EVCP Expresso – December 2020

Dear Colleagues,

December – finally! The end of 2020 is in sight. We won’t forget the physical and emotional toll of this tumultuous year and the see-saw of events – the pandemic, the renewed battle for racial justice, the economic crisis, climate change, and the election. In thinking about the burdens we carry, I’d like to share my own reflection on 2020, a year that will be infamous in history, and how I strive to find hope for the future.

For me, a key moment occurred on my 67th birthday in June. The news was grim. The pandemic was coming back in a second wave. And just like it, my thoughts arose in waves. I remember turning on CNN and seeing the graphs showing the number of COVID-19 cases in Europe moving downward, while the exact opposite was happening here in the United States. It was a striking indication of how the design and infrastructure of our public health and health care systems have failed us compared to our peer countries.

That was hardly a new revelation. Those of us who study health care know where we fall in terms of the benchmarks of success. The United States spends about 17 percent of its gross domestic product on health care, according to the Organisation for Economic Co-operation and Development’s 2020 Health Statistics, far more than any other country. Yet our outcomes – in markers like life expectancy, infant mortality, and unmanaged diabetes – are worse than most, as noted by the Peter G. Peterson Foundation. But the pandemic has made crystal clear the flaws in our approach to health care. And this was just the first swell of the despondent thoughts.

The second – triggered by my frustration over our health care system – concerned the executive performance that has been going on in our nation’s capital, which is also not new. I realize there are a range of opinions out there, but for me, personally, the actions and inactions related to DACA, climate change, arms control, Title IX regulations, student financial aid, diversity training, the Affordable Care Act, and so much more, run counter to the core values we hold at UCSF and my own sense of what it means to live in a just, free, and responsible society.

The third was my renewed outrage at our country’s continuing inability to defeat racism. The heartbreaking murders of George Floyd, Breonna Taylor, Ahmaud Arbery, and too many others, as well as the limited legal consequences, reinforced how endemic racism is in our society. Although I was encouraged that so many people rose up to voice their indignation, it disturbed me to no end that a graphic video recording of George Floyd’s murder was necessary to open many people’s eyes to the truth that has been ignored for centuries, and it worried me to recall past occasions where similar outrages and uprisings failed to bring meaningful change.

And the fourth depressing thought focused on the public discussion of climate change, the pandemic, and many other issues – that we have tens of millions of fellow Americans who do not believe in science. I consider this an indictment of our educational system as well as a breakdown in ethical reporting by media outlets.

But the final wave was the dispiriting realization that all of these issues are intertwined with the incredible economic disparity that exists in our country, a divide that is only getting wider. Wealth inequity is a critical determinant of every one of the problems above. I know this gets into the perennial debate of the merits of capitalism versus socialism, but I wonder how much the New Hampshire state motto of “Live Free or Die” – which has been interpreted to mean “I’m going to take care of my own needs, the rest of you are on your own, and don’t tell me what to do” – represents the mindset of many Americans. Can’t we find a better balance between individual freedom and social responsibility?

So here I was, ready to celebrate a birthday, and these dismal thoughts all came down on me at once. I posed a question to myself, one that I not only never asked before, but never even imagined asking: If I could do it all over again – if it was 1953, and I could see this future unfolding, and I was about to be born with some control over my destiny – would I choose to live in the United States of America?

My answer in the moment was, “No.” Our system is flat-out flawed, and there are other places where, I honestly believe, they do a better job – countries that have more of a social fabric that helps all people, that provide a safety net, and that are governed in ways that support their values as a society. My answer rejected my upbringing, which was to believe that the U.S. is the greatest experiment in democracy the world has ever known. But the evidence before me was telling a different story.

What began to pull me out of this darkness was thinking about my heroes. I’ve written here many times before about my greatest hero, Dr. Martin Luther King, Jr. If you know his story, you know he really, really struggled with the realities of his lived experience – not just because he was a Black man in the South, or his life was continually threatened. It was also because within the civil rights movement, he was accosted from all sides about which strategy to take, causing him to experience bouts of depression. And yet, amazingly, he was always able to publicly convey a powerful and inspiring message of hope, because, through it all, he truly believed that a better day would come.

Many of us – and I certainly include myself in this – have nothing to complain about. Given my privilege and place in society, it should be easy for me to be positive. But how could Dr. King maintain hope, given what he went through?

And I think of John Lewis’s final letter to all of us, which ran as an op-ed piece in The New York Times. He spoke of the “unholy oppression” that confronted him growing up in America – and the inspiration he took from seeing the Black Lives Matter movement rise up in his final days. “You filled me with hope about the next chapter of the great American story when you used your power to make a difference in our society,” he wrote. I was again struck by how these great individuals and others were able to find hope despite all the challenges, horrors, and inequities that exist in our society. I’m sure they would look at 2020 and say, “Yeah, life can be pretty awful. But we’ve got to believe. We just have got to believe that there’s a greater future, a brighter future.” And I remembered Dr. King’s great quote about the arc of the moral universe, and thought how many times in history the arc bends in fits and starts to advance justice: women’s suffrage, Gandhi’s non-violent decolonization of India, the anti-apartheid movement, children’s rights, gay rights…

With that, I pulled out of my birthday-pandemic doldrums and refocused on the remarkable work of the good people all around me at UCSF and in countless places throughout the country – support staff, frontline health care workers, scientists, educators, students, bus and shuttle drivers, grocery store clerks, folks manufacturing PPE, and all the people working so hard to keep on protecting the safety of others!

So, there you have it. My thoughts from June are not going to send me elsewhere. Inspired by the best the pandemic has revealed about the capacity of people like those of us at UCSF to confront a crisis, I rolled up my sleeves with a refreshed outlook, and went back to work on my own part – alongside all of you – toward a better future. Thank you all for sticking with it during this difficult time. And thank you for staying committed to the long, arduous, far-reaching tasks that will build our society into one that is truly respectful, inclusive, and caring for all. This can only happen if we believe it is possible.

His Holiness the Dalai Lama recently conveyed this so well: “We all have seeds of compassion, loving-kindness and concern for others. On that basis, if we make the effort, we can build a happy human community.”

From my cup of kindness to yours, here’s to ringing out the past year – and ringing in a future full of hope.


P.S. Feel free to let me know how you navigated 2020 and if you have ideas about how we can make life better in 2021, at UCSF or beyond. Please write me at [email protected].

back to top


Dan’s Tip of the Month

His Holiness the Dalai Lama speaking to the virtual audience during the dialogue on Resilience, Hope and Connection for Well-being as part of this year’s Happiness and Its Causes Conference in Australia from his residence in Dharamsala, HP, India on November 19, 2020. Photo by Ven Tenzin JamphelWhen I recommended The Book of Joy: Lasting Happiness in a Changing World in the February 2020 Expresso, little did I know that the world would be transformed with such adversity in a matter of months and how dire life could become for tens of millions of people. Our need for collective joy and happiness has never been this great. Tipped off by our own Laura Kurtzman from the UCSF Office of Communications, I found myself enthralled by and cherishing the graciousness and light emanating from the wisdom of His Holiness the Dalai Lama during the November 19 Happiness & Its Causes 2020 conference. While it clocks in at an hour and 24 minutes, the virtual dialogue on “Resilience, Hope and Connection for Wellbeing” between His Holiness and University of Sydney Professor Ian Hickie is almost like a meditation in itself (and because it’s on Zoom, we get to see His Holiness’s residence in Dharamsala, HP, India). Embodying happiness, peace, and harmony, the conversation is filled with hope – perfect listening as a tumultuous 2020 draws to a close. Wishing a peaceful season to all.

back to top