‘We must accept finite disappointment, but never lose infinite hope.’ — Martin Luther King Jr. (1929-1968)
Editor-In-Chief, Chester “Trip” Buckenmaier III, MD, COL (ret.), MC, USA
My wife, two close friends and I have recently completed a three-night passage around Cape Hatteras, North Carolina, on our Lagoon 42, Shavasana, as we move our sailing vessel south for the winter and the end of the 2025 hurricane season. The Cape Hatteras region of the Atlantic is notorious for shipwrecks, as wind, weather and the mighty Gulf Stream often collide there in a dangerous mix that can be perilous for unprepared mariners. The famous Union Civil War ironclad, the Monitor, foundered and sank in a Hatteras storm in 1862; the recently discovered wreck is now a marine park. My son-in-law, Dan, likes to remind me that the region is nicknamed “the graveyard of the Atlantic.” Thank you, Dan, that is helpful.
In truth, though, the hopes and dreams of many intrepid sailors and passengers have come to disappointment in the region. Obviously, modern weather prediction, navigational electronics and advanced sailing technology stack the deck in our favor regarding a safe and successful transit of this area. Even so, early one evening, a particularly large wave tossed a Shavasana crewmember from the deck into a hard-sided cooler, which was very painful (we would learn later she sustained a nondisplaced rib fracture). We have a standing rule on the boat that the crew should always maintain three points of contact with the ship. One hand for the boat (or the king, as British sailors would say) and one hand for yourself.
Nevertheless, despite all our efforts to avoid damage superstitious (much), I have poured my fair share of rum into the water to engender favor from the sea gods. I maintain infinite hope, bolstered by my unending efforts to be prepared, that my sea passages will be safe or injury while sailing, when Poseidon decides to be angry, no amount of hope can avoid some disappointment. Despite all my modern advantages in navigating my vessel from point to point, I am always humbly grateful to do so without significant injury or damage to crew or craft.
The last 12 months have been a sea storm, of sorts, for federal medicine. As a medical editorialist, I have been hard-pressed to keep up with the ongoing tempest of changes at the Health and Human Services Administration (HHS) that seem ill-conceived and, in many cases, outright dangerous. I have exhausted myself—and likely you, dear readers—keeping up with HHS insanity. It has been a sweet relief to distract myself with the challenges of sail passage making from the daily grind of government and HHS announcements. Sailing can be dangerous, but it is rarely irrational. That is not to say I have disengaged. I love this democracy too much to remain silent as our country navigates these troubled waters.
The federal medicine ship was well-built. It has a strong hull, some of the most advanced equipment on the planet, and it is crewed by health professionals who are the envy of the world. My message during this last, hopefully peaceful, month of 2025 is that we can, and will, weather the current storm. There have been numerous disappointments and dubious decisions concerning the nation’s healthcare, and it has been grinding to the soul. Indeed, at times, the disappointment does seem unending, but this, too, shall pass. This short editorial has no purpose beyond reminding everyone in federal healthcare to take a pause this holiday season, to remember what motivated you to this career of service in the first place, to take a few more slow, deep breaths, and to cling to your loved ones a bit tighter. Federal medicine is an indispensable part of our constitutional republic. It is normal and human to lament disappointments, but as M.L. King Jr. understood in his fight for civil rights, one must never lose hope that, through tireless effort, things will eventually get better.
