2265 North Clybourn Avenue    Chicago, IL 60614    P: 773.296.6700     F: 773.296.1131

Dying In A Leadership Vacuum: The NEJM Editorial in Context

By now, you’ve probably read that the editors of the New England Journal of Medicine (NEJM) published an editorial entitled “Dying In A Leadership Vacuum” that asks Americans to work together to vote out Donald Trump because of his dreadful mismanagement of Covid-19 and the subsequent deaths of more than 220,000 Americans.

To call the editorial scathing would be putting it mildly.

If you don’t have time for the entire piece, please read this closing section:

Anyone else who recklessly squandered lives and money in this way would be suffering legal consequences. Our leaders have largely claimed immunity for their actions. But this election gives us the power to render judgment. Reasonable people will certainly disagree about the many political positions taken by candidates. But truth is neither liberal nor conservative. When it comes to the response to the largest public health crisis of our time, our current political leaders have demonstrated that they are dangerously incompetent. We should not abet them and enable the deaths of thousands more Americans by allowing them to keep their jobs.

By way of background, you might like to know something about what this journal and this editorial mean to physicians themselves.

First, you’ve probably heard that the NEJM is prestigious. There are literally thousands of medical journals from around the world available in English. Every medical specialty in the US alone publishes its own stack of them, and there are 135 recognized specialties in the US, with dozens of other unrecognized ones (like Chinese medicine, herbal medicine, and more).

But physicians everywhere pretty much agree that the NEJM is the gold standard of medical publications. It’s been continuously published since 1812 and in its pages appeared the first milestones in medical history. Here’s a bit more on its mission and history.

When I was in medical school and during my residency, my training hospital would order a stack of the journals every week. We’d pore over each issue and discuss not only the articles, but the letters to the editor. The mark of an excellent researcher at any medical school was that his or her work had been published in the NEJM.

According to the analytic service Journal Citation Reports, NEJM has the highest “impact factor” of any medical journal published anywhere. This means that an article appearing in its pages garners significant mainstream attention that endures throughout the ensuing decades.

In other words, the editorial asking Americans for the sake of their health and well-being to vote Trump out of office will be quoted as part of US history.

Powerful and unprecedented
The powerful editorial (which I’ll link to again here) was signed by all 34 of the journal’s editors. It condemns Trump’s handling of the pandemic, calling it dangerously incompetent and asserting that the administration has taken a crisis and turned it into a tragedy. This is the first time in its 208-year history that the NEJM has ever supported or rejected a political candidate. Only three other times has an editorial been signed by all the editors.

The NEJM editorial reminded me of a curious fact about doctors. Across the board, the medical profession is surprisingly non-political. And while physicians certainly identify as Republicans, Democrats, or Independents, it’s been regularly noted that getting them to vote can be quite a challenge.

A real question, especially in the context of this NEJM editorial is “why?”

Why do fewer than half of US doctors (48%, same as college students) show up to vote? This compared to about 75% of lawyers. Surveys among physicians report the very excuses you might expect: “no time,” “don’t keep up on political issues,” and so forth.

Shifting tides
Throughout the 20th century, medical societies, medical schools, and hospital boards were quite conservative, almost reactionary. The AMA only allowed Social Security to pass in 1935 if all language were removed that might include health care coverage. Until the Affordable Care Act (ACA) passed in 2010, every single effort to provide health insurance for US citizens, including Medicare, had been steadfastly blocked by virtually all state and national medical societies.

Medical students in the US have traditionally been taught to believe what their elders believe, and I can say with certainty there wasn’t a single member of my University of Illinois class of 200 (90% male, 99% white) who didn’t believe that socialized medicine had something vaguely to do with Russia and the communists.

With the passage of the ACA, the AMA had a massive change of heart. Virtually all physicians today see the moral necessity of providing health care coverage for all Americans. Doctors are deeply concerned that overturning the ACA will bring back the much-loathed pre-existing condition denials for care, especially given the potential long-term health consequences for people with Covid-19.

And now in the US, with 7.72 million documented cases of Covid-19 and 214,000 deaths (according to the reliable Johns Hopkins Coronavirus Resource Center), the numbers increasing daily, suddenly politics has become central to the lives of healthcare professionals. Especially when you consider the more than 900 frontline healthcare workers whose deaths from Covid were sometimes attributable to a lack of protective equipment. Remember the nurses wearing garbage bags?

For shame. Hence the significance of the editorial in the journal we all respect the most.

Be well,
David Edelberg, MD

Leave a Comment


  1. James Gandre says:

    As always, you write a compelling and honest piece here. This president is the most horrendous person who has ever held this post and he has caused such unspeakable destruction to this country in just about every manner possible. Although I don’t know how, may we recover quickly from the grave illness called Trump. And thank you again for being who you are. It is an honor to know you.

  2. Sharon Figueroa says:

    “For shame” is absolutely spot on. It seems there is not a speck of decency left anywhere in politics. It is outrageous.

  3. A. Heisler says:

    Thank you NEJM and Dr. Edelberg.

  4. Dr. David W Bailey, DC says:

    My good friend and colleague died last night.
    Covid-19.

    Thank you, David. I will forward this to my primary.

Join our Newsletter

Get health recommendations, delicious and time-saving recipes, medical news, supplement reviews, birthday discounts, and more!

Health Tips

Dr. Edelberg’s Health Tips contain concise bits of advice, medical news, nutritional supplement and pharmaceutical updates, and stress relief ideas. With every Health Tip, you’ll also receive an easy, delicious, and healthful recipe.

When you sign up to receive Health Tips, you can look forward to Dr. Edelberg’s smart and very current observations arriving in your in-box weekly. They’re packed with helpful information and are often slightly irreverent. One of the most common responses to the tips is “I wish my doctor talked to me like this!”

Quick Connect

Get One Click Access to our

patient-portal

The Knowledge Base

Patient education is an integral part of our practice. Here you will find a comprehensive collection of staff articles, descriptions of therapies and nutritional supplements, information addressing your health concerns, and the latest research on nutritional supplements and alternative therapies.

Telemedicine – Now Available at WholeHealth Chicago

In order to maintain your continuity of care, WholeHealth Chicago now offers telemedicine appointments with most of our practitioners. During a telemedicine visit, you and your healthcare provider can review medical history, discuss symptoms, arrange for prescriptions, and more. When necessary, labs and diagnostic imaging can be ordered from a facility near your home, and our Natural Apothecary can ship supplements quickly to your door.

Please contact Patient Services for details and scheduling a telemedicine appointment, or to change a regular appointment to telemedicine by calling 773-296-6700.

We’re looking forward to meeting with you in our virtual consultation room soon.

DIAGNOSE-IT-YOURSELF: COVID-19

Far and away, the commonest phone call/e mail I receive asks about COVID-19 diagnosis.
Just print this out, tape it on your refrigerator door, and stay calm.

ALLERGIES

• Runny nose
• Sneezing
• Red, swollen eyes
• Itchy eyes and nose
• Tickly throat
• No fever

COLD
• Runny nose
• Sneezing
• Sore throat
• Mild muscle aches
• Mild dry cough
• Rarely a low fever

STREP THROAT
• Painful sore throat
• Hurts to swallow
• Swollen glands in neck
• Fever

FLU (Standard seasonal flu)
• Fever
• Dry cough (no mucus)
• Sudden onset over few hours
• Headache
• Sore throat
• Fatigue, sometimes quite severe
• Muscle aches, sometimes quite severe
• Rarely, diarrhea

CORONAVIRUS-COVID 19
• Shortness of breath
• Fever (usually above 100 degrees)
• Dry cough (no mucus)
• Slow onset (2-14 days)
• Mild muscle aches
• Mild fatigue
• Mild sneezing

Recent Health Tips

  • Brain Fog and What To Do About It, Part 1

    You can’t remember the name of the Netflix movie you saw just last night, literally hours ago. And that actor–what was his name? He was in, you know, that other movie. You think it was a thriller, but maybe a war movie. Then you get a notice from Verizon that they’re turning off your phone for nonpayment. But you’re pretty sure you handled it. Variations Read More

  • Protecting Yourself From Overdiagnosis

    Bill, a healthy looking guy in his mid-40s, came to WholeHealth Chicago because he wanted to get off Lipitor, the widely prescribed cholesterol-lowering drug. Bill had virtually no risks for heart disease and all four of his grandparents were still alive and quite independent, but a few years ago his cholesterol was on the high side and his doctor insisted on the Lipitor. Arthur has Read More

  • Dying In A Leadership Vacuum: The NEJM Editorial in Context

    By now, you’ve probably read that the editors of the New England Journal of Medicine (NEJM) published an editorial entitled “Dying In A Leadership Vacuum” that asks Americans to work together to vote out Donald Trump because of his dreadful mismanagement of Covid-19 and the subsequent deaths of more than 220,000 Americans. To call the editorial scathing would be putting it mildly. If you don’t Read More

Join our Discount Program

Member benefits include 10% off all your purchases. Low, one-time membership fee of $25 ($35 for family).

MORE INFORMATION

Join our Newsletter

Get health recommendations, recipes, medical news, supplement reviews, birthday discounts, and more!