Fair Winds and Following Seas

post it notes on window that say sorry we are closed covid 19

California is ablaze. It was 130 degrees in the Mojave Desert two weeks ago. The Democratic and Republicans National  Conventions have ended. The November election is coming toward us like a freight train. COVID-19 is flaring, subsiding, flaring again – and this is our new reality. Lives have been put on hold. Mortgages cannot be paid. American Airlines is laying off 19,000 employees. Concert halls are silent. Indeed, all of the work for the Institute is being done with Zoom calls, on-line classes, and by email.

Some people are talking about re-imagining healthcare. Some are talking about the obvious need for single-payer. Others are focusing on the way that the virus has been shining a bright light on the gross inequities in our country and the fact that America has failed to provide equal access to medicine. We know that a vaccine will not be the end of this.

I don’t think that re-imagining is enough. I don’t even think that healthcare is the subject. And I don’t think that the conversation starts with trying to answer the question, “How do we fix a broken system?” It is time for a paradigm shift. For radical change.

We need to be talking about biology, biography, and civic responsibility – and it is this conversation that will lead us to creating a world in which wellness and health are sustainable and valued.

The pandemic has clearly shown us that where you live, how you live, and the circumstances of your life will determine your disease risk and your outcome, but this is not news to us. Dr. Sandro Galea’s address at our 2019 symposium clearly outlines key factors such as connectedness, food, housing and jobs that are rarely considered when talking about healthcare reform. Institute Scholar Dr. Steven Woolf’s article about The Power of Prevention and What It Requires details the real cost of ignoring preventative medicine in favor of the healthcare system as we know it.

I have spent this summer in conversations with thought-leaders and practitioners from around the globe. We are looking for answers, but first, we are defining the questions.

Where do we go?  What do we do? How do we start? Is it possible to create a tectonic shift in the conversation which will lead to real and lasting change?

This summer, three generations of our family spent a week sailing on the Chesapeake Bay – and there is nothing like life with an infant and toddler on a boat to focus the mind. Some days were stifling, some evenings were breathtaking, once or twice the dawn brought rain. Our lives were defined by the forces of nature: the sun, the wind, and shining stars on a moonless night.

There was time to think. Time to see a young family coming up in a world that is fraught – and we are not done. Our work is not done. We need to be expansive in our thinking and our commitment to change. We need to listen to the voices of people from all walks of life, be they doctors, community organizers, economists, scientists, anthropologists, or historian – to everyone interested in making a difference. We must find a new way forward.

We must look everywhere. We must turn our expectations upside down. We must continue to ask questions and accept that sometimes the answers will sound crazy – and sometimes that is where the wisdom lies. And in the midst of the chaos that is our world today, I must remember those nights on the boat, when the welcome breeze whispered a message of hope for the new day. Fair winds and following seas.

We can do this.