Featured

From 1776 to 2020: A Vision for a “more perfect Union”

The United States’ healthcare system combines public health efforts with mostly private delivery of health care. Usually they coexist side by side with some but infrequent interaction. The public health emergency created by the pandemic forced them into a “union” that quickly became politicized, and unfortunately diminished the effectiveness of the response.

In ophthalmology, visual acuity is measured by the distance one can see compared to “normal”. A person with 20/80 vision can see at 20 feet what a normal vision person can see from 80 feet. Perfect vision is labeled 20/20.

Maybe you expected 2020 to be a perfect year. I doubt that any of us would say it was. The year brought

  • a contentious presidential election and an unexpected serious pandemic
  • peaceful protests and raucous riots
  • racism confrontations and reconciliation pursuits
  • health inequities battles and healthy community pursuits

This next year 2021 has already had its share of problems, but I think most of us feel calmer, more hopeful, and eager to resume many of the activites we put on hold last year. And that includes a 4th of July celebration.

Statue of Liberty
Lady Liberty lifting her torch in New York harbor
Independence Day, July 4

Every year on July 4th the United States celebrates Independence Day- the day in 1776 the original 13 American colonies established an independent country.

A few years later they established a government as specified in the Constitution of the United States, to “form a more perfect Union”.

The United States Constitution

The Constitution does not specifically mention, establish, create, or endorse a healthcare system. Some phrases in the Preamble hint at it though-

  • establish Justice
  • insure domestic Tranquility
  • provide for the common Defense
  • promote the general Welfare

Government sponsored health care programs

The Affordable Care Act, aka Obamacare

The  United States Congress passed the Patient Protection and Affordable Care Act (ACA) in 2010 to guarantee basic health insurance to all citizens.  During his term in office, President Trump vowed to “repeal and replace” this law but although it has been modified, it is still in place.

Healthcare for military service members, veterans ,and their families

During the American Revolution the fledgling government extended health care benefits to the soldiers and veterans of that war; that system evolved into the current Department of Defense military health care system which covers service members and the Veterans’ Administration system for veterans.

a Veterans Administration clinic
a Veterans Administration clinic (photo by Dr. Aletha)
American soldiers serving in Afghanistan
American soldiers serving in Afghanistan
Medicare and Medicaid

Two other government healthcare programs- Medicare and Medicaid are over 50 years old. 

Medicaid provides insurance coverage for adults and children who are unemployed or low income.  

Medicare covers disabled children and adults  and persons 65 years and older.

a senior adult couple relaxing in lawn chairs
by Brayden Heath from LIGHTSTOCK.COM

Department of Health and Human Services

Most of the health care activities of the federal government fall under the agencies of the Department of Health and Human Services or HHS. The Secretary of HHS serves in the President’s Cabinet.

Due to the COVID-19 pandemic, we’ve heard more about the HHS in the news than usual; maybe you’ve never heard of these agencies. Generally, management of a pandemic or other public health emergency falls within the work of the CDC.

Centers for Disease Control and Prevention–

The CDC’s mission is simple but encompasses many facets of health

“to work 24/7 to protect America from health, safety and security threats, both foreign and in the U.S.”

The CDC website devotes an entire section now to information, guidelines, and news about the SARS-CoV-2 virus and COVID-19.

illustration showing the coronavirus which causes COVID-19

The goal of public health is to avoid or prevent health threats from becoming public health emergencies, like the COVID-19 pandemic. If they accomplish the mission, we hardly notice. But when an outbreak occurs, their work suddenly becomes visible, scrutinized, and debated.

The CDC director, Dr. Robert Redfield, spoke to Congress soon after the pandemic started, and his assessment of the response and funding for it were not positive. Lack of funding hampered the federal government’s response to the coronavirus outbreak, he told lawmakers on March 10, 2020.

“The truth is we’ve underinvested in the public health labs,There’s not enough equipment, there’s not enough people, there’s not enough internal capacity, there’s no search capacity”

Dr. Robert Redfield, Director, CDC

The Trump administration subsequently enlisted private companies to help cut the difference. The CDC partnered with Integrated DNA Technologies to manufacture the COVID tests under a CDC contract. IDT partnered with commercial labs for the testing.

2021-the Biden Administration

On December 7, 2020 President Biden’s transition team announced that Rochelle P. Walensky, M.D.  was slated to become the new director of the Centers for Disease Control and Prevention. In a 2021 interview she talked about the “big questions that keep her up at night.”

  • How are we going to ensure that the people who are hardest to reach with COVID vaccines receive it?
  • How are we going to ensure that when everyone else is not thinking about COVID we are still leveraging the infrastructure and connections we’ve made and that we address the collateral damage of this pandemic: the hypertension , the pediatric vaccinations that haven’t happened, HIV control?
  • How are we going to address a resurgent opioid crisis that I thought I’d never see again?
  • How are we going to address gun injury prevention?
  • How do we not only protect this nation, as we realize that we need to protect the world, too. Not just for humanitarian purposes, but because we are so integrally linked, as this virus has taught us.

National Institutes of Health– NIH

The National Institutes of Health, part of the Public Health Service,

  • supports biomedical and behavioral research with the United States and abroad,
  • conducts research in its own laboratories and clinics,
  • trains promising young researchers, and
  • promotes collecting and sharing medical knowledge.

And within the NIH is the NIAID– the National Institutes of Allergy and Infectious Diseases, which has been an invaluable source of guidance as the United States and the world works to understand and manage this new infectious disease.

President Donald Trump Visits NIH
President Donald Trump visited NIH on March 3, 2020 and toured the National Institute of Allergy and Infectious Diseases’ Vaccine Research Center (VRC) to learn about research on a vaccine for the novel coronavirus SARS-CoV-2. From left: VRC Deputy Director Dr. Barney Graham, NIH Director Dr. Francis Collins, VRC Director John Mascola, Department of Health and Human Services Secretary Alex Azar, President Trump, and VRC Research Fellow Dr. Kizzmekia Corbett.
credit NIH, public domain
Novel Coronavirus SARS-CoV-2
This scanning electron microscope image shows SARS-CoV-2 (orange)—also known as 2019-nCoV, the virus that causes COVID-19—isolated from a patient in the U.S., emerging from the surface of cells (green) cultured in the lab.
 
Credit: National Institute of Allergy and Infectious Diseases-Rocky Mountain Laboratories, NIH
President Biden Visits NIH Vaccine Research Center
NIH immunologist Dr. Kizzmekia Corbett speaks to President Joe Biden about the fundamental research that contributed to the development of the Moderna and Pfizer COVID-19 vaccines when the President visited NIH’s Vaccine Research Center on February 11, 2021. Credit: NIH/Chiachi Chang

Food and Drug Administration– FDA

The FDA joins the pandemic response by

  • reviewing and approving diagnostic tests for the coronavirus
  • protecting consumers from fraudulent products for COVID-19.
  • issuing Emergency Use Authorizations (EUAs) for ventilators
  • sampling and testing of respirators for importation

Late in 2020 the FDA gave Emergency Use Authorization to 2 vaccines against COVID-19. By December Americans began receiving “shots in arms”, a welcome step in returning to normal.

COVID-19 Diagnostic Test Attire
FDA Commissioned Corps officer RADM Estella Jones, DVM, OCET Deputy Director and Co-Chair of the FDA Animal Welfare Council, oversees Commissioned Corps officers as they practice proper fitting of protective items. Healthcare workers testing patients for COVID-19 novel coronavirus infection must wear specific protective gowns, gloves, ventilation masks, and full facial shields as shown, and must replace these items after each patient is tested. credit FDA, public domain

Occupational Safety and Health administration-OSHA

OSHA is part of the United States Department of Labor. OSHA’s administrator answers to the Secretary of Labor, who is a member of the cabinet of the President of the United States.

Congress created the Occupational Safety and Health Administration (OSHA) in 1970 to

ensure safe and healthful working conditions for working men and women by setting and enforcing standards and by providing training, outreach, education and assistance.

For the pandemic response, OSHA offers guidance on

  • returning to work
  • preparing workplaces for COVID-19
  • worker exposure risk to COVID-19
  • for specific industries including airlines, farms, retail, corrections
  • use of respiratory protection equipment

important laws that administer and regulate both private and public healthcare.

The Affordable Care Act- ACA
Health Insurance Portability and Accountability Act-HIPPA
Emergency Medical Treatment and Labor Act- EMTALA
Americans with Disabilities Act-ADA
Family Medical Leave Act-FMLA
replica of the Liberty Bell at Disney World, Florida, photo by Dr. Aletha

Let Freedom Ring

In the Declaration of Independence, the founders of the United States created a nation based on the “self-evident truths”  of  “Life ,Liberty, and the pursuit of Happiness” and to promote “Safety and Happiness” . 

They didn’t mention “healthcare” either, maybe because in the late 1700s medical practice was more superstition than science.

Surgery was rudimentary due to no anesthesia and infections frequently proved deadly due to no antibiotics.

No one had even imagined, much less identified the human genome, and viral DNA-what was that??

I wonder if they intended their new government to spend so much time and money providing and regulating health care –most of which was not available or even imagined at that time? 

Public vs Private-not a perfect Union

The United States’ healthcare system combines public health efforts with mostly private delivery of health care. Usually they coexist side by side with some but infrequent interaction.

The public health emergency created by the pandemic forced them into a “union” that quickly became politicized, and unfortunately diminished the effectiveness of the response.

But despite the lack of coordination and cooperation between all levels of government and private citizens, our health care professionals, in both public health and private medical practice stayed true to their calling. Many risked their own lives to care for COVID-19 victims. Others sacrificed time and finances to lead the pandemic response in their communities and on social media- maybe not perfectly, but definitely UNITED in resolve to lead, help, and heal their fellow citizens through this unprecedented health emergency.

Let’s celebrate!

woman holding a sprakler
Let’s celebrate ! This photo and featured image from stock photo site- Lightstock.com (affiliate)

Celebrating the HEART of life, liberty, and the pursuit of HEALTH and happiness

I’d love for you to follow this blog and follow me on social media.

I share information and inspiration to help you transform challenges into opportunities for learning and growth.

Add your name to the subscribe box to be notified of new posts by email. Click the link to read the post and browse other content. It’s that simple. No spam.

I enjoy seeing who is new to Watercress Words. When you subscribe, I will visit your blog or website. Thanks and see you next time.

Dr. Aletha

a woman in a red, white, and blue shirt
Me, a few years ago, showing my patriotic spirit by posing in red, white, and blue
a sketch of various electronic devices
RoboForm Everywhere to manage your passwords

The Magic of Normal- Book Review

In this post I review Dr. Maky Zanganeh’s memoir, “The Magic of Normal,” which chronicles her journey from fleeing the Iranian Revolution to becoming a successful executive in robotics and cancer research. While the book highlights her professional achievements, it maintains an emotional distance, offering insights into corporate life more than personal struggles. Still, it is a compelling narrative.

The Magic of Normal

Hope, Love, and Beyond

by Maky Zanganeh

Published by Forbes Books January 2025

2025 Global Book Awards Gold Medalist in Biographies & Memoirs – Women

Thank you, NetGalley and publisher, for sending this book for review consideration.

A Driven Life Told at Arm’s Length: My Take on Dr. Zanganeh’s Memoir

A Story That Begins in Revolution

Dr. Zanganeh describes her book as a chronicle of her private and professional journey, though at times it feels more like a book‑length résumé than a personal memoir. She begins in Iran, which she fled after the Iranian Revolution. (Ironically, while I was reading this, the United States—my own country—was in a military conflict with Iran.)

Her family initially supported the revolution, but the country soon descended into war with Iraq. With the means to do so, her parents sent her and her sisters to France, where they lived with relatives, attended college, and where she eventually trained as a dentist.

From Dentistry to Robotics and Beyond

Then her life pivoted sharply. Instead of practicing dentistry, she entered the business world and rose quickly, becoming a high‑level executive at a budding robotics company. She led the team that created the first long‑distance robotic surgery, and later founded another company that developed a breakthrough cancer drug.

A Personal Life Mostly Offstage

Her personal life stays mostly in the background until, almost abruptly, she mentions becoming pregnant. Because of her demanding career, she sent her son to live with her parents, who raised him while she continued traveling the world for work—a lifestyle that sounded exhausting to me, though she seemed energized by it.

Illness, Resilience, and the Pandemic

Everything shifted when she was diagnosed with breast cancer, a disease she had previously encountered only from the vantage point of a medical business executive. The timing was terrible, arriving just as the COVID‑19 pandemic began. Still, she approached her illness with the same determination that fueled her career, and she survived.

Testimonials, Business Lessons, and a Sudden Genre Shift

Throughout the book, Dr. Zanganeh seems to have a knack for meeting the right people at the right time, many of whom offer glowing testimonials in the final chapter. That chapter also includes a lengthy, detailed guide to starting and running a successful company. It felt like it belonged in a separate book and landed a bit flat after the more personal sections.

Admiration, Achievement, and an Emotional Distance

She speaks with deep affection for her family and credits them with much of her success. She also praises her business partners and colleagues, describing their strengths in detail. As someone who has worked in the medical field, I found her accounts of robotic surgery and cancer‑drug development genuinely interesting.

Still, I finished the book feeling that I didn’t truly know her. She is clearly driven by success, validation, and recognition, without exploring the source of that drive.

Her Most Human Moments

One of the most compelling moments comes when she writes passionately about the assault on women’s rights—especially in Iran—and about the suffering in Gaza following the Hamas attack on Israel. She questions why the world continues to fight wars and what it will take for that cycle to end.

My Thoughts: A Memoir for a Specific Audience

While I found parts of her journey interesting, I wouldn’t call this a universal must‑read. It feels best suited for people who are curious about the corporate world or who want insight into how high‑powered executives build companies and careers. Since it’s a Forbes publication, that audience seems intentional. Readers looking for a more intimate memoir will come away wanting more. You may find such insights in the articles on her website.

A Deeper Look

Dr. Zanganeh addressed several personal, health, and professional issues in her book. Based on this review, what else do you want to know about her and her work?

She experienced

  • political unrest and war
  • separation from family
  • personal illness from COVID-19 and breast cancer
  • Her father’s terminal illness and death
  • high-pressure professional life

Which of these resonates with you? If you read her book, which might be of most help to you?

From the halls of MD Anderson Cancer Center as a patient & care giver to her father battling cancer,
to groundbreaking work in medical research,
she illustrates how science, innovation, and community can illuminate the path to recovery.

From Dr. Zanganeh’s website

Photos of Dr. Maky Zanganeh

The cover image of this post was created by JetPackAI available with WordPress.

Exploring the HEART of Health

I’d love for you to follow this blog and follow me on social media.

I share information and inspiration to help you transform challenges into opportunities for learning and growth.

Add your name to the subscribe box to be notified of new posts by email. Click the link to read the post and browse other content. It’s that simple. No spam.

I enjoy seeing who is new to Watercress Words. When you subscribe, I will visit your blog or website. Thanks and see you next time.

Dr. Aletha

June: Father’s Day, Family Fitness, and Summer

June marks the midway point of the year, transitioning from spring to summer with its warm days and outdoor activities. It features Family Health & Fitness Day, promoting community health through parks and recreation, and Father’s Day, celebrated on the third Sunday. Much happens for a short month.

Are you someone who wonders how June arrived so soon? By the end of this month, the year will be half over. It is another of the short months with only 30 days, but there is much to remember and do. (Pop quiz-what other months have 30 days? Answer at the end of this post.)

Spring meets Summer

Many of us in the northern hemisphere made it through the cold dismal winter months only to contend with spring storms. Near where I live we have had devastating tornadoes. I’ve seen reports of massive flooding in other areas.

June promises warm, even hot, summer days to enjoy outdoor activities and vacations. The first day of summer occurs in June, called the summer solstice. South of the equator you experience the winter solstice.

graphic of the earth explaining equinox and solstice
An illustration of the changing relationship of the earth and sun throughout the year; original source not known

It’s the longest day of the year, then the days progressively shorten until the first day of winter in December.

Family Health and Fitness Day

NRPA’s Family Health & Fitness Day — celebrated the second Saturday in June each year — promotes the importance of parks and recreation in keeping communities healthy.

Various research studies have confirmed that local parks, recreation programs, green spaces, and access to the outdoors are critical for creating healthy, active, and resilient communities. Parks and recreation play a critical role in supporting our mental and physical well-being, and Family Health & Fitness Day is a great opportunity to celebrate this.

The National Park and Recreation Association encourages communities to participate by inviting families to be active and healthy at their local park or recreation center. Whether that involves hosting a special event, such as a family fun run, planning a health and wellness fair, or simply encouraging community members to engage with your local trails and facilities, there are endless opportunities to be as creative and fun as you’d like with your celebration!

Ideally, recreation for fun and fitness should be a year-round activity.

Father’s Day

In the United States, we observe Father’s Day on the third Sunday in June. It’s not quite as big a deal as Mother’s Day in May, but it is catching on. I understand other countries have similar observances for fathers.

I wrote a post featuring a well-known Bible story about a father and two sons. It’s popularly known as the story of the “prodigal son” which became the name of a short-lived television series a few years ago.

Considering Fatherhood: Lessons from the Prodigal Son Story

In the United States, Father’s Day is celebrated on the third Sunday in June. A biblical story about a father and his two sons illustrates the concept of forgiveness and celebration. The “lost son,” also known as the prodigal son, represents someone who leaves and then returns, seeking forgiveness. The passage encourages honoring important father…

Keep reading

Exploring the HEART of Health

I’d love for you to follow this blog and follow me on social media.

I share information and inspiration to help you transform challenges into opportunities for learning and growth.

Add your name to the subscribe box to be notified of new posts by email. Click the link to read the post and browse other content. It’s that simple. No spam.

I enjoy seeing who is new to Watercress Words. When you subscribe, I will visit your blog or website. Thanks and see you next time.

Now the pop quiz answer-

Months with 30 days are April, June, September, and November. Congrats if you knew all.

Notice two are in the first half and two in the second half of the year.

I appreciate your time and interest and invite you to help me share the HEART of health by sharing this and other posts. There is no charge for this content but gifts are always welcome and appreciated.

Thanks,

Dr. Aletha