“Only a life lived for others is a life worthwhile.” — Albert Einstein (1879 – 1955)

Editor-In-Chief, Chester "Trip" Buckenmaier III, MD,  COL (ret.), MC, USA

Chester “Trip” Buckenmaier III, MD,
COL (ret.), MC, USA

For some time now, I have had the privilege of expressing my opinions on federal medicine within U.S. Medicine as the editor-in-chief. Occasionally, at meetings or major events, I will have folks introduce themselves as followers of the column, and they will comment on a particular editorial that was meaningful to them. I also get comments, both positive and negative, from the USMedicine.com website and via email, and I make it a point to read them all. I appreciate all of these interactions, both positive and negative, because they confirm that people are reading and thinking about the topics on which I comment. Of course, not everyone agrees with my views, and, although their disagreement is sometimes expressed with a bit more venom than I would like, people cannot deny that I caused them to pause and think. Certainly, every one of my reader’s comments, no matter how flattering or vitriolic, causes me a reflective pause. I would suggest that the highest purpose of any editorial is to stimulate contemplation in another human being, and this purpose transcends the topic of the editorial in question. I recently received a letter from Dr. David Feldman, a Fresno VA gynecologist, that certainly caused me pause to think (see Dr. David Feldman letter to the editor, page XX).

Dr. Feldman’s letter was flattering to me, personally (never a bad start when you want an editor’s attention), but more importantly it hit on an issue I am dealing with personally, the transition from active duty to veteran status. Honestly, the transition for me (short of having to now think about what to wear in the morning) has been buffered by the fact that I am back in federal service as a civilian doing essentially the same work I was doing while in uniform. Fact is, I was too chicken to face real retirement, and my only transition was learning to tolerate wearing a tie all day (I hate ties). Shoot, I have not even stopped writing this column. David’s letter speaks to the angst so many veterans must endure as they pass from a career of “selfless service to being completely discharged from any service at all.” This letter struck me, because I know exactly what Dr. Feldman was describing from my own six-month period without a CAC card. The interval between my retirement from the Army and my hiring into federal service was one of the most anxious periods of my life. I had other employment opportunities and certainly could have taken my life in a very different direction, but I longed for the feeling of purpose that service to the country provides. For me and — as David so eloquently noted — many other veterans, selfless service is a powerful motivator, and the abrupt loss of that motivation either through retirement or medical discharge can be extremely stressful and life-disrupting.

In his letter, Dr. Feldman recommends that we tap into this resource of people who need to continue to serve through programs that reach out to these veterans and link them with various service opportunities. This is an idea I wholeheartedly support. He reached out to me because he believed I “seem to know the system better than most.” This was the only flaw in David’s letter, because, honestly, I know as much about the federal system as I know about women. Based on my high school and college dating history, well, we will agree I know nothing about women. What I have learned in my 27 years of federal service is how people willing to express an opinion, offer a solution to a problem and take an unflinching stand on an issue can make a difference. Dr. Feldman, by taking the time to express his opinion via his letter and then go a step further and allow U.S. Medicine to publish that opinion, cannot help but influence the “system,” because this action will cause people to think. There is power in an idea like David’s, but these ideas have to be served up to the masses with the hope they will spark someone’s interest to act locally. Many such small acts eventually lead to more recognizable changes in the federal system. I know U.S. Medicine touches these leaders, because they contact me on editorials that stimulate or spark comment and/or disagreement.

As editor-in-chief of U.S. Medicine, I am provided a monthly forum to comment on issues salient to federal medicine. The power of this opportunity is never lost on me as I generate each column. I never know what particular leader or group will be stimulated by these editorials, although from time to time I appear to hit the mark for some folks. I understand David’s concern that his idea will “fizzle away,” if not placed in front of the key leaders able to act. Sadly, I have learned as my career has matured that those leaders with ability to act on their own within our bureaucracy are a fiction. I have personally witnessed the well-founded plans of senior leaders wither and die under the machinations of our system. So, we must rely on leaders like David being willing to express their ideas and opinions. While I cannot promise that U.S. Medicine will publish every letter or comment sent, I can confirm we think about all of them. I encourage those letters and comments. Who knows who you might influence and what change may occur? Finally, Dr. Feldman, thank you for your service.