It is Halloween—read a fascinating history of the day when the dead are said to rise—and the day after, parts of the world will celebrate Dia De Los Muertos, the day of the dead. In many traditions, not a frightening day or even one indulgent with candy. Rather, it is a day of solemn celebration, of honoring one’s ancestors and indeed, remembering from whence one came.
In Mobile Medicine, we have too many occasions to think about the legacies of those we have loved, served, and lost. We should also consider who we might be if we had never met them and find a reason to give thanks. Trust me, my friends: You are better off for having known them. They helped to make you who you are.
This week, Tabitha Boyle, Fire Paramedic Services Chief of the Philadelphia Fire Department, sent me a remarkable and touching package: a collection of challenge coins, rank insignia, and several awards—all duly and deservedly won—by our late, great, and most thoughtful friend Michael Touchstone.
Even readers who may not have had the pleasure of intellectually parrying with Mike in person may have seen the JEMS interview that I did with him; or read the papers that he diligently published about leadership in the Fire and Mobile Medicine profession—and it was he who compelled me to call it that, rather than an “industry.”
I can still hear Mike’s voice, his chortle, and his insistence that we use only particular and accurate language. I remember how proud he was to have graduated—after retiring!—with a certificate in Systems Thinking from Cornell University…the Ivy League! He looked forward to writing a children’s book, to having deep and meaningful discussions with friends and wife and children, and to the culinary arts and Old Fashions that he loved so much. He died decades too young, but by then, his body was already broken.
This week, my college friend Erik Bresocnikis celebrating the birthday-in-Heaven of his baby girl, who died of brain cancer in 2020. There’s nothing fair to say here; there is no silver lining. Though Erik and his family are not alone in their grief, with pain that will never pass, it is shared by the ones who love them.
But what Erik knows—and few others do—is that when my team was asked to build a registry of children with special health needs—kids with a range of complex and serious illnesses—I called him to ask if I could dedicate the work to Kendall.
It will forever be my honor to know—and now, to share with you—that a tool that has touched healthcare’s essence by protects young people and their families and the Responders who care for them, is the legacy of a young girl who we can no longer see or touch or hear. Does she know about her lasting impact? I believe, perhaps, that she does.
Many among you knew Bruce Graham, who died of ALS far too young and far too long ago. Bruce taught me about the politics of our profession and saw the future of its technology. He was a confidante, an idea man, always good for a belly laugh and a handshake that made my paws feel puny, and he would proudly declare that potatoes were the only ground-grown thing that would pass his lips).
More than once, I’ve been challenged to wonder: Could Bruce really have been so right? Or could he, somehow, be helping things along?
When I was younger, among my first publications in the academic niche called neurotheology—in simple English, the study of the biological basis of religious experience, and more specifically, the notion of a spot in the brain that is attuned to whatever one calls God—identified that two camps had emerged in the field:
The “Reductionists,” as I called them, were convinced that everything about religious experience was a figment of physiology; these are the same people who will read about biblical miracles and have to find some explanation in weird weather or the temporary inversion of gravity or the Sun decided to dance, or something. Whatever it is, there cannot be anything beyond rational, easily observable explanation.
By contrast, the “Religionists” were the opposite: they were basically apologists for faith. Everything was a sign of connection to some higher power—more than once I even reached out to the author of one or more books on the subject to point out that their “scientific” explanations made no sense.
Some of the narratives described in bestselling books read with eerie similarity to superpowers depicted in old comics. There were the same folks who, when shown dinosaur bones deep in the ground, would say that God put them there as a test. The was no room for rationality or logic, as any such explanation was a red herring.
But I figured out the actual answer: As you likely guessed, the truth is somewhere in the middle. Between “nothing has meaning” and “everything is supernatural.”
Then it hit me, and nothing could be more fun (or poignant) to keep in mind during Halloween: Do you realize that we have precisely the same amount of evidence for the existence of ghosts as we have against them? Which is to say: NONE EITHER WAY. None for, none against.
All we know—and this we know for sure—is that most of us cannot experience all that exists in the world. Forget dark matter and other esoteric topics: we know that we cannot see ultraviolet light, but that it can burn us.
We know that the sky looks different when you’re in the city and the countryside, but all that is out there is not what has changed—it is we who have shifted, our perspective, how much noise is around us, whether in front of our eyes on computer screens, or bombarding our ears, or sapping our empathy.
When I wrote my graduate thesis, I tacked on a chapter called “On Love and Angels,” and while I’ll spare you the full details, the punchline was this: Angels are those that make an impact on our lives… then leave. The trip of it all is that we cannot know what their impact will be at the time.
All we can know, and usually in hindsight, is that at that moment—because of that person or sound or thing or piece of feedback—we were forever changed. This idea has come up elsewhere; I wish I could say that I was the first to consider the divinity of inspiration. In fact, the word “inspiration” has a religious origin: “to breathe into,” as in, to take in a godly spirit and be able to do things and see beauty and paint and make music and see the Matrix.
Rest assured; inspiration is not always pleasant: I would not be in the Mobile Medical profession were it not for September 11th, 2001. What if my business partner’s father and sister had not passed away? What if my own Dad’s health were better, and I had not watched my mother care for so many family members?
I might not be an entrepreneur if my grandmother had not said something to me, early in my career, which compelled me to try repay their sacrifice daily. I might not have gone to business school if I’d been better at organic chemistry, or if I hadn’t been sick while taking the law school exams.
I might not have thought about patient logistics if Baxter Larmon, from UCLA (who many among you know and respect), had not talked with me—more than ten years ago—about “patients as packages” (and then warned me never to refer to them that way!).
I might not have met Bax if I had not previously met Mark Wittman, a physician and investor during a venture pitch event; turns out, they knew each other from med school.
The road we walk is long. On Halloween, we relish that it winds through gullies filled with ghosts. Could they be the source of so much innovation? Now that Chief Boyle sent me these challenge coins, what will they teach me? Better question:
Did she find me by accident—by merely stumbling upon my eulogy for Mike? Or could Mike have been sitting invisibly next to her, suggesting that she click on the article that connected us? It does not dull the pain, but might Erik smile to know that his baby girl is protecting the health and wellness of so many others?
Could she have whispered in the ear of the woman who called me to ask whether Responders would benefit from a heads-up about kids with complex needs? Maybe…just maybe.
