IV. Cold Sweats, Butterflies and Miracles ꟷ Taking on Health Care
- T Michael White MD FACP
- Sep 8
- 8 min read
Fixing United States Health Care
Letters to the File
T Michael White MD FACP
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Letters to the File
IV. Cold Sweats, Butterflies and Miracles ꟷ Taking on Health Care
III. Privilege = Responsibility ꟷ Sounding Our National Health Care Alarm
II. Ending Vaccine Mandates ꟷ Leadership Opinion = Responsibility
I. An Honest, Truthful Transition
(more to follow)
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IV. Cold Sweats, Butterflies and Miracles ꟷ Taking on Health Care
“A dream doesn't become reality through magic;
it takes sweat, determination and hard work.”
“The miracle is not that we do this work, but that we are happy to do it.”
Mother Teresa
The WhiteHouse on the Belleair Bluff
Monday, September 8, 2025
Hello Dr. Mike (a letter to the file).
After significant gut-wrenching soul searching, you have decided you are duty bound to step publicly (not your thing) forward and sound the alarm ꟷ our United States Health Care (non) System, in serious disarray, is leaving increasing numbers of our fine citizens without access to affordable, basic, compassionate health care. Having collected your thoughts (III. Privilege = Responsibility ꟷ Sounding Our National Health Care Alarm), your initial move was to communicate them via email to a legion (one by one) of citizen thought leaders ꟷ no minor task.
Thoughts communicated ꟷ exhausted, you took to your bed.
Deep in dream, a CIA operative (too) accurately reported reactions to your magnificently wordsmithed, earnestly sounded alarm. In descending order:
Directly to spam;
Moved (unopened) to spam;
Cannot be delivered;
Deleted unopened;
Received, read and deleted without response; and a blessed few (this is a most lonely business)…
Received, responded to and forwarded to others for their consideration.
Responses that came your way uniformly agreed that access to care was a major concern, but counseled that inadequate patient literacy, tort reform, clinician burnout and the attack on medical science must now also be addressed. Soberingly, these few kind responses uniformly went on to tenderly convey ꟷ United States Health Care is an irresolvable hot mess well beyond your paygrade. Short of a miracle ꟷ despite best efforts, nothing can/will be done.
In hot and humid Florida, bed-shaking rigors awoke you in a cold sweat. Your epiphany: “Just what in tarnation do I think I am doing?” All at once, reality came down on you:
While our fine country is in the midst of a worse than imagined, unaddressed health care crisis;
While many understand there is a crisis but, pleased (for the moment) with their own care ꟷ the “I got mine syndrome” ꟷ care not;
While Rome (health care) is burning, some are actively eroding our scientific and public health foundations of care;
The problem is insurmountable, and solutions are unachievable;
It is beyond embarrassing hubris) for you (not the sharpest tool in the shed) to think that you alone, without resources and support might make a difference; therefore…
Recognizing futility, you must cease aggravating the many (including yourself).
Bleary-eyed, you understood your path forward ꟷ cease and desist; stand down; back off; get real; take a pill. Relieved of responsibility (and with the assist of a pediatric melatonin gummy), you fell back into peaceful sleep.
The dawn brought a re-read of III. Privilege = Responsibility ꟷ Sounding Our National Health Care Alarm and clarity. Privileged, despite odds, you have the responsibility to soldier on. While not taking your quixotic self ( certified legend in own mind ꟷ LIOM-C ) seriously:
Duty bound, you must step up and seriously confront this health care crisis;
Rationalizing, you shall subscribe to the “butterfly effect” ꟷ small actions (even as inconsequential as yours) can have massive impact; and
You shall display (and believe in) the bumper sticker ꟷ MIRACLES HAPPEN! (490 words)
Respectfully submitted with fondest personal regards,
Dr. Mike LIOM-C
Please share your wisdom, insights and perceptions (your reality) about what I have right, wrong and/or omitted. I will be delighted to hear from you, and my thought processes will be much the better for it. Thank you for considering. Dr. Mike
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III. Privilege = Responsibility ꟷ Sounding Our National Health Care Alarm
"Privilege is here, and with privilege goes responsibility."
John Fitzgerald Kennedy
“You cannot escape the responsibility of tomorrow by evading it today.”
Abraham Lincoln
The WhiteHouse on the Belleair Bluff
Friday, September 5, 2025
Hello Dr. Mike (a letter to the file).
For a lifetime, you have had the privilege of participating in your beloved, sacred medical profession. For seven decades, Medicine (the dreaming, the becoming, the practicing, the experiencing) has consumed you. At times, your journey has been arduous; however, it has always been unfailingly fulfilling. Any sacrifice on your part, has been repaid a thousand-fold. Privileged to have been (and remain) a physician, you have been truly blessed. It is a career and (inseparable) life you would wish for all.
As you wind down and look back, you recognize your profession has been lent to you for only a brief time. At some conscious/unconscious level, you have always understood that this privilege has never been yours for the keeping. It has only been entrusted to you to, to the best of your ability, implement, prudently steward, burnish and ultimately pass on.
From the beginning, you have known, this gift (this privilege) has been accompanied by responsibility ꟷ responsibility to leave your profession better than when it was first entrusted to you. Now, nearing your end, you take this responsibility seriously. In that regard, seeing something, you have the responsibility to say something:
The seeing: health care in our fine United States has become an alarming paradox. On one hand, for those in the right place at the right time, care is beyond splendid. For others, it is, at best, an inaccessible, unaffordable wish ꟷ and those counted among these less fortunate are increasing.
The saying: you must sound the alarm ꟷ our national health care is in disarray. While recognizing and praising much good, we must, together, design and advance the solution ꟷ an organized United States Health Care System ꟷ that immediately provides universal access to affordable, basic, compassionate, safe, timely, efficient, effective, equitable (just), patient-centered care (C-STEEEP).
As you step forward, please recognize that you are not alone in this. Like you (administrator, citizen, clinician, matriarch/patriarch, patient, politician, significant other), others too have responsibility to our trailing generations ꟷ to your and their progeny ꟷ to provide them universal access to affordable, basic, compassionate, safe, timely, efficient, effective, equitable (just), patient-centered care (C-STEEEP). (355 words)
Respectfully submitted with fondest personal regards,
Dr. Mike
Please share your wisdom, insights and perceptions (your reality) about what I have right, wrong and/or omitted. I will be delighted to hear from you, and my thought processes will be much the better for it. Thank you for considering. Dr. Mike
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II. Ending Vaccine Mandates ꟷ Leadership Opinion = Responsibility
“Opinion is the medium between knowledge and ignorance.”
Plato
“People do not seem to realize that their opinion of the world is also a confession of character.”
Ralph Waldo Emerson
The WhiteHouse on the Belleair Bluff
Thursday, September 4, 2025
Hello Dr. Mike (a letter to the file).
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As you endeavor, against all odds, to construct an enhanced United States Health Care System, others, seemingly good, intelligent souls, are setting out in real-time to plunder the imperfect care that now exists. Flummoxed, you are confronting…
Yesterday, Florida’s Surgeon General stepped forward, with the Governor at his side, to state that Florida will end all vaccine mandates. The rationale ꟷ in the name of patient freedom, each individual (or parent) must have the right to decide what is administered to her/his body. On the surface, I understand that sentiment. However, weighing the risks (epidemic illness, morbidity and death and downstream education, career and financial consequences) against the benefits of personal freedom in this matter, the ratio overwhelmingly supports vaccine mandates.
Stepping back (farther than you care to), you are trying to understand Florida Leadership’s desire to place personal decision-making ahead of scientific wisdom aimed at the public good. As the kids say, you might find yourself ‘down with that’ provided the following requirements are met:
The Surgeon General and the Governor demonstrate that removing vaccine mandates is the will of the majority of Florida’s citizens;
Most importantly, the Surgeon General and the Governor state that they will take personal financial, moral, political and professional responsibility if the public’s health is harmed;
The Surgeon General and the Governor acknowledge that their quest to remove vaccine mandates will enhance (intentionally or unintentionally) vaccine skepticism;
The Surgeon General and the Governor, eliminating vaccine mandates, will at the same time make vaccines and vaccine administration available at no cost;
The Surgeon General and the Governor will significantly bolster health care services (for example, clinicians and hospitals) in anticipation of regular recurring health care crises;
The Surgeon General and the Governor will require that individuals (and parents) who desire to opt out of vaccinations first demonstrate that they are making an informed decision by 1) taking a course describing the diseases measles-mumps-rubella, polio, chickenpox and hepatitis B; and 2) pass a written exam;
The Surgeon General and the Governor inform individuals (and parents) that contraction of preventable diseases may impact the health, education, financial security and life itself of those near and dear to them;
The Surgeon General and the Governor inform individuals (and parents) that their contraction of preventable diseases may significantly harm vulnerable members (family, neighbors, classmates and friends) of their community; and
The Surgeon General and the Governor inform individuals (and parents) that, in this complex world, they may be held financially, legally and morally responsible for harms caused by their informed failure to protect the public.
Dr. Mike, in your final analysis, if, as the Surgeon General and the Governor step forward to remove vaccine mandates, they are stepping up to the personal (including financial), political and professional responsibility for all of the above, while disagreeing, you must recognize their right to their opinion. If they are not taking responsibility, they must step down. (495 words)
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Respectfully submitted with fondest personal regards,
Dr. Mike
Please share your wisdom, insights and perceptions (your reality) about what I have right, wrong and/or omitted. I will be delighted to hear from you, and my thought processes will be much the better for it. Thank you for considering. Dr. Mike
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I. An Honest, Truthful Transition
“Honesty is the first chapter in the book of wisdom.”
Thomas Jefferson
“Three things cannot be long hidden: the sun, the moon, and the truth.”
Buddha
The WhiteHouse on the Belleair Bluff
Tuesday, September 2, 2025
Hello Dr. Mike (a letter to the file).
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For the past year, you have been seriously contemplating what may be done to improve health care in these fine United States. Steeping up to honesty and telling yourself the (painful) truth:
Communications with learned citizen thought leaders uniformly support opinion that that United States health care is a non-system that is in serious, ever-worsening disarray;
In discussions, dramatic measures have been identified that can be readily implemented to immediately improve health care;
Having had the privilege of a medical career, you personally feel obligated/compelled to try to make a difference;
With all due respect sir, you do not have the gravitas (the personal, political, professional standing) to command a national audience’s attention in these critical matters; so
Given that your well-meaning, quixotic, efforts are proving to be fruitless, you must (to the relief of family, friends and colleagues), for your own mental and physical well-being, relax and stand down.
Honesty and truth are liberating. As you must, you shall stand down ꟷ but only publicly. Privileged with a career in medicine, you shall not abandon your responsibility to strive to do meaningful work that may make a difference. Therefore, you shall:
Introspectively, regularly write formal, thoughtful letters (like this) to yourself;
Formally assemble/collate them in this file;
Quietly publish them on this website: Fixing United States Health Care --- Letters to the File;
Be pleased if any choose to find the webpage and consider its contents; and
Be doubly pleased to (however unlikely) receive reactions regarding what you have right, wrong and or omitted.
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Respectfully submitted with fondest personal regards,
Dr. Mike
Please share your wisdom, insights and perceptions (your reality) about what I have right, wrong and/or omitted. I will be delighted to hear from you, and my thought processes will be much the better for it. Thank you for considering. Dr. Mike
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