Are We Our Brother’s Keeper, Or Not?

In 1992, on a cold, blustery spring day in Cambridge, Mass., I attended a talk which still echoes loudly in my heart and soul. The affair was quaint, almost genteel, typical of gatherings of this type; you know, small crowd, light lunch, high-calorie discourse. Just my cup of tea (pun intended).

The speaker was Robert Reich, the eminent economist who had just been appointed Secretary of Labor by his old Oxford University classmate, Bill Clinton. In an earlier and headier time, both were Rhodes Scholars who forged a close friendship born of shared values, big dreams and deep personal connection.

His talk, simply entitled, “What Do We Owe One Another as Americans” was gorgeous, 20 minutes at the most, a beautifully embroidered tapestry of politics, economics and penetrating social commentary. To this day, I have not had a lunch that nutritious.

Without ever once mentioning it by name, Reich laid out in stunningly pithy detail all the elements of the social contract. He never invoked Locke, Hobbes or Rousseau, nor did he wade too deeply into the murky waters of Rawlsian ethics, which recasts the social contract –whatever version you endorse – in terms anchored in contemporary American political philosophy. And, perhaps most interesting to me, he never once mentioned health care, an omission I found fascinating.

You see, I believe health care is now ground zero in the debate over our embattled social contract; it is, in my view, one of the last functional institutions standing in our culture. And now it is seriously endangered, a casualty of a deeply divided, toxic cultural state, perched on the precipice of immanent collapse.

What do I mean by this? I’d like to respectfully offer a few observations:

During the past two years, I have watched friends, family and colleagues work tirelessly -- and at great personal risk -- to care for us all during the pandemic. I especially wish to recognize our army of angelic nurses who, day in and day out, hold the hands of the suffering and dying. Their loving touch is often the last human gesture the sick experience before they leave this troubled world.

My own physician son contracted a serious case of COVID-19 while covering a COVID-19 ICU for a large health system in New England. Despite the fact that many of those requiring care chose not to follow the basic safety recommendations of our public health experts. He and his colleagues dug in and did the hard work typical of dedicated health care professionals with great compassion, empathy and selflessness.

Now we are fighting with one another everywhere; on airplanes, at school committee meetings, in restaurants, waiting rooms and other public spaces. The dividing line seems to be self-interest in the name of freedom vs. social responsibility to exploit, for the common good, a collective sense of “we-ness.” Bill Clinton once said “There is nothing wrong with America that cannot be fixed by what is right with America.”

Along the way, our corps of health care providers and first responders have become exhausted, demoralized and angry. Their feelings have shifted from relentless care and concern for patients to frustrations about the public avoiding its duty toward preserving public health, not to mention civility toward one another. So many disheartening stories abound of patients and their families intimidating and abusing staff. This anomie has yielded epidemic rises in depression, anxiety, PTSD and suicidality among health care providers. Our Health Care Heroes have paid dearly, supporting that oft-quoted line that “no good deed goes unpunished.” 

So, here we are at the start of a new year, facing yet another wave of COVID-19, with our health care system once again stretched to its limit with health care workers who are leaving their beloved professions in droves. My heart aches for my friends and colleagues; I worry about how to keep their spirits up over the next trying months The costs are staggering in terms of treasure, morale and resilience. I also worry about how we are going to staff our health care system that is stretched to our physical, financial, and emotional limits.

This is what keeps me up at night as a senior leader in a large and vital health care system.

Therefore, out of great concern and compassion, I humbly but pointedly ask you who can do more to help and support the system, two important questions:

“What do we owe one another as Americans?”

“Are we not our brother’s keeper?”

Your answers will speak volumes about who we are as a changing society and what kind of future we will leave our children.

Paul G. Simeone, Ph.D., M.A. is Vice President & Medical Director of Behavioral Health for Lee Health and an Assistant Clinical Professor for Florida State University College of Medicine