Is there anyone out there who isn’t anxious? If the election took your focus off of Covid, albeit temporarily, given that you still had to think about whether it was safe yet to send your child back to school for in-person classes, return to your away-from-home office, stop disinfecting your groceries, or if you could touch your mail without a 72 hour sequestration period, the respite was brief. Covid infections are climbing at a rapid rate (now over 11 million in the US alone), as are hospitalizations, and the number of patients in ICU beds. The chances that you will come into contact, knowingly or not, with someone who is contagious, and thus risk becoming ill yourself, are rising with each passing day.
Covid notwithstanding, the 2020 election is now over. Fortunately for democracy, there has been no legitimate evidence of widespread voter fraud. Nonetheless, we are, so far, deprived of the opportunity to calmly adjust to the prospect of a new administration due to highly politicized rhetoric, bureaucratic maneuvering, and legal challenges to the validity of the election results. If we are Biden supporters, we are unsettled by the seemingly spurious allegations of voter irregularities, attempts to delegitimize the election outcome, and erected barriers precluding a smooth transition of power. Repeated allegations by talk show hosts and media pundits make us worry that Mr. Trump, who mathematically lost the popular vote and electoral college tally, will refuse to leave office. If we are Trump supporters, we are convinced that ballots were compromised, the election was stolen, that there will be a socialist takeover (although exactly what this looks like, and the specific deleterious consequences are unclear), anarchy will reign, our suburbs will suffer impending threat of violence, and our cities will surely be looted and burned. In addition to all of these external concerns, we are either mourning the impending forfeiture of Thanksgiving celebrations, or fearful of relatives bearing the corona virus along with the stuffing and gravy. We may warily anticipate our guests volleying opposing political philosophies across the table, a scenario destined to counteract the expected tryptophan-induced post prandial lethargy. We may be divided along partisan lines for almost everything, but are United in our States of Insomnia and Indigestion.
What should we do? My mother was a therapist who resolutely believed that, with enough time and effort, most conflicts, and problems, could be resolved-with one caveat, which she memorably illustrated in response to my expressed frustration of trying to convince a patient to act in their own best interest. This was that when you (the therapist, the doctor, the mediator, the facilitator) are working harder than the patient/client/interested parties, that’s a problem. The implication of this analogy is that our national divisions can be bridged, compromise, progress, and unity can be achieved, if we care enough to be willing to listen to one another, to learn, and to actively work towards solutions.
It seems to me that the need to work together is self-evident-in a “we hold these truths to be self-evident” kind of way. The truths to which I refer, the rights enshrined by our Founders in the Declaration of Independence, to Life, Liberty, and the Pursuit of Happiness, cannot be achieved in a vacuum. They exist in the context of our relationships with our natural and chosen families, our friends, our co-workers, the extended radius of people with whom we interact, either directly or indirectly, and with our government, which creates and implements the policies and laws of the land. These rights which we enjoy are also predicated on our health, the protections afforded by our justice system, and our morality, be it secular or religious in nature. Just like any valuable relationship, our rights require respect, nurturing, effort, and dedication.
Among my many identities and roles, I am a physician, which, in my case, took the combined form of healer, psychologist, educator, and supporter. In order to have a functional, mutually rewarding relationship with my patients, it was necessary to agree on certain truths and norms, and to abide by certain rules, among which was that we must communicate with honesty. If a patient were to misrepresent or omit relevant medical history, the likelihood of arriving at a correct diagnosis would be severely compromised. Failure or distortion of truth in medicine benefits no one, and is, in fact, dangerous. Within the wider context of care, all clinicians must accept, and agree on, standard ranges of normal-for symptoms, labs values, radiologic imaging, etc. If there is a tangerine-sized opacity in the middle of the right upper lung on X-ray, it is untenable for a radiologist to tell the ordering physician the images are normal, and it is likewise unethical for the ordering physician to tell their patient, “I think it’s nothing.” What one could and should say is “there’s something there, here are the possibilities, let’s discuss how we can determine an accurate, specific diagnosis.” The patient must then be willing to listen, and to believe that we are acting in their best interest. If they assume that we are lying, that we have ulterior motives, or that their shaman is a better source of medical information than we are, their medical problem is unlikely to be resolved in a satisfactory manner and the relationship will not survive. Therefore, this is not a productive approach.
In the same way, for all of us, whether we are the general public, politicians, journalists, or influencers, to participate in a functional society, with advancement of the common good, to preserve the freedom to enjoy Life, Liberty, and the Pursuit of Happiness, we must find a way to agree on basic facts, those which are demonstrably true. We must employ respect, hold judgement, celebrate difference. We must be willing to venture outside our silos, our echo chambers, to seek out and cultivate purposeful, but civil, discussions with people from different backgrounds, from opposing persuasions, with alternative opinions (but not alternative facts), so that we can identify commonalties and solutions which are mutually agreeable. Put more simply, we must talk to each other with absence of malice and we must build on these conversations to achieve a more perfect union.
Unresolved conflict keeps me up at night. Evidence based threats to the security and stability of my world make me anxious. Having a framework for resolving the dilemmas that we face as a nation gives me purpose and hope. We can do this if we try.