Flanked by Malls
Mile after mile of big box stores, chain restaurants and indistinguishable strip malls flanked the highway. It felt like the geography of consumption had swallowed the uniqueness of place. From the seat of my modest car, I felt oddly diminished by the towering signs and parking lots. I couldn’t help but be enveloped by a sense of insignificance. With every passing mile, there was a reminder that, despite my role and my thoughts, I was just another driver passing through the machinery of modern commerce.
This landscape mirrored a tension I heard from rheumatologists at ACR Convergence. We want to be individuals and to bring our unique perspectives and humanity to the bedside. Yet we are increasingly at the mercy of massive systems—hospital networks and insurance companies. Both patients and clinicians seem anonymous to those who seem solidly and firmly in place while we scurry around them toward where we want to go.
Still, just as my car must traverse these zones to reach home, we too must navigate corporatized medicine without losing our identities. We can’t pretend the strip malls aren’t there or that the billboards aren’t distracting, but we have to keep our eyes on the road. We must keep moving, discerning what to engage with and what to resist. Progress doesn’t mean assimilation. Rather, it means movement with intention.
And so I moved with great intention. I drove past the shopping centers and the outlet villages, and slowly, the buildings thinned out. Ahead, I saw the familiar rolling hills of the Midwest. Fields and silos and wide, open sky greeted me. I was nearing the heartland.
Into the Heartland
At some point, I snapped out of my highway hypnosis. Gone were the brake lights and exits, and instead, there was now open highway and horizon. With so few cars around, I set the cruise control and relaxed my right foot. To my left and right were rows upon rows of freshly harvested corn fields. I passed dilapidated red barns with faded paint and machinery resting from the fall harvest. This was a different world from the gleaming towers of Chicago. But it was no less significant. It was quieter, more rustic and somehow more enduring.
What struck me about this landscape was that it is fundamentally built by calloused hands. As a rheumatologist, I couldn’t help but imagine examining those hands and feeling for swelling and for bone spurs. Here, the musculoskeletal system felt highly tangible, even through the bug-splattered windshield. I felt convinced the presence of fully functioning joints is critical to the livelihood of the people whose houses I was passing by. It was a great reminder that our work is not merely clinical. Joint and bone health is tied to the infrastructure of the entire nation.
