Unus Pro Omnibus, Omnes Pro Uno
Unus pro omnibus, omnes pro uno is a Latin phrase that means "One for all, all for one" in English. It has come to be the motto traditionally associated with the titular heroes of the novel The Three Musketeers written by Alexandre Dumas, père, first published in 1844. In the novel, it was the motto of a group of French musketeers named Athos, Porthos, Aramis and d’Artagnan who stayed loyal to each other through thick and thin. It is also a motto used by the company where I now work. As many of you know my company is dedicated to fighting the spread of Kidney disease and preventing patients from having to undergo dialysis.
In novel/movie, d’Artagnan when entering the final battle scene and almost certain death gathers the musketeers together and says:
“if we must die, if we must die, then let it be like this….One for All, and All for One”….
The movie inspires me not because it is another example of a hero being heroic in the face of grave danger. After all, that is what heroes do. I am inspired, rather, because d’Artagnan says if we “must” die, then let it be like this. Meaning, there is not necessarily nobility in dying or even in the way we die, rather there is nobility in, when faced with death or other perilous circumstances, we face them together or each for the other. In the example of my company, we don’t wish any patient to have to dialyze, but if they “must” dialyze, then we, as caregivers are in it with them. There is no underestimating the goodwill this generates. Switzerland, in fact, has adopted this phrase as their national motto. Aristotle would have surely embraced this concept for he believed for a society to be successful it had to be organized around a common purpose, and it was in the striving for the “good” in that purpose that created a state that would best serve the citizens.
Why This High Minded Musing
In two days I face my own perilous situation. I will have abdominal surgery for a condition called Chrons. Chrons is a disease, unfortunately with no cure, that causes inflammation, pain and discomfort in an individual’s intestinal region. If the condition does not respond to medication, then surgery is required. I have had the disease since I was 18 and this will be my second surgery. With only two surgeries in 20+ years I am one of the lucky ones. I am also lucky because I have access to a healthy lifestyle, good doctors and insurance. Sadly, even in America, these aforementioned assets are not readily available for all Americans. I suppose it is surgery, and perhaps the fear of one’s own mortality that surgery brings that has made me contemplative and motivated me to write down a few thoughts.
Private, Badge of Honor
For the 20+ years that I have had Chrons, I have kept it quiet, worn it like my own private badge of honor. My loyal supporters: a couple of college fraternity brothers, my best friend from law school, my uncle and my mother (who when we dealt with my first surgery spent more than 4 months by my bedside in the discovery, surgery and recovery phases of my illness). I suppose they, my family more generally, together with the woman in my life, can be viewed as my musketeers. When I found out that I would again require surgery, the words of d’Artagnan sprang to mind. I boldly stated to my mother that “if we must die, if we must die, then let it be like this—One for All and All for One”! She did not care for that and began quoting me numerous bible verses on faith. I had to tell her that I was not being fatalistic or even depressed. My faith, in my opinion, is unshakable. The poem “Invictus”, Latin for “unconquerable” hangs on my wall. I know God is the master of my faith, the captain of my soul. I was saying if I “must” die, and I do not think that is even a remote likelihood in this context, then let’s be in it together. Let you all be strong for me. Luckily, they, my entire family, teammates and friends have been greatly supportive. Why then had I kept this a secret for so long?
A Role Model Emerges
Growing up I played football, I wrestled, and I even fought. As an adult I spent over ten years on Wall Street as a lawyer and later an Investment Banker. None of these endeavors were for the timid. I felt if I showed weakness, I would be written off as weak. This perceived weakness would limit my advancement possibilities. I could not have that. I mean I am a hard charger, the Gordon Gecko of my group, maybe even a future Congressman or Senator. In many ways I have been a walking contradiction. Saying I want to make change in the world, impact the political process and do for those less fortunate. I long could have used my own disease and access to the assets I have to better raise awareness, but I did little. Perhaps I was paralyzed by fear or too selfish from the pursuit of those things I wanted to achieve. Whatever the case, I did not sacrifice or at least in the way that I should have sacrificed. This has changed meaningfully in the past two years. I have always been interested in our healthcare system. Two years ago I received the opportunity to work for a terrific company that specializes in dialysis. Not only do we treat patients, but educate, advocate and raise money for those less fortunate. The company has provided me many opportunities, for which I will be eternally grateful, to put my money, heart, soul and advocacy efforts behind the prevention of this disease that needlessly impacts so many.
My second inspiration also involves my company. Last week I found out that my boss and mentor also has Chrons. He relayed to me that he has been an active member of the Chrons Foundation for years, even traveling to speak on the subject. He is one of the highest ranking and most respected executives at our company. It really made me look at myself and ask “what have I done” to carry out the “One for All” motto in the society at large. After all, perhaps like Switzerland, to truly live this motto I can not just be concerned with my own musketeers, rather almost by definition don’t I have to do my part to impact and support greater society? I know that success, for me, will not be limited by my advocating for others with this disease. If it does, I reject that brand of success. I will be unafraid. I have been blessed with resources that can assist others and prevent suffering. I plan to use them. I thank this mentor, more than he knows, for modeling the way.
An Ounce of Prevention
The cases are well made for prevention. Whether Republican or Democrat I hope that one day our society will see that access to healthcare for all is a good thing. While everyone may not like the healthcare bill that was recently passed, it does have two very important attributes—greater access to healthcare for a greater number of Americans and more dollars for preventative healthcare. Many ask “why should I pay for someone else’s healthcare”? I say we pay either way. If a person, who has a condition that could have been detected early and treated with prevention, and instead of preventative care they are forced to receive treatment for often, then, catastrophic conditions at the ER, society bears a far greater cost in the later circumstance. County hospitals, and their ER rooms, where patients who do not have insurance go as a place of treatment of last resort, are funded by tax dollars. Simple math tells me that I would much rather pay for prevention than catastrophes. The data varies, but for the system, we know that this delta in preventative dollars and dollars spent on emergency treatment can be in the billions.
I do believe everyone should pay their fair share of healthcare costs. I like a formula based approach here. Perhaps a marginal dollar analysis that ranks the priorities in life: shelter, food, etc and says out of your after tax income and after food, clothing and shelter you must pay x% toward healthcare prior to paying for other items that are, as judged by society, of a lesser priority. Even under such a formula, it is likely that many Americans would not have healthcare or would be under-insured. Unless we say as a society that we are willing to let our citizens die in the streets when they are sick and can not pay, which I hope and pray to never be a part of such a society, then we must cover the gap. I, as a tax payer, would rather pay for more prevention and less emergency care, because it is less expensive and would actually save tax dollars.
Take me as a case in point. I am blessed to have good insurance. I get regular check ups, healthy living plans and medication that prevent the onset of more serious situations like surgery. If, for example, half of my preventative care had been taken away, and I had, over the last 20 years, two additional surgeries, those surgeries would have amounted to several hundred thousand dollars vs. the few thousand on the aforementioned preventative care measures. If I had not had insurance, that delta of those several hundred thousand dollars would have to be covered by the system when I went to the ER. Multiply that times millions of uninsured Americans and you will arrive at a serious threat to our system.
In the final analysis people die. We face a question of how they die and how we as a society want to express our nobility. Again I say, “if they must die” let’s make it fewer people, let’s make it less painful and more cost effective for us all. We can do this through a system of better preventative care. We can do this through a motto as simple as “One for All, All for One”.
Thank you everyone for your prayers and well wishes with my upcoming surgery. Hopefully by the grace of God and the hands of a very skilled surgeon at UCSF I will be fine. Let us all think about those who are not as fortunate as I. There is great nobility in that pursuit.
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