Everyone's a Cynic

Nearly a decade ago, in late 2010, I was applying to PhD programs and wrote these words for my personal statement.

Within weeks of working my first job out of Bowdoin College and foray into the world of academic research, I learned that my suspicions of the world were true. Poring through whistleblower affidavits, I saw how Big Pharma was as aggressive as I’d imagined. The Food & Drug Administration was funded by the same drug manufacturers it was commissioned to monitor. The game was rigged. Yet cynicism was not the transformative lesson of my early career. It was how the researchers I worked with dealt with their knowledge of an imperfect system. Even as they kept a critical eye on them, they cooperated with pharmaceutical companies and government agencies to produce research that evaluated the impact of flawed policies. Cynicism could not deter them from changing the world. And I want to change the world through health services research.

The essay itself wasn't that great. It may be the reason I didn’t get into some schools (that one school, in Boston). But I’ve been thinking a lot about cynicism and the rigged game lately. More so than usual. Mostly though, I have been so very angry, disappointed, and anxious. These emotions are not new to me (however suave I may seem to you). They are par for the course in public health, in healthcare, and in health policy. We study bad outcomes and how to prevent them. We yell into voids and shake our fists government inaction (see also, Affordable Care Act; see also, gun violence). We even shoulder some of the blame. If only we were better communicators, maybe they would've listened. 

And so it is both familiar yet heartbreaking to feel this blend again, on what feels like the grandest scale. Our health system was already broken, but the situation keeps being exacerbated by poor and selfish management in and outside of the government. We need to stay home for the near future. We need to stay home on Easter Sunday. People are dying. There isn't enough help to go around. You don’t need the exhaustive list. We are all living with the consequences. We are failing our healthcare workers. And we are failing our communities. 

Yet cynicism was not the transformative lesson of my early career. It’s the belief that we can change the broken world. I have so many friends and colleagues in this fight. I look to those who rail back against the incompetence and demand better. Who speak plain truths to the public even when they are harassed for doing so. I look to those who are building models and creating the evidence base for how we should move forward. I look to the healthcare workers who have prepared their wills, and who volunteer to go into the hospital knowing full well how unprepared they are. I look to you. You who are still reading and playing along by staying home. By helping your neighbors. By sharing laughter and good information. And we do it regardless of who is in office, or how smoothly our systems work. We do it because we can change the world (see also: history of hand washing).