“I am tired of being sick and tired.” – Fannie Lou Hamer
It is 2018. The adage “I’m sick and tired of being sick and tired” may be swirling around your head at any given moment, especially if you are an avid consumer of news from the mainstream media, social media or any other form of information dissemination. It appears we Americans have either reached a point of perpetually having our hair on fire or a complete and utter disconnection from the fever pitch of outrage. We are one Executive faux pas or tweet away from ushering in a massive, national nervous breakdown. For public health professionals working in areas reliant on federal funding, or funding streams that match federal funding, the talk of deep and indiscriminate cuts to vital programs, the fruits of which go largely unseen by the American citizenry, is in and of itself outrageous.
Does wasteful spending occur in public programs? Yes, it must be addressed which is not synonymous to destroying programs in their entirety. Can the private sector do things better than the public? At times. Executing public health interventions in a far-reaching, efficient, sustainable manner at the most should be driven by public-private partnerships. Each sector can learn vastly from the other. Across the board, one is not superior to the other. The everlasting goal is to find a point of equilibrium that offers the best of outcomes for the most people.
Are we susceptible to repeating past mistakes due to our restlessness – good, bad or indifferent – in wanting change? Maybe. This is likely to occur due to a mix of malice manifesting as willful ignorance and invoking “other-ism”, encountering unintended consequences when the goal is to do the most good for the most people and plain ole naiveté. Is there a legitimate reason for us to be concerned about the future of the American experience? Yes and no. Even if we were not experiencing a period of steadfast outrage, we should always remain vigilant in protecting our way of life, ensuring our legacies endure, and making sure others around the world share in our public health successes.
My Start as a Public Health Professional
I began my public health professional journey in 2009 as a Masters in Public Health (MPH) graduate student in the Ryals School of Public Health at the University of Alabama at Birmingham (UAB). After having decided that I can better serve the collective, greater good as a public health professional and not as a medical one, I left Atlanta – where I earned my bachelor’s degree in biology – to return to my native state of Alabama. At the time, I knew very little about public health, its reach, its invisibility and its monumental role in ensuring the longevity of humankind. I can recall that I knew for sure I wanted to learn more about and contribute to the behind-the-scenes work of public health. At this point, my outrage began.
I was outraged to learn the trials and tribulations public health heroes such as John Snow in London endured in convincing the power structure in England the real reasons behind seemingly haphazard outbreaks of cholera. This is the British epidemiologist John Snow, not the King of the North who lives in Winterfell.
I was outraged to learn over and over again; the systematic polices, programs, and uninformed, hate-driven mindsets that unyieldingly subjugated African Americans to a life of mind blogging impoverishment for centuries on end. Lack of will? Skirting personal responsibility? The enjoyment of being “cared for” by plantation owners? Inferiority of DNA overall or the left side of the brain in particular? Hardly when faced with unchecked, at times state sanctioned (or at the very least the state willfully turning a blind eye) physical violence and mental terrorism. It is outrageous to learn that so many of our ancestral, fellow countrymen were intentionally subjected to abhorrent diseases and ailments while droves of others were not. I was raised 20 miles south of where most of the Tuskegee Syphilis Experiment victims lived.
I was outraged to learn that former leadership within the United States Department of Health and Human Services drug its proverbial foot in addressing the emergence of HIV in some of America’s largest cities all because the earliest of victims were gay men. Said Americans got what he deserved because of “insert reason,” and we ought not help. Its God’s will that they suffer, they preached.
However, the outrageous experiences I have come to know as part of the upward trajectory of public health legitimacy and the evolution of America’s views have time and again been facilitated by perseverance, unshakable goodwill, irrefutable science, and even the double-edged sword of “things can always be worse.”
I was encouraged and reassured about the power of public health, science and equanimity when epidemiologist John Snow figured out the English were being infected by the Broad Street water pump and that he did not give up in making his arguments in a thorough and well-resourced manner.
I felt a sense of optimism and accountability when the United States Government – with the allocation of $10 million – promised to give lifetime medical benefits and burial services to all living participants of the Tuskegee Syphilis Experiment; when President Bill Clinton officially apologized on behalf of the Nation in 1997.
I was rejuvenated to learn there were doctors, nurses and public health officials in San Francisco, New York City and finally the Centers for Disease Control and Prevention in Atlanta who continued their quiet pursuit of studying clues that eventually led to the discovery that HIV was the cause of the “gay cancer” in American men. Officially, it was the French who first discovered HIV – full disclosure.
Outrage with a Purpose
My point is that outrage is not waged for the sake of being a “Debbie Downer,” a sore loser or an incessant complainer governed by no admirable goal – even though such buzzkills are amongst us. For the right reasons, outrage can blossom into something that benefits us all, something that rights horrible wrongs and ensures we stay on a purposeful path. It can awaken us to unfavorable phenomena that may have otherwise slipped through cracks created by complacency and comfort.
Outrage – when harnessed productively – can ensure we see problems when they first emerge as a trickle, a minor inconvenience, before they morph into an irreversible cataclysm. We should not allow the bombardment of outrageous man-splaining; tweets; uninformed, hasty policy decisions and lies (little white ones or otherwise) deter us from putting forth our best foot. The continuation of accumulated public health wins, our quality of life and longevity depend on it.