“A word is worth a thousand pictures.”

― Elie Wiesel

Automation. Globalization. Climate Change. Words. What do they mean to you?

Elie Wiesel’s quote above is not only poetically beautiful, it is exquisitely true.

To some, those words are inconsequential, things that can be avoided or ignored. Maybe even a hoax – especially climate change. For others, those words represent reality, an oncoming, inevitable tide that must be addressed.

I see these issues being addressed by multiple opinion writers in the media, by certain candidates for public office, by a few communities and a few private citizens. But the painful truth is that we as a society at large are avoiding addressing these issues in a comprehensive way. Why is that?

As a psychiatrist, I have had multiple experiences with patients who have become aware of some painful truth, have realized what needed to be done about it, and then have done nothing. Almost always, the reason for that paralyzed inaction has been what one of my teachers called the “dirtiest four-letter word in the English language,” – fear.

Fear is the great crippler that blocks us from solutions, along with its close cousin, denial. We physicians see it in all medical specialties. The patient who ignores chest pain, who ignores blood in the urine, who ignores a tumor in the breast.

“Oh, it’s nothing. I don’t have to see a doctor. They charge too much, anyway.”

Fear is also a determinant in how we assign meanings to words. A great clue for this is when you hear people give meanings to words that are radically different from the definitions for those words found in a standard dictionary. In last Sunday’s Tribune Opinion section, there were six superb articles that tried to address these issues. They all had in common key words that mean one thing to the authors and quite another to segments of the public. I’ll mention just a few – “guns,” “government,” “Democrat,” “socialism,” “American.” Even the “Declaration of Independence!” As different as those words are from each other, whenever there is a distorted negative meaning attributed to it, you can bet that fear is behind it.

Automation, globalization and climate change. These four words, which are genuinely scary, provoke more fear than almost anything else. They provoke denial, despair and hopelessness. But they will not be dismissed. They cannot be ignored. So what will it take to help people face the oncoming tide bravely?

The good news is that we have been in this situation before. In the 1930s, our country was in dire peril. Franklin Roosevelt, responding to the paralysis, said, “We have nothing to fear but fear itself,” and then he gave the country a new way to think about the future, and tools to survive the time of crisis.

We have such a thing now. Proposed by Andrew Yang and others, it is called a “Universal Basic Income,” (UBI) or, as Yang prefers to call it, a “Freedom Dividend.”

Some people, out of fear, call the idea one of those “tax and spend liberals’ pipe dreams.” But if we think like physicians, we can assign an entirely different meaning to it, and that is, “short term disability payments.”

When a physician is treating a serious illness that can be cured, but will require extensive treatment and rehabilitation to achieve the cure, the physician will arrange for “short term disability payments” to tide the patient over and help them live while they are going through the arduous and difficult treatment necessary to be cured and/or rehabilitated. That’s what the UBI means to me – short-term disability.

When we are physically disabled, short-term disability helps us get through the pain of rehab that often involves learning new skills, new ways of doing things. Thus it will be for the “illness” of loss of jobs and loss of health stemming from the tides of automation, globalization and climate change. A temporary aid while we learn the new skills for the new jobs that are bound to arise. A temporary aid to help us get through a difficult period and become fully healthy and functional again. That’s not so bad.

If we can face our fears, what we can accomplish as individuals, we can accomplish as a nation.

Michael A. Kalm, M.D.

Michael A. Kalm, M.D., is a psychiatrist with 40 years of experience in private practice in Utah.