January 20, 2021

Inauguration Day: The center holds, the Republic stands, and we can all go to bed this evening, no matter what our political leanings, knowing that there are stable individuals controlling the levers of power. What does this portend for the future, especially for those corona virus related public health issues in which I am most interested? I can’t say that I know. I am hoping that we will begin to see a unified national response, rather tha a piecemeal local one dependent on the whims of politics. I’m hoping those in charge bring the resources of the federal government to bear on the vaccination effort and that extant vaccines get into willing arms as quickly as possible. Most of all, I’m hopeful that policies will be crafted that will tilt the balance away from the side of profit back towards the side of people.


I have no idea how successful any of these shall be in either the short or the long term. particularly this last onel The economic powers that be which shield capital from the depradations of the people with needs are strong and entrenched and neither political party has really taken them on in some decades due to the great costs of maintaining the current apparatus of elective office, particulary the cost of campaigning in the media age. Lofty promises have been made, but results have been few and far between since the mid 1970s when the earnings of corporations began to outstrip the earnings of workers – and those curves have diverged further and further from each other over nearly five decades. That’s a lot of societal repair.


I’ve been talking a bit about the Big Lie regarding the truth of who won the election, the idea of it having been stolen by the Democrats from the Republicans still having currency in some circles despite essentially no evidence to corroberate this belief and plenty of evidence that the Democrats took both the popular and electoral voted fair and square. There is, however, an even bigger lie that’s been promulgated for decades. The one that the collapse of earning power by Blue Collar and rural Americans is due to a theft of resources by those below them on the social scale, whether by undercutting them in the job market or through governmental benefit, rather than to a redistribution of wealth to those above them on the social scale through corporate consolidation, multinationalism, and redistribution of economic resources outside of the US. This has fed the deep divisions in our country and they are likely beyond the ability of any one administration to repair.


There is one thing that gives me a great deal of hope and that was on display at the Inauguration in the person of Amanda Gorman with her brilliant reading of her poem ‘The Hill We Climb’. This young black woman, full of poise and meaningful words, captured our current moment perfectly and, to me, is emblamatic of the rise of the Millennials and Generation Z to power. She joins the Florida high school students whose work and commitment helped take down the untouchable NRA, the youthful climate change activists, and the committed young people I work with in medicine who are facing the challenges of Covid-19 head on. It’s a generation who clearly sees where the old forms and ways of doing things are broken and who are unafraid of speaking truth to power and moving forward.


The Baby Boom is not going to relinquish social, economic, and political power easily or gracefully but time is coming for them. Demographically, somewhere around 15% of the generation will have died by 2030. They will then die off rapidly over the next two decades, roughly 40% in the 2030s and another 40% in the 2040s. A few will linger on with the last American boomer passing away around 2080 at the ripe old age of 115. There will be a wholesale changing of the guard in society over the next twenty years and from what I have seen, the kids are alright and we’re in pretty good hands going forward.


We’re now at 400,000 deaths in the US from Covid-19, most of whom would not have needed to die had this virus arose at another point in modern US history but, as it coincided with an administration with minimal interest in the commonweal, an accidental plague it did become and we all have to live with the consequences of that and whatever part we played in allowing it to happen. Our fascination with infotainment over real news and analysis, our wish for quick solutions, our unwillingness to endure discomfort for the sake of others – all of these helped the virus establish itself here in ways that have cost real lives and untold suffering. Now we have the chance to make some different choices but it remains to be seen if we, as a society, will be willing to do that. I hope we can.


In the meantime, I’ll still be here. Watching, writing, trying to interpret the course of events in ways that help me make sense of this crazy world we find ourselves in. I’ll continue to follow my particular mantra, one which I have been imparting to medical students for decades: the world is saved one patient at a time. I have hope that the plague will recede enough that other things in my life will get back on track but I am content for the moment with my work, my thoughts, and a little recreation on the side.


Here’s to new beginnings, but in the meantime you know what to do. Wash your hands, wear your mask, social distance, and stay out of indoor crowds. May your vaccine arrive soon should you choose it.

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