- Ethos/Pathos/Logos
Sixteen years ago, I became part of what Donald Trump has called “the Deep State.”
I served as a Policy Director at the CDC. A Policy Director helps figure out what laws make communities healthy. We are also responsible for that quaint notion of the balance of powers. Policy Directors spend much of our days responding to questions from Congress. Those lawmakers are then held responsible by the public and so, my job is—was—to help Americans hold government accountable.
I fell in love with public service my first day. It started in a dimly lit conference room filled with people and paperwork. We took the civilian Oath of Office, standing in front of an American flag: “I do solemnly swear that I will support and defend the Constitution of the United States against all enemies, foreign and domestic.” My mouth quirked before breaking into a huge grin. I wasn’t in a musty-smelling conference room in Metro Atlanta; I was raising the flag at Iwo Jima.
I then walked into another conference room, stupid grin still on my face. The presenter introduced herself: “Branch Chief for the Comprehensive Cancer Control Branch.”
It was the debate that got me—a debate around the central tenants of public health: what is the greatest good for the greatest number of people? This Branch Chief presented the findings from the Division’s pilot program to increase colorectal cancer screening rates among the uninsured. The pilot worked so well, Congress was funding a national program. Every single state would get funding to detect and prevent cancer. But here was the catch: the new program would focus on raising colorectal cancer screening rates for everyone, not just the uninsured.
The audience grumbles. They worry about leaving the uninsured and the poor behind. It was the same exercise we debated in my Public Health Ethics class in grad school, but here it mattered. To real citizens. Someone passes around a microphone. “Beth, Health Economist. I’m really worried about perpetuating health disparities. Why aren’t we using funding to reach those with the greatest needs?” Another person grabs the microphone—Cindy, Health Communication Specialist. “I’m thinking about Curtis, who we featured in our most recent campaign, and how he suffered when he was diagnosed. Are we considering stigma?”
The concern is genuine, I realize, breathless.
“We can raise screening rates for everyone,” the speaker replies, clicking to the next slide. A line graph appears—a gentle but pronounced downward slope. The ticks at the x-axis mark cancer deaths five years out. “We can increase screening rates, which will prevent thousands of new cancers. We’re going to save thousands of lives.”
“Thousands of lives,” I whisper to myself, circling it on the first page of my Brand New Job notebook. My mouth is now a permanent smile.
By the end of the presentation, I am in love.
For sixteen years, I used all those appeals when speaking with the people who run this country.
Logos: Look at the descending line on this graph, every tick another person saved.
Ethos: It’s the right thing to do, the greatest good for the greatest number.
Pathos: Colorectal cancer was an awful way for your constituent, Curtis—a new grandfather—to die.
But I always had the most luck when I started with pathos. It helped I was a natural storyteller who could find a way to make the x-axis come to life.
After all, what is a story? A story is nothing more than: “Once upon a time, there was a person, and you should care about their experience because you’re a person, too.”
- Metaphor/Simile/Analogy
In May 2020, I was supporting CDC’s largest emergency response in history. There was no known treatment for COVID-19 at the time, and we were working desperately to prevent the spread. I was working fifteen-hour days, subsisting on reheated cups of coffee, microwave meals, and Pirate’s Booty popcorn.
I never grew accustomed to the pace of death in emergency response. None of us do, I suppose. But this one—you remember—was especially awful. Our daily 8:30 AM briefings started out with sharp sloping curves—up. Always up. Always exponential.
Heart-wrenching stories supplement these slopes. In May, the story was that New York City had so many dead grandfathers and matriarchs and little sisters, their hospital morgues ran out of space. Workers—exhausted, vacant-stare healthcare workers working three-day shifts—resorted to storing the bodies in refrigerated trucks.
At around lunchtime, a half-eaten Healthy Choice meal at my side, a news story comes through: the Lieutenant Governor of Texas told a reporter that businesses need to reopen, and grandparents should be willing to sacrifice themselves for the good of the economy.
I blink. My analytical brain kicks in first: of course, he’s posturing, because closing businesses is politically unpopular. It is quite common in health policy to look at the cost of an intervention versus the lives saved. And you can measure value in all sorts of ways—lifetime earnings is one, like any good capitalist. Life years is another.
But this was a complete perversion. A complete flip of the x-axis: how many lives should we sacrifice to open the Home Depots and the Office Maxes and the Pet Smarts? What is the exact ROI of a grandfather’s life? Is it more than a grandmother’s? What if she bakes incredible panettone and hasn’t had the chance to write down the recipe yet? Is she to resign herself to dying in an ICU, drowning in her own mucus, unable to hug her bubbies? Or are they supposed to be okay with that because now they can go out to eat afterwards at a Chili’s?
I walk away from my cold lunch. I sit on the bed.
I think of my own grandmother, who would wear her dangly American flag earrings to her annual fourth of July picnic, where we would play Clue together on her breezeway.
And then the realization hits me: People stopped caring about other people. None of this works—public health, emotional appeal, ethical appeal, the collective, public service—if people don’t care about other people.
I curl up in the fetal position.
A “Reduction in Force,” it’s called. Like good bureaucrats, we change this instantly to an acronym: “RIF.” Then a verb: “RIFed.”
We strategize. We look to the last time there was a RIF: the Clinton Administration, and implementation took two years. We dig into the regulations—the Administration will propose the change to Congress (that pesky balance of powers again), and then, once approved, conduct a “bump and retreat” so the government does not lose our expertise. We will move jobs elsewhere within the federal government, hopefully within CDC.
On April Fool’s Day—bonus points for DOGE’s sense of humor—I wake up at 4:45 AM and check my email. I’ve been RIFed, along with the rest of my Division. There is no proposal to Congress; no “bump and retreat.” We will lose all access to our computers, our files, and each other by 5:00 PM.
We enter the conference room. Someone puts a box of tissues in the middle of the table.
“What are we going to tell staff? What are we going to tell states?” Our Branch Chief asks. She’s wearing her green shawl. I’ve done the same—wrapped myself in my slouchiest cardigan. I swallow.
Our Management Official chimes in. “We need to tell them they’re done.”
“But what about—” our Branch Chief starts again, raising her voice.
“We’ve been RIFed. We took an Oath—”
This is the umpteenth time someone has evoked our Oath of Office in this room. The first was when we were instructed to erase years of scientific data from our website back in January.
“I took an Oath to the Constitution! To the American people! This violates Article 1—”
“We serve the President. All we can worry about is where to turn in our equipment—”
“That’s not true—”
The Branch Chief’s pain and anger radiates off her in waves. The Management Official’s pain and anger is a whip, fast and sharp. I wince at each lash, even those not directed at me.
The Management Official cracks. “You need to show leadership!”
The guilt hits me. If only my congressional strategy had been better. If only I’d scheduled our briefing with the House for last week, rather than next. If only I hadn’t gotten strep throat two months ago. If only my briefing materials were better. Congress—that body representing the people—would have saved us. If only I’d shown more leadership.
Sitting in the middle of a conference room, I bury my face in my cardigan sleeves and cry. Like a child.
- Subject/Verb Agreement
“The way to greater American prosperity is encouraging people to move from lower productivity jobs in the public sector to higher productivity jobs in the private sector,” DOGE wrote to us in January. But the RIFs and additional cuts turn into the largest layoff in U.S. history—since IBM, in 1993. Companies that rely on federal contracts stop hiring; nonprofits pull back.
I apply for every job I can find. I struggle in cover letters to describe my work in terms of shareholder value.
I stumble through interviews, feigning interest in sales and AI integration. I trip out of the gate with the answer to, “tell me about yourself.” With the RIF still in court, I’m in limbo. I gulp out, “I serve as…I mean, I used to serve…”
Most interviewers are kind. A few even appreciate my joke about being unsure of using past or present tense.
I have to learn to write all over again. I spent 16 years editing. I would get sentences from brilliant scientists, who would say, “data on this public health area of concern were collected and analyzed by CDC.”
And I would reply, “Can we change this to be more impactful? Why should the audience care?”
“I can rewrite that to reiterate the exact data point—”
“No. I’m asking you to be more comfortable bragging about how important this work is. Why it matters.”
The scientist grows quiet. Bragging is not evidence-based.
I am gentle. “Are people going to die if we don’t act right now?”
“Yes. Especially in places with really vulnerable people, like nursing homes. Daycares. Homeless shelters.”
“Say that.” We strike the line, typing together. The page grows red with tracked changes. “Now let’s make it active voice. Let’s talk about what CDC is doing.”
The scientist frowns. They dislike rhetoric.
But that’s how we understand each other, isn’t it? We understand rhetoric. The words at the edges of the bell curve, beyond technical accuracy. The ones we hear about public servants, over and over: Waste. Fraud. Abuse. Lazy. Corrupt. Evil.
“Well, it’s not CDC alone. We worked with health departments, doctors—”
“Could someone see the whole picture?” I ask. “Could they knit it together for the whole country without us?”
“No.”
“Then CDC did it. I’d even push you to use the first person: We.”
I find it hard to disentangle my own singular from the plural. What did I accomplish—just me? I helped. I helped tell stories to Congress, which passed laws. People helped implement those laws, working in communities, talking with patients. But it was always the collective. It was always people caring deeply about other people.
That’s the worst part: when you break institutions, we blame each other, and ourselves.
I sketched the impact of the programs I worked on over sixteen years, trying to estimate my own number of lives saved. It’s about half a million a year, or about eight million people. I could calculate the ROI, but I don’t have the heart.
Besides, it’s not mine. It’s ours.
That was always the point of public service: the plural, active voice, in present tense. And now, I need to learn to write again. In the singular, this time. As a citizen.
