Can you hear me?

Last week before the Super Bowl, I wrote about the infamous kneel of Colin Kaepernick and the analogous dilemma facing US physicians. If kneeling is a centuries old sign of deference and respect, a sign of humility and vulnerability, but doing so during the national anthem is contrary to our norms and beliefs, then it is rather easy to see why the gesture created so much reactivity.

Physicians are caught in the same paradox. How do we protest against any/all injustices without violating the sacred Hippocratic oath that we take, much less appearing ludicrously hypocritical due to our status in society?

Social media is a wonderful way to connect to people that otherwise was not possible prior to a little known platform known as Six Degrees created in 1997 and enabled users to upload a profile and make friends with other users. Naively most good hearted folks believed that a virtual sandbox would follow wherein we could all play together (nicely). Unfortunately, we now have (un?)equal parts social media and sociopathic media. I received more than my share of such bizarre, if not nasty, messages following last week's article.

Suffice to say, when Travis Kelce bumped into Coach Reid during the Super Bowl and poured out whatever vitriol (hot mic, notwithstanding), the photos and videos, and sound bytes of the interaction flooded screens everywhere. Inescapable. And then followed all of the op-ed pieces about the inappropriate behavior, or, alternatively, the strength of the bromance bond, or even the secret lessons (buried in the heat of the moment) for future Super Bowl contenders to heed, lest they ever seek to hoist the trophy and wear the ring.

And, then, just THREE days later we witnessed the type of societal, homicidal, sociopathic behavior on the streets of the victor's city so emblematic of our world today, in real life. Not just virtual behavior, sadly enough.

So, how, in all of this noise and societal detritus, can we, as clinicians and healers, expect to be heard? And how do we message our concerns? If taking a knee is not going to work, and, as several suggested, it is time to stand up, to whom and to what remains the quixotic question.

Before we attempt to answer that doozy, maybe we should also ask who will lead and carry the collective message? If there is one thing about Coach Reid captured in that photo (assuming he is neither deaf, dumb, or blind), it is the amazing calm he effuses. The grace he gives to his player is actually deafening. A leader bringing calm into chaos. Knowing not to feed into the anger. Choosing perhaps another time and place to deal with Mr. Kelce.

For what is the value of anger? Is anger useful? Anger only begets anger. We have normalized anger today. Anger may have a place, but most of the time it is almost useless. And certainly actions stemming solely from anger are of no use at all. Anger is a turbulent state of mind, and feeds like a cancer; ruinous to body and soul. Anger motivates, to be sure, but it diminishes the power to distinguish right from wrong.

We need a Pinball Wizard* (or two, maybe three). "Someone who stands like a statue, becomes part of the machine;" who always plays it clean. Who "ain't got no distractions, can't hear no buzzers and bells." Leaders, not villians.

In the past 20 years we have seen downward reimbursement, closing of hospitals, shrinking workforce, loss of access, and countless other injustices playing out in just about every clinical environment all of which are producing anger, no doubt. And also producing rightful indignation (perhaps the only virtuous side of anger). And, if you don't love the profession of medicine and you don't value humankind, why else would you become a doctor? Seriously. Because there's gold in them thar hills?** Maybe in someone's hills, but not exactly in the healer's hands, today.

It feels like the noise is getting louder, the circumstances more critical, and the proverbial cliff is nigh. Or is it already too late? And the powerful machines will rule the day? In spite of all of the anger? Can anyone become part of the machine and silence the madness?

The answer is yes. And those people are called leaders. A leader must bring a vision into reality. Coach Reid tuned out the crowd, the f-bomb, and the camera. He focused on the win. He clearly kept his cool under pressure.

We are at a convergence point when the noise is too loud, the anger too much, the distractions too great. We need Coach Reid.

Healthcare needs leaders now more than ever. My old boss said, "I don't care where you get them, but bring me some leaders."

Who is bringing the vision forward, if not for the struggling physicians, but for the patients we care for? Who speaks for them? And, if no one is listening, is there even any sound?

When Major Tom*** was floating in his tin can, Ground Control messaged Major Tom, "Your circuit's dead, there's something wrong. Can you hear me, Major Tom? Can you hear me, Major Tom? Can you hear me, Major Tom? Can you..."

The Sound of Silence https://www.youtube.com/watch?v=qn0QBXMYXsM

*Pinball Wizard, lyrics by Pete Townshend.

**American Claimant, by Mark Twain

***Space Oddity, lyrics by David Bowie