REAL GRAVITY

A Film With Real Gravity

By

Leonard Zwelling

            Throughout
the health care reform debate, those opposed to any changes that would involve
a government solution to lowering costs, increasing access or improving quality
posited that such solutions would be mistakes because government cannot do
anything right. I respectfully disagree and the film I saw on Saturday makes my
case perfectly.

While the box office tills were
spinning like slot machines in 3D and IMAX over Gravity, a film surrounding
another government project, space exploration, and what might go wrong, Captain
Phillips opened to excellent reviews. The plot seems to be about how a common
American merchant marine captain managed to show the world his bravery by
surviving a hijacking of his commercial vessel off the Somali coast four years
ago. But I came away with a very different message. What I saw was a love
letter to the US Navy and deservedly so.

Without going into the details of
the rescue that is well documented in news accounts of the event, the
professionalism, competence, readiness and dedication displayed by our men and
women in uniform completely blows apart the idea that the government can’t do
anything right. The discipline and humanity that our troops showed in bringing
Captain Phillips home alive is mind-boggling. The degree of preparedness and
rehearsal that the Navy Seals must have used to execute this rescue at sea was
stunning. That it was done in a matter of fact fashion despite tremendous risks
and possibilities for fatal error is a real tribute to the training and quality
of those who volunteer to serve their country. Even if this was mildly
Hollywoodized (and it did not appear to be), this was daring stuff that might have
endangered many just to save one American civilian.

It is worth seeing this film just
to remind yourself that every once in a while (and Zero Dark Thirty makes the
same point) government gets it exactly right and we ought to be glad it does.

Let’s also recall that despite the
calls from some elderly to “keep the government away from my Medicare”, this
too is a government program that works extremely well. Perhaps it does not work
with the precision of the Navy Seals, but show me a senior who would forego it
for insurance bought in the open, private market (Medicare Advantage not
withstanding).

            And let’s
also remember that MD Anderson is a government institution. It too worked very
well for years showing how a partnership between government support and
individual initiative could be so effective when both parties worked toward a
common goal, the eradication of cancer, It was never about the money at
Anderson—before I got there and for many years after.

           

Yet, here we are now, for the
second time in five years at a place in our history of which we have little knowledge.  Finances might cause us to shrink our
imaginations and have to choose NOT to do something. But that is the state of
medicine today, particularly academic medicine. Strategic choices and planning
are par for the course and we simply cannot do everything we would like to and
thus all major care centers with research missions have to make difficult
choices.

            But no
choice we have to make at Anderson can be any more challenging than the ones
the Navy had to make on the high seas off the coast of Somalia in 2009. Does
Anderson need a gun to its head to make the right calls? I guess it depends on
whose got the gun and whose head it is pointed at.

            In the
final scenes of the film Tom Hanks’ character is being tenderly but firmly
cared for by a Navy medical corpsman who happens to be a woman. It is a one on
one interaction. The huge aircraft carrier and the accompanying destroyers and
helicopters, the bigness of the US Navy, vanishes in the face of one provider
and one patient. This too is the government at work. And as Tom Friedman titled
his last book: This Used To Be Us. Here I mean MD Anderson where the
doctor-patient interaction was the reason for being not just a secondary source
for money.

            And at MD
Anderson, it can be again. Just as invading Iraq and bombing Afghanistan was a
BIG over-reaction to 9/11 and only a SMALL precision strike by a few backed by
the power of the many gained America some measure of revenge in Pakistan,
Anderson needs to remind itself that responses to adverse situations must be
measured, perhaps needing the resources of BIG, but executed by the skills of a
few. And those few are so rarely the ones on top or in charge.

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