To Be Optimistic or Not to Be
By Greg Ganske
February 15th, 2026
A movie about Shakespeare and a musical piece by Bach started me thinking about how much better the world is today than it was not so long ago. Who would want to return to the days of routinely high childhood mortality and ubiquitous elderly blindness? How lucky we are to live in the modern world!
If you see the current movie “Hamnet” be prepared to cry. Peter DeBruge of Variety described the film as “so emotionally raw as to be almost excruciating at times.” Here art refuses to look away from grief.
The film dramatizes the family life of William Shakespeare and his wife Anne Hathaway (in the film called Agnes) as they deal with the death of their 11-year-old son Hamnet to bubonic plague.
As Hamnet dies, Shakespeare’s mother who herself lost a child says, “What is given may be taken away, at any time. The trick is never to let down your guard. Never think you are safe. Never take for granted that your children’s hearts beat, that they sup milk, that they draw breath, that they walk and speak and smile and argue and play.
Never for a moment forget they may be gone, snatched from you in the blink of an eye, borne away from you like thistledown.” The fact that childhood mortality was twenty times more common in the 16th century than today didn’t mean parents suffered the less in losing a child.
A few days later I heard on Sunday Morning Baroque radio Bach’s organ prelude “Before Thy Throne I Now Appear” reflecting a profound, peaceful acceptance of his death. What strikes me is that Bach dictated this deathbed chorale to his son-in-law because he was was blind from botched eye surgeries for cataracts by an untrained surgeon.
His eyes became infected and he suffered terribly from this before death.
Fellow German composer George Frederick Handel also lived with declining vision following failed cataract surgery by the very same intinerant “doctor.”. Unfortunately, this type of “couching” procedure of pushing the cataract lens back into the eye resulted in improved vision only a third of the time at best and had very high complication rates in an age that didn’t know about antisepsis and had no antibiotics.
Compare yesteryear to today. Child mortality before the age of five 100 years ago was about 30% compared to under 4% globally today. In 1915 infant mortality in the U.S. was 99 deaths per 1,000 live births and decreased to 5.6 per 1,000 by 2023. Infectious diseases and poor sanitation were the main reasons for earlier high mortality rates.
150 years ago, cataract surgery was a last resort procedure only for the blind and carried a high risk of infection, inflammation and secondary glaucoma due to large incisions and lack of sterile technology. Cocaine was only introduced for local anesthesia 130 years ago. Before that patients were tightly bound so as to not move during extremely painful surgery.
Twenty to thirty million cataract surgeries around the world are now performed each year with around 75,000 daily. With an aging global population 60 million procedures are expected annually in a few years. Today greater than 95% are successful and visual threatening infections occur at a rate of 0.02% to 0.08%.
In this age of 24/7 news, terrible things from everywhere in the world are almost instantly delivered to our smart phones. When the average American watches 4 and a half hours per day, it is easy to think the world is going to hell in a hand basket. These two examples of progress remind me that we need to keep a perspective on the world that is not doom and gloom. This not not to say that we should be Pollyannas—there are certainly many serious problems to be concerned about.
However, there are several facts that we can make us hopeful about the future. These are reported in what some have called Progress Lit, the modern canon of progress literature.
Stephen Pinker’s Splendid Enlightenment Now,” Gregg Easterbrook’s It’s Better Than It Looks: Reasons for Optimism in an Age of Fear, Norberg’s Progress: Ten Reason to Look Forward to the Future, Radelet’s The Great Surge: The Ascent of the Developing World and Diamandis’ Abundance: The Future Is Better Than You Think are all examples of books of hopefulness.
In thinking about child mortality and blindness the best-selling book I was reminded of was physician Hans Rosling’s Factualness: Ten Reason We’re Wrong About the World—And Why Things Are Better Than You Think. Rosling posits that most people are wrong about the state of the world. Many people think the world is getting worse when it is not in many ways considering actual facts and perspective.
Rosling surveyed 10,000 people and showed that 80% of those surveyed knew less about the world than random guessing would have predicted. Rosling thinks that media systemically skews data and trends and selects stories to make people think the world is getting worse. Bill Gates thought this book so important that he offered to buy it for any 2018 graduate student on request.
Among other things he points out: statistics show the majority of the world lives in a middle-income country, life expectancy continues to rise, deaths per year from natural disasters decreased by more than half over the past 100 years, nearly all children in the world have been vaccinated against some disease, and more than 80% of the world has access to electricity.
For example, in the early 1900’s there were 181 disaster deaths per million people while 100 years later the number was 11. Or consider that an astounding forty million planes land safely each year.
Rosling points out that poverty globally has decreased markedly. The old way of categorizing the world into “the developed world” and the “developing world” is outdated. His four-category model based on income per person is recognized by the UN.
He shows that most countries are now in the middle range. Rosling shows that seeing the world as “them” and “us” is to miss how many people are in the middle and better off for it. Gates called the four income levels framework a “revelation.”
How have Rosling’s insights held up? Jaqueline Ying-En Tung in “Factualness: How Far Have We Gone—2023 Data Updates” points out that in the past 20 years, the number of people living in absolute poverty has been halved. “Before 1966, a majority of people lived in extreme poverty. From 2000-2019 there has been a remarkable reduction in percentage of people experiencing extreme poverty from 29% to 9%. In 1997 40% of the population of China and India were in extreme poverty.
By 2017 the poverty rate in in India was 12% meaning 270 million people were lifted out of poverty. In the same year China’s extreme poverty rate was just 0.7% meaning 500 million people had escaped harsh poverty.”
The most important Factualness insight might be the issue of peace. While it doesn’t seem like it when we see ubiquitous news reports of Russia’s invasion of Ukraine or Hamas’ attack on Israel and Israel’s bombardment of Gaza or the Syrian civil war, fewer people are dying as a result of wars than in most of the 20th century and if statistics are reliable prior to the 1800’s, also.
Rosling isn’t without worries. He remains concerned about global pandemics, nuclear war, climate change, and the “unknown risk”, among others. For example, the Covid epidemic two years after the publishing of his book set back many parameters of progress.
An American bard, Billy Joel, sang in “Keeping the Faith,” “Cause the good ole days weren’t always good, and tomorrow ain’t as bad as it seems.” Rosling’s book shows how much objective progress the world has experienced in a relatively short time. The world is a better place than we often subjectively feel, which is not to say that we shouldn’t strive to make it better.
Greg Ganske, MD, is a retired plastic surgeon who cared for women with breast cancer, farmers with hand injuries, children with cleft lips, trauma and burn patients. He served Iowa in the United States Congress from 1995-2003.
-30-
Greg Ganske, MD, Member of Congress (ret), is a retired plastic surgeon who cared for breast cancer patients, children with birth defects, farmers with hand injuries, and burn patients. He served Iowa in Congress from 1995-2003.
Comments 20
Thank you for the thoughtful column and reading recommendations . The glass is indeed half full. 👏
As a child I would hear my mom’s stories as having a doctor who worked through the night as babies at that time (with me being a surprise) being small might be blinded by the O2 needed to survive. Great advancements in care since the mid 1950’s. My eyesight was undamaged. Mom would smile when she’d report that the doctor would write a paper about it. A Dr whose name I don’t even know that benefited me.
I am at an age when every phone call seems to announce the death of a dear one. My Pal, Jimmy Sexton, and I marvel at our mutual distain for ringer, the text, the odd comment, or the Legacy passage from Curley& Sons ( formerly Sheehy & Sons).
Just last week I lost balance on the ice shredded every fiber in my old neck and no wear a high white cervical collar that makes me look like Pat O’Brien in an old Cagney movie. I went back in the classroom on Friday was treated with great solicitude by my students and the staff. Is this merely due to my diminishing capacities and hoary old age? I think not.
People are kind. As the kids were busy with work on their computers, I re-read the works of Henry Howard, Earl Of Surrey who was executed for treason against Henry VIII – Hanged, Drawn and Quartered. But before that gruesome end, Lord Surrey lived a full, violent, creative and compelling Renaissance life. He was an English founder of the sonnet form along with another treasonous nobleman Thomas Wyatt, who had had his wicked way with Anne Boleyn before Royal Harry tore off britches. Lord Surrey translated the Roman poets Virgil, Horace, Catallus and Martial into English. One by Martial knocked me into consciousness out of my navel gazing pessimism.
The Things That Cause a Quiet Life
By Henry Howard, Earl of Surrey
(Written by Martial)
My friend, the things that do attain
The happy life be these, I find:
The riches left, not got with pain,
The fruitful ground; the quiet mind;
The equal friend; no grudge, no strife;
No charge of rule nor governance;
Without disease the healthy life;
The household of continuance;
The mean diet, no dainty fare;
True wisdom joined with simpleness;
The night discharged of all care,
Where wine the wit may not oppress;
The faithful wife, without debate;
Such sleeps as may beguile the night:
Content thyself with thine estate,
Neither wish death, nor fear his might.
Good Lord! The ‘Quiet Mind’ and ‘The Equal friend’ -that cat Surrey sucked life’s marrow with gusto.
Read my friends; we will be Okay!
Thank you for your viewpoint and sharing. Encouraging and optimistic. God is in the details.
Great stuff as usual Mr Hickey. I would love it if you ever find time to publish your distilled “greatest hits” for the rest of us frustrated humanities majors.
How about this? Think how fortunate we have both indoor plumbing and vehicles powered by internal combustion engines (or now, for some, electric motors). Each advance meant that our interior and exterior environments were no longer befouled by human or equine waste. Not something to sneeze at, much less inhale. And another, in this instance a medical advance: the development of open heart surgery and the invention of the implantable cardiac pacemaker. Thanks for this go to C. Walton Lillehei of the University of Minnesota and Earl Bakken, a Minneapolis resident, in the 1950s. Dr. Lillehei’s first attempts at this surgery involved “cross circulation”; the vein of a blood donor par excellence was connected to a vein of the patient during the surgery to keep the brain oxygenated and the patient alive. Often this donor was the parent of a child who suffered from congenital heart defects, a child who was truly a “goner” even with the surgery. For the parents, their only hope was that their child would be the first successful patient. Close to forty such patients died before the first one survived for any length of time. From Dr. Lillehei’s advances came the pacemaker, first a stand-alone machine, next an implantable one. For that, Dr. Lillehei approached Earl Bakken, who with his brother owned a shop in Minneapolis that repaired medical and electronic devices. He, in conjunction with Dr. Lillehei, developed the implantable pacemaker, which today keeps alive millions of people and enriched others with millions: the company Mr. Bakken founded is Medtronic, which amply rewarded his investors. Another great example that confirms Dr. Ganske’s thesis that things are often better than they seem.
Not to disparage one of the giants of cardiovascular surgery, but “cross circulation” had no real future due to insurmountable obstacles including blood incompatibility. Modern open heart surgery as now performed was made practical and possible to all by John Gibbon’s invention of the heart lung machine – who IMHO should have been awarded the Noble prize. And despite my constant criticism of “gummint” medicine, I must admit that the first fully practical IMPLANTABLE pacemaker was invented by VA researchers. “In 1958, Dr. William Chardack of the Buffalo VA hospital (now the Buffalo VA Medical Center) teamed up with engineer Wilson Greatbatch and Dr. Andrew Gage to implant an electrode in a dog attached to a pulse generator. In 1960, they implanted a pacemaker into a 77-year-old man, who lived for 10 months after the surgery. In that year, they implanted pacemakers into nine other patients, several of whom lived for more than 20 years after the implant. Chardack and Greatbatch’s design was the first implanted pacemaker to be commercially produced.”
Dr. Ganske, thank you for your article today. Sometimes it is important to “Look Up” from the stuff of this time. History is very important and not embraced for its wisdom. Praying for John Kass and his family. Thankful for John’s friends who are contributing in his absence.
Insightful column. I agree with Rosling’s premise. The world is a much better and safer place than before. However…
Rosling is still concerned about climate change? Rosling’s whole point is to stop fearing things that when examined are not really as bad as many claim.
Even if man made climate change was real, why is it bad?
Pessimist: the glass is half empty.
Optimist: the glass is half full.
Engineer: the glass is the wrong size.
You’re exactly right on Climate Change. Is man making an impact? Yes, but it is being dramatically exaggerated by the Climate Crazies. The issue is closer to a “So What”? than a catastrophe.
Miracles do happen, big and small. Yesterday I lost or misplaced my I-phone, and when all my searching options played out, I invoked a last minute desperate prayer to St. Anthony, and lo and behold my son Mike comes without notice walking into the restaurant with the phone that he retrieved from an Uber driver who had contacted him.
That is why I invoke the Saints as intermittent spiritual help for our good friend John and his family. If they can find my phone, they can aid John in a swift recovery. Amen
Gregg-
Great suggestion on an eye opening book. “Factfulness.” I believe is the correct title by H. Roseling.
Lot’s of facts to counter the left’s narrative of doom and gloom. Especially the pathetic book by Paul Ehrlich-‘The Population Bomb.’ And to think he’s was or still is a professor at Stanford
You’re making my day sir, Thank you.
Robots and AI will make life even better, not worse
This is a very important message Dr. I think most folks are kind and good hearted and we do live better now in many ways. The owners of the nation want to divide us, they want us at home alone on our computers arguing with each other instead of engaging one another with empathy, compassion, and a willingness to try to do good.
The World is awful and getting worse feeds the Big Government grifters . The only answer to whatever crisis du jour is for the Governement , run by ‘Experts’ , to do something . Something Big . A bad flu season became the Covid Panics , costs yet to be determined. Climate Change has cost trillions and not done anything but made the windmill and solar panel grifters very rich at the expense of the Little Guy that pays his taxes and electric bill with Real Money . Now in NYC we get , they get , the warmth of compassion and 21 dead from the cold . The list goes on and on and on. In the fight betweeen Reason and Emotion , Reason always loses . Always
Yeah, as long as you can afford it. Medical bankruptcy is #1 cause of most peoples bankruptcy in this country. We should be ashamed of ourselves.
My wife needed a hip replacement. Orthopod didn’t take Medicare. We shelled out $20,000 for him to operate. Luckily the hospital took medicare.
Yeah we have the greatest health care if ya got the bucks. Sad, very sad.
“Everything better” does not sell newspapers, or increase eyeballs to myriad websites, or podcasts, or increase clicks to “influencers” or substacks.
Nice column. It is important to look at the bigger picture and truly appreciate the great progress that has been made over the centuries. 24/7/365 instantaneous worldwide news has many negatives. No offense to New Zealand, but if triple homicide happens there, learning about it doesn’t help me in the slightest.
The contemporary zeitgeist of presentism, which through ignorance lacks respect of those who came before us and made our comfortable lives possible, puts us at great risk of social devolution.
Great Billy Joel line. Almost posted that to another JK column a few months ago.
Hope JK is doing ok and he will be back here soon.
I am more than a little bit skeptical about the CCP’s reported poverty rate. They lie about everything.