I hope that you will be voting today. I also hope that you will make sure to encourage everyone you see to also make the effort. This note is coming out early so that I might emphasize what I expect you already know. This is a very important election. I have heard and read that the 2018 midterm election is a referendum on the first two years of Donald Trump’s presidency. I believe that calling the election a referendum on Trump is only partially right. I would put the stakes even higher and call it a referendum on the future.

 

I have always considered myself to be pretty knowledgeable about American History. I was the eighth grade winner of the DAR medal for the best student in American History!  I can tell you all about the Spanish Explorers. I have visited many of the big battlefields of the Civil War. I can put forth a good argument that the Civil War was fought over slavery even though my college professors tried to convince us that it was only about “states rights.” Recently I have been forced to admit that I knew places, people, and dates, but my knowledge of how social issues and self interests interacted with commerce, science, and the ambitions of individuals to create the real story had largely escaped me because it was not what I was presented in class or had read in books. It seems that “history is written by the winners.” It seems that what we are taught is largely driven by someone else’s strategic objectives.

 

Over the last few weeks I have had my eyes opened to the deficiencies of my real knowledge and lack of depth in my understanding of American history. I have been working my way through Jill Lepore’s new book, These Truths: a History of the United States. I have long been an admirer of Lepore’s articles in The New Yorker. Her long list of literary credits is impressive but are even more remarkable when underlined by her academic credentials. Since 2012 she has been the David Woods Kemper ’41 Professor of American History at Harvard University. Andrew Sullivan’s review of These Truths in the New York Times characterizes the book quite accurately when he writes:

 

These Truths,” by Jill Lepore — a professor at Harvard and a staff writer at The New Yorker — is a one-volume history of the United States, constructed around a traditional narrative, that takes you from the 16th to the 21st century. It tries to take in almost everything, an impossible task, but I’d be hard-pressed to think she could have crammed more into these 932 highly readable pages. It covers the history of political thought, the fabric of American social life over the centuries, classic “great man” accounts of contingencies, surprises, decisions, ironies and character, and the vivid experiences of those previously marginalized: women, African-Americans, Native Americans, homosexuals. It encompasses interesting takes on democracy and technology, shifts in demographics, revolutions in economics and the very nature of modernity. It’s a big sweeping book, a way for us to take stock at this point in the journey, to look back, to remind us who we are and to point to where we’re headed.

 

Sullivan isn’t quite accurate. The book is only 799 pages including the introduction. The other 130 pages plus are mostly references that give testimony to her scholarship. I definitely agree with the way Sullivan ends his review:

 

…if you reread the book and ask yourself, what is the period of American history that most resembles today?, you would have to say, I think, the late 1850s and early 1860s. Here’s Lepore’s description of that time: “A sense of inevitability fell, as if there were a fate, a dismal dismantlement, that no series of events or accidents could thwart.” Lincoln thought of the nation as a house, and quoted Scripture: “A house divided against itself cannot stand.” And his words, as always, cut through the ages like a knife.

 

What I like most about the book is the new perspective on our natural character that it offers. Lepore begins the book with the moral conflict associated with Columbus’ treatment of the residents of “Hispaniola.” She presents clear evidence that there was an awareness of the moral ambiguities that existed even in the 1490s about the way that the native population was treated. These original moral arguments and many others that have followed: slavery, the Imperial conquest of the continent, the abuses sustained by labor, the denial of franchise and voice to women, the sins of the Jim Crow era, the abuse of Native Americans, and Vietnam have been ignored or glossed over when we talk about our greatness. She makes it impossible to hide from the overarching contradiction between our theoretical image of “These Truths” describing universal equality and the history and experience of minorities and those without power in this country that is inconsistent with our sense of who we are. 

 

We have never really settled the issue of how we are to be governed. We have been caught between a fear of authoritarians and our fear of the lack of deep understanding of the broader “unwashed” electorate. Our “greatness” has been in our struggles more than in our outcomes. Our heroes have often had authoritarian tendencies even as they have reluctantly submitted to the controls outlined in the Constitution as a balance between the three branches of government. Long before Donald Trump promised to lead us to greatness by letting go of our place as the international leader of the free world, the rest of the world was confused by the contradiction between who we said we were and what they could see in the realities of the inconsistencies of our domestic policy or the Imperial tendencies in our foreign policies. The pendulum of our inconsistencies swings back and forth through history. Kris Kristofferson’s lines fit us.

 

He’s a walkin’ contradiction, partly truth and partly fiction,
Takin’ ev’ry wrong direction on his lonely way back home.

 

Nothing underlines the oscillating nature of our politics and the fickleness of the electorate more than the debate on healthcare. A hundred years ago we did not want universal healthcare because the Germans had it. Eighty years ago we were convinced that it was a slippery slope to socialism. We launched great initiatives in healthcare and declared a war on poverty in the sixties. After wasting money in Vietnam, we cut back on the “War on Poverty.” In the eighties we abandoned our commitment to social justice. We shifted from concerns about the underserved to new efforts to guarantee that “shiftless people” who were unwilling to work got nothing. The contradictions continue. Barry Goldwater launched the rise of a divisive form of conservatism but was on the board of Planned Parenthood. The NRA once advocated gun control. Lepore’s picture suggests that we spin back and forth as we make very small and painful steps toward “These Truths.” Over decades and centuries progress seems to occur.

 

The question behind all the struggles, abuses, and eventual reversals of wrongs and small steps forward is whether what happens next will be more of what has happened. Will we get back on the road toward equality or will we permanently abandon the effort to build a society founded on “These Truths?” Is it possible that “the referendum” on Trump will be the first painful step toward a renewal or restatement of our commitment to equality or a confirmation of our current path? Will the outcome suggest that everyone deserves a chance at better health as an expression of “These Truths?” It is reassuring to see that the arc of our history has continued to bend toward justice, but that should not be considered to be a guarantee. We have voted out as many failures as we have voted in, but there is never a guarantee that we can do it again.

 

It is startling to realize that there was less than three years between the Voters Rights Act of 1965 and the assassination of Dr. Martin Luther King, Jr. Richard Nixon won the election of 1972 with 61% of the vote as he gleaned every vote in the electoral college except those from Massachusetts and the District of Columbia. Lepore shows us that the movements in history can be slow like the advance of a glacier or sudden, unexpected and violent like an earthquake.

 

A review of our history suggests that there is not much that is new in our politics. Ideas and allegiances switch parties. Now Democrats care about Planned Parenthood and gun control. African Americans were once mostly in the Republican Party, but FDR drew their votes into the Democratic column. Fake news is a concept that is at least a hundred years old. Many presidents have told us lies. All this is true and reassuring, but it does not mean that we can expect that the last two years will be followed by a correction toward opportunity, the resolution of our social controversies, or even a return to government that pursues better health for every citizen.

 

I’ve had conversations with patients who would try to fend off my concerns about their destructive health habits by saying “I’ve never had a problem before.” I would acknowledge that reality, and congratulate them on the health that they had enjoyed, but then I would comment, “You know, it’s never been this late before!” I am not an advocate for living as if we are nearing the “end of time,” but I do believe that there is no protection going forward from what has never happened, yet. We protect ourselves and what we care most about when we work against “what has been” to protect ourselves from “what might be.”

 

Has the internal discord this country has experienced for the last forty years since Vietnam divided us and began our drift toward our current inability to abide large numbers of our neighbors become a permanent change of course? Will spontaneous healing occur? Time will tell, but I do believe that to be passive in this moment would be to misread history. The story that Lepore tells oscillates toward justice because there has always been those who worked for a course correction. The usual outcome of their work was not victory, but slow progress through participation.

 

I am hopeful, not optimistic, that this election will initiate a set of events that will protect the positive principles of the ACA, and be a step toward the opportunity to use what we have learned to build programs and pass legislation that move us closer to the Triple Aim. I am afraid to be optimistic because no one will know what comes next until today’s vote is tallied. If it turns out that a majority of voters likes this administration because it has put money in their pockets, likes its approach to North Korea and Iran, likes the way it has protected our borders by turning away women and children, likes its stance on climate change, applauds its abandonment of public education, and believes fear, rather than opportunity, is the key to progress, then I want to be prepared to see the day as a battle lost, but hope it’s not the end of the struggle.

 

A small majority for progressive ideas in the House would be a delight. Capture of both the House and Senate would be evidence of a new day coming. I want to be resilient even if the day ends in disappointment. I believe that “down ballot” victories in the elections for schools committee, town and county government, and state legislative positions can form a foundation for future statewide, congressional, and presidential victories. The picture that accompanies this post suggests that in my little town those “down ballot” contests are important. I love the juxtaposition of the old maple tree trunks with the placards for my local candidates that I hope will help us take the first step in the resumed journey toward “These Truths” and the Triple Aim.