A dual citizen's choice between two imperfect systems

Certified coach Kathleen Muldoon discusses her article, "Choosing between care and country: a dual citizen's Independence Day reflection." As a dual U.S. and Canadian citizen and mother to a child with complex health care needs, she explores the profound tension of navigating two vastly different systems. Kathleen recounts the painful, personal decision to turn down a job in her native Canada after discovering its universal system, while philosophically aligned with her values, would likely fail to provide the timely, specialized support her son requires. The conversation delves into the "quiet grief" of choosing the fragmented but fast-moving U.S. system to meet her son's needs at the cost of her own well-being and a return to her homeland. Kathleen explains how this trade-off informs her work in medical humanities, highlighting how health care systems reflect deep cultural priorities about interdependence and worthiness, and the hidden emotional costs for the caregivers who must live within them. The key takeaway is that no system is perfect, and true citizenship involves loving a country enough to name its limits and bravely holding the tension of uncomfortable choices.

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