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Apart from the many eulogies, the understated value of a liberal lion, and the draining intensity of a national funeral  (the magnitude of which could be engendered by no other Senator), it was a tough week to be a liberal. I have had tears in my eyes repeatedly over the last several days as I watched the highs and lows of Kennedy’s life and, in the process, reviewed the course of my own adult life, which was intertwined with that of Teddy Kennedy and his liberal causes. I was continually reminded, as no doubt many of you were, of my own mortality. In many ways, Ted Kennedy was thrust onto the national stage before he finished his boyscout career and before he got all of his merit badges. Neither Jack nor Robert got to finish their manual for Teddy’s career, so he had to write his own  as he went along.  He had to do it by himself as he grew up in public and helped the nation to grow. Teddy’s education was as much an education of the nation as it was for Teddy himself. What America grasped is that good people, especially those whose lives are entirely spent in the public sphere, cannot be perfect instruments serving the public good. Indeed, the better they are and the more open they are happens to be the means by which we see the glow of their imperfections. Maybe that was the best lesson that Kennedy could teach us.

I was unprepared for the sheer magnitude of the national mourning that we saw on television;  streets were lined by onlookers in tears, many with signs of well-wishing and thousands were waiting in line to view him lying in state. It seemed to be agreeably and almost automatically accepted by television news and the space filling demands of our newspapers that, with Kennedy gone, it was the passing of an era, embodied in the death of a special political figure, the likes of which we will never see again, in part because the country hasn’t earned quality leadership. The fact that GW Bush got elected proves the character flaw in our national politics.

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For many young people in America today, their only knowledge of a passionate, progressive liberal politician is what they know and hear about Ted Kennedy. During the years of the Reagan revolution, Ted Kennedy manned the tiller for liberal causes: he won some and lost some, but he always had his eye on pursuing issues  that served the interests of America as a country, with special reference to the disenfranchised. In many ways, I grew up with Ted Kennedy, though I never met him. He was elected to the Senate from Massachusetts, successfully running for the seat vacated by his older brother John, who won the Presidency in 1960. The year Teddy won his Senate seat in 1962, was the year I entered medical school. When he died yesterday at age 77,  he had been a Senator for 47 years. More than any other Senator, with the possible exception of Paul Wellstone, I resonated with Ted Kennedy and relied on him to make sound policy decisions. He had a great knack for attracting and assembling a bright, hard-working staff, but he was also hard-working and led by his example of great oratory skills, combined with his capacity to also be a policy wonk. With Ted, you got a twofer! It was always a pleasure to watch him in the Senate on C-Span, grilling a witness giving testimony related to a bill, where he could quote verse and line and knew far more about the details of the bill than anyone of the experts that were called to testify. He and his staff knew how to craft a bill better than any other Senator.

It was always clear that the Kennedy’s were a special family, even though they were not without controversy, including Ted’s accident at Chappaquiddick which probably sealed Ted’s fate as a Presidential candidate. Father Joseph had created a huge base of wealth through his dealings in the stock market, liquor distribution and as a Hollywood movie mogul. As a result,  his children didn’t have to worry about financial security; they all seemed liberated and energetic to pursue interests that didn’t require the generation of substantial  independent wealth. Their patriarch, Joseph Kennedy, had once considered running for the Presidency himself, but dashed those prospects when he supported appeasement with Germany as Hitler’s war machine was building up (Joseph was then ambassador to England). Nevertheless, what Joseph Kennedy instilled in his children was a zeal for public life and a passion for not losing elections.

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Our health insurance system is not the only thing in American medicine that is badly broken. Academic health centers across the country, both public and private, have fallen into a cesspool of corruption and greed that has tarnished the image and reputation of our medical schools, which were once considered to be ethically-driven, pristine cultures of research and medical education. The modern American medical school was born in the 19th Century, spawned by public pressure to overcome the primitive  colonial medical practices that produced the disaster of the Civil War, where more than 600,000 soldiers died, in large part through the poor and ignorant medical practices used at a time when there was no standard for medical education in America. The American medical schools of today began as a fusion of rigorous training in the sciences, coupled with medical school ownership of a teaching hospital, such that medical students were trained at the bedside through academic clinical observations combined with the emerging scientific principles that improved steadily throughout the 20th century. The single largest impact on medical care in this country was  created when Medicare and Medicaid emerged in the 1960s. It was the stimulus of government reimbursements for treating elderly and poor patients that led medical schools to begin admitting patients in large numbers and in effect, they began competing with the private medical sector and the physicians that, in many cases, had once trained under them as medical students, residents and interns.

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