A Case for Friendship
There may be more reason to prioritize this virtue than we do
Today, May 24th, is the 3-year anniversary of the passing of my beloved friend and mentor, Michael Lippman, MD. He taught me much about the art of lifelong activism. More recently, I've realized that a great lesson he unintentionally demonstrated was the value of friendship. I want to thank my mom (Jenny Ward), Paras Sethi, Kelly Shanks, and Robert Jaffe for reading drafts and providing ample encouragement.
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I recently read an article about a jazz saxophonist, which left me reevaluating the virtues I hold closest. In the article, renowned jazz historian Ted Gioia delves into the world of Jimmy Giuffre's eccentric and cryptic approach to music composition. He habitually breaks musical paradigms, challenging what is even considered jazz. His albums range from solo saxophone to ensembles featuring a bass clarinet, alto flute, bassoon, and English horn. To an onlooker accustomed to traditional instrumentation, his musical decisions appear random, even reckless. As a jazz historian, Ted Gioia felt bewildered by the pace of his musical evolution from album to album, while still producing music enjoyed by artists and audiences alike.
Here come spoilers, if you want to read the article yourself. Ted Gioia eventually met Jimmy Giuffre to learn more about his creative process. He explained that musicians play better when they are happier. Specifically, when they are with their friends or buddies. Instead of starting with a theoretical instrumentation framework, it was the chemistry between musicians, no matter the instrument they played, that took precedence and later determined the music they created.
Leveraging the chemistry between individuals as a starting point goes against how most people start an endeavor they hope to be successful. Much like a job posting, Ted Gioia writes that many musicians start projects by imagining rigid qualifications an ideal ensemble might possess. This process is aligned with how many people also select professions, romantic partners, and towns to live in. I am no exception. Partially based on a checklist of job criteria I desired, I pursued medical school. Similarly, I chose my specialty and residency program based on predetermined criteria. And though I have more or less ended up where I chose to be, I do find myself regularly debating whether these decisions were the best ones.
The success of Jimmy Giuffre’s artistic process prompts me to consider times in my life when I also tried to accomplish something worthwhile with my buddies. Were we productive or successful? In high school, I ran cross country guided by the wise and prolific Lester Hampton, who fostered a culture of camaraderie and achievement. Though training under Coach Hampton was arduous, I very much felt like I was hanging with my buddies for two hours every day after school. This was by far the most athletic time of my life.
My brother was also on the cross country team. Though, beyond high school, our running careers diverged. In his life, he prioritized his friendships with runners. Now that it has been 13 years since we ran on a team together, he is far more athletic than I am, despite being afflicted by type 1 diabetes.
Beyond high school, I lacked community membership forged by a specific mission. When I first applied to medical school, I was not friends with anyone else doing the same. Neither was I relationally close to any physicians. Though I performed fairly well in school, my applications were rejected. I applied a second time, only to be met with the same fate. Without any job prospects, I followed my girlfriend to Seattle, where she was moving for a master’s degree. After delivering food on my bike for a month, I landed a job at the front desk of a community health clinic. At the front desk, colleagues came and went at a steady cadence. I eventually managed to build a friendship that I cherished. His name was Ermias Yohannes. He was my age and was planning to apply to medical school. Not long after meeting, we found ourselves spending more time together at coffee shops than we did at work. We studied for the MCAT, drafted application essays, and navigated the medical school application process together. We even joined Toastmasters to improve our public speaking. I enjoyed Ermias’ company. He is thoughtful, kind, and well-informed on certain poorly understood topics. For instance, I learned about the political tumult between Eritrea and Ethiopia and how the Eritrean-Ethiopian War transplanted him to Ethiopia and then to Seattle during his childhood. These stories revealed themselves as we refined the articulation of our life experiences through many medical school applications. Through our collaborative work ethic and life reflections, I also found myself writing better than ever.
As my relationship with Ermias deepened, I simultaneously found myself influenced by a physician at the clinic. I was assigned to communicate with the patients under the care of Dr. Michael Lippman, who insisted I call him “Michael”. He was another individual whose values I felt aligned with my own. He exuded a rebellious spirit, which I similarly hoped to demonstrate and channel into my own endeavors. A bond was forged when Michael saw me reading Medical Nemesis by Austrian priest and philosopher, Ivan Illich. Published in 1974, this book was ahead of its time, criticizing the healthcare industry's tendency to iatrogenically create disease in patients. I learned Michael was an avid reader. And from that day forward, he always made a point to drop off the weekly NYT Review of Books on my desk after he’d finished reading it. To me, this was a shocking act of kindness, given my perception of his position high in our clinic’s hierarchy.
Michael had an epic career, on and off the clock. During our time together, the old Public Health building we worked in was demolished, replaced by a fancy new clinic next door. On our final day of work in the old building, we were free to write messages on the walls of the clinic. I will never forget what Michael wrote:
Anyone working in healthcare might suggest a few things are unusual about Michael, only by looking at this message:
The duration of his career in public health
His pride and enthusiasm after so many years
Coming back to friendship. When Michael chose a career in family medicine in Seattle, WA, I suspect this was partially driven by a desire to immerse himself in a community of like-minded individuals. During and beyond residency, he fostered a tight-knit network of friends who shared a moral compass aimed at utilizing healthcare and the prestige of the profession to catalyze the common good. Over the course of time, I saw that Michael was well connected with people working in public health, many of whom he considered a friend, if not an “idol”. When I joined Michael's clinic in 2015, he was still working side-by-side with his esteemed comrade, Dr. Robert Jaffe (“Bob”), who had been working with Michael since training in residency together.
Michael was in no way a hierarchist. Not long after I left for medical school, I witnessed his deep rapport with colleagues of all backgrounds and professions while he spearheaded the unionization of our clinics scattered across the entirety of Seattle. And back when tobacco advertising was more common, and cigarettes more accessible to minors, he worked alongside physician friends to deface approximately 100 tobacco signs and billboards representing what he lamented as the "death industry". Although he was arrested in the process, his protest against tobacco advertising was perceived positively by colleagues, and the charges against him were eventually dropped.
Michael leaned in and took action when the opportunity was ripe. Once he leaned in, he didn’t let up. Though I believe he lived a life aligned with his true nature, his achievements could never have been realized, or well-received, in isolation.
Fundamentally, I feel Michael’s audacity was kindled by his community of friends. His work was defined by humor, creativity, and loyalty, virtues recognized and cherished by the community he belonged to. His colleagues who reciprocated these virtues also found enough fulfillment and reason to endure their rigorous career choice. Though I was only a scheduler at the clinic when our paths crossed, I also felt emboldened by Michael. I found myself reciprocating loyalty to the clinic and our patients beyond what was justified by my wage or work conditions. This sentiment ran so deep that during one (unsuccessful) med school interview, I blurted out that I could see myself happily doing any job in our clinic, and that it was the mission that mattered most to me. My interviewers were not impressed.
Once I did leave for med school, the degree to which I subsequently experienced a sense of loss surprised me. Ted Gioia’s essay helps me recognize that it wasn’t the loss of a profession, an organization, or even Seattle itself that I mourned—it was the loss of friends: a group bound by virtues emboldened by camaraderie.
Michael’s life demonstrates a valuable lesson for younger generations, myself included. Wherever we go, there will be poltergeists of student loans, organizational politics, workplace inefficiencies, and monotonous tasks. We might imagine a workplace utopia where all processes function effortlessly, as expected and intended. But in a world where a thirst for ease precedes all other virtues, authentic community, personal growth, and fulfillment are diminished, if not absent. Rather than making a checklist of prerequisites for vocational satisfaction, what if we asked first, what do I value? And then, how can I live out these values with my friends? These questions are easy enough to ask. But a sincere quest for answers might lead us to an idiosyncratic community of individuals bold enough to consciously dissent from the norm. Whether seeking truth, fighting for a just world, or pursuing artistic expression, the journey is emboldened by the camaraderie of good friends.
On the flip side, where else might we bring out the best in others through camaraderie, where it might not be expected?
Beautiful. Thank you.