The tally starts quietly.

Years of believing things that weren’t true, or weren’t the whole story, begin to add up. At first, it feels abstract, a gap here, a simplification there. The kind of half-understandings you inherit without question because they make the world feel orderly and manageable.

But over time, the abstraction thins.

Those gaps begin to take shape in the real world, in who gets care and who doesn’t, in which suffering is named and which is ignored. They show up in the stories we tell about responsibility, who has it, who deserves help, who is expected to endure. What once felt harmless starts to harden. The tally becomes harder to look at, not just because of what we didn’t know, but because of what we accepted, repeated, and helped build.

That’s where regret enters, not as guilt for its own sake, but as recognition. A reckoning with the distance between what we believed and what those beliefs cost.

And if public health means anything at all, it has to begin there.

I grew up inside those early stories. Not the loud, obvious kind of propaganda, but the ambient kind. The ones that pass as common sense. Meritocracy myths. Bootstraps logic. The steady reassurance that the system basically works if people just try hard enough.

The first cracks didn’t come all at once. Maybe they started when I left the U.S. on my own as a teenager and saw the world without American exceptionalism shaping everything. Or maybe they came later, in fragments, through books I didn’t have time to read in college because I was buried in labs and problem sets as a triple science major, or through conversations that found me unexpectedly in a hardware store, a tea shop, an elevator. Small moments that accumulated into doubt.

The unlearning that followed has been slower and sharper. Concepts like the imperial boomerang gave language to something I had already begun to sense, that the violence empires export doesn’t stay contained. It returns. Surveillance techniques tested abroad become domestic policy. Tactics refined elsewhere get repurposed here. The line between “over there” and “at home” dissolves. It’s not a glitch in the system. It’s part of how the system sustains itself.

Realizing that has meant sitting with how much I didn’t see, and how much I wasn’t meant to see. These days, a lot of that learning comes from outside formal institutions, from organizers, historians, and abolitionists sharing knowledge in places like Instagram. It’s humbling, and sometimes embarrassing, to recognize how much time I lost to narratives designed to keep people compliant, isolated, and unsure of where power actually lives.

That sense of disorientation carries into how I think about public health now. What they don’t really teach you is this: the U.S. doesn’t meaningfully invest in public health as a system of care. It invests in response. In managing crises after they happen. In campaigns that focus on individual behavior while leaving structural conditions intact. In research that gets published, circulated, and rarely implemented.

Even within that research, there’s another layer of absence. Who gets counted, and who doesn’t.

I’m a South Asian Muslim woman. My family came to the U.S. decades ago. When I look at health data, I rarely see us clearly. We’re folded into “Asian,” or “Other,” or left out entirely. The same is true for many immigrants, for Muslims navigating healthcare systems that don’t recognize them, for anyone who doesn’t fit neatly into demographic categories designed without them in mind.

This is where data disaggregation becomes more than a technical issue. When data is aggregated, it doesn’t just simplify, it obscures. It hides who is suffering, who is dying, who never had access in the first place. When studies don’t break down results by race, income, immigration status, or religion, they tell a partial story. They're telling the story of whoever was easiest to study, convenient…whoever fit the mold. Call it what it is: erasure with a methodology section.

A few weeks ago, I was in Tampa with a friend. We spent the day drifting between thrift stores and long stretches of strip mall sprawl, talking the way you do on road trips, loosely at first, then more honestly. At some point, the conversation turned to regret. It started small, education choices, paths not taken. I kept circling back to the idea of medical school.

Part of it was practical. Stability matters when you’re trying to be the main source of income for your family. But it wasn’t just that. It was the pull of usefulness, the appeal of having a skill set that feels immediate, concrete, and undeniably needed.

As usual, the conversation didn’t stay contained. It widened into something more familiar, a late-night dissection of power, responsibility, and that low, persistent sense of futility that can creep in when the scale of the problem feels so much larger than any individual effort.

Somewhere in that spiral, something clarified. The conversation about regret began to connect to something else, how we understand love, and how we build community, especially under pressure.

There’s a difference between friendship and community, and it matters more than we often admit. Friendship is affinity. It’s the people you choose, the ones who understand you, who you would find your way to regardless. Community is broader, and often less comfortable. It includes people you might not naturally gravitate toward, but who you are bound to through shared conditions, geography, or need.

In moments of stability, that distinction can blur. Under strain, it sharpens. Friendship sustains you emotionally. Community sustains you materially. You need both, but they do different work.

Regret often sits at that intersection. It shows up in the moments where connection felt possible but didn’t happen, when we stayed quiet, kept our distance, or chose safety over solidarity. When the stakes are low, those moments can feel forgettable. When the stakes rise, they don’t.

The questions become harder to ignore.

And yet, regret isn’t only paralyzing. It can also be instructive. It can point, with uncomfortable clarity, to what matters, reminding us that love, in all its forms, requires presence and risk.

That becomes especially visible in darker political conditions. Love stops being abstract. It becomes the foundation for something more tangible: mutual aid.

Care networks don’t run on ideology alone. They depend on real relationships, on people showing up for each other in specific, material ways. Whether it’s organizing a phone tree, sharing resources, or offering a place to stay, those actions are grounded in care that is felt, not just theorized.

Under those conditions, community shifts. It stops being a casual social arrangement and becomes a survival structure. Ordinary spaces take on new roles. Dinners become planning sessions. Book clubs become ways to circulate knowledge. Informal networks become lifelines. Mutual aid, in that context, isn’t charity. It’s reciprocity. It’s the understanding that care moves in both directions over time.

Because of that, relationships change. Bonds deepen quickly, sometimes out of necessity. But so does the risk of loss, through fear, through fracture, through absence. That’s where regret can return, sharper than before, in the realization that care, withheld or delayed, carries consequences.

At the same time, something else becomes clear. Isolation isn’t accidental. It’s functional. Systems of control rely on it. When people are fragmented, disconnected, and unsure of one another, they are easier to manage.

Which means that building networks of care, however small, is not just supportive. It’s oppositional. Every shared meal, every childcare exchange, every act of collective support pushes against that fragmentation.

Seen this way, the regret about medical school starts to shift. It’s still there, but it looks different. It becomes less about a specific credential and more about a deeper desire, to be useful in ways that feel real.

And the truth is, usefulness isn’t limited to formal expertise. Mutual aid doesn’t require an MD. It requires attention, consistency, and a willingness to show up.

Maybe that’s where a different understanding of public health begins to take shape, not in institutions that fail to see us, or in data systems that collapse our experiences into invisibility, but in the infrastructures people build for themselves when those systems fall short.

If public health is, at its core, about what allows populations to survive and stay well, then it’s worth asking where that actually happens. Often, it’s not in official programs or policies, but in the quieter, less visible networks people create, community fridges, medication sharing, childcare collectives, informal systems of care that operate without recognition but with real impact.

You can call that many things, community care, grassroots organizing, survival.

Or you can call it what it is: public health that actually works.

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