“Those who forget the past are condemned to repeat it.”

Didn’t take long, did it?

The quote in the title is from George Santayana. The movie is It’s a Wonderful Life with Jimmy Stewart as George Bailey along with Clarence Odbody, who played Clarence the angel. The scenes are from the moments when Clarence shows George what the world would have been without him and his value to his family, his friends, and his community.

Remember those scenes. They are immensely relevant to what is happening right now before our very own eyes: Dismissing the members of the ACIP in its entirety to be replaced by a group of appointees is not just news—it may be fatal. And the “look backs” will be real life, not scenes from a long-past movie.

It’s hard for me to believe that in just a bit more than one month of writing how much I have covered has contained kernels of prediction of what we are witnessing today in real time.

Absolutely unbelievable.

There is the potential a whole lot of folks are going to be harmed by this one action by our secretary of health and human services—not by his ACIP dismissal action alone, but because of what might happen down the line, even years from now, as a result. By then, the decision makers may be long gone from the political scene and influence and likely gone from this earth as well (by natural causes, I need to add—sensitivities being what they are these days).

I may be wrong. I don’t believe I am. But I don’t want to or need to find out. This entire situation is unacceptable and is playing out in the public arena.

Does my bluntness make the point?

Sadly, I don’t believe cloaking myself in science these days has much merit. The denigration of expertise is in full force, visible to all, and shapes the public perception of health.

A sad day, indeed.

So, for now here are a couple of non-scientific principles, some references to the blog, and some personal life stories to reinforce points that I believe must be made—before more damage is done.

First, the non-scientific principles:

• Principle #1: “Da plane! Da plane!”
• Principle #2: Shut your mouth and focus on the task at hand
• Principle #3: “Who’s on first?”
• Principle #4: Clarence the angel

Principle #1: Da plane

“Da plane” became a euphemism for the tactic we are witnessing daily: “Look here, and don’t look at that shiny object over there.”

Inject and deflect. Ignore the economic pain and dislocation coming and don’t pay attention to the deficit. Instead, buy meme coins and come to my house for dinner! Don’t worry about denial of due process; reopen Alcatraz,” etc., etc. You can provide your own examples.

Some have been writing and opining that this was all a masquerade to get the public masses to deflect their attention from real issues. That’s the way the public is.

That observation is not meant to be offensive. It is just the tactic being employed, and it works. No one was talking much about the developing disdain for the public’s health and the expertise that informs it.

That was the plan, and it worked—so far.

Principle #2: Shut your mouth and focus on the job and task at hand.

Principle #3: Who’s on first and I don’t know on second.

A prime example here is Secretary of Defense Hegseth. Remember him?

Haven’t heard much from him or about him until this weekend, have you? At least, not in the spaces I read and listen to every day. Remember how he was story #1 during the Senate hearings? How about the “scandal” when one of his friends was fired for alleged leaking and went public with the mess in the Pentagon?

If you dig into what happened next, you will find reports that the White House told him to lay low and get some people in the room who knew what they were doing. And the press moved on to the next shiny object. News cycles have a way of doing that.

Well, it wasn’t just Hegseth. Kennedy had to quiet down and focus as well, except for his head popping up occasionally like a tulip in the field.

Kennedy started his journey of controversy with Senate hearings as well.

I wrote a blog about his appearances before the Senate committees and his confirmation hearings. He could not give a straight answer.

Remember these promises with words to the effect of:

“No, I don’t hate vaccines. Yes, I support the science. Who’s on first, and I don’t know is on second …”

If it weren’t so serious it would be humorous, except it is not humorous. It is our lives at stake and the lives of our children and grandchildren, born and unborn.

That, too, is in the blog.

He went fairly quiet after that, didn’t he? DEFCON 1 to DEFCON whatever just from putting a zipper on his mouth—until now.

In the meantime, it was all about deflect, deny, denigrate, and destroy.

Calling Senator Cassidy, calling Senator Cassidy! Where are you, Dr. Senator Cassidy?

Kennedy misled many of you.

Are you there, Dr. Senator? Are your colleagues there? Does anyone recall the oath we took as physicians to first do no harm? You are the one hope here to persuade others of the dangers that may be just around the corner in our future.

Maybe it is time to start making some quiet phone calls. There is a budget bill pending, if I am not mistaken. What is going on here with Mr. Kennedy is that important—as in, “Liar, liar! Pants on fire!”

Principle #4: Clarence the Angel

Who doesn’t recall the epic scenes in It’s a Wonderful Life with Clarence the Angel, Jimmy Stewart about to jump from a bridge, Potter’s town without George Bailey’s influence and presence, and the bells in heaven? We are living in that moment right now, and many don’t even know it or, worse, even care about it.

I am a physician, an oncologist, who has sat holding the hands of too many people when we could do literally nothing but sit there and hold their hands as life slipped away.

Today, over 50 years later, hands still go cold; however, there are fortunately far fewer lost to cancer.

Cancer medicine is like that, just as in regular medicine: The progress is slow; however, the impact is real, all the way from preventing disease in the first place to helping people survive catastrophic illness.

The latter is dramatic, focused on the individual; the former much less so, sneaking up on you and the population writ large—like a ghost in the middle of the night until the sunlight shines and you realize the miracle that is happening all around you.

How many folks haven’t died from cancer or other serious illnesses like lung or heart disease either because they saw the dangers in smoking and stopped before the real final damage was done or never started in the first place because of messaging and education on the harms of smoking?

How many colon cancers were prevented because someone had a polyp removed and cancer never reared its ugly head in the first place?

How many millions of you out there are alive because someone else took the time or made the effort to stop smoking or got a colon polyp removed?

You will never know the answer, because the cancer never happened in the first place.

There is a “law” in economics describing a multiplier effect: A dollar is not a dollar.

Depending on what you do with your dollar, there are a lot of downstream things that happen, far beyond your decision whether to buy that cheeseburger and soda or save that dollar so a bank can lend it to someone who creates jobs or buys a house that employs carpenters and plumbers and landscapers—whatever.

One dollar multiplies itself many times over in our communities and our economy every day, yet you never think about where that dollar travels or what it does, do you?

Ditto on the cancer thing: You never think about what doesn’t happen because someone doesn’t get cancer in the first place and whether perhaps—just perhaps—you are here on this earth today because your grandfather listened to the messages and never smoked in the first place or stopped smoking before the cancer, the lung disease, or the heart disease stepped in to take his life prematurely.

Think about that the next time a child is born, or graduates high school, or gets married, or has a child of their own. Just take a moment and think about it.

Millions of people are alive today because someone did something positive for their health a long time ago, something you may not even be aware of, but allowed them to live and make you you.

Well, folks, the same multiplier effect happens with public health:

Those vaccines so many are quick to question have saved millions of lives from death, despair, and disability. And you will never, never, never know who. But we know the facts, and the facts about vaccines don’t lie, and the positives way outnumber the negatives. Millions of lives saved from disease, disability, and death should get someone’s attention.

I would bet if you dug deep into your family history you would find your own stories to tell about life, survival, and generations born because someone did something right with their lives and their health.

I know, because I have those stories:

Example #1: My uncle, Jay Leonard Lichtenfeld

I am named after my uncle I never met. You know how I know him? I know him because of this card I receive every year. It is called a Yahrzeit reminder. In the Jewish faith, it is a reminder to light a memorial candle and say prayers for the departed every year.

Leonard (as he was known)—if I recall correctly—died when he was between 24 and 27 years old. I am told he was a special, kind person. He died from pneumonia, probably pneumococcal pneumonia, an infection that today is routinely treated and usually quickly cured with readily available antibiotics.

He died in 1942. Penicillin—our first “real” antibiotic—became widely available after the end of World War II, a couple of years after Leonard died.

Leonard couldn’t get penicillin or anything else. A young life of promise and hope gone. Poof. Didn’t exist. And I doubt anyone else in the world is thinking of Jay Leonard Rubenstone right now except me, writing this blog.

He hadn’t married, he had no children, no survivors, no legacy—except a grave marked by a stone in a cemetery in Philadelphia and a postcard I receive every year. And when I am gone that memory will be gone as well.

Example #2: My father, Max Lichtenfeld

He was born in November 1911. My dad was 45 years old when he died—of obesity, hypertension, and kidney failure. I was 10 years old.

My dad knew he was dying before I was born. I came into existence late in his life by the standards of his day, but I came to be, and here I am almost 79 years later. No brothers or sisters, just me carrying the legacy of my father.

There were no treatments for hypertension, obesity, or kidney failure back then. Nothing. Just a rice diet from Duke that worked a little because it was low sodium. No medications for the blood pressure, no dialysis machines (they came along a short time after his death), no kidney transplants (they came a long time after he died). Nothing, nothing, nothing.

I missed my dad. I miss my dad. I miss his smile, his hugs, his support, his life, and maybe his pride in what I have been able to do with my life. I still love my dad. He still has a place in my heart and always will until I take my last breath. I have not had my dad in my life, or my children’s lives, or my grandchildren’s lives—for 69 years.

My survivors and those I have helped along the way will be here because my dad was alive long enough to make me happen.

Example #3: My wife, Sandra

Yes, my wife. My dear wife. The person who supports me every day and for whom I have immense love and gratitude for her being in my life.

Fortunately, there is no card for Sandra. Just hugs, kisses, love, and conversation every day. Lots of reasons for being proud of Sandra and her legacy, but I won’t bore you with them here. Someday maybe, but not today. It is one incredible story of hope and inspiration that moves me every time I think about it.

Why is she in this blog?

Sandra has had several near-death experiences over the past couple of years, one from COVID-19, one impacted by COVID-19, and a chronic disease which fortunately she now has under excellent control (or perhaps I should say “we have,” since it is a team effort—me, hospital staff, and clinicians included).

She was vaccinated against COVID-19 before her first critical illness. She spent several days in the hospital COVID-19 ICU near death. Her body fought the infection, and she is here today.

If you are a skeptic, you would say the vaccine didn’t make a difference. She became critically ill anyway. If you are a believer, you would say the vaccine and the care she received saved her life. We knew the vaccine didn’t prevent COVID-19, but the data were clear: It did diminish the risk of death from COVID-19.

I am a believer that the vaccine influenced her recovery. In fact, having done some immunology research in the past, I anticipated the timeline—maybe not quite Babe Ruth predicting the home run, but close enough.

When Sandra was taken from me to the COVID-19 ICU, where I could only talk with her on the cell phone and watch her labored breathing, I told family, friends, and colleagues that if the vaccine was going to work, it would do so in the next couple of days as the B cells were fading and the T-cell memory kicked in. My professional colleagues were skeptical. Today they acknowledge my prediction was correct about vaccines and T-cell memory.

The next day, the fever started to abate, recovery quickly ensued, and here we are today—a couple of more rocky steps along the path in the meantime, but here nonetheless.

I would venture to say that Sandra has had a genuine impact on the lives of others as a physician, a mother, a grandmother, and a friend; on patients, on medical students, on physicians in training to become the gynecologists of the future, on her colleagues, and on her profession.

And, of course, on me—in ways you will never fully appreciate.

She helped bring me out of depression and despondency, to move on with life, and to hopefully influence others for some good, including writing this blog.

I firmly believe that without her, I would not have survived—literally. It was that close.

There is more: If I had the time and you had the patience, I could tell you my story about the beginnings of the pandemic; what we had to think about, predict, and ponder; the early data we saw; the lives that were lost—over one million in the U.S.; the suffering that happened; the long COVID-19 that still disables many; and the death and destruction that would have ensued without those vaccines that so many now dismiss as ineffective or dangerous.

Being alive gives one the luxury to speculate on theories. Those who died aren’t here to point out misconceptions. It is easy to talk about herd immunity today because there is a herd. There was no herd back then.

The audacity of some to dismiss the lives lost, to make excuses for their earlier positions, to forget the humanity of the moment is astonishing to those of us who faced a pandemic that, even with vaccines and treatments, became one of the worst in modern recorded history.

Those are the principles and the brief stories of impact.

Vaccines are part of our lives, our journeys, our survival, our ability for many to avoid illness and disability.

Do they have side effects? Yes. That is part of any medication. Mostly good, sometimes not, occasionally resulting in severe consequences or even death as a side effect of their administration to prevent disease in many others.

As physicians, we always try to balance risk, benefit, and outcome. When millions of lives are improved—with decades of data to show for it—the balance is clear. Not perfect, but very clear.

Mr. Kennedy, your statements put the future at risk. You speak about science and conflicts of interest, yet you have your own conflicts, having made millions through litigation. You highlight selective pieces of science and present them as facts, but often without context.

Because of limited space, I cannot ignore those you have brought into positions of responsibility to promote your agenda. One day I will share thoughts on them as well.

Please consider the potential consequences of your actions on our future and our children’s future.

Once again, the operator is calling:

Paging Dr. Cassidy … Dr. Senator Cassidy, where are you? Please call the operator. We have an emergency and need your help!

J. Leonard Lichtenfeld is an oncologist.