Good morning. The events in Charlottesville occurred nine days ago, but they continue to haunt like a tolling church bell. The image of willful hate and intolerance, parading in the gaudiness of Tiki torches, remains as dispiriting today as it did on August 12. But in the days since then, “Charlottesville”—that beautiful city turned chyron—has become something else as well: a touchstone for our collective divide, a reminder that a century and a half after the Civil War, which came to its end at a Virginia court house 60 miles from Charlottesville, America’s soul is still riven.
It is not one partition that separates us, but many. They are marked in a dozen colors across the map: north–south; urban–rural; Republican–Democrat; aspiring Americans and those who believe the country cannot risk or afford them; news believers and deniers; those who see an unfair nation that has moved spitefully away from them and those who celebrate its bounty and potential.
In July, as Republicans in Congress attempted to repeal and replace the Affordable Care Act, yet another of these national schisms was laid bare. The fight over healthcare reform was not truly over mandates and CBO scores; it was never about the bullet points of legislation—though that’s what grabbed much of the media attention. Rather, it was a battle over deep-seated beliefs. The argument centered on a philosophical, even moral, question: What role, if any, should government play in making sure its citizens can get the medical care they need—and how much should it protect them from the financial, if not biological, ravages of disease? At a deeper level, the question was (and is) this: Should one group of wealthier citizens help pay to protect another group who can’t afford the full cost of their care?
In early August, before Charlottesville, we heard the renewed rumblings of still-more debates—decades-old clashes over the role of the Food and Drug Administration—and the splits here are no less emotional. Should the FDA aggressively protect Americans from the harm that may come from new drugs or should it get out of the way and let innovators bring medicines more speedily to the market? Should dying patients have the right to try experimental, unapproved compounds or should the standard rules of clinical trials—a process that, boosters claim, provides safety and knowledge to many—be left inviolable? Should industry help pay for its own drug and device approvals or does that compromise the integrity of the system?
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We might think that matters of health, medicine, and science should transcend the parochial quarters that bitterly separate Americans. But this summer reminds us that we all have work to do to bridge those divides—to find a way, impossible as it often seems, to extinguish the distrust, fear, and loathing from our disagreements even as we heartily disagree.
Two days after the Civil War’s end at Appomattox, President Lincoln addressed a large crowd gathered outside the White House, rallying the torn and exhausted nation to the cause of “reconstruction,” as he called it—a task he knew would be “fraught with great difficulty.”
“Unlike a case of a war between independent nations,” said Lincoln, “there is no authorized organ for us to treat with. No one man has authority to give up the rebellion for any other man. We simply must begin with, and mould from, disorganized and discordant elements.”
It was the beginning, he hoped, of a re-inauguration of the republic that was born, in the throes of another war, nearly nine decades earlier. He believed dearly in that healing process, long though it would be.
It was Mr. Lincoln’s final public address. Four days later he was dead—at the hands of a man who couldn’t let go of that fear and loathing.
This essay appears in today’s edition of the Coins2Day Brainstorm Health Daily. Get it delivered straight to your inbox.
