The Body, Politic
Tonight's feature event was a talk sponsored by the California Medical Association and given by political analyst Dan Schnur. To be honest, I've never had much of an interest in politics, policy, or economics, despite having an awareness of their undeniable impact on the state of science, technology, and medicine in our society. Somehow, I've never quite shaken the stereotype of the dirty politician--a disdain for bureaucracy as an impediment to, rather than a facilitator of, progress.
Add to that inherent disinterest the isolation of living in the oft Eden-esque "Stanford bubble" for 6+ years, and you have the makings of a genuine science nerd--a sociopolitical ignoramus. Obviously, this is not something to be proud of...without a broader understanding of the context in which we, as scientists and as health care providers, operate, our work loses some of its applicability and relevance.
And although my plans for "changing the world" currently consist of a more bottom-up, one-patient-at-a-time approach, I don't want to be just another cog in the machine. That is to say, not having the solution is no justification for turning a blind eye to the problem.
So this is how I turned up at the talk this evening. Having realized that I know absolutely nothing about the Californian political landscape, and with it becoming increasingly possible that this is the state I may eventually settle down and practice in, I felt that a little education was in order.
As it happens, Dan Schnur was an incredibly engaging speaker, despite his right-wing convictions. (I kid. Although I'm a registered Democrat, and I do swing liberal on some issues, I'm generally pretty centrist. But that's neither here nor there...you're not paying good money to read about my political leanings. Not that you are paying any sort of money to read about anything I say. Although that would certainly be nice, wouldn't it? Right. Back to the topic.)
Basically, the conclusion was that, given the current political climate in the state, it's highly unlikely that any type of large-scale, sweeping health care reform could be implemented in the next several years. So, what then? Back to being an apolitical cog?
Well, suggests Schnur, in the words of John McCain, it is important not to let "perfect" become the enemy of the "good". Which is to say, if we are always holding out for the ideal, and are unwilling to accept anything short of that, no progress will ever be made. Sometimes we have to compromise, and push forward, even though we may only be getting 3/4, or 2/3, or even just 51% of what we wanted.
I appreciate this statement. I think it's a valuable philosophy in more arenas than just politics (interpersonal relationships, for example, cannot survive without compromise). But this discussion really got me to thinking about the nature of medicine--because it is one area where such a mindset doesn't fly. In medicine, we are trained to pursue perfection. There are no compromises, no "baby steps" to greatness...anything less than the ideal--the perfect diagnosis, the perfect treatment plan--is settling. And in this line of work, "settling" could cost someone his life. Melodramatic? Maybe.
It sounds a bit like the tagline for some ER-type television show, I know, but it's the reality we live with, whether we choose to consciously focus on it or not. And perhaps that's what makes the prototypical scientist so different from the archetypal politico; perhaps that's why I find it difficult to navigate a domain that seems for all the world to me to consist mostly of strategizing and haggling, without definitive answers or tangible solutions to the problems. Which is not to say that the dichotomy doesn't present itself when going the other direction as well: the surgeon's way of thinking is essential on the job, but outside of the OR, it can lead to frustration, inflexibility, and discord.
So what did I take away from tonight's talk? Yes, I learned a lot about the state of politics in California; yes, I agree that the focus at present should be on smaller changes (i.e., health insurance portability, education/outreach aimed at getting eligible individuals and families enrolled in MediCal and other assistance programs).
But more than just on a political level, the discussion provided food for thought on personal philosophies and attitudes in general, and how being in the field of medicine molds the way we think. (The issue of nature or nurture--or, in other words, how much of it is medicine shaping our personalities versus whether those in the profession self-select because they possess certain character traits...or if the two are mutually perpetuating--that's a whole 'nother can of worms that I won't tackle now.) And, no, I don't have any answers--no neat, tidy "take-home message" that sums up how I should think about the issues...but then again, isn't that kind of the point? ;-)
Epilogue: In case you were wondering what I did with myself the rest of the day, when I wasn't waxing philosophical...
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Morning: work on agenda for Arbor meeting
Noon: meeting with the superfly, totally awesome Arbor Follow-Up & Referrals crew:
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Afternoon: miserably unsuccessful attempt to cram more biochem. decide to work out instead.
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Afternoon (cont.): further non-productivity. went for a run around Lake Lag.
Evening: went to talk. finally started to make headway on studying.
Tomorrow: more (you guessed it) Arbor meetings, and a surprise birthday party...shhhh!
Posted at 11:11 PM
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