description, a game

try this with someone you’re texting; pick a theme, a subject, a concept, a word, whatever, and take seven messages to each offer a description; you can make what you wish of the seven messages, but you only get seven, no more, no less

here’s a personal example; the subject is ‘un bosque’

cada segundo, cada momento, cada nombre, acercó un poco el fin

la lluvia bendecía los pulmones de la tierra, la música de las lágrimas de nuestro aliento unía este mundo con los otros

y en esta unidad, por una hojita, de un gran árbol joven, una gotita de agua esperaba por un poco más tiempo, rezaba por solo algunos segundos más antes de perder para siempre esa piel verde y suave y dulce y mía

del mismo cielo se cayeron, de las nubes vinieron, y se encontraron de nuevo para despedirse juntos, parece

the edge of the leaf, the edge of the universe, slid closer as they looked across quilted skies into each other’s eyes, leaving behind a trail of their hopeless dreams, pieces of their hearts

¿Qué me estás cobrando, dios, qué me cobras?
lo que paga la gota que goza, mi amor, el fuego siempre vuelve al sol

a drop of water slid off a leaf, a silent rain sighed, and a community of trees stood by, offering its respects to another love that once flew and now dies


the institution of medicine

must be the political arm of wellbeing,

and today,

it clearly is

no such thing –

i am dreaming here,

but hear me out,

if you would,

imagine a time when money

is taken out of politics,

and the institution of medicine

realizes that it, too, must

do away with the notions of




for such considerations bear the risk

of obfuscating judgment

in such a way so

as to undermine its political responsibility

to patients, friends and communities

to serve their personal welfare

and the spiritual harmony of society;

these same considerations

may contradict

the very project of medicine,

for the healers have built themselves


to which they

summon the people

to receive their

lives as alms,


from which they

watch the people

give fifteen more years of life

to a white, ‘educated man’

than to a black ‘uneducated’ man,


atop which they

abandon the people

for prestige,


and glory,

an unethical greed, cowardice, and pride


the wellbeing of the healers from

the wellbeing of their patients,

leaving the patient-healer relationship without



compassionate healers

must be part of

the communities, part of

the families, deeply involved in

the struggle for justice,

an endeavor that, yes, is

impossibly monumental and overwhelming

and suffocating,

but if it were anything less,

would it be worthy of purpose?


when the person

from whom you

seek help, advice, consolation, acceptance and comfort

is someone who suffers with you,

healing happens together,

healing is a true, just, peaceful


it is the moral responsibility of Medicine

to unite warring factions

to cultivate and model this relationship –

a life that is healthy

insofar as it is free.



On public health

Our conscious experience is often sold to us as a collection of disparate parts that we must endlessly struggle to put together to form a coherent whole. The endeavor precludes true completion because the conscious effort cannot keep apace with time, as only the present eternity can hope to accommodate the totality of existence. It is this struggle, the tiring and burdensome affair of defending the borders of the illusion of the largely Western notion of the self, that I believe to be among the factors most upstream of life and correspondingly, health, outcomes. For, as I write prior, an analysis of the present state of society and the progression of its numerous comorbidities is incomplete without an honest dialogue with history. But, of course, the approach we take to history and the lessons we learn from it are largely dictated by the terms of our consciousness. Real, sustainable change that moves the world toward justice and love requires not just alterations to the contents of our thoughts, feelings and beliefs, but rather, fundamental modifications to our understanding of the kinds of things that we are and our relation to all else that may or may not be.

A dear friend of mine struggles with depression. She has tried a number of medications, but they numb the vivacity of her character. She has thus chosen to forego pharmaceutical treatment, attempting instead to address her symptoms with Cognitive Behavioral Therapy (CBT), patience, resilience and the support of both herself and others. Highly intelligent and deeply compassionate, she is acutely aware both of what she thinks and what she feels, but nevertheless, a small portion of the time, her mind usurps the throne. What follows, in her words, is a brutal irrationality that attacks her worth, her happiness. How does the mind become pathological, and how can it be remedied? More importantly, how can it be prevented? These questions are becoming increasingly relevant in the field of public health. Lopez and Murray (1998) estimate that by 2020, unipolar major depression will be the second leading cause of global disease burden as measured by disability-adjusted life years. The etiology of depression, similar to that of many of the mind’s nemeses, is highly complex, including both biological factors and environmental factors (Saveanu & Nemeroff, 2012).

If the environment is partially responsible for the onset of an illness like depression, well, who then is responsible for the environment? An examination of mental illness and its place in society offers valuable insight as to how we treat each other, and how we may improve. Ultimate responsibility for all that happens in society is shared by all its members. Empiricism demands that particular characters are isolated as being disproportionately responsible (e.g. an abusive parent, callous peers) for particular health outcomes (e.g. mood disorders) so as to offer schema for intervention and clearer explanatory and causal mechanisms. The requirements of the culture of science, though, need not come at the expense of dismissing our collective efforts in sustaining the social game.

Responsibility is localized and handed out much like material goods, and the culpability that follows in less fortuitous circumstances is an unsurprising product of how we characterize the mind. The notion of ultimate shared responsibility is incompatible with the notion of an immutably demarcated self. A metric of the public’s health includes those maladies the existence for which the public is at least partially responsible. People that suffer from depression are people whose minds have been, to some extent, compromised by cancers of society. Such instances should produce humility and an anger borne of a commitment to make amends for the pains brought upon by a history of mistakes. Holistic models that address circumstance and volition at all levels of society, like McLeroy et al’s (1988) ecological model or Link and Phelan’s (1995) theory of fundamental causes, are evolutionary byproducts of a discipline that aims to be ever more effective in diagnosing and treating the public. Such evolutionary gains are necessary if the public’s health, if the mind’s health, is to be improved.

I thought public health might be changing as a discipline into something that it does not want to be. That is, my worry was that the greater the breadth of ‘health,’ the more it would aim to be without being much of anything at all. But, as I reflect upon the value of play, the dangers thrust upon laborers in an exploitative system, the potential for a dogmatic institution like religion to partner with the deconstructive biology of public health, and the misery that awaits older adults relegated to the peripheries of social attention due to imposed declines in productive output, I realize that public health is well-situated to work at both ends of the spectrum. Indeed, the constitution of public health may demand that it be so. Interventions on the ground, in schools, in mental health facilities, age-supportive communities, etc. are soldiers of the institutional war waged upon oppressive and outdated systems. Public health ties itself to the betterment of humanity. Progress on such a scale may require interventions along the entirety of the scale.


Link, B. G., Phelan, J. (1995). Social Conditions as Fundamental Causes of Disease. Journal of Health and Social Behavior, 35, 80-94.

Lopez, A. D., & Murray, C. C. (1998). The global burden of disease. Nat Med, 4(11), 1241-1243.

McLeroy, K. R. et al. (1988). An Ecological Perspective on Health Promotion Programs. Health Education Quarterly, 15(4).

Saveanu, R. V., & Nemeroff, C. B. (2012). Etiology of depression: genetic and environmental factors. Psychiatric Clinics of North America35(1), 51-71.


a meditation on the word

i wonder what a word is

is it a thing that can rightly be called a thing

does it have boundaries

does it have lines that i can draw, see and share with others

does it have limits

sometimes, it feels like it does

sometimes, words seem to flutter as leaves do at the base of the highest mountains in the most magnificent lands

the lands, of course, of feeling

of being

and other times, words greet you with the embrace of an ocean,

deep blue, deep, blue, welcoming,


the way i see it, i guess, either purpose was prior to the word, or the word was prior to purpose

but, you can rule out the latter

for, the substance of word is meaning, and meaning is grounded in purpose

that is, you cannot have a word without meaning, and you cannot have meaning without purpose

it follows, then, that a ‘word’ prior to purpose would constitute a contradiction fundamental to the nature of the word

so, it seems to be the case that purpose preceded the word,

purpose preceded the birth of the element of human communication

purpose, thereby, preceded the genesis of worded thought

to seek purpose, then, in the vast majority of the manifold ways in which we are taught to in contemporary society, paths structured and contained by worded thought, is an absurdity

further, the word, it appears, has been corrupted

humanity has enslaved the word and rapaciously groomed it into a servant of violence

the word, we must have realized, was a dance, a song, a story, through which we could stay with others, a medium through which we could share purpose with each other, a foundation upon which we could build society,

and breathe, together

in a home of love, an economy of word, where transaction is without traditional temporal value, for this kind of value defines social activity as a divisive struggle, might come about,

and in such a world, the word may act not only to bring purposes together, but also serve as the basis upon which an altogether different purpose arises,

one of all people,

the people

now, the character of meaning had to be configured before any particular meaning was attributed to any particular word; that is, the unifying device of the word, meaning, holds all words derived thereof in its domain

let us call this character of meaning the ‘source meaning’

it is evident that, at a critical historical juncture, violence was chosen as the source meaning

why was violence chosen, in lieu of love?

how was violence chosen, in lieu of love?

we set sleeping innocence aflame, and brutally proceeded to turn violence into the despotic ruler of a dehumanizing system of oppression

our being together, our language, our words, all of it – poisoned

lost, but not forgotten

broken, but not hopeless

the amputation of purpose, the mockery of truth, the murder of freedom,

comprise the challenge that is reality,

a challenge that we must meet,

for we must end the rape of the word,

and love must be liberated

we can overthrow the tyrant that is violence,

for the mind is the origin of its power

we must overthrow the tyrant that is violence,

for, in the last analysis, the peace that is justice demands it