The politicization of Medicine is hard to watch. I’m sure there’s a more sophisticated way to say that, but that’s the truth. Most of my close family members work in Medicine. 4 doctors, a 4.0 premed student, and a couple more nurses and pharmacists. They went into it with an understanding they’d hold a place of trust in their community, and that’s dissipating before their eyes.

I’m a lawyer, I went into this business knowing plenty of people wouldn’t like what I do. But I know it’s not what Medicine wants. I think some healthy distance between Medicine and politics ought to be maintained. It’s not just the doctors’ wishes; that trust in Medicine is too important to society. It needs to be built up.

Dr. Gonsalves mentioned a few different way to accomplish that today. I wanted to throw one more. Some of the speakers over the semester mentioned how hard it is to keep everyone’s messaging on the same page. Political figures have to work to keep their jobs, and they’ll take recommendations and get creative in how they interpret them. There may need to be some courage to straighten out the record when recommendations get turned around—like a game of telephone. I think we started to see that a bit as the Covid Pandemic went on. More of it might benefit everyone and go toward building back that trust.

This isn’t the typical interpretation of stigma in this era. But there is a subtle and unspoken stigma people feel against becoming infected with Covid. The result is that people walk around sick and in denial until it is undeniable. It’s a reoccurring trope in comedies, and we laugh it off—”sure, maybe them, but I’d never”—yet it’s very real.

The people I’ve seen coughing or sneezing since 2020 have nearly all been convinced, for various reason, that it was certainly not Covid. Have you seen the same? I’ve had a good friend admit he lost his taste but still declare he knew, without testing, it wasn’t Covid. I’ve seen the single fiercest of Covid safety advocate I know stroll into class, sneezing, snuffling, and hacking coughs until the whole of the rest of the students had packed up, mid-class, and moved to the other side. She very genuinely refused to consider that she had Covid.

Everyone does it, maybe not to this degree. But symptoms develop slowly, and we have to make a proactive decision at some point to make our day and our week a whole lot worse. The best (and only subconsciously selfish) strategy is to remain confident it’s nothing and that it will subside. In many mild cases, that’s exactly what happens.

To counteract this, we need to build a culture of calm around Covid. We need to destigmatize it and gently encourage people to be honest. The only social pressure we should foster should be ‘Do not walk around sick.’ We have not placed much of our limited social capital to realizing this, so for the time being the beast still walks among us.

There was a lot of discussion around student’s declining attitudes toward the college experience. A lot of disparate theories were thrown out there, but they seemed disjointed and often conflicting. For an example, in regards to rising student apathy, hyper competitiveness was offered as the culprit. Beyond the conflicting nature, I think this explanation cuts against 1) our flagging global academic standings (under our own, domestic rankings), 2) what the average long-serving professor would say across nearly any discipline, and 3) common sense/observation. 

The most common sense explanation is that undergraduate students are seeing what their brothers and sisters, older friends, and upperclassmen are graduating into and are dismayed. This was vaguely touched on last week, but it was shunted to the periphery of the discussion. It should be front and center.

Cost of a college education rises year over year. Number of diplomas dispensed rises year over year. Yet the number of people actually working in their graduating field drops year over year. The debt-incurred-to-salary-potential ratio is reaching an unsustainable level. This problem is troubling in and of itself. But the worst caveat is yet to be noted—the skyrocketing debts foisted upon these children are undefaultable. It will be extracted from the kid come hell or high water. We do not allow this in any other loan structure in the United States. Bankruptcy is always a way out. Everyone, everything is defaultable—save the loans we make to our children. 

When you consider all these growing problems together, it’s fast becoming a blatantly predatory practice, yet colleges express no willingness to engage in a meaningful exploration of this problem. We’re still selling hopes and dreams at college. How do you put a price upon this? I don’t know, but we did. And you’re going to pay it. Even if you find yourself bussing tables at a coffeeshop. Even if it kicks home ownership out of your reach. Even if it takes the rest of your life to repay. And when we discuss it, we’ll suggest it’s a failure of optimism in the student body. It’s not a mental error or shortcoming to be troubled upon finding that the prosperity you thought you were promised isn’t actually in reach. Especially when you begin to feel how real and concrete the debt is compared to the fine piece of paper it’s bought you.

We have not presented a coherent answer.

There’s a basic problem in integrating public health with national politics. At the end of the day, a public health expert makes their analysis and offers it to political entities, elected officials and their appointed agents. And then those individuals are off to the races. The expert has little room to maneuver if they begin to get creative with the expert’s original advice.

I don’t think Anthony Fauci is a hero with a cape or a villain with a goatee, but I think his conflict with Donald Trump displays, in spectacular fashion, this eternal problem such an expert faces – ‘If you jeopardize my messaging or my reelection chances, you are replaceable.’

I don’t know if there is a clean solution to this hard reality. We can discuss measures that would seek to insulate experts from political backlash. But, in the end, as public health and domestic politics become more integrated, the present majority party of the state has a lot of leeway to elevate or sideline such experts. And in a democracy, it becomes messy to argue that should not be that case.

I like to offer solutions where I can, though this one is tough. Perhaps this is an argument for the case that public health experts should try to maintain political distance to the extent that they can. Money and status from politics aren’t offered without expectations. TINSTAAFL. But nothing gets done if there’s no money for salaries, studies, and keeping the lights on.