The Next Three Quarters

Image: Photograph ISS070-E-1178, taken by an Expedition 70 crew member aboard the ISS and over the Indian Ocean in 2023. Credit: NASA/JSC.

The second quarter of the 21^st century is dawning.

On its eve, in 2025 alone, fossil fuels were estimated to have been used more than in any year in history; all nine nuclear weapons states increased spending related to those weapons; the U.S. Department of Energy publicly announced that “AI is the new Manhattan Project;”[1] the world’s richest 12 billionaires reportedly came to own more wealth than the poorest half of humanity (more than 4 billion people); the Group of Seven (G7) likely cut global health and humanitarian aid more than in any year since its founding; the Global Peace Index 2025 indicated that there were 59 active within-nation conflicts (the most since the Second World War) and 78 countries engaging in conflict beyond their borders; the Hague Summit Declaration set the North American Trade Organization (NATO) on a course to more than double its military spending by 2035; and (some say) the nail in the coffin of the so-called “rules-based international order” was placed.

For reasons like these, the Bulletin of the Atomic Scientists moved its “Doomsday Clock” from 89 to 85 seconds to midnight on January 27, 2026.[2] This is meant to signify that the risk of a global catastrophe today is higher than at any point since the clock’s creation in 1947. Moreover, the Doomsday Clock has had no counterclockwise motion towards safety since 2010. This suggests the need for an ambitious, new movement—one that can not only push the minute hand of the Doomsday Clock back, but the hour hand too. This is a blog examining issues related to building such a movement in the health professions over the next three quarters of the twenty-first century. It is a blog for the extinction medicine movement, dedicated to the American psychiatrist Robert Jay Lifton who died in 2025 at the age of 99, and its philosophy is to make every second count.

Why Another Blog?

The Next Three Quarters was born of moral tensions encountered when working to learn how to care for individual patients and all of humanity. It began over a winter break in December 2025 as a personal reflection and stock-taking exercise to aid decision-making on whether to “pause” clinical training to finish a textbook on extinction medicine. While I chose to continue clinical training at that time, the process of coming to that decision generated much writing. That writing morphed into an essay series tentatively slated for cross-posting on the International Physicians for the Prevention of Nuclear War (IPPNW) Peace and Health Blog. The idea was for the series to represent a sort of middle ground, if you will, between finishing the full textbook ASAP and completing medical school.

Posting now signals belief that it is increasingly important to speak up on social issues. In the midst of extraordinary local, national, and global challenges, disruptive emerging technologies, and a World Medical Association International Code of Medical Ethics that no longer mentions the word “humanity, it also signals a skepticism that world leaders are any better prepared to promote peace than their early twentieth century counterparts. We must begin to act appropriately.

I intend for this blog to serve two purposes. The first is to help myself and readers stay oriented to the big picture during the closing quarters of the century, acknowledging that history will not end in 2100. We are living through the so-called "Great Acceleration," and the world is changing precipitously. Questioning whether doctors will become like the horse and buggy is no longer idle chatter, and even the AMA Journal of Ethics has been eaten by the artificial intelligence (AI) funding zeitgeist. At the same time, AI driven social media algorithms, ultra-processed content, and possibly large-language models are impairing our ability to see the forest for the trees.[3] This blog aims to extend IPPNW’s core mission of reducing the threats of nuclear weapons by tuning attention to the forest that influences how that mission is to be achieved.

The second purpose of this blog is to provide an avenue for commenting on current events related to building extinction medicine. This blog (not social media) will be among the first places that I go to communicate what I think in a largely unfiltered manner, starting with its first non-introductory post on the SpaceX IPO.

Who This Blog is For

While I hope to strive for the blog's content to be relevant to everybody, its present reading level limits its accessibility. I expect that health professionals, scientists, global risk scholars, philosophers, historians, and activists will find it of interest. Like the extinction medicine textbook, topics covered will be trans-disciplinary and include medicine, public, global, and planetary health, history, moral philosophy, behavioral science, peace and conflict studies, nuclear weapons, earth systems science, space science, and AI, among others. In addition to members of IPPNW, those who find themselves part of (or critical of) social movements argued to be driving the “race” to build artificial superintelligence (ASI) may find it of particular interest. The medicalization, science, and ethics of human extinction will be central, in line with the focus of extinction medicine.

A Scaffold for the Next Three Quarters

To set the tone for blog posts to come, here are some events and predictions by others which may shape how people think about the world over the next 75 years:

• 2026: Quarter Millenium of the United States of America

• 2030: World takes stock of United Nations’ 2030 Agenda for Sustainable Development

• 2045: Centennials of nuclear weapons use at Trinity, Hiroshima, and Nagasaki

• 2045: Ray Kurzweil’s prediction for the Singularity

• 2047: Tricentennial of the American Medical Association

• 2049: Centennial of the People’s Republic of China

• 2050: World takes stock of Paris Climate Accord’s goal of net zero carbon emissions 

• 2063: World takes stock of the African Union’s Agenda 2063

• 2066: World Meteorological Organization predicts ozone hole back to 1980 levels

• 2080s: United Nations projects human population size peaks at 10.3 billion

• 2100: Climate Action Tracker predicts global mean temperature reaches 2.6°C.

[1] It is wise to consider who benefits and who is put at risk from such narratives. At the same time, it is worth acknowledging that the U.S. Department of Energy was formerly the U.S. Atomic Energy Commission which was formerly the actual Manhattan Project that developed nuclear weaponry.

[2] As an interesting, albeit post-hoc note, a draft of this essay also had the Doomsday Clock moving from 89 to 85 seconds as a placeholder before the announcement, but this was not intended to be a prediction per se.

[3] Google Search was the primary information gathering tool used in the writing of this blog post. Its associated "AI Overview" tool was part of that search. However, the draft and final version of this blog post were human-written.