AbstractIn the Perspective in this issue of the Hastings Center Report (September‐October 2017), Barron Lerner contrasts the “true believers” in public health schools—“people willing to crusade for any program designed to reduce morbidity and mortality”—and the political operators in the “real world” who often stand in their way. Lerner takes us through some of those programs, both past efforts that were successful and widely accepted and current endeavors that look promising but face all sorts of obstacles. Keep the faith, he admonishes. The “winds change and public health efforts currently out of favor can once again gain support.” Lerner's meditation‐cum‐exhortation is one of six essays in this issue about how to set and pursue public health goals in light of the gap between ideals and reality.