Social Ills: Number One With A Bullet
On Meet the Press on Sunday, December 22, Chuck Todd and his panel reviewed the biggest stories of the past decade. I was sure that the number one story would be the election of Donald Trump. That was only number 4 tied with the killing of Osama Bin Laden. No, the number one story of the past decade according to these experts was the combined social ills within the American public and the inability of politicians to deal with them. These include gun violence, hunger, poverty, suicide, the opiate crisis and further addiction to everything from the Internet to pornography. The country is being overwhelmed by social problems even as the economy grows and unemployment shrinks. What’s going on?
No one around Chuck Todd’s table was sure and Peggy Noonan, my go-to columnist, was there along with Helene Cooper, Doris Kearns Goodwin and Rich Lowry. This is the A-team for Chuck Todd. How could it be that no one had the answer to America’s social ills?
I think the problem is one of leadership, or the lack thereof. There are no powerful and righteous leaders on the American scene right now in positions to grapple with the problem of societal ills. The politicians have given this up to focus on getting elected. They are more partisan than ever. They cannot work with each other and cannot craft compromises that might attack the problem of gun violence or opiate addiction because they won’t even acknowledge that these things are problems. While Congress is fooling around with impeachment and the president is lying his way back to the White House, average Americans are struggling to make sense of a country that no longer leads the world economically or morally. Oh yes, we still have the largest economy but despite Mr. Trump’s America First beliefs the well-being of Americans is inextricably linked to that of people all over the world. There is no retreat from globalization and the effects of climate change (the number 2 story of the past decade). Americans are caught in the whirlwind that is the worldwide challenge of interdependency and the quest to save the planet.
The same is true of medicine. Where forty years ago, the greatest challenge facing American medicine was diseases, many deriving from our own behaviors—eating, drinking, not exercising and driving like maniacs, this has now all gotten so bad that the life expectancy of some Americans has actually declined for the first time. What have we been doing all this research for if people are going to live shorter lives? People won’t get vaccinated. Why? Because there is no trust in the establishment of medicine or politics that vaccination will actually save lives. (Hint: it does).
Today, American medicine is focused on money. Doctors’ practices are bought up by health systems that negotiate with large insurers for prices of the services that are ever more complex and used with a certain lack of judgment. I faced this myself when after a abdominal hernia repair and the certainty that I had become obstructed, I returned to the ER only to have a CT scan before I ever saw a doctor. Hell, I knew what was wrong and I didn’t need to spend $500 to find out. NPO. Drop an NG tube. I will live. Certainly, in my day, I would have at least examined the patient before ordering the test. No longer. I am not even sure that some of these young doctors know which end of a stethoscope goes in the ears let alone know that the most important part of that implement is the part between those ear pieces.
I think social ills stem from people getting lazy. Life overwhelms them. Too many signals are coming in from too many places and those signals are scrambled. During Watergate there were three networks, all telling the same truth. Now there are countless news outlets and everyone can choose his or her truth.
I see it everywhere and I am sure that only dynamic, thoughtful and well-trained leaders can change things. Mr. Trump is not that and I am not real happy with many of the Democratic choices. For some reason the Democrats are tending toward candidates who promise the world (free health care, free tuition, debt forgiveness,) without also demanding the obligation to earn these rights. Socialism is not the answer for America and it never will be.
As a boomer, I return to January 20, 1961 when President Kennedy asked us what we could do for our country. I think our politicians need to be reminded of his words and stop this petty fighting over nonsense (and let’s face it, the impeachment business is alternatively serious and malarkey, petty and all-encompassing). Surely, Congress has better things to do and surely the leadership of MD Anderson has better things to do than to spout feel-good nonsense about Fighting Cancer and addressing cancer as if it were a person, rather than be candid about the limits of our abilities to combat established malignancy and re-stress the importance of prevention and the implementation of sound living habits and timely cancer screening.
By definition, our social ills must be of our own making. As such they can be solved. We just need leaders up to the task. I just don’t know where they are any more.
“Where have you gone Joe DiMaggio a nation turns its lonely eyes to you, woo-woo-woo.”
“The fault, dear Brutus is not in our stars. It is in ourselves.”
Social ills can be healed, but first we have to admit that they exist and make their healing a national priority. Right now our national priorities seem to be acquiring guns, using opiates, fighting foreign wars and reality TV. Surely we can do better than that.