War and Upheaval.

May 2026. These days, it seems fitting to remember a quote from A Tale of Two Cities by Charles Dickens: It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of light, it was the season of darkness, it was the spring of hope, it was the winter of despair. The stuff of fiction from another era, yes. But what could better describe the state of our country and, in fact, of so many parts of our world these days? Throw a dart at a map of the world and it won’t land very far from a war-torn, anguished population. But it also won’t be far from a thriving and peaceful population or even a regime of remarkable innovation and progress. A world of extremes! It’s easy to apply the quote above to our own United States. We are a country of amazing development and discovery, in technology, science, medicine, the arts, and so many other domains. Yet we are savagely politically polarized, with the word “bipartisan” hard to find. For those of us trying to promote constructive collaboration, the bewildering winds of war make it hard to keep our balance—whipsawed between a goal of peaceful leadership and one of invasion and war. Yes, parts of the world represent “the worst of times,” of terrorism and antagonism. But trying to do something about it requires teamwork and the Congressional consensus embedded in our Constitution. And for those of us in the medical field, we must not lose sight of the fact that citizens of all countries are human beings trying to survive. Our job is to bring “the best of times” to the aid of those in need. In the March issue of the Journal, for example, Nekovei and colleagues coached us on navigating the mental health needs of Iranian Americans, involving compassion for these fellow citizens, many of whom have loved ones in their war-torn country of origin. And on the bright side, congratulations are in order for Kunitoki and co-authors for this year’s winning entry in our annual resident paper competition, appearing in this May issue of the Journal. The authors considered a novel question: are birthdays not just days of celebration for everyone? Instead, could they be days of intensified stress for some of our patients, even leading to the need for hospitalization? The best of days for so many of us may, in fact, be risk factors for the worst of days for some.