November 11, 2022

Dear Interested Readers,

 

It Was a Beautiful Day To Vote, and Hope and Democracy Survived. 

 

I usually love to vote. This year as election day approached, I was very apprehensive about what life would be like after the “red wave” washed over us.  Most years, casting my vote makes me feel like I have fulfilled a sacred obligation. This year I anticipated an experience more like having a tooth pulled or having my taxes audited, usually survivable but nevertheless a very painful experience. 

 

For many years, I voted at the elementary schools my sons attended in Newton and Wellesley, Massachusetts. During those years casting my vote required special effort and patience. At times the lines were long, even when I arrived before the doors to the school gym opened to let the voting begin. Standing in line was a social event because most of those in line were neighbors I knew who like me were trying to vote before their commutes to work. Some people brought coffee and breakfast sandwiches to their wait while others read their newspapers. I was in line early to ensure that I could vote, and then get to work on time. I always voted before I went to the office or to the hospital because, as all doctors know, you never really can predict with certainty when your day will end. I rarely got away from my professional responsibilities in time to be sure I would complete the trip back to my neighborhood polling place before it closed at seven.

 

One of the joys of retirement has been that I do not need to be strategic about when I vote. Tuesday, we planned to vote in the late morning. Tuesday was a beautiful late fall day with a cloudless sky. It was nippy with the temperature in the high 30s and a breeze. The beauty of the day took the edge off the experience that I was dreading. You can see the scene if you look at the header on this note.

 

I was surprised to see that there were so many cars on Main Street and a lot of foot traffic coming into Whipple Hall which is a multipurpose municipal building where we vote and some town meetings occur like one that recently drew a large crowd to hear a proposal for sixty units of workforce housing. A portion of the building is also our police station. I don’t know how Whipple Hall was used before I came to town. There could have been basketball games or dramatic productions there because the hall has a hardwood floor and a stage with a curtain. It looks a lot like the gym/stage combination that existed in the circa 1900 building that was my junior high school. I don’t know how long Whipple Hall will continue to double as our police station because at every recent annual town meeting there has been chatter about building a new police station. Change can be quite slow in a small town where everyone has a voice and the right to be heard.

 

Campaign workers with signs were confined to the front lawn near the monument that honors the town’s people who died in the Revolutionary War, the Civil War, and in World War I. I mention that in part because today is Veterans Day. I always connect the right to vote with the reality that over all of our wars more than a million Americans were willing to offer their lives as a sacrifice to gain, protect, ensure, and extend the right to vote. Their sacrifices and service make it a sacrilege to fail to exercise your franchise to vote. I am not a veteran but there have been many in my family and among my friends.

 

The fellow on the monument has a long rifle and a cap that suggests he was a soldier in the Civil War. The list of those honored who died in the Civil War covers three sides of the monument. I know several people who have the same last name as some of those who are honored by having their names carved in granite. There are similar monuments on town squares and in front of municipal buildings in communities across the country.

 

In the South, I have seen similar monuments that differ from the one in New London in only one way, the soldiers honored by the monuments in those towns below the Mason-Dixon line wore gray and were fighting to dissolve the union and preserve the institution of slavery and the way of life it enabled. Those we honor with the statue in front of Whipple Hall wore blue and fought to preserve the union and cleanse it of slavery. I am awed when I try to imagine the depth of the divide that precipitated the sacrifice of 620,000 American lives.

 

I hope that we are not anywhere near reproducing the horrors of that war, but as we focus on our current differences and continue to debate how to understand and move forward from our paradoxical history of seeking freedom while enslaving millions it seems prudent to understand that the Civil War did not end racism in our country and that our scientific achievements have not created a system of healthcare free of racial bias. It seems abhorrent to me that there were elections in some states this week where politicians ran on platforms that subtly included the idea that we should not teach “critical race theory” in our schools. Many of those same politicians wanted to deny women reproductive freedom and proposed bans on issues related to gender and sexuality. Predictable conformity to authority, not personal freedom, seems to be their idea of the American way.

 

The idea of banning the study of our struggles with race and how it impacts the lives, health, and healthcare of millions of people among us today seems to me to be almost as bad as denying the holocaust or the fact that there has been a protracted genocide of Native Americans. Voting seems crucial in the effort to preserve the possibility for future generations to understand how to continue to preserve, protect, and improve our democracy. Indeed, democracy is always on the ballot.

 

Everyone inside Whipple Hall was in high spirits, and the process was extremely efficient so despite the crowd we were in and out sporting our “I voted stickers” in less than fifteen minutes. Voting in New Hampshire was heavy. Over 600,000 people voted which was a record for midterm elections. In Derry, one of our larger towns, things did not go smoothly after the town decided to go from three polls down to one. Derry is a “red town.” The majority of the 12,000 votes there went to Republican candidates. Robert Frost lived on a farm in Derry and many of his famous poems were written there. My town doesn’t have a literary giant connected to it, but Donald Hall, a former poet laureate of America lived in Wilmot, the next town to the east of my town. I enjoyed hearing him read some of his poems at our library. Unlike Derry, my town is a “blue town.”  As you can see in the chart below, once again, we gave about two-thirds of our votes to Maggie Hassan and the other Democrats.

 

 

 

 

After casting my vote, I was anxious all day as I waited to see whether inflation and dissatisfaction with Joe Biden and his policies would claim more votes than concern for the planet, the preservation of a woman’s right to manage her own reproductive choices, and the defense of democracy from those who don’t trust elections and want to impose their views on their neighbors. I assumed that perhaps the only thing that would be positive about the day would be that the awful vitriolic political ads would finally end.

 

In retirement, I have been more of a participant in the political process in my community than when I was working and had very little unscheduled time. Pre-covid, I enjoyed getting to meetings of the local Democratic party, attending events to hear candidates speak, and doing some door-to-door campaigning. My wife enjoys attending a group that calls itself “Ladies Left of Center.”

 

I have had some very interesting experiences campaigning. Several times I was treated very rudely, but more often I was told that the effort was appreciated and that the person on the other side of the door would vote for the candidates I was supporting. I will never forget one doorway encounter. 

 

It occurred on a chilly overcast Saturday morning in early October a few weeks before the 2016 election. There is not much rental property in my town, but there is one old historic farm where the big house, the barn, and some other buildings have been repurposed as small apartments. The setting has beautiful views in all directions. We need more “conversions” of this sort because we have virtually no “workforce housing.” I went from apartment to apartment pretty quickly. There were no responses at about half the doors, and I would just move on to the next door.

 

At the last door, I knocked then knocked again, because I thought I heard a TV playing. After waiting for a couple of minutes with no response, I was walking away when I heard a weak voice say, “Hello, can I help you?” I turned around and was met by an elderly woman with her hair up in a neat white bun the way my grandmother used to do her hair until she got too old and tired to do the braids and then wrap them around her head like a small crown. The next thing I recognized was that tears were welling up in the woman’s eyes and running down her cheeks. Over her shoulder, and through the doorway, I could see a television playing. It looked like the woman had been watching some cable news program like CNN or MSNBC. I had been a little miffed as I turned away from her door because I could tell that someone was at home watching TV.

 

I apologized for disturbing her, but she quickly said that there was no problem and continued by saying that she was actually happy to see someone. She explained that she had been watching “that horrible man who is running for president,” and it had upset her. I immediately knew what she meant because it had just been a few hours since the Washington Post had released the “Planet Hollywood” recording of Donald Trump talking with Billy Bush about the excesses with women that were so easily available for a celebrity like him. She had just gotten the news on that cold Saturday morning that such a disturbed man was actually free to talk like that, much less run for president. As she continued to cry she implied that she would be devastated if by chance he were to win. I assured her that she had nothing to fear. I was certain that with her vote and the votes of millions of people who shared her values, Hillary would surely win. We talked with unsupported certainty. I think we were both hoping without any real assurance that there was no way that a man who spoke that way about women could ever be elected president of our country. 

 

That encounter has been replayed regularly in my mind over the intervening years. After the election, I thought about going back to see how she was doing, but I did not. I don’t think I knew what I could say that would have made a difference. Her fear was then a reality that could not be changed for four years. I hoped that she took some comfort in the reaction of the hundreds of thousands of women like my wife and several of our friends who put on their pink hats and boarded buses for demonstrations in Washington, New York, Boston, and other cities, large and small, across the country. 

 

It was four years of lies and narcissistic excesses, and then came January 6, 2021. The fact that hundreds of elected officials could participate in all the lies and excuses that have followed was even more confounding for me than the lies and boorish behavior of one powerful narcissist. It has been hard to accept MAGAism in a country that I was once taught to believe was the best example in the world of political virtue.

 

Despite all that has happened, I still share the disbelief behind the tears of that old woman. I know there is a “cultural” logic that explains how we could have ever elected someone like Trump who scoffs at decorum and cares nothing for the “norms” of political behavior that are necessary for democracy to work. Trump was, and is, the antithesis of what I had learned in my high school civics class a political leader should be. What has been even harder to explain than how such a man can get elected is why so many experienced and previously respectable politicians say, “How high?” when he says “Jump!” Liz Cheney said it best in the first public hearing of the House’s January 6th investigation:

 

“Tonight, I say this to my Republican colleagues who are defending the indefensible: There will come a day when Donald Trump is gone, but your dishonor will remain,”

 

It has been hard to accept that after being “outed” dozens of times for behavior that so blatantly demonstrated his anti-democratic propensities that were even more dangerous than treating women as objects former president Trump’s influence has continued to bring victory and political power to his clones and admirers. In 2016, I could not believe that Trump had wiggled out of an event that would have ruined almost any other politician just by passing it all off as “locker room talk.” In 2022, it was hard to believe that most Republicans were essentially saying, “Ain’t no flies on Trump.” It was so reassuring to see some of those people who sacrificed their reputations and integrity to gain his favor lose on Tuesday.

 

If 30,000 lies and four years of erratic behavior culminating in an insurrection could not defeat MAGAism, it seemed logical to accept the opinion of the pollsters and the press that we were about to be washed away by a “red wave” as “independents” were more concerned about their short term personal finances than by the possibility for long term policies that fostered equity and justice, improved the health of the nation, protected democracy, led the way in the struggle against global warming, and ensured the protection of personal rights like fair elections. How sweet it was as Tuesday evening slowly became early Wednesday morning to realize that the press and the pundits were wrong and that across the land there was a majority of Americans who were tired of MAGAism and would cast their votes in the defense of democracy.

 

My hopes for an ever better and more equitable America are buoyed by the pluralistic collection of citizens who came out to show by their votes that they wanted to damp the red wave. In many places, it took a greater effort to vote than it should have thanks to decisions of conservative courts and the efforts of Republican-controlled state legislatures and governors trying to win culture wars by making it harder for their opponents to vote. It amazed me that there were more than three hundred candidates for office who were still willing to demonstrate their fealty to Trump. It is hard to believe that there are still some election losers like Doug Mastriano who are still modeling Trump’s illiberal behavior by refusing to accept that they lost. The threat to democracy has not completely passed, but we have moved from a hurricane of concern about a red wave to a doable cleanup task after the eye of the storm has passed.  It is a joy to see that all we value was not washed away.

 

Last week there was every expectation that after January and for the next two years there would be little hope for the passage of policies that might improve the social determinants of health. In last week’s letter, I advised you to begin to consider what you and your colleagues could do for your patients and your community without help from those who set public policy. I imagined that President Biden would be dividing his time between vetoing terrible legislation and defending his administration from committees in the Hosue launched by Kevin McCarthy and others who see sowing discord as a path to sustained political power. Now, there is the possibility of a politician of President Biden’s skill and openness to bipartisan efforts being able to make a little bipartisan progress toward better health care for all Americans even as Republicans gain control of the House with a small majority. I know you are probably thinking that I am being unrealistic, but hope is not fettered by reason, and as the election has demonstrated, good reasoning is not always right. 

 

I hope that this letter gets most of my political concerns out of the way for a while. Last night I attended an event offered by Joe Knowles who is now two years into the bold experiment of giving $400 a month of private money to poor first-time mothers for the first three formative years of their newborn’s life. It’s a pilot program exploring the benefits of one form of universal basic income. As Joe implied at the event, talking about the social determinants of health is really a long way of saying that you are talking about poverty. 

 

Have a great week. Stay hopeful for a less divided America. Ask yourself what you and your friends and colleagues might be able to do to contribute to the progress toward equity in all aspects of our society as we pursue the dream of better affordable healthcare for everyone, and as we continue the effort to move us all toward the end of poverty some sweet day.

Be well,

Gene