Abdul El-Sayed - Healing politics : a doctors journey into the heart of our political epidemic

The author has modified names and identities and, in some cases, created composite stories throughout this book to protect privacy.

Copyright 2020 Abdul El-Sayed

Cover 2020 Abrams

Published in 2020 by Abrams Press, an imprint of ABRAMS. All rights reserved. No portion of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, mechanical, electronic, photocopying, recording, or otherwise, without written permission from the publisher.

Library of Congress Control Number: 2019939904

ISBN: 978-1-4197-4302-3

eISBN: 978-1-68335-813-8

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In the name of God, Most Merciful, Most Gracious,
To Emmalee and her sisters and brothers
in humanity, our hope.

Indeed, I was sent to perfect the good in human character.

The Prophet Mohamed, peace and blessings be upon him
(authors translation)

Medicine is a social science, and politics is
nothing else but medicine on a large scale.

Dr. Rudolf Virchow

by Ady Barkan

by Ady Barkan

Over the past few months, my vision has become increasingly blurry. The problem has varied throughout the day, and some days have felt better than others. But the trendline seems clear. Its been particularly frightening for me because I am already suffering from a deadly, debilitating neurological disease called ALS, which has paralyzed my whole body and left me dependent on a ventilator to breathe, a wheelchair to move, and 24/7 home care to survive. For some unknown reason, ALS does not affect the eye muscles, and so they are now the only part of my body that I can control. I use them, and excellent eye-tracking technology, to write and speak. Without my eyes, life would be impossible. So the deterioration of my vision has been particularly frightening. Was it a result of ALS? Or of some fluke, particularly tragic other problem?

It took me two trips to the ophthalmologist and about twelve weeks to discover the real culprit: I had developed a mild case of farsightedness, which could be solved by a simple pair of +1.25 reading glasses, which now are perched stylishly on the bridge of my nose.

What is so notable about this minor saga is that it took me so long to resolve the issue, despite the tremendously high stakes, my access to good medical care, and the simplicity of the solution. Inertia, uncertainty, and fear had kept even me from going to the local drugstore and trying on a pair of twenty-dollar glasses.

Although the particulars of my story are tragic, my failure to get reading glasses is, I learned from Dr. Abdul El-Sayed in the pages that follow, completely routine and commonplace. Every morning, children sit in classrooms and cannot see what is on the blackboard. Their education, their career prospects, our collective investment in them as members of civil societyall undermined by a simple problem (with a simple medical solution) that we are failing to address because complicated, multifaceted social and political obstacles stand in our way.

That is what this book is about. It is about our public health, and the ways in which our lives are constrained and cut short because of the collective choices we make, and fail to make. As the commissioner of health for the City of Detroit, Abdul worked to change those choices, change those outcomes, put glasses on the bridges of many more young noses. With limited resources and political constraints, what is a public health official to do? Abdul has lived that challenge, and he recounts it with insight and humility.

But this book is also about so much more. It is about the broader illnesses facing our society and our body politic, and the options we have for curing them. Abdul brings to this exercise the rigor and skepticism of an elite epidemiologist, eschewing the easy answers in favor of those that recognize the interconnectedness of our systems and lives and politics.

This book is also about the man who has written it. Abduls parents immigrated from Egypt to the United States, like millions before and after them, in search of stability and security and a better life for their children. And so Abdul grew up buoyed by privilege and burdened by prejudice. In the aftermath of 9/11, he was a star student whose name screamed out Muslim. He learned to navigate the dual identities, the high and offensively low expectations of him, and emerged as a shining example of the best America has to offer.

Abdul trained as a scientist and a doctor. But I met him when he had become a different kind of public servant. On the campaign trail in the summer of 2018, with our democracy under grave threat, I witnessed his charisma and brilliance and power. His compassion. His vision. And his optimism. I witnessed how Michiganders responded to it. And I also witnessed how the political establishment responded; how the forces who felt threatened by Abdul defended their status quo.

And so, ultimately, this book is about the future. Or at least one future. A future where evidence informs our analysis. Where empathy guides our politics. Where people like Abdul are our leaders. Can we reach that future? The answer depends on us.

Ady Barkan

Santa Barbara, California

December 2019

About two weeks after I launched my campaign for governor of Michigan, Sarah, my best friend and wife of eleven years, suggested we grab some dinner. Rather than a casual meal at home, she opted for something more special, and chose one of my favorite spots: Supino Pizzeria, in the heart of Detroits Eastern Market, just steps from where I had launched the campaign.

Sarah had news to share. After we finished off the last slice, she grabbed both of my hands and looked me in the eyes: Youre going to be a father.

I had figured that this was the news. After years of waiting to finish our educationsSarahs also a doctor, and we were in college when we got marriedwe had started trying to get pregnant a few months back. But nothing prepares you for the emotion that comes with those words. Some odd combination of elation and fear swept over me as we hugged. We were going to be responsible for a tiny human lifesome part each of us, but altogether new. But there was also a third emotion I had not expected: inspiration.

I had always been circumspect about the idea of having children. After all, there are so many parents struggling to care for their own kids. I wanted to dedicate my life to supporting them. Would having a child of my own detract from that mission? And then there are so many children who dont have parents at all. Why bring a child into this world when there are so many who need parents already?

Then my cohort of friends started to have kids. I noticed that when they talked about the downsides, they used language I could relate to: you dont get any sleep; theyre expensive; youre no longer the person your partner is most interested in. But when they described the benefits, their words were emotional, hazy: Its just this... feeling, this love, one said.