Introduction
Many Americans are fearful and angry, desperately trying to understand what happened to our country when Donald Trump was elected as the 45th president of the US. Others are elated that their voice was heard and are now excited to be part of the Trump/Pence Movement to “Make America Great, Again”. Interestingly, ten years ago, upon the election of Mr. Barack Obama, many (usually not the same people) experienced the negative emotions and concerns about the future of the country that their grandchildren will live in. As a practicing psychiatrist I have encountered many patients experiencing wide range of emotions ranging from depression to elation, in personal encounters friends and family share the range of responses as do pundits.
For the past eight years, I have been on a journey to understand/ diagnose our political system and provide healthy treatment plan that has helped me accept the political reality of a Trump presidency and reaffirm my gratitude for the American political system and move forward with hope to participate as the most important player in that system..an engaged citizen. Utilizing the tools of the medical profession as a framework, I have actively examined the seemingly diseased political ecosystem and the potential treatment to return our body politic to health. The 2016 election campaign and the election of Donald Trump, has demonstrated the severity of the conditions suffered by American Democracy. Mr Trump was able to identify the symptoms of of the dysfunction caused by the malignant cancer of the political system that is destroying our democracy. His insight into and ability to address the psychological needs of a large segment of the American population were remarkable. Tens of millions of citizens recognized that that the US body politic is suffering from a serious disease and cast their ballots for Dr. Donald Trump and his Trumpism oriented treatment plan to radically treat the symptoms of the “Cancer”. The proposed treatment plan, similar to many Cancer treatments undertaken by desperate individuals suffering with life threatening disease, is likely to be more destructive if not fatal. Over the next months, as part of The The Citizenism Project's What Would James Madison Do? and we will expand on the Case of the Cancer of the American Political System and focus on a constitutionally informed, bio-psycho-social-spiritual treatment plan to address the underlying causes of Diseases of the US Body Politic and limit their manifestations. The Pain Opioid Epidemic , a symptoms to the many challenges to our society will be used to provide a framework for citizen engagement and participation in healing.
Below, is an article written a few years ago, as an introduction to Cancer of the American Political System series. The Cancer metaphor for understanding the body politic, was evoked during another political contentious period when the United States debt was the focus of political debate in Washington and had contributed to the shutdown of the federal government. The series uses the cancer metaphor as a frame work to understand the toxic political environment that has produced our current political situation. More important, it builds on the evolving options for cancer treatment to offer a treatment plan for the cancer of the US body politic.
Cancer is an often used metaphor to describe aspects of the political ecosystem and the pathology of the body politic. Many Americans are familiar with John Dean’s, cancer on the presidency warning to president Nixon about the seriousness of the Watergate break-in. Robert Kennedy Jr. in a 1963 speech marking the 175th anniversary of the ratification of the US constitution, noted the danger of the malignancy of racial inequality in American democracy. In his speech to the nation on September 10th, 2014 President Obama, declaring war on ISIL (ISIS) stated “It will take time to eradicate a cancer like ISIL”. Recently a New York Time article claimed that Trump’s efforts to oust Mueller show the ‘Cancer’ on This Presidency. Fareed Zakaria, prior to the 2016 election concluded that “Donald Trump is not a normal candidate. He is a cancer on American democracy”.
The president and the presidency are not the only potential cancers within our body politic, Erskine Bowles, Co-Chairmen of the President’s Commission on Fiscal Responsibility, and currently with the Fix the Debt campaign, tells anyone who will listen that “this debt is like a cancer that will truly destroy this country from within if we don’t fix it”. The choice of cancer as metaphor is understandable. It implies mortal danger, evokes strong emotions and an urgent call to action. Mr. Dean was not the first to use the cancer metaphor to describe a threat in our society. James Madison, in providing the rationale for the forming the structure of the US government used the disease metaphor to explain the need for the US Constitution. Abraham Lincoln referred to cancer as a way to describe slavery in the 1860. Although Mr. Bowles and others are right to be alarmed by the growing debt, the description of the national debt as a cancer misdiagnoses the problem that is facing our nation. The focus on the national debt distracts us from addressing a more pernicious problem, the current political environment and the political system that has produced it. The concern about the national debt and the fiscal deficit crisis that have occurred over the past years is just one symptom of the dysfunction caused by the malignant cancer that is destroying our democracy.
More concerning than the budget deficit and the debt is the loss of trust that the American public have in their government and that that they do not trust that elected leaders can lead as times of crisis. Furthermore there is a growing recognition that the “political bargain” between the government and the citizens is rigged in favor of select groups. Without effectively addressing the underlying “cancer”, any “treatment” will not change the destructive path we are on as a nation. Multiple approaches have been attempted to address the challenges facing American politics with little success, the destructive nature of the function of our body politics progresses, finding an approach to contain the damage and formulate a road map for healing our body politics is gaining urgency.
The Cancer of American Politics Series builds on the understanding of the biologic cancer process and current treatment approaches as a framework to address the political cancer that has developed in our body politic. We use The Medical Case Presentation as a framework to address the problem list that is the modern cancer in the body politic. It is our goal to a more deliberative, respectable solutions oriented process inspired by hope and built on compromise that serves the public. Our treatment plan focuses on citizens as crucial contributors to the healing process. The series starts with an examination of the similarities of the biology of cancer and the current US political system.
Offering “clinical examples” from our politics, this series describes the symptoms of the American political system. We highlight the similarities in the pathogenesis of our current political status and cancer. We utilize current clinical approaches to cancer care from Harrison's Internal Medicine 18th Edition, and provide writing of James Madison's, Federalist papers to give historic perspective on the solutions that the US Constitution was meant to provide to the challenges facing our nation.
Understanding the way a disease evolved, its natural course, is helpful not only conceptually but also clinically in selecting treatment approaches. Current treatments for most cancers have been able to achieve remarkable results. The Series, offers a solution oriented treatment plan for the cancer of our politics that builds on the understanding of the cancer process and the medial ecosystem to treat it. We utilize Web .2 and social media tools to propose a platform for a citizen oriented ecosystem for democracy. The platform for democracy enables the public to diagnose the underlying causes of the cancer and mobilize the required response and monitor progress toward achieving the best outcomes. The plan outlines a, multi-factorial and multistage strategy that provides interventions for immediate, mid range and long term holistic treatments. The series provides links to relevant resources, case studies, and tools to engage and create a community of “practitioner healers” who are dedicated to curing the Cancer of the American Political System. We provide a research agenda for democracy that mirrors the evolving understanding of the biology of cancer formation, and treatments. The areas of exploration include but are not limited to options for targeted and precision treatment
James Madison, was not a physician however he was using medical concepts in one of the most important documents of American democracy, Federalist, no. 10, that was published 22 Nov. 1787. In this paper, which explaining the recently adopted US constitution to the public and contributed to the ratification of the US constitution, Madison was able to provide a diagnosis of the governments that had existed at the time and to provide a treatment plan to address the pathology. Madison noted that the “violence of factions” played a role in the “instability, injustice and confusion introduced into the public councils, have in truth been the mortal diseases under which popular governments have everywhere perished”. He further explained that “Among the numerous advantages promised by a well-constructed Union, (Conceived of in the constitution) none deserves to be more accurately developed than its tendency to break and control the violence of faction.”
Mr. Madison’s and the other founding fathers’ treatment plan, the US constitution has been remarkable in providing a fairly stable framework to weather the past 225 years and achieve remarkable success in creating a government that has seen peaceful national elections and succession of political power. During this time the United States has become a global superpower and the standard of living of our citizens has been unprecedented. It is quite clear however that the “violence of faction” with special interest and money in politics is contributing to our current “instability, injustice and confusion”. It is our current “mortal disease” and requires an updating of the treatment plan.
Case Presentation : Cancer and the US Political System ( Contact Us for Access to Draft)