Memoir of a Middle Class Activist, 2025

Life in academe and the outside world

In the immediate aftermath of the January 6, 2021 seizure of the Capitol, I gave thought to writing a novel with the premise that the insurrection had succeeded and Donald Trump became the 45th president of the United States. The actions of President Trump starting immediately after his inauguration on January 20, 2025 were worse than anything I could have imagined. Facing the immorality, and my own mortality, I decided instead to review my variegated life, leaving a record for my progeny and others.

Despite the variegation, there have been a few constants. I was born into the middle class and though better off than where I started, remain steadfastly in the middle class, precariously balanced between enjoying the comforts it provides and fighting for social justice, the second constant in my life. Had I gone into journalism or history rather than medicine, I might have aligned my professional goals more closely with my social activism.

A few words of explanation about the transitions between variations. My early work in screening for rare, single gene diseases under public health auspices led me down the rabbit hole of genetics. By the 21st century, genome-wide screening for common complex diseases, under the rubric of "personalized medicine", was being touted by many physicians, scientists, and the mass media; what I called genohype. My understanding of genetics dissuaded me that genetics would ever be as important as environment and behavior in improving health for the vast majority.

Going from being a doctor to a patient was another transition. Had I remained in Baltimore this transition might have been smoother as I knew my way around the medical establishment at Johns Hopkins. Having arrived out west – still another transition – without any professional connections, and at a time when medical care was being rapidly corporatized, I became a patient at a for-profit-like medical network that, literally made me fear for my health. Because of my upper middle class status, I was able to relieve my anxiety, and improve my health, by purchasing concierge care. Most people in the middle and working classes are not in this position. I have become an ardent activist for universal healthcare to reduce inequality in healthcare and improve health.

The pleasure I derived from writing might have been dispersed had I become a history professor or a journalist. Writing scientific papers did not do the trick, and on my retirement from medicine, I transitioned to writing fiction. Initially, I had little intention, financial need, or ambition to publish what I had written. I received sufficient encouragement from those who read my early efforts that eventually it became my goal to publish, as reflected in Cloudsplitter Press and this website. Memoir of a Middle Class Activist is my most recent effort.