As the year's end approaches, thoughts turn to resolutions soon to be forgotten and commitments as fragile as the snowflakes sure to come in the season ahead. What will remain, however, are reflections of a year gone by, a year in which personal and professional events provided soaring highs and some depressing lows, a year in which too many people close to me had terrifying glimpses of mortality and became reintroduced to their own vulnerability, and a year in which I was made repeatedly to take stock of the world around me. In the year gone by I saw my hope for health care reform and universal coverage dashed in a chaotic flight from social responsibility by people who should have known better.…