a scientific skeptic to credit the nurse, but, for whatever reason, he did stop stammering. And he did a lot of reading to boot. He dared to join a debating team and, before long, he was selected keynote speaker at his high school graduation.

After that, he turned toward medicine. His reading and his personal experience with a disability made him decide that he wanted to be a psychiatrist. But after braving the years of chemistry and anatomy--not his strong suits, he says--he couldn't get beyond a summer stint at a state mental hospital. His job there was to stick gastric tubes down patients' throats to bring them out of convulsive shock.

"Well," he recalls, "I came out of that summer feeling that, really, there wasn't much that psychiatry had to offer."

A friend suggested that with his interest in communities and politics, he would be better suited to the growing field of public health. Shortly after that, he enrolled in a public health program at the University of Minnesota.

He has no regrets--well, no major regrets. There was that time, in the 1940s, when, as California's chronic disease chief, he crossed out a sentence in a school brochure stating that smoking was bad for the health.

"I didn't think there was evidence for it," he says ruefully. Only a few years later, one of the studies he commissioned suggested he was dead wrong.

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