Medicine For People!

October 2020: Learning to Live Together

Image credit: Ali Zifan - This file was derived from:  USA Counties.svg, CC BY-SA 4.0,

Not Red and Blue, but Purple:
Trust and Sacrifice

Red + Blue = Purple

Political maps of the United States are usually colored red and blue. Instead, we should make them in various shades of purple, like a bruise. The analogy is apt these days, for the red/blue division runs right through neighborhoods and families, and sometimes right through a man’s soul.

I am one such man. Last month in our newsletter I urged an end to the demonization of our police, and this month I am going to urge you to consider the importance of electing a president who wishes to bring us together, rather than one who tries to tear us apart.


To keep this newsletter relevant following the election, let me talk about trust. You can’t practice medicine without it. After the physical examination, and the diagnosis, and the description of the treatment, it all comes down to trust. When I was hospitalized last summer, even with all my advantages of education and medical networks, it still came down to trust. It comes down to trust for all of us. For this is your precious body. At stake is your physical comfort, and your ability to wake up each morning and fulfill your responsibilities, enjoy your leisure time, and achieve your life goals.

People’s trust in the healthcare system is not only fading, it’s endangered. Some time ago, a couple of people were standing near the boat haven with signs protesting vaccinations. A few words with them convinced me that nothing I could say in the time I had available would change their minds. There was enough evidence of malfeasance, such as the revolving door between the vaccination authorities and the vaccination industry, to make them believe the outright liars and fraudsters. Without question there are fewer bodies in the cemeteries because of vaccination, and fewer disabled people because of vaccination, but they weren’t buying it.

The Bankruptcy of Trust

As Dr. Martin Cetron of the CDC relates,  Ebola in Africa was more deadly because of a bankruptcy of trust in the health authorities there. He felt we were in the same boat here. Our president has decided that his own political survival is more important than the public health work of the CDC. We all know the consequences. Even the flagship journal of my profession, the New England Journal of Medicine, has taken the unprecedented step of urging an end to his administration.

I add my own voice for two reasons.

We are Choosing our CEO

First, the United States is a huge enterprise with immense planetary influence. An enterprise of this magnitude has more moving parts and more built-in intelligence (and its opposite) than any corporation. Every four years we choose a new Chief Executive Officer. How long do you think Boeing would last if the interview process for the new CEO was carried on in the same shallow way our elections are? How well do you think Boeing would prosper if the new CEO carried out his office by boasting of his superiority to experts and ignoring their recommendations?

Climate—The Elephant in the Room

Second, we face unprecedented challenges as the climate changes. Changing weather patterns led to the drought in northern Syria with resulting migration of refugees to Europe. Syrian political problems were exported to areas as far away as Germany. If we are to survive those challenges here, we need leaders who recognize the need to address our emissions. We need leaders who focus on consensus and solutions, not lies, division and violence.

The Wisdom of Jimmy Carter...

The most prescient wisdom I can recall coming from the White House was a five minute speech by Jimmy Carter in 1979.

He pointed out that in comparison to previous times, we

  • worshiped self-indulgence and consumption.
  • defined ourselves less by what we did, but by what we owned.
  • disrespected schools, news media, churches and government.
  • defended extreme positions with extreme tenacity.

What he saw then has continued without abatement. In his words, "a balanced and a fair approach that demands sacrifice, a little sacrifice from everyone, is abandoned like an orphan without support and without friends."

...Echoed by this Physician

 Look at any medical bill and it’s clear in about two seconds that there is no free lunch in medicine.  It’s true for treatment as well.  For instance, a medication called buprenorphine can be life-changing for people addicted to opioids, but without an investment of courage from the patient, it’s not nearly as effective.  The courage the addicted person needs is the courage to own their addiction, to start giving back to life more than they have been taking from it, to sacrifice their old life entirely and give themselves to a completely new self and a completely new life.

The courage required of the doctor is to accept that each person who comes to you wants to get well.  If they seem to be deluded about some medical fact or to be a hypochondriac, you need to let that go. You need to give up any sense of superiority to them and to trust that they have as much right to a comfortable life as you do.  You need to trust that together you can solve the problem.


This goes beyond the medical world.  Political junkies on the left need to recognize that looting and destruction in the name of justice is still looting and destruction. Individuals must act responsibly, not the opposite.  Political junkies on the right need to understand that we are all in this together, and that the community actions we call taxation and government are not the enemy. While not all of the solution, they are a crucial part. 

What President Carter is saying is that our prosperity has a price.  Do we pay it ourselves or do we push it off to others, to future generations or into the atmosphere?


Going beyond this election and its outcome, we need to have faith in each other.    We need to have faith in ourselves. Please join me in voting for and then working for civility, humility, and a better world.

I’m Asking a Favor

I enjoy your emailed feedback, both the agreement and disagreement. Either way, I learn from it and know all of our readers would.   If you don’t mind responding publicly, please enter any feedback below.  If you would rather send a private email, please do so.

Thank you!


With appreciation to Jill Buhler Rienstra for timely editorial assistance.



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Medicine for People! is published by Douwe Rienstra, MD at Port Townsend, Washington.