Every year, in the weeks before Christmas, there is at least one television station airing the movie "It’s a Wonderful Life." Watching this 1946 film has become an annual ritual for me. This year, however, I saw it from a different perspective (more about this later).
The story, with which you may well be familiar, takes place during World War II in the fictional small American town of Bedford Falls— a sort of "Everytown." The townspeople are generally kind and respectful of their neighbors, and they usually have a sense of community and social obligation. The hero, George Bailey (who is wonderfully played by James Stewart), is the owner of a small, family-run savings and loan company. George has sacrificed often in his life. He gave up the chance to go to college in order to manage the family business. He used the money saved up for his honeymoon to prevent a run on the bank.
In the latest catastrophe, his uncle/business partner loses most of the bank’s money. George faces ruin, scandal, and maybe prison. He decides to jump off a bridge and end it all but is saved by Clarence, an apprentice angel. Clarence saves George by letting him see what his hometown would have been like had George never existed.
Bedford Falls without George Bailey is very different. The town is dark, dirty, and sleazy—full of slums, bars, strip-joints, and pawnshops. Even its name is different—Pottersville, a name that ensconces that of the greedy, unscrupulous slumlord who has gained control of the town’s economic life because there was no George Bailey to offer the people an alternative. The town pharmacist has been imprisoned for accidentally poisoning a child because George was not there, working in the pharmacy, to catch the error. A troopship in the Pacific has been bombed and sunk with all hands on board because the pilot who was to have shot down the attacking planes (George’s brother Harry) drowned in childhood since George was not there to save him.
George finally realizes that his life does matter and asks to be allowed to live again. On returning to Bedford Falls, he finds that his neighbors have collected enough cash to save the loan company.
Where am I going with all this? I see a place—Bedford Falls—that exemplifies altruism, idealism, and a vision of individuals forming an interdependent community. Pottersville, on the other hand, is characterized by greed, indifference, and "every-man-for-himself-ism." I don’t think I’m wrong in suggesting that most of us entered medicine (and then pediatrics) because of a desire to help others, to be useful, and to be of service. Furthermore, I think that after some time in practice many of us have seen how inadequate society’s safety net has become for protecting so many of our fellow citizens. Our sense of community is shrinking. Who decided that the most important consideration should be to make more and more money (whether the profits are ours or those of the insurance industry, the hospitals, or the pharmaceutical companies) at the expense of good patient care? Will we ever get back to Bedford Falls?
Some of us may have thought that President Obama would be the Clarence who would show us the way. But maybe we have to find the way back ourselves.