By MIKE MAGEE

On the evening of December 29, 1940, with election to his 3rd term as President secured, FDR delivered these words as part of his sixteenth “Fireside Chat”: “There can be no appeasement with ruthlessness…No man can tame a tiger into a kitten by stroking it.”

Millions of Americans, and millions of Britains were tuned in that evening, as President Roosevelt made clear where he stood while carefully avoiding over-stepping his authority in a nation still in the grips of a combative and isolationist opposition party.

That very evening, the Germans Luftwaffe, launched their largest yet raid on the financial district of London. Their “fire starter” group, KGr 100, initiated the attack with incendiary bombs that triggered fifteen hundred fires that began a conflagration ending in what some labeled the The Second Great Fire of London. Less than a year later, on the eve of another Christmas, we would be drawn into the war with the bombing of Pearl Harbor.

Now, 83 Christmases later, with warnings of “poisoning the blood of our people,” we find ourselves contending with our own Hitler here at home.  Trump is busy igniting white supremacist fires utilizing the same vocabulary and challenging the boundaries of decency, safety and civility. What has the rest of the civilized world learned in the meantime?

First, appeasement does not work. It expands the vulnerability of a majority suffering the “tyranny of the minority.”

Second, the radicalized minority will utilize any weapon available, without constraint, to maintain and expand their power.

Third, the battle to save and preserve democracy in these modern times is never fully won. We remain in the early years of this deadly serious conflict, awakened from a self-induced slumber on January 6, 2020.

Hitler was no more an “evil genius” than is Trump. But both advantaged historic and cultural biases and grievances, leveraging them and magnifying them with deliberate lies and media manipulation. Cultures made sick by racism, systemic inequality, hopelessness, patriarchy, and violence, clearly can be harnessed for great harm. But it doesn’t take a “genius.” Churchill never called Hitler a “genius.” Most often he only referred to him as “that bad man.”

The spectacle and emergence of Kevin McCarthy, followed by Mike Johnson, as Speaker of the House, and the contrasting address by House Minority Leader Hakeem Jeffries as he handed over the gavel, represent just one more skirmish in this “War for Democracy.” 

If our goal is a “healthier” America – one marked by compassion, understanding and partnership; one where fear and worry are counter-acted by touch and comfort; one where linkages between individuals, families, communities and societies are constructed to last – all signals confirm that the time is now to fight with vigor.

As Churchill vowed on his first day as Prime Minister, “I have nothing to offer but blood, toil, tears, and sweat.” At about the same time, FDR offered this encouragement, “We have no excuse for defeatism. We have every good reason for hope — hope for peace, yes, and hope for the defense of our civilization and for the building of a better civilization in the future.”

The re-emergence of white supremacists and nationalists, theocratic and patriarchal censorship, and especially post-Dobbs attacks on women’s freedom and autonomy, are real and substantial threats to our form of government. They indeed are minority views, but no more so than the minority in 1940 which allowed a small group of “bad men” to harness a relatively small nation of 70 million people into a force that very nearly conquered the world.

Following the December 7, 1941 attack on Pearl Harbor. Churchill packed his bags and headed directly to a British battleship for the 10-day voyage in rough seas (filled with German U-boats) to Norfolk, VA. Hours after arrival he was aboard a U.S. Navy plane for the 140 mile trip to the White House which he entered in a double breasted peacoat and a naval cap, chomping on a cigar. He would remain the guest of the Roosevelts for the next three weeks, heading home on January 14, 1942.

On Christmas Eve, he joined the President on the South Portico of the White House for the lighting of the White House Christmas tree. Here is what Churchill said to the President’s guests and 15,000 onlookers: “Let the children have their night of fun and laughter. Let gifts of Father Christmas delight their play. Let us share to the full in their unstinted pleasures before we turn again to the stern tasks and formidable year that lie before us. Resolve! – that by our sacrifice and daring, these same children shall not be robbed their inheritance and denied their right to live in a free and decent world.”

He spent the following day working on a speech to be delivered to a Joint Meeting of Congress on December 26, 1941, the kind of a Pep talk all good and decent people of America could benefit from today.  As we ourselves have learned since January 6, 2021, Churchill was right to warn us of complacency and caution, and that “many disappointments and unpleasant surprises await us.” 

He was clear and concise when he warned that day that Hitler and his Nazis (whom Trump so openly admires) possessed powers that “are enormous; they are bitter; they are ruthless.” But these “wicked men…know they will be called to terrible account…Now, we are the masters of our fate…The task which has been set is not above our strength. Its’ pangs and trials are not beyond our endurance.”

“Trump will be defeated,” he would say were he with us today. “You may be sure of that!” But we must be up to the task – brave, organized, and strategic. Now is the time, and as the British Times of London editorial reminded in 1942, as Churchill set foot once again on homeland after his American visit, timing is everything. “His visit to the United States has marked a turning-point of the war. No praise can be too high for the far-sightedness and promptness of the decision to make it.”

Mike Magee MD is a Medical Historian, a regular THCB contributor, and the author of CODE BLUE: Inside America’s Medical Industrial Complex.

By MIKE MAGEE

“Don’t call me a saint,” said founder of the early 1930’s Catholic Workers Movement, Dorothy Day. “I don’t want to be dismissed that easily.” Oddly enough, says Jesuit writer, James Martin, “That quote is probably the biggest obstacle to her canonization…Given that quote, would Dorothy really want to be canonized?”

This week’s election results were a sliver of bright light in what has been a rather dark period. But it is at times like this that quiet heroes emerge. If courage has a face, this morning, as results across the land show a sweeping victory for Democrats, and specifically those advancing the cause of women’s autonomy in managing their own health decisions with their doctors, it belongs to a young woman from Kentucky named Hadley.

In the final weeks of the Kentucky governor’s race, as Politico reported, Andy Beshear gave voice to the woman who directly addressed his opponent on camera.  “Anyone who believes there should be no exceptions for rape and incest could never understand what it’s like to stand in my shoes. This is to you, Daniel Cameron. To tell a 12-year-old girl she must have the baby of her stepfather who raped her is unthinkable.”

Absorbing the results of the elections with the rest of us are Governor Chris Christie, Governor Ron DeSantis, Ambassador Nikki Haley, Vivek Ramaswamy, and Senator Tim Scott who took the stage last Wednesday evening in Miami at the 3rd Republican Primary Debate. No doubt they are surrounded by consultants trying to figure out how best to spin this issue. As Dobbs has played out in states like Kansas, Ohio, Kentucky, Wisconsin and beyond, political scientists are likely reminding that in politics, “Sometimes when you win, you lose.”

Court packing on a federal level, and even more importantly by Republican leaders on the state level, has tipped the power of our nation toward minority rule, allowing repugnant leaders to seize control of our legal system. That power has been used over the past decade to allow passage of laws that attack existing rights such as women’s power and autonomy over their own bodies, or construct barriers that obstruct the popular will of the people.  Examples include promoting  extreme gerrymandering and voter suppression, dead ending the Dream Act, or allowing citizen access to weapons of war and a permitless gun-carry law in Florida.

Understandably, citizens have wondered, “Will our Democracy die.” Hadley’s courageous decision reflects a stubborn and determined stance, by she and many others throughout this land, to assure the answer is, “No. Not on my watch!”

Her image and words will be lasting for three major reasons. They prove that:

1. A healthy democracy requires participation and engagement of citizens.
2. Freedom and autonomy, including access to health professionals, is sacred and personal.
3. Women will not accept second class citizenship.

Trump no doubt remains unaware that he has lost everything. Many of his most ardent supporters, including Leonard Leo, the mastermind behind the court packing scheme that brought us the Dobbs decision, remain firmly in a state of denial. But even they must admit this morning, as they stare into Hadley’s eyes, and listen to her steady voice, they have met their match. And she is a young woman who’s message is clear, “Enough is enough!”

Likely channeling another woman’s spirit from a century ago, Hadley’s courage (listen here) was more human than super-human. As Dorothy Day quietly proclaimed, “Don’t call me a saint. I don’t want to be dismissed that easily.”

Mike Magee MD is a Medical Historian and regular contributor to THCB. He is the author of CODE BLUE: Inside America’s Medical Industrial Complex.

by MIKE MAGEE

Exactly 1 year ago, mental health experts alerted the medical world to their version of an assessment scale for yet another new condition – “doomscrolling.”

As defined in the article, “Constant exposure to negative news on social media and news feeds could take the form of ‘doomscrolling’ which is commonly defined as a habit of scrolling through social media and news feeds where users obsessively seek for depressing and negative information.”

No one can deny a range of legitimate concerns. Faced with continued background noise from the pandemic, add global warming, renegade AI, and the Republican Congress. And now, the devastating attacks on Israel and growing instability in the Middle East. It is no wonder that we can’t turn off the Instagram feed.

With real challenges like these, our troubled world needs her doctors and nurses to stay focused more than ever on their primary professional missions – managing health and wellness, sickness and disease, fear and worry, and yes, now “doomscrolling.”

John J. Patrick PhD, in his book Understanding Democracy, lists the ideals of democracy to include “civility, honesty, charity, compassion, courage, loyalty, patriotism, and self restraint.” The 4.2 million registered nurses and 1 million doctors in America are agents of democracy.

Regrettably, they are already being drawn away from patients by three powerful forces.

1. Corporate Dislocation – To assure maximum reimbursement, doctors and nurses are routinely asked to prioritize time and contact with data over time and access to patients.
2. Health Technology and AI Substitution – Rather than engineering solutions to expand real-time patient contact, most innovations are further distancing patients from healthcare professionals.
3. Legislative Intrusion – Complex medical decisions, long entrusted to the patient-health professional relationship to negotiate, are being transferred to ultra-conservative legislators.

We live under a constitutional and representative democracy, as do two-thirds of our fellow citizens in over 100 nations around the world. The health of these democracies varies widely. The case for democracy emphasizes its capacity to enhance dignity and self-worth, promote well-being, advance equal opportunity, protect equal rights, advance economic productivity, promote peace and order, resolve conflicts peacefully, hold rulers accountable, and achieve legitimacy through community-based action.

One of the challenges of democracy is to find the right balance in pursuing “the common good” which has dual (and often competing) arms. One arm is communitarian well-being and the other, individual well-being.

Blending personal and public interests is complex. In health, one might argue, this tension has led to our dual system – one, largely profit driven, interventional and science discovery based, and the other largely public, preventive and focused on communitarian public health.

Both nursing and medicine have embraced professionalism and launched new graduates by voicing “oaths” or promises to themselves, their colleagues, and our society as a whole.  These lists of promises or pledges, their language and priority ordering, help reveal both the history and intent of these noble professions.

Of course, the most famous oath in Medicine is the Hippocratic Oath reaching back some 2000 years to Greece. In pledging to a grouping of ancient deities, it recognized that interventions should “do no harm” and that confidentiality was paramount.

By 1964, this oath was sufficiently out of date that many medical schools embraced an updated version written by Louis Lasagna, MD. The oath includes a communitarian connector: “I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.”

The Penn State College of Medicine’s Oath in 2022 offered a counter-balance by giving top billing to the patient, with the oath to the patients, not to Greek gods: “By all that I hold highest, I promise my patients competence, integrity, candor, personal commitment to their best interest, compassion, and absolute discretion, and confidentiality within the law.”

The Geneva based World Medical Association, in the shadow of the Nuremberg Trials, provided a list of pledges in

their 1946 Declaration of Geneva in order of appearance including:

1. the service of humanity
2. patents first
3. patient autonomy and dignity
4. respect for human life
5. absence of bias or prejudice on any basis
6. commitment to patient privacy
7. guided by professional conscience and dignity
8. honor the noble traditions of the profession
9. respect and gratitude to teachers, colleagues and students
10. share knowledge to advance health care
11. commit to personal health and well-being
12. never violate human rights.

Nursing has also relied on professional Oaths. The first was the Nightingale Pledge, created in 1893 by the Farrand Training School for Nurses and named after Florence Nightingale. It is believed to be based on the Hippocratic Oath and was modernized in 1935. In the 1950’s, the American Nurses Association (ANA), created a formal Code of Ethics, including Nursing’s 9 Provisions (or Pledges) committing to: compassion and respect, patient-focus, advocacy, active decision making, self-health, ethical environment, scholarly pursuit, collaborative teamwork, professional integrity and social justice.

Health professionals need to be laser focused during these troubled times on patients. Doctors and nurses, day in and day out, by managing fear and worry, reinforcing community and family bonds, and championing hopefulness, guard against a true “doomsday scenario” – the destruction of our Democracy from within. The patient is our primary concern and deserves our full professional attention.

Mike Magee MD is a Medical Historian and regular contributor to THCB. He is the author of CODE BLUE: Inside America’s Medical Industrial Complex (Grove/2020).