Category Archives: Joe Lieberman

DeMarco: The images that shape our lives

The Op-Ed Page

Dr. Ernest Guy Ceriani

By Paul V. DeMarco
Guest Columnist

As a graduation present, one of my best friends from college gave me a book titled Let Truth Be the Prejudice by photojournalist W. Eugene Smith. She knew I was on my way to medical school and chose the book because of a photo essay called “Country Doctor.” It documented the work of Ernest Ceriani, the sole physician for the people of Kremmling, Colorado, an isolated hamlet of about a thousand. The essay was published in 1948, when Ceriani was 32.

The images captivated me. There was a reality, a chest grabbing truth contained within. Smith said of the essay “I spent four weeks living with him. I made very few pictures at first. I mainly tried to learn what made the doctor tick.”

His patience was rewarded. The image that has been my lodestar captures Ceriani in the wee hours. He is in a homey hospital kitchen after completing a lengthy surgery. He wears a cloth surgical gown and cap. His mask is untied. He is slumped against the counter with the stub of a cigarette in his left hand and a slightly listing cup of coffee in his right. His exhaustion is palpable. In another photo (see below), he is holding the head of a 2-year-old child who had been kicked in the head by a horse. His brow is deeply furrowed. He is worried, afraid for the child’s sight. In another, he is on a home visit. He is sitting on a bed, listening to the chest of an elderly man dying of a heart attack.

I must admit that I had no idea what I had signed up for when I committed to medicine. I was the first doctor in my family and had never experienced a serious illness, nor had any family member or friend. I didn’t have a mentor to tell me what medicine would be like, but in a moment, these stark black and white photos showed me. I saw that being a doctor means to sometimes be afraid, to sometimes suffer, to carry the burden of your patient’s illnesses, to watch them die.

I write this not to tell you I have succeeded in my hope to follow in Ceriani’s footsteps. He bore a burden that I doubt I could have carried. Nor is it to say that the type of medicine I do is the most important or most difficult. There are physicians that put their lives on the line in war zones, brilliant bench researchers, and masterful surgeons whose accomplishments dwarf mine.

I tell you this for two reasons. First because Ceriani’s example is still powerful, and should remain relevant in patient care of all kinds, including quotidian practices such as mine. I teach medical students and give a talk every year entitled “Joy in Medicine.” Perhaps that wasn’t the title you would expect, given my description of medicine’s trials. Medicine is, of course, also full of joys and rewards. But accepting those requires no training. What allows doctors to maintain their sanguinity is an ability to anticipate and then face tragedy.

Physicians can make two mistakes confronting this reality. One is to be subsumed by the distress of their patients and become overwhelmed. But the more common mistake is to remain aloof, to treat medicine as a job rather than a vocation, as a means to a lifestyle. In these days of incentive contracts which reward physicians for increasing the number of patients they see or procedures they do, patients who gum up the works with thorny problems or unexpected complications become unwelcome. I can’t count the number of patients who over the years have broken into tears during a visit. There is no extra reimbursement for giving a despondent patient your undivided attention. I can rarely offer any helpful advice. But I do all I can do, which is listen. Surprisingly often, we both feel better for the time we spend together.

I ask the students to imagine a middle way in which we do our best to fully acknowledge our patient’s dignity without losing our bearings. I have had patients who have suffered unimaginably. One dealt with the death of her husband and then the tragic death of her son two days later. I can only go a certain distance into that pain. But I try to walk with the patient far enough.

Students want to know how far that is. I can’t fully articulate it. It’s the same sense I have that keeps me from getting too close to a campfire or to a cliff. Sometimes I go farther than I might, knowing that I will have help recovering. My medical colleagues, including my wife, who is a nurse and has lived the pressures of primary care practice with me, are there to support me in my temporary grief for my patients.

I have walked that line mostly successfully for thirty years thanks to the lessons contained in “Country Doctor.” Some days I don’t give enough, and others I let the pressure of getting the work done truncate my ability to fully engage. I could not have lived Dr. Ceriani’s life as a solo practitioner in the Rocky Mountains. But he has been my constant inspiration, and I am surely better for my friend’s thoughtful gift, one of the most important I have ever received.

A version of this column appeared in the April 16th edition of the Post and Courier-Pee Dee.

Has South Carolina become for Dems what it was for GOP?

The main thing about the SC primary, of course, is that the right candidate runs and wins it. Hint, hint...

The main thing about the SC primary, of course, is that the right candidate runs and wins it. Hint, hint…

I mean in terms of the presidential primary process.

Starting in 1988, and ending in 2012, SC was in many ways the contest Republicans had to win. It was key to both of the Bushes especially. SC Republicans went around saying things like “We choose presidents,” yadda yadda. They did this because they picked mainstream, establishment candidates with appeal beyond the base, and our early primary helped tip the selection process in their favor.

Then, in 2012, it all fell apart with the rejection of Mitt Romney in favor of the fire-breathing Newt Gingrich. And we know what happened in 2016 — yeah, SC Repubs picked the eventual winner, but the whole national electorate had to go stark, raving mad in order for that to happen. At the time of the SC primary, it looked like Palmetto State Republicans were chasing off in another crazy direction alone, as with Gingrich. If decisions were still made in smoke-filled rooms by a party elite, SC would have lost its early primary by now. (In saner times, SC Republicans would have salvaged the hopes of the hapless Jeb! They had never let a Bush down before.)

Meanwhile, over the last few elections, this red state has gotten more important to Democrats. I was impressed by how many Dems we saw trooping though our editorial boardroom in 2003-4 (my own favorite being, famously or infamously, Joe Lieberman). And while he didn’t get the nomination, the execrable John Edwards’ win here helped get him the second spot on the ticket.

SC was very helpful in helping Barack Obama get the momentum he needed to pull ahead in 2008. The SC Democratic primary wasn’t really a contest in 2016, with Hillary Clinton winning hands-down as expected.

But this year, you’d think the Democratic nomination was going to be awarded right here, on the spot, next Feb. 29. They’ve been trooping through here in battalions, for months. (You’ve seen me complain about that distraction, and media fascination with 2020 over 2018, back during the campaign last fall.)

This is an interesting phenomenon. There have always been some aspects of the Democratic contest in this blood-red state that caused folks to pay attention nationally. That was largely because there are essentially no black voters in Iowa and New Hampshire, so Dems who won in those places would be told, “Let’s just wait and see how you do in South Carolina.”

But this thing we’re seeing now exceeds what we’ve seen in the past. With the huge field, and particularly with some of the chief contestants in it being African-American, we are looming large.

I’ve had a lot of occasions to note this; we all have. What kicked this off today was Vanity Fair’s “The Hive” making this observation about Bernie Sanders:

None of Sanders’s opponents are scared by those numbers, however. Because what Sanders was less good at in 2016 was spending his large pile of money to win votes. Particularly the crucial Democratic primary votes of women and African-Americans. Especially in the key state of South Carolina. And three years after being crushed by 47 points there by Hillary Clinton, with an even more challenging field of primary rivals shaping up, Sanders is showing little sign that he’s going to get it right this time around. True, in January he spoke in South Carolina on Martin Luther King Jr. Day. Sanders has also taken every opportunityto blast President Donald Trump as a racist. Yet Sanders remains remarkably awkward on the subject…

The piece ends with a lengthy quote from our own Bakari Sellers.

I don’t know why that particularly grabbed me. Something about Vanity Fair of all entities calling poor li’l ol’ us “the key state.” Anyway, you’ll be reading plenty more like that.

This is deeply ironic, of course — a state that hasn’t been in play in the general election being so important to Democrats. But it’s increasingly a thing, and it’s going to be interesting to see how it plays out going forward.

In short, will this story have a happy ending (with Joe Biden deciding to run, winning in SC, and going on to win the White House), or not? That’s my perspective, anyway… 🙂

The stream of Dems who came through our editorial board room in 2004 was impressive. Since that was pre-blog, this is the only photo I have from that time. It was shot by a Dean fan when my assistant Sandy Brown and I were escorting the governor from the building after meeting with him...

The stream of Dems who came through our editorial board room in 2004 was impressive. Since that was pre-blog, this is the only photo I have from that time. It was shot by a Dean fan when my assistant Sandy Brown and I were escorting the governor from the building after meeting with him…

 

You go, Joe!

Picture 038

All sorts of people don’t want Joe Lieberman to be the new head of the FBI. The identities of these people — Roger Stone, partisan Democrats — and their reasons for opposing him are, for me, arguments for giving him the job immediately.

Joe’s my main man, one of my favorite Joes — and I like me some Joes. I literally talked myself hoarse over the course of three hours browbeating my editorial board into endorsing him for the Democratic nomination for president in 2004. (He got skunked in the SC primary, which I expected, but to this day I have the satisfaction of knowing we endorsed the right guy, rather than Edwards or Kerry).

I was cheering like mad when he gave his hostile party the back of his hand and ran for, and won, re-election as an UnPartisan (not overtly, but in spirit). I was sad to see him retire from office.

So I’d like to see him out there in the forefront again.

But… I say that with some trepidation. Being head of the FBI with Donald J. Trump as POTUS sounds like the perfect example of the kind of job you wouldn’t wish on your worst enemy.

So I’m happy to see Joe in the news again, but a little worried for him if he gets it. Some others who like him feel the same way. Also, while I’m sure Joe would do a great job at whatever he set his mind to, “FBI director” isn’t the first job I would think of in looking for a perfect fit for Joe. I’d vote for him for senator, or president, in a skinny minute — but I don’t look at him and think, “cop.”

I don’t know what’s best. But it’s good to see ol’ Joe again….