I am not announcing my candidacy for President of the United States. For one thing, my Rolodex is deficient in billionaires, and for another, I have a day job -- in which a global campaign to leverage the power of lifestyle as medicine figures prominently. I see some important parallels.
I am not running for President. But looking on and listening in to those who are, most recently the debate among democratic candidates, I am compelled to think about what I would say if I were among them. I have two minutes to make my case while Anderson Cooper taps his foot. So here goes:
I want to be President, and I am a Democrat -- so you immediately have a general sense of my policy inclinations. My views on climate change, Planned Parenthood, frack-a-thons in the Alaskan wilderness, the minimum wage, tax avoidance by the uber-wealthy, women's rights, gay rights, gun control, fur coats and health care access -- are pretty much what you would expect them to be.
I might surprise you in the area of foreign policy, where I believe a dove can sing softly, but carry a mighty cudgel in its surprisingly formidable talons. I have in mind a New Age doctrine of territorial inviolability that is to this post 9/11 world what the Monroe Doctrine was to the frontier nation of 1823. It's a good tale, frankly -- but now is not the time. Anderson looks restless.
For now, it is the process of politics itself I want to address, with a candor to which you are surely unaccustomed. Pundits will tell you that campaigns are waged in poetry, but governance plays out in prose.
Another way to put that is that we candidates will promise what sounds too good to be true, rather like the authors of those lose-weight-effortlessly-and-fast books, and you will suspend your disbelief, and then we will, inevitably, disappoint you (as those authors do). We will promise you the moon and stars in soaring verse because it is customary to do so, and then only manage to fill a few potholes between Montclair and Secaucus and call it a day in abjectly prosaic fashion -- because that's reality.
In other words, almost all campaign promises are BS. Call that poetry if you like; or bullet-proof coffee.
Why is it so? Is it because we disavow our own aspirations once elected? Not at all.
It is because the power to change this gargantuan, diverse, fractious melting pot of ours does not reside at the pinnacle of concentrated power. The great power of the Presidency of these great United States does not, for the most part, reside with the executive privilege of the President; that is the purview of despots, benevolent or otherwise. The power of the Presidency is the power of persuasion, and a strength born of, and only of, unity of purpose. The President is Persuader-in-Chief. The only true source of power is consensus.
Consensus derives from clarity and commonality of purpose and process, and attendant persuasion. Persuasion, in turn, derives from trust.
And so we come to the glaring irony that douses the potential light of this beacon on a hill. The soaring, poetic rhetoric of campaigns is never about keeping things as luminous as they are; it is, inevitably, about change. Change from what? The status quo.
But the status quo is defended by those who own it; by those profiting from it. And those profiting from how things are now, are the ones with the wealth -- now. And thus, they are the ones with the power now, whenever and wherever wealth is power. They like things as they are, or they wouldn't be that way.
So you see the paradox. Satisfying the benighted expectation for soaring campaign promises is prerequisite to getting elected. Once elected, the realities of governance confront the richly funded defense of the status quo, and the delivery falls glaringly short of those seductive promises. The gap between reality and promise undermines trust. In the absence of trust, there is no persuasion. In the absence of persuasion, there is no consensus. In the absence of unity, there is no strength commensurate with that of the entrenched status quo, and entrenched it remains. Consign to the annals of our history another chapter entitled: "business as usual."
I like poetry as much as the next candidate. More, probably; I write it myself. I recite it. But reference to poetry and prose is coy and euphemistic. The harsh reality is that hyperbole leads to disappointment; disappointment leads to distrust; distrust leads to disunity; and disunity among the many plays perfectly into the hands and the power of the affluent, organized few. There is no innocence in a litany of unfulfillable promises; they are the cornerstones of quagmire.
My one promise, then, is not to promise what I cannot deliver. I will tell you what I think is right, and why, and fight for it. If enough of you are persuaded, all change is possible, because that's how this democracy was designed to work. If enough of you are unpersuaded, we can call the lack of change gridlock, or ascribe it to the checks and balances that are supposed to prevail when we are divided. Change comes only with consensus; consensus comes only with trust. Squandering trust for campaign triumph consigns the governance that follows to some sad approximation of disaster.
I am not, actually, announcing my candidacy for President of the United States. But I am listening to those who have. The first of them to speak anything remotely like this inalienable truth to the powers waiting to belie the poetic hyperbole -- will certainly have my vote.
David L. Katz, MD, MPH, FACPM, FACP is not running for President of the United States. He is, however, campaigning to fulfill the promise of lifestyle as medicine. There, too, false promises have propagated distrust. There, too, the profits of the few impede the progress of the many. There, too, the assertions of fools and fanatics, and the exploitations of industry, have tarnished the legitimacy of true authorities. There, too, disunity is enemy to our better destiny. And there, too, is an opportunity to rise above the din and the discord; to forswear exaggeration; to champion only the most reliable, time-honored and actionable of truths; to resurrect trust; and to advance in common purpose from common ground toward common goals. Or something like that, preferably in iambic pentameter.
Director, Yale University Prevention Research Center; Griffin Hospital
President, American College of Lifestyle Medicine
Founder, The True Health Coalition