A Holiday Wish for America

This holiday season, my wish is that we, the people of the United States of America be given the gift of reflection, so we can admit that in our quest to be the land of the free we’ve made some big mistakes. Of course everyone makes mistakes- it’s the inevitable consequence of action. But the biggest mistake of all is not admitting when you’ve made one.

We are not supposed to be the place where all the wealth is concentrated in the hands of the few. That was the other place, the one our founding fathers hoped they’d left behind when they drafted the Constitution (and that my grandparents hoped they’d left behind when they left Russia at the beginning of the last century.)

So where did we go wrong? In addition to conflicting with our highest values, our unprecedented economic disparity between rich and poor is a threat to our ultimate survival as a nation. To heal we would be well advised to do what, at their best, doctors do- put patient care before pride,  re-examine our basic assumptions and try to figure out where we went off course.

What I’ve learned in 30 years of practice as a physician and psychoanalyst is that this question, “where did we go wrong?” is actually its own answer, because it challenges us to think about new ways to go right. We doctors make lots of mistakes in our efforts to help our patients. It goes with the territory. But a precious part of medical education is learning to learn from these mistakes. When we prescribe a course of treatment and our patient gets worse, we can get in big trouble if we’re so insecure about questioning ourselves that we can’t acknowledge what is in front of our eyes. The ability to ask ourselves where we went wrong helps us to move things in a more positive direction, based on the best information we have. That’s why experience is such a great teacher in the field of clinical medicine, and why medicine has accomplished so many good things.

But just as an unquestioned belief in the correctness of one’s remedies is a recipe for malpractice, an ideological approach to our American malady is a recipe for disaster. An inability to reflect and question is not patriotism, it’s the blueprint for a “house divided” that’s bound to collapse. There won’t ever be a double blind study to determine whether we should move in one direction or the other in our approach to the internal and external problems we face as a nation. But we have years of experience, and if we could only learn from the mistakes we’ve made, perhaps we could find some creative solutions to the challenges we face in ensuring that government by the people and for the people is sustainable.

Let’s take as an example some of the policy questions that divide us. Should we decrease taxes or raise them? Should we lower barriers to trade with other countries or increase them? Should government be big or small? These are not questions that are philosophical, they are practical, and they are to some extent answerable on the basis of the experience we’ve had thus far. Bipartisan efforts to formulate approaches based on a knowledge of what has been tried and what has succeeded or failed might lead to policies that were evidence based, not ideology-based. That might allow us to try things out and see how they work. Such an approach would require a commitment to review and re-evaluate on a regular basis, analogous to the way that physicians approach treatment planning. And if we got things wrong, legislators would have to stop blaming each other and work to get things right. Of course, this means they would have to stop fighting with each other.

Here, another analogy comes to mind. The mental health field has given us the concept of the “dysfunctional family.” There is, in fact, a lot of evidence that children raised in situations where their parents can’t work together cooperatively are vulnerable to severe anxiety, and that, conversely, common purpose and cooperation from the top down contributes to the emotional security that makes for healthy kids. Husbands and wives have all kinds of issues to argue about in approaching the problems of daily life, but, for the post part, getting together to work on them is more important than getting it right. In fact, to a large extent, getting together IS getting it right.

That is to say, there is something of fundamental value in believing that the people we depend upon, whether parents or public servants, are working cooperatively on our behalf. A commitment to a bi -partisan problem solving approach to government doesn’t mean we wouldn’t make mistakes- it would make it more likely that we could recognize, reflect upon ,and learn from the ones we have made. That would be a whole lot better than blaming. And perhaps a beneficial side effect of such an approach would be a decrease in the anxiety epidemic that seems to be afflicting American society. (That’s one trickle-down effect that I’d like to see.)

If you’ve read this far, perhaps you’ll remember that I’ve introduced all of the above  as a “wish” instead of a prescription or a recommendation. That’s because at this American moment what I have proposed seems so utterly out of our collective reach. And of course, wishes are not a substitute for action, and there are some gifts we can only give to ourselves. But ‘tis the season for wishes. And with the New Year ahead, it’s also the time to resolve ourselves to be who we need to be to make sure that “government of the people, by the people and for the people” was not just wishful thinking.

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