By MIKE MAGEE
Health care needs its heroes.
I came to that conclusion this week through a roundabout route.
First I read Maureen Dowd’s interview entitled “Dara Khosrowshahi, Dad of Silicon Valley”, in which she, with some affection, gives the reader a look behind the scenes at the personal life of the current Uber CEO. At one point, Dowd shares her conversation with Dara’s 20-year-old daughter, Chloe, a Brown student, who wants us to know her father was a seriously good dad. In support of this belief, she reports that “When she was little, her father – a fan of Joseph Campbell…would concoct children’s stories set in faraway kingdoms…”
This, of course, forced me to acknowledge that I didn’t know who Joseph Campbell was. Bill Moyers came to the rescue. His June 21, 1988 interview titled “Joseph Campbell and the Power of Myth — ‘The Hero’s Adventure’”, begins with a clip from Star Wars where Darth Vader says to Luke, “Join me, and I will complete your training.” And Luke replies, “I’ll never join you!” Darth Vader then laments, “If you only knew the power of the dark side.” Moyers asked Campbell to comment.
JOSEPH CAMPBELL: He (Darth Vader) isn’t thinking, or living in terms of humanity, he’s living in terms of a system. And this is the threat to our lives; we all face it, we all operate in our society in relation to a system. Now, is the system going to eat you up and relieve you of your humanity, or are you going to be able to use the system to human purposes.
BILL MOYERS: So perhaps the hero lurks in each one of us, when we don’t know it.
By then, I was aware that Joseph Campbell, who died in 1987 at the age 83, was a professor of literature and comparative mythology at Sarah Lawrence College. His famous 1949 book, “The Hero With a Thousand Faces” made the case that, despite varying cultures and religions, the hero’s story of departure, initiation, and return, is remarkably consistent and defines “the hero’s quest.” His knowledge of this quest gained him a large following that included George Lucas who was a close friend and has said that Star Wars was largely influenced by Campbell’s scholarship.
Whether health care or technology, unfettered capitalism is more than adept at breeding predatory systems that beg for redemption. Author Emily Chang spoke to this predilection in her 2018 book, “Brotopia”, describing Silicon Valley types as “secretive, orgiastic, and dark.” Dara Kharowshaki’s CEO predecessor at Uber, Travis Kalanick, was labeled one of the worst. When Dara took over, New York Times technology expert, Mike Issac asked in 2019, “Can this rational, charming chief without the edge, ego, or cult following of wacky founders succeed in today’s insane economy?”
But Dara’s journey across and within Uber seems to be guided by his inner “Joseph Campbell.” Departure, Initiation, Return. He appears to be mid-stream in challenging his own system. Not naming Mark Zuckerberg, he mused, “I think, just like Uber, some of them grew up too fast and some of them didn’t take responsibility for their power and I think now they’re being called to reckon… I think the age of ‘I built a platform, I’m not responsible,’ that time is over. And now the question is, what does the responsibility look like? Defining it and putting guard rails around it, I think that’s a healthy thing.”
Health care if anything is more complex than Silicon Valley. Deeply segmented but fundamentally opaque and collusive, the Medical Industrial Complex controls 1/5 of the economy with power literally over life and death decision-making. With its share of heroes – from everyday doctors and nurses to unassuming scientists birthing “just-in-time” cures – the system also has bred some first-class villains of the likes of Arthur Sackler, Martin Shkreli, and Elizabeth Holmes.
Health care, for all its pure and idealized mythology, has descended into the belly of the capitalist beast. Its vaulted training institutions have captured and bred many of our nation’s finest, only to trap them in a compromised and conflicted “Initiation” phase, from which they never “Return.” As Dara told Dowd, “sometimes the system ‘works too well’: I think capitalism has its claws in our democratic societies in ways that has allowed it to overly optimize for its benefit.”
Health Care needs to be certain that its young and developing heroes, who depart from their civilian lives, to be initiated into a life of service and sacrifice, are not captured by “the dark side.”
Those who train doctors and nurses and health professionals, who lead research and discovery, who administer health care institutions, need to understand the fundamental challenge in “the hero’s quest.” As Joseph Campbell stated, “Is the system going to eat you up and relieve you of your humanity, or are you going to be able to use the system to human purposes?”
Mike Magee, MD is a Medical Historian and Health Economist and author of “Code Blue: Inside the Medical Industrial Complex.“