You Can Break My Heart But You Can’t Break Me

Image by kjpargeter on Freepik

I realize I am a few days late with my Valentine message. Sorry. I’ve been busy getting over a recent heartbreak. Don’t worry, I’m not about to use this platform to talk about my personal life And anyway, I save that content for paid subscribers. Kidding. Or am I? There is only one way to find out.

I’m talking about the heartbreak of realizing bravery is rare and cowardice is pervasive. The heartbreak of watching institutions, organizations and individuals you admired and trusted epically failing to meet the moment. For my fellow Wicked fans, I am talking about Elphaba meeting the Wizard level heartbreak. All at once you see things the way they are, and they aren’t the way you thought they were, or the way you want them to be. Leaders aren’t leading. The safeguards were a mirage. Too many of the powerful are complicit.

Ok, now that I have started writing I realize it's probably a good thing that I didn’t publish this on Valentine’s Day. Strong doom and gloom vibes here. I blame the DC weather and the ongoing dismantling of our Democracy.

To be clear, the heartbreaker I’m talking about (today) isn’t the Democratic party or Democratic electeds. I’m talking about the healthcare industry. I’m talking about health system leaders. I’m talking about professional medical organizations and their leaders. I’m talking about everyone in the healthcare field who is in a position of power but hasn’t found the courage to stand up to the unprecedented attacks on our patients, our profession, and its foundational principle of nonmaleficence (aka do no harm).

If you had asked me a few years ago what the response amongst medical professionals, our professional organizations, and our hospital systems would be if RFK Jr. was nominated to lead HHS and Dr. Oz was poised to run CMS, I would have (after lol’ing at how preposterous this hypothetical scenario was) imagined we would all rise up together like the Avengers, led by…our leaders. You know, the ones who are currently in positions of power.

Avengers: Endgame (Screenshot)

Instead, from the inside looking out, it feels more like everyone is scrambling over each other to relinquish their “weapons” and surrender their super-powers. The primary goal seems to be avoiding risk and conflict, not rising to meet the moment and standing up for science or our patients.

I really thought we had more fight in us.

It’s breaking my heart.

Did I expect healthcare executives and physician leaders and Boards of Directors and professional organizations to know exactly what to do in these unprecedented times? Of course not. Did I know how to run for office? No. But I figured it out. Did I know how to deal with incessant, disgusting online harassment? No. But I figured it out. Did I know how to handle my opponent, Nancy Mace, calling me a child abuser? No. But I figured it out. Did I know how to give a compelling stump speech? Participate in a debate on live TV? No. But I figured it out. Did I know how to get Mark Hamill’s attention on Twitter? No. But I figured it out. I figured it all out because what I was fighting for–the 73 million children in this country– was that important to me.

For the most part, healthcare leaders are scientists and clinical providers, not exactly the most politically savvy constituencies. I am certain they feel they are well beyond their comfort zone right now. But some of them are lawyers and businessmen/women who probably do have a bit more inherent political know-how. Unfortunately, one of the heartbreaking lessons I have learned is that for them, the bottom line is and always will be their bottom line. On the contrary, for me and my colleagues on the frontlines of the healthcare system, patients always have and always will be our bottom line. I hesitate to paint with too broad of a brush here because I know not all executives are Ebenezer Scrooge (or Scrooge McDuck as he is best known in Children's Hospitals) and not all frontline healthcare providers are Bob Cratchit trying to put food on the table for Tiny Tim. But I do know that your response to a threat will vary based on who and what you are trying to protect. I have learned this lesson the hard way too many times to count the past few years.

And that gets to the root of my heartbreak. I expected that when the threat was so great, when the stakes were so high, we would all assemble in defense of children, in defense of patients, in defense of science.

Because if we are in the endgame, does the other stuff even matter?

I know I am not the only physician who feels deeply disappointed and heartbroken. I know that because many have texted me, emailed me, DM’d me. I know that because they are talking to the media. I know that because of the messages I received when I posted this devastating Politico article. I know that because they stop me in the grocery store, the toy store, and the hospital to thank me for being loud and saying what needs to be said.

I know what is at stake. I know this is the endgame. But it’s not the end. (There is a second Wicked movie, after all.) I know what I need to do. I just wish more of us were doing it. And I wish our leaders would lead the way. But out of necessity, new leaders will emerge.

My heart is broken but I am not broken.

Don’t let them break you.