From the President’s Desk: Where we direct our gaze

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We returned home from China in time to watch election returns that upended many perceived realities. A few days later, almost every informal discussion at the AMA Interim Meeting in Orlando circled back to uncertainties. What’s next for medicine? Patients? Pathology? Would new leadership be appointed to direct the CMS? NIH? FDA? CDC? If so, who? And where would that lead? It was, and still is, too soon to frame a collective response.

One way to think about this is that we have more fluidity than anticipated just a few months ago. More than that, we just don’t know yet. This is the time to be thoughtful and cognizant, to lift our gaze and be open to what is on the horizon. As change inevitably comes to our medical neighborhoods, we should seek a reasonable, evidence-based understanding of exactly what is changing and why, of where we fit in, and of how we can protect our patients from untoward outcomes of any disruption.

We will manage uncertainty by focusing our gaze on the big picture, helping to create a lexicon for discussion, and insisting that our laboratory teams set aside any anxieties to ensure that the quality of care our patients receive doesn’t suffer. We know who we are and that is good.

Just before the election, the poet and musician Leonard Cohen died. Obituaries that began to appear a few days later featured some of his better-known poems and lyrics, reflecting his introspective nature. Reading between the lines, I think Cohen wanted to say that we ride a continuum from birth unto death, that nothing is nor should be perfect, and even the most airtight argument may not be the last word. His thoughts were clearly in favor of the long view.

“There is a crack in everything,” he famously wrote. “That’s how the light gets in.” And that, too, is good.

Dr. Friedberg welcomes communication from CAP members. Write to him at president@cap.org.