Thursday, April 18, 2013

42 and Our Country's Health

I hope you get to see the movie about Jackie Robinson’s baseball’s career wearing the only number retired by all teams, number 42.[1]
What does it have to do with the health of our country? Let me explain.

Robinson was humiliated, ridiculed and grossly abused because of being the first African American to join Major League Baseball. Of course, those attacking him were a product of their culture; they could not help themselves. But, they did not make any effort to transcend their culture, as others did who sensed the innate injustice of discrimination. The latter were enlightened enough to go beyond the injustices that the Constitution had only partially addressed 100 years before.[2]
Whenever I review any case or historic episode where ambition, fanatism and ignorance oppress the human mind I am deeply moved, as I was when first standing in Thomas Jefferson’s rotunda 3 decades ago. The immortal words therein inscribed had a profound impression on my young heart (they still do):

I have sworn upon the altar of God eternal hostility against every form of tyranny over the mind of man.”
And so it was that the same emotions were stirred in me watching this film and reading a recent article in the Journal of the American Medical Association. It states what I have consecrated my career to, and for which I have been reviled, and still do by the most ignorant and prejudiced sectors of our rapidly changing society:

“Bridging the divide between health and health care,” JAMA 2013;309:1121
  • “Health Care delivery accounts for only 10% of preventable deaths, with the remainder attributable to personal behaviors, social and environmental determinants, and genetic predispositions. As currently constituted the Health care delivery system has little direct control over these other factors. However, consensus is developing that truly controlling health care costs and improving the overall health of Americans will require a much closer partnership, permeable boundaries, and increased interdependence among the health care delivery system, the public sector, and the community development and social service sectors.”
  • “To create a culture of health will require creating a market for health, moving away from the current market for treating disease.”
No, I have not suffered as much as #42 did, but, as an ethnic man, I have had a taste of what he went through in that respect. But, the anguish of being rejected when I only expressed what more brilliant minds have documented in the best of medical, anthropologic and science journals since I graduated from medical school, can be equally wounding and distressing.
I have forgiven all those who “know not what they do.” I also have forgotten them. Truly; but, I cannot fight the tears when such movies touch my soul.

[1] The Yankee’s Mariano Rivera is the last to wear it by the end of this season
[2]Slavery by any other name,” by Douglas A. Blackmon; Anchor Books, 2008