My Father Didn’t Understand
My father didn’t understand. As is typical of many immigrant parents, he was hoping that all of his kids would earn a good living, so that he could stop worrying so much about their survival. And I, his last child, had gone to an elite law school, a gateway to wealth. Why had I decided to take a job with a small, community-based not for profit, working as a community organizer and a lobbyist on behalf of strong air pollution control laws and aggressive anti-tobacco policies? A job, mind you, that paid about half of what I would have made at one of the big downtown law firms where I had interviewed.
I tried to explain it. I told him that I wanted to do Good. I told him that a person has two sources of pride in their work – how well they did the work and what the work was. Most lawyers, I said, could take pride in how well they performed. However, I predicted that, after 20 years of doing the same thing over and over again, I would find it harder and harder to take pride in my skills. The trouble was, as a lawyer, it was hard to find a career path that allowed you to take pride in what the work actually was. In language I developed much later, I intuited that I could have a job, a profession or a calling. I worried that if I didn’t respond to the calling, and only pursued the profession, I would soon end up with nothing but a job.
A few years later, well after I had established a career in Doing Good, my father called and asked if I were interested in purchasing an immigration law practice from his cousin. No, I told him. “Why not?” he asked. “She makes $200,000 a year, net,” he said. I didn’t want to be an immigration lawyer, filing reams of papers, spending endless hours arguing with government agents, all in the service of corporate clients who wanted to keep their foreign professional staff in the country. I was trying to do something “more worthwhile.” I wanted to do “meaningful work, Good work.” His practical suggestion was: buy the practice, run it for 10 years, live on half the profits and put the other half in the bank. At the end of the ten years I would be a millionaire, and then I could go and “do Good.” How, he wondered, could I pass up being wealthy?
How could I? By what standard did it make sense to pass up certain material well-being at the cost of only a delay in “doing Good?”
He didn’t understand. Neither did I, completely. I wanted to take pride in the work that I was doing, to finish a day of hard work and feel good about what I had tried to accomplish. If the air was a little cleaner, if cigarettes were a little harder to buy or to use, if people with lung disease led slightly easier lives, then that would make me feel that my life had a purpose.
But why was that my responsibility? I didn’t ask.
Why Be in Public Health?
Years later, I had earned another degree, in public health, and the School had offered me a job on the faculty. I had never thought about teaching or writing, but it sounded better than trying to make an honest living, so I said yes. Nobody ever told me how hard it was to teach! It looked so easy — you just stood in front of people and talked! I had been doing that since I was a toddler.
While I was studying environmental health science, one of my professors asked me in a casual conversation what I thought the goal of public health was. Lyn Babcock had a set of 40 or so little hand cut cards, with a different phrase on each. He asked students to sort through the cards and find the ones that expressed what they thought the purpose of public health programs and policies was. I don’t remember what was on the cards. They were a mix of grand goals and mundane achievements, some ephemeral and some monetary. But I remembered struggling with the question.
The first class I put together, Public Health Advocacy, was the first of its kind at U.S. schools of public health. It taught students to think analytically about political change. Assuming that you had identified a programmatic or policy problem, how might you define a solution and how might you advocate for that solution through the various policy-making processes that were available? (I still teach this same material today, but usually in short courses for existing public health professionals.) I wasn’t, however, asking the most basic question: Why bother?
A couple of years later, the faculty of the School revised the curriculum for our masters of public health degree. The new curriculum included a class called “Ethical, Legal and Political Contexts of Public Health.” It was approved on the title alone.
I was asked to put this required course together, and I have been teaching it and its successors for more than 30 years.
Somewhere along the way, on a bit of a whim, I asked the class why they were in public health. I got the usual hems and haws. Some thought it was a good career. Others wanted the intellectual stimulation. I always cautioned that anyone who was coming into public health for the big bucks ought to see me after class.
Sooner or later, someone in the class would say “Because I want to help people.” Why?, I would ask.
“Because they need the help.”
“Because I ought to help them.”
“Because it is the right thing to do.”
“Because that is what I want to do with my life.”
“But why you?” I wanted to know. “What obligation do you have to other people?” And why me? What obligation do I have to other people?
DS
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