Medical Device Daily National Editor

Full disclosure here: I'm an unabashed Barack Obama fan and think that yesterday's inauguration will launch a huge wave of positive energy in this country.

But even I was taken aback when I picked up a magazine's tribute issue to the new First Family, opened it to the very center section, and was struck by the two-page photo spread: of then-presidential nominee Obama at the pre-election rally in Denver that attracted an estimated 100,000 or so. The photo, framed only by the edges of the magazine's pages, shows Obama seemingly standing unsupported by anything except this vast human stage, and reaching out, seeming to touch the hand of a young man in the crowd below.

This mass of folks hides the little bit of actual stage he is standing on, but the photographic illusion provides multiple iconic allusiveness: of water-walker, Sistine Chapel-roof-power-of-life provider, or even yuppie rock star. (Other photographs I've seen of Obama, at similar huge gatherings, have served to capture a halo-like light around his head. And: "paling around" with superheros in a new Spider-man comic that was issued last week).

Rock stardom, yes, but no miracles or super-power solutions are likely for all our current problems. But I am convinced that he will be able to fuel great strides forward for this country in several areas, especially for U.S. healthcare because of the leadership quality suggested by this iconic photo.

I base this on two facts about his experience (despite accusations by his opponents that he emerged from an experience-less void). The first is his oft-repeated story of watching his mother struggle with insurers as she was dying of cancer, and his obvious resonance with the many in U.S. society who face these same struggles, or the larger struggles by those who have no health coverage at all.

The second isn't exactly a fact, but what he has already revealed concerning his approach to leadership, dovetailing with my personal (admittedly loosely formed) theory concerning the flight of birds.

It's amazing, those V-shaped patterns of flight. Why do all those birds follow that lead flyer in perfect sync? How does that leader achieve that loyalty of form and formation – though no larger, faster or more powerful than that phalanx of followers?

I've read that biologists believe there is a sort of chemical synergy here that those hundreds of birds are not simply following the whim of one, but that this lead avian and the hundreds behind share a chemistry so that if that First Bird no longer "got" this group chemistry, it would be superseded by another.

That is the chemistry I see in that photo of Obama, standing above, but reaching out to that human sea. He will leverage – via these gatherings, the Internet, YouTube - the tectonic shifts taking place in U.S. opinion, both youthful and diverse. And it is this chemistry, a vital electricity, that was obvious in the enormous crowds in Washington for the inaugural event that demonstrate the vast support for this president that so reflects his diverse appeal, his emphasis on inclusiveness. And this chemistry should fuel his desire, as he put it in his inaugural address, to achieve "what can be imagined joined to common purpose."

The critical mass of opinion, I believe, will guide President Obama toward large healthcare reform from the bottom-up (or, flock of birds-like, from the popular will forward), not imposing change (as perhaps was the problem with the efforts of Hillary Clinton) on a resistant community, but using the energy of "yes" to achieve what is capable of being done.

As I have written elsewhere, Obama's methodology is likely to be one of pragmatism, not ideology (Medical Device Daily, Dec. 30, 2008). Ideology, for instance, has blocked sterile needle programs – though proven to reduce the rate of AIDS – and healthcare to the children of legal immigrants, this latter soon to be reversed (and to the children of illegal immigrants, though they need it too.)

No doubt, the Obama administration is going to disappoint many, since, as The Onion so succinctly has put it, we have voted this man to the worst job in America (and, as well, his family to the type of scrutiny usually reserved for a Petri dish).

But my hopeful expectations are not just for Obama; they are for the entrepreneurial and innovative spirit about which medical technology and U.S. healthcare so like to boast of. I have hope that via the flock-of-birds approach, Obama will use American opinion: to drive us a broader reach with basic healthcare; to refuse to abandon children in the womb and through the first through years of life because lacking this care; and provide a model for exercise and healthy living that will put a dent in our epidemics of obesity and other chronic conditions that devour 80% of our healthcare dollar.

Yes, as we witnessed that inaugural event and consider the prospect of positive healthcare change, I do indeed believe, hope, assert: that he – because we – can.

(An earlier version of this article appeared in the Jan. 14 issue of Medical Device Daily Perspectives, our free weekly e-zine. To sign up to receive Perspectives at no charge, go to and click on the MDD perspectives button at upper right.)