April 9, 22021
Dear Interested Readers,
Preparing For Transformation
I have been feeling disoriented since the Biden/ Harris inauguration. For four years I had felt vulnerable to the mismanagement and outright inhumanity of a narcissistic wannabe autocrat who was supported by those who saw him as a pathway to achieving a society that advantaged the advantaged and disregarded those in need by blaming them for their own misery. It was four years of waiting for the next announcement of an attack on the environment or some further withdrawal from domestic or international responsibility. We had come within one vote of losing the ACA which needed an upgrade and not the unwarranted pressure it was getting in the courts and through continuous administrative attacks that were chipping away at the small gains it had achieved. All this was further compounded by the dread of what a conservative Supreme Court might do to further add to the inequities in our society as it considered the reproductive rights of women, the rights of LGBTQ+ people, and any other recent social issues that an evangelical minority might engineer a pretense to reverse.
The first two years were the worst part. Everything seemed vulnerable as the incremental improvements of the last thirty years seemed to be “slip slidin’ away.” The most consistent sources of relief were leftish political columnists who consistently declared that the emperor had no clothes, and the comedians on the late-night talk shows who relished pointing out the buffoonery that was being passed off as legitimate domestic and international policy in thousands of inane “tweets” that were the president’s chief tool in the continuous flow of lies that he fed to the base he had cultivated to admire his greed, racism, and xenophobia. All that sane people could do was pray that some miracle might save us as we shook our heads in disbelief saying, “What has happened? This can’t be America!” But it was America in that bizarre moment.
Some relief came in the midterm elections as enough people turned out to vote for the preservation of the relief that the ACA gave them from the disadvantage of a “pre-existing” condition. Fear of losing the ACA was certainly not the only reason a Democratic majority was elected to the House, but it was a big reason. Perhaps the real reason was that a sleeping majority in 2016 had let the unthinkable become a reality and after two years wanted no more.
Despite it all, many pundits believe that were it not for his disastrous management of the pandemic Donal Trump would still be president. I would rather think that the majority of Americans were fed up with what a minority of Americans had brought on us in 2016. I would rather think of his loss of the election as “just deserts” in the way it was described by Brian Bennett and Tessa Berenson in a November 7, 2020 article in Time magazine entitled “How Donald Trump Lost The Election.” They wrote:
It all finally caught up to him. The lies, the outrageous boasts, the disorder and disastrous management, the rants and the race-baiting, the predatory instincts and compulsion to dominate—all the things that made President Donald Trump the ringmaster of the American political circus at last compelled a majority of voters to drive him out of the tent.
Few other Presidents in modern history so inflamed the nation or exposed the cracks in our democracy as Trump. In the end, Trump’s pride didn’t just precede his fall, it precipitated it. Until the final months, his campaign was managed by a novice who burned through millions of dollars. Trump thought he could wish away a deadly virus. He dismissed his legions of critics, preferring to bask in the adulation of fans. He governed as President only of his base, and he ran for re-election without pivoting toward the center. He barely articulated a policy vision for a second term. He campaigned hard, jetting to dozens of rallies on Air Force One in the final weeks of the campaign, and outperforming the expectations of many thanks to a formidable ground game, a sophisticated campaign data operation and a passionate base of support.
But in the end, the Trump presidency ended much as it began: with a thin margin in key states separating two candidates in an anxious nation, and Trump appealing to America’s demons over its better angels, hurling baseless claims that he’d been robbed.
It is finally over, but the memories and fears linger and it is hard to shift mental and emotional gears and resume the path toward the true American dream as described by Martin Luther King, Jr, the virtual antithesis of Donald Trump, on a hot August day in 1963 not far from where Trump would spew more lies on January 6 to incite a riot that would attack our democracy. Despite all the damage that Trump did, and even as we think about the despair that we have known and the uncertainty that lies ahead, Dr.King speaks to us from across the decades. King’s dream remains the true destiny of America.
Let us not wallow in the valley of despair. (My Lord)
I say to you today, my friends [applause], so even though we face the difficulties of today and tomorrow (Uh-huh), I still have a dream. (Yes) It is a dream deeply rooted in the American dream. (Yes)
I have a dream (Mhm) that one day (Yes) this nation will rise up and live out the true meaning of its creed (Hah): “We hold these truths to be self-evident, that all men are created equal.” (Yeah, Uh-huh, Hear hear) [applause]
I have a dream that one day on the red hills of Georgia (Yes, Talk), the sons of former slaves and the sons of former slave owners will be able to sit down together at the table of brotherhood.
I have a dream (Yes) [applause] that one day even the state of Mississippi, a state sweltering with the heat of injustice (Yeah), sweltering with the heat of oppression (Mhm), will be transformed into an oasis of freedom and justice.
I have a dream (Yeah) [applause] that my four little children (Well) will one day live in a nation where they will not be judged by the color of their skin but by the content of their character. (My Lord) I have a dream today. [enthusiastic applause]
I have a dream that one day down in Alabama, with its vicious racists (Yes, Yeah), with its governor having his lips dripping with the words of “interposition” and “nullification” (Yes), one day right there in Alabama little black boys and black girls will be able to join hands with little white boys and white girls as sisters and brothers. I have a dream today. [applause] (God help him, Preach)
I have a dream that one day every valley shall be exalted (Yes), every hill and mountain shall be made low, the rough places will be made plain (Yes), and the crooked places will be made straight (Yes), and the glory of the Lord shall be revealed [cheering], and all flesh shall see it together. (Yes Lord)
This is our hope. (Yes, Yes) This is the faith that I go back to the South with. (Yes) With this faith (My Lord) we will be able to hew out of the mountain of despair a stone of hope. (Yes, All right) With this faith (Yes) we will be able to transform the jangling discords of our nation (Yes) into a beautiful symphony of brotherhood. (Talk about it) With this faith (Yes, My Lord) we will be able to work together, to pray together, to struggle together, to go to jail together (Yes), to stand up for freedom together (Yeah), knowing that we will be free one day. [sustained applause]
This will be the day, this will be the day when all of God’s children (Yes, Yeah) will be able to sing with new meaning: “My country, ‘tis of thee (Yeah, Yes), sweet land of liberty, of thee I sing. (Oh yes) Land where my fathers died, land of the pilgrim’s pride (Yeah), from every mountainside, let freedom ring!” (Yeah)
And if America is to be a great nation (Yes), this must become true. So let freedom ring (Yes, Amen) from the prodigious hilltops of New Hampshire. (Uh-huh) Let freedom ring from the mighty mountains of New York. Let freedom ring from the heightening Alleghenies of Pennsylvania. (Yes, all right) Let freedom ring (Yes) from the snow-capped Rockies of Colorado. (Well) Let freedom ring from the curvaceous slopes of California. (Yes) But not only that: (No) Let freedom ring from Stone Mountain of Georgia. [cheering] (Yeah, Oh yes, Lord) Let freedom ring from Lookout Mountain of Tennessee. (Yes) Let freedom ring from every hill and molehill of Mississippi. (Yes) From every mountainside (Yeah) [sustained applause], let freedom ring.
And when this happens [applause] (Let it ring, Let it ring), and when we allow freedom ring (Let it ring), when we let it ring from every village and every hamlet, from every state and every city (Yes Lord), we will be able to speed up that day when all of God’s children (Yeah), black men (Yeah) and white men (Yeah), Jews and Gentiles, Protestants and Catholics (Yes), will be able to join hands and sing in the words of the old Negro spiritual: “Free at last! (Yes) Free at last! Thank God Almighty, we are free at last!” [enthusiastic applause]
I have a dream that one day every valley shall be exalted (Yes), every hill and mountain shall be made low, the rough places will be made plain (Yes), and the crooked places will be made straight (Yes), and the glory of the Lord shall be revealed [cheering], and all flesh shall see it together. (Yes Lord)
This is our hope. (Yes, Yes) This is the faith that I go back to the South with. (Yes) With this faith (My Lord) we will be able to hew out of the mountain of despair a stone of hope. (Yes, All right) With this faith (Yes) we will be able to transform the jangling discords of our nation (Yes) into a beautiful symphony of brotherhood. (Talk about it) With this faith (Yes, My Lord) we will be able to work together, to pray together, to struggle together, to go to jail together (Yes), to stand up for freedom together (Yeah), knowing that we will be free one day. [sustained applause]
This will be the day, this will be the day when all of God’s children (Yes, Yeah) will be able to sing with new meaning: “My country, ‘tis of thee (Yeah, Yes), sweet land of liberty, of thee I sing. (Oh yes) Land where my fathers died, land of the pilgrim’s pride (Yeah), from every mountainside, let freedom ring!” (Yeah)
And if America is to be a great nation (Yes), this must become true. So let freedom ring (Yes, Amen) from the prodigious hilltops of New Hampshire. (Uh-huh) Let freedom ring from the mighty mountains of New York. Let freedom ring from the heightening Alleghenies of Pennsylvania. (Yes, all right) Let freedom ring (Yes) from the snow-capped Rockies of Colorado. (Well) Let freedom ring from the curvaceous slopes of California. (Yes) But not only that: (No) Let freedom ring from Stone Mountain of Georgia. [cheering] (Yeah, Oh yes, Lord) Let freedom ring from Lookout Mountain of Tennessee. (Yes) Let freedom ring from every hill and molehill of Mississippi. (Yes) From every mountainside (Yeah) [sustained applause], let freedom ring.
And when this happens [applause] (Let it ring, Let it ring), and when we allow freedom ring (Let it ring), when we let it ring from every village and every hamlet, from every state and every city (Yes Lord), we will be able to speed up that day when all of God’s children (Yeah), black men (Yeah) and white men (Yeah), Jews and Gentiles, Protestants and Catholics (Yes), will be able to join hands and sing in the words of the old Negro spiritual: “Free at last! (Yes) Free at last! Thank God Almighty, we are free at last!” [enthusiastic applause]
Pardon the long quote, but I believe that ‘the dream” is a message that envisions a transformation that is still in the future. One way to hasten the realities that the dream envisions is to frequently read and reflect on the importance of the dream. I expect that the journey toward the dream will be both an adventure and a continuing struggle that is filled with perils as was demonstrated during the four years of Trump’s presidency. But there will also be incremental gains as demonstrated by the eight years of leadership from Barack Obama. With the election of Joe Biden, we are back on a course following a leader who is determined to get us closer to the dream. I truly believe that someday the dream will be a reality. It’s just that the change in direction is so sudden after such a long period of misery that I am a little dizzy.
I go to bed earlier since January 20. There is no need to stay up to listen to Stephen Colbert and Trevor Noah. They seem disoriented also as they try to remember how to be funny and insightful without Donald Trump as a foil. Perhaps they find it hard to make jokes about a decent man like Joe Biden, an ordinary sort of man who has the extraordinary ability to have friendships that can span the wide political differences between a noble John McCain and an earnest Barack Obama. Joe Biden is the man of the moment whose actions and policies will drive the next leg of the journey. It is a journey of transformation that will be lead by a man for whom transformation seems like a new experience. Some people find it interesting that the Joe Biden that we elected president has also undergone a rather rapid transformation himself which is truly remarkable for a man in his late seventies. Ezra Klein published an analysis of the president’s transformation in his column in the New York Times this week in a piece entitled “Four Ways of Looking at the Radicalism of Joe Biden: It’s unexpected, but it’s not inexplicable.”
Klein does a great job of describing Biden’s recent transformation. His writing is always interesting. He begins:
Joe Biden didn’t wake up one day and realize he’d been wrong for 30 years.
I covered him in the Senate, in the Obama White House, in the Democratic Party’s post-Trump reckoning. Biden was rarely, if ever, the voice calling for transformational change or go-it-alone ambition.
But you’d never know it from his presidency. The standard explanation for all this is the advent of the coronavirus. The country is in crisis, and Biden is rising to meet the moment. But I don’t buy it. That may explain the American Rescue Plan. But the American Jobs Plan, and the forthcoming American Family Plan, go far beyond the virus. Put together, they are a sweeping indictment of the prepandemic status quo as a disaster for both people and the planet — a status quo that in many cases Biden helped build and certainly never seemed eager to upend.
Over the past few months, I’ve been talking to White House staff members, to congressional Democrats, to policy experts and to the Biden administration’s critics to better understand why President Biden is making such a sharp break with Joe Biden.
When I read that intro I was intrigued. Is it possible that Joe’s transformation could be infectious? Could he put us back on the path to the Triple Aim? Is it possible that so many in healthcare who have been standing on the sidelines might be miraculously inspired to join the effort to move toward the dream by asking themselves what they might do to increase the equity in their practice, which is one of the six domains of quality? Is healthcare also open and ready for transformational change? Will healthcare professionals examine their world with a commitment to changing their environment as they seek to increase equity and close the differences between their current environment and the other five domains of quality: patient-centeredness, safety, efficiency, effectiveness, and timeliness?
Joe’s job is to propose and get passed the laws that will shape the environment, provide the resources, level the playing field, correct some of the past injustices and otherwise plow the ground of our society in a way that will foster the transformation of attitude that will enable the many components of the dream. If there is any lesson to be learned from the tragic death of George Floyd it is that we wallow in ugliness, and when we see it on the street we are often incapable of responding quickly enough to prevent a deadly outcome. We literally have a second pandemic of gun-related deaths and injuries. Each day there are hundreds of shootings and killings. There are so many gun-related deaths that unless the circumstances are very dramatic we pay little regard to the fact that they occur at rates of over 300 a day. As the richest nation on earth, we have one of the highest death rates from guns per 100,000. Sudden, unexpected gun violence is a “shrug your shoulders” reality that can turn a trip to the grocery store into the last thing that you do in this life. Nothing is for certain. Joe’s hands are full with a host of problems and needs and the Senate is capable of tying his hands.
Klein gives his take on the change. In my opinion, he never gets the reason right which is that Biden has grown in stature to match the challenge of the moment. Everything in his life has pointed to this moment. He has had political failures, personal losses laced with unimaginable grief, and has often been out of step with the times. He is a walking demonstration that to rise to new heights it is often necessary to have experienced great lows and losses. Defeat and disappointment can be teachers. Klein comes close to this explanation but makes Biden look a little opportunistic when he writes:
Biden is a politician, in the truest sense of the word. Biden sees his role, in part, as sensing what the country wants, intuiting what people will and won’t accept, and then working within those boundaries. In America, that’s often treated as a dirty business. We like the aesthetics of conviction, we believe leaders should follow their own counsel, we use “politician” as an epithet.
But Biden’s more traditional understanding of the politician’s job has given him the flexibility to change alongside the country. When the mood was more conservative, when the idea of big government frightened people and the virtues of private enterprise gleamed, Biden reflected those politics, calling for balanced budget amendments and warning of “welfare mothers driving luxury cars.” Then the country changed, and so did he.
I will leave it to you to put forth your own explanation for the Biden we have at this moment. The more important concerns are what will this Biden be able to accomplish with your help and what is the transformation you need to undergo to join the effort to create the equitable world we want or if that is too far to reach insure that we will not slide back into the world we just threw off with great effort after great losses.
That is the conversation that I want to join, and I hope to explore over the next several weeks. How will we be transformed? How passive or how active will you be and how will we prioritize our objectives? There is a lot to consider.
What A Difference A Week Makes. Finally, It Is Really Spring.
This time last week the lake was still partially frozen and the Red Sox were busy being “swept” by the usually inept Orioles. It was still more winter than spring although there was evidence that spring was a plausible concept. If you compare the header from last Friday and today’s header you can easily see the difference. In today’s header, the sky is very blue with scattered puffy white clouds. The lake is a mirror that reflects those clouds so perfectly that you need to look at the hills to be sure what is up and what is down. Last week’s header was taken late on a cold and windy afternoon. It shows a dull grey sky and hunks of floating ice. It makes you feel cold just to look at it.
This last year has been very hard for most of us. It’s nice to hope that things will be better soon. Like many Americans and most of our friends, my wife and I have spent the last fourteen months in an approximation of solitary confinement. One of us goes to the post office and the adjacent grocery store most days, but that is it. We did drive an RV cross country and back, but we were in our “bubble” the whole way. We have meetings with family and friends as well as organizational activities on Zoom. We also attend church and even play “Mexican Train” online. We have had Zoom weddings, Zoom birthday parties, and even a Zoom funeral. Most “passings” get nothing other than a shake of the head and a call to the surviving spouse.
I have not had a haircut since March 13, 2020. My beard would be down to my midchest if I did not trim it myself. My unshorn hair usually hangs loose with my white curls falling below my shoulders. A bandana gives me that “Willie Nelson” look. Who knew that ponytails were so uncomfortable? The weight pulls against your scalp. But that misery is almost gone because we are one week post our second Pfizer shot. This time next week we will presumably be protected and will emerge from our cell. I know that many people might think that we are being overly cautious but the data suggest that the mortality from COVID for those over 75 is greater than 10%. All those worries like the ice and snow of winter will be in the past soon. I have made an appointment to get a haircut on April 21. It seems that getting an appointment for your hair in April of 2021 is as hard as it was to find toilet paper in April of 2020!
I did not get COVID, but I have not avoided physical problems this last year. I have mentioned before that I fell on an icy downslope during a walk at the end of February. Until now I haven’t revealed what an educational process my recovery course has been for me. I did not break my hip, but I think that it might have been better to have had a fracture than what seems to have occurred which was an injury to my sciatic nerve. If I had broken my hip I would be much better by now. I have finally accepted doing less and am making some slow progress with the help of a physical therapist though there is a long way to go. Now my walks are around the house with a cane. I use a TENS unit several times a day. Sleeping for more than an hour or two at a time is still difficult. I now understand Lady Macbeth’s line, “Oh for sleep that knits the raveled sleeve of care!”
I had discovered last fall that a brachial plexus syndrome was bad news. The pain and numbness in my left arm and hand that I thought was bad news has improved but the sciatica is much worse. I knew but had never experienced that pain from a nerve injury could become a chronic debilitating issue. All of my walks seem like they occurred during another life. I feel shame for all the pains my patients had that I did not fully comprehend. Pain is an intensely personal reality.
The pain gets a lot easier to bear on a spring day like we enjoyed yesterday. I sat on my deck in a rocker with my feet on a gliding footstool and enjoyed the warmth while I watched the lake and dreamed of all the things I would do just as soon as my sciatica has resolved. I was also looking for the loons since my wife reminded me that last year they were back as soon as the ice was out. They should be back from the Maine coast any day now. What I did see, and you can see them below, was a breeding pair of “common mergansers,” I also saw a single wood duck or bufflehead but it flew away before I could take its picture. I did not get much of a view of the second bird that had a black and white head.
I was able to observe the mergansers for a much longer time. We have mergansers on the lake every summer. Mother merganser is like a drill sergeant as she patrols the lake with her crew of eight to ten ducklings. Mergansers are divers, but I have rarely seen the mother dive probably because her ducklings are the focus of her attention and pop is nowhere to be seen, much less share parenting.
The only male merganser that I had seen before yesterday was in a picture in my Eastern Birds, the field guide by Roger Tory Peterson. The breeding male merganser looks nothing like the female. It has a white body and a rounded black head. The female has a reddish beige body and a top notch. Since there were no ducklings both the male and female that I saw were doing a lot of diving. Suffice it to say, watching those birds, observing the lake, and enjoying the warm sunshine made for a fine day even though I never moved from the deck. To top it off, two recently vaccinated friends interrupted their bike ride to stop in and tell me that they hoped it would not be long before I could join them again in their outdoor adventures. Being an invalid who enjoys an occasional visitor is definitely a role I have never played before, and spring gives me high hopes that it will soon be over.
Things are also looking up for the Red Sox. They lost the first three games of the season and it looked like another dismal year was coming, but now they have won the next four and they are tied for first place! It is spring, and it is okay to hope for miracles. Anything is possible.
Be well. Take good care of yourself. Enjoy the coming of spring. While we are preparing for sweeping transformational change don’t let anything keep you from doing the good that you can do every day,
Gene
