Hope, Action, and Tears in Devastating Times

This is a medical newsletter, but I must digress today into the political event that has been devastating to at least half of my patients. High blood pressures, anxiety, grief, despair, marriage spats, family conflicts, tearing eyes, chest pains, abdominal cramps, headaches, nausea. And that was just Wednesday.

As a doctor I need to continue seeing all types of patients, people, human beings. I’m trying to understand why a majority of Americans voted for a self-evidently bad person and his plan - ripe with vindictiveness, bereft of compassion, hostile to our dying planet, and openly, lasciviously disrespectful of women’s bodies. A bitter man who incites and revels in political violence. I think it is a minority of people who truly embrace much of the above, but I’m guessing a larger number simply fall into dark echo chambers while searching for changes in our challenging lives. Are they complicit with the worst of what’s coming?

Divide and conquer - as old as the dark playbook itself. Blame immigrants, not outrageous billionaires, nor a system which is about to be rigged even more against the middle class and the poor.

Some tears are emotional tears, distinct from reflexive or basal tears. They contain a unique biochemical cocktail that includes stress hormones like ACTH and prolactin, and natural painkillers like leucine-enkephalin, which are actually being passed through our tears while crying. This partially explains why people often feel better after "a good cry." Emotional tears also trigger the release of oxytocin and endorphins while activating the parasympathetic nervous system, creating both psychological relief and measurable physiological changes that help return the body to emotional balance.​​​​​​​​​​​​​​​​

I haven’t had a good cry yet. I’m not so good at that. Rage is more natural. But I hugged no less than 5 patients yesterday. Real hugs. Like you do with family. It felt damn good. I encourage you to be freely giving with your hugs, now more than ever.

When democracy faces grim times, it's natural for those who understand the brutal alternatives to feel grief, fear, and despair. Palpitations. I saw an elderly man yesterday who nearly starved as a child in WWII Italy, and wept at America’s embrace of fascism and strong men. But throughout history, these times have also sparked the most profound movements for positive change. It could take 4 years or 40 years, but this week’s setback need not completely determine our future. Instead, it can become another catalyst that inspires us to build something better. I personally need a break, a standing 8 count, and then it is time for more shadowboxing.

Understanding our current situation is the first step toward changing it. Many of our neighbors supported authoritarian leadership not out of malice, but from a complex web of economic anxiety, fear of change, and genuine belief in promises of stability and renewal. Maybe as a reader you were one of them. Many responded to messages that resonated with their deep values of loyalty, tradition, and security. Though I may strongly disagree with their choice, demonizing them only helps deepen the divisions that make democracy vulnerable.

I just learned of something called Moral Foundations Theory, which suggests that people prioritize different moral values in their decision-making. What do authoritarian-leaning voters prioritize? What are some ways to show how common the ground truly is between them and the “liberals they own?”

We need a framework for common debate at the Thanksgiving table, assuming there is one. When we have the emotional energy to do so, here are those values most of us share, along with examples of common ground:

Loyalty

• Frame environmental protection as "being loyal to our country by preserving American natural treasures."

• Present immigration reform as "being loyal to American workers first."

• Discuss healthcare as "taking care of our own people."

Security/Authority/Respect

• Frame anti-corruption measures as "restoring proper order and respect for law."

• Present police reform as "helping officers better serve and protect."

• Discuss education in terms of "respecting teachers' authority and expertise."

Tradition/Sanctity/Purity

• Frame environmental issues as "keeping our air and water clean and pure."

• Present healthcare as "protecting human life." Women’s lives and bodily autonomy especially.

• Discuss corporate regulation as "cleaning up corrupt practices."

For example, rather than arguing climate change with pure data, we might say:

"As Americans, we have a sacred duty to protect our beautiful country and pass it on better than we found it. We shouldn’t let companies, foreign or domestic, pollute our precious land and water."

This approach connects with an existing value system rather than challenging it directly. The goal is to show how progressive policies can actually support and enhance mutual core values. I fear that many moral voters will feel betrayed by what actually happens over the next four years and beyond, if they consume impartial news and facts.

The path forward requires both wisdom, courage, and incredible resilience. There is certainly more destruction of democratic norms on the way. But we must try to build genuine connections across divides while standing firmly against policies that threaten democratic institutions and human rights. This means having difficult conversations with respect and empathy, while also organizing robust resistance to protect our shared future.

Here are some ideas about what we can do today to keep defending democracy. OK, maybe not today. Let’s keep feeling shitty for a bit. But soon? In challenging times, our strength lies not just in grand gestures but in the steady rhythm of daily actions that beats along with our daily concerns.

Protect democratic institutions through daily choices

• Subscribe to and support local independent journalism, assuming it does not suck.

• Learn and share digital privacy and security practices. Trump and his crew have declared war on the “enemy within,” journalists, activists, donors, and vulnerable populations. This is real.

• Share verified information rather than inflammatory content.

• Make regular donations to civil rights organizations when possible.

• Call your representatives about issues that matter.

• Attend city council meetings and speak up. Consider a beta blocker if you get extremely nervous!

Build connections and coalitions

• Have polite conversations or lunch with neighbors whose views differ from yours.

• Join community groups and attend local meetings.

• Create discussion groups and safe spaces for dialogue. Our daughter’s school did this already yesterday.

• Build alliances across racial, religious, and class lines. This assumes you are not an end stage racist or neo-nazi.

• Support local organizations doing crucial community work.

• Check in on elderly or isolated neighbors. Knock on the door.

• Host events that bring diverse groups together. Preferably with good ventilation if you are inviting me ;)

Take strategic action

• Register voters in your community. This is a long game, and I salute my parents-in-law for their selfless volunteerism in this regard over the past decade.

• Support ethical businesses. I’m partial to mom and pop and local businesses. I try to avoid chains at all costs. Why go to Starbucks when you can support your local coffeehouse, if you still have one. If you don’t, maybe you should open one! Function, Chapterhouse, Rival Brothers, Ultimo, Rally, Herman’s next time you’re in Philly.

  (Feel free to move here, too, by the way. We are the birthplace of freedom in this country, and we aim to continue the bulwark. Want to play militia in Philly? F around and find out.)

• Join election protection efforts. I know my poll workers like long time neighbors.

• Consider running for local office. Even the PTA counts.

• Participate in strategic boycotts when needed.

• File legal challenges when rights are threatened. This one is tough, but it’s possible we will need to do this when targeted, as was promised.

• Attend and organize peaceful protests.

Protect vulnerable communities

• Volunteer with organizations serving at-risk populations, especially if you are retired, or looking for more purpose and meaning outside your 9-5.

• Provide or support legal assistance programs.

• Speak up against bias and misinformation. I called that out just yesterday as a person told me he was a “black trans-woman in a white man’s body.” A lot of people feel empowered to say provocative stuff right now. I also told a patient yesterday that no, ivermectin does not work for Covid, and here’s a link to excellent scientific evidence.

• Show up when communities need support.

  First they came for the socialists, and I did not speak out—because I was not a socialist.
  Then they came for the trade unionists, and I did not speak out—because I was not a trade unionist.
  Then they came for the Jews, and I did not speak out—because I was not a Jew.
  Then they came for me—and there was no one left to speak for me.
  —Martin Niemöller

~

Remember: authoritarian illnesses thrive on isolation and overwhelming us. Every time you build a connection, share accurate information, support an independent business, or help a neighbor, you're strengthening democracy's immune system. These actions, multiplied across millions of people, create the resilient social network that preserves freedom and justice.

The choice before us isn't whether we face challenges - that's constant, and has already been politically inflamed. The choice is how we respond.

Take care of your mental health, maintain genuine connections, and remember that your daily actions matter.

Throughout history, citizens have successfully resisted and reversed authoritarian turns through persistent, strategic action and unshakeable solidarity with each other. The key is to avoid both despair and complacency. Instead, we must channel our grief and anger into sustained, strategic action while building the relationships and communities that make democracy resilient.

On an issue like climate change, I am resigned like most of the expert scientists that it’s too late to avoid terrible pain and suffering. We see this in the floods and droughts, crop failures, mass animal extinctions, and the 82° Fahrenheit days like yesterday in Philly in freaking November. But like our very lives themselves, futility is certain and the universe indifferent, all of which frees us to create purpose and meaning like the god within.

I once wrote a post entitled Do you want to be helped, heard, or hugged? Though I feel hostile right now, that anger is already morphing into a desire to both give and receive hugs, to hear and be heard, and to help in little ways that add up to something greater than myself. I’ll aim to keep writing here and not be cowed by those who would prefer I surrender my authority and implicit expertise in deference to intimidation or misinformed health agendas. I’m down with loyalty, tradition, and security, too. Primary care is about taking care of all people, and I’ll keep doing that.

How are you doing? Some emotional tears for catharsis?

Need a hug, too?