At the end of the commencement ceremony for the 2013 CT Health Leaders Fellowship, we were all invited to stand and take one step forward, symbolizing the first step of a thousand mile journey. It is a journey of eliminating health disparities. I had spoken earlier about being an equal opportunity activist, and that this journey was but one of many journeys I am on.

All of this came back to me in many ways this past week. Thursday night was the annual Nurse's dinner at the Community Health Center. One of the stories was of a 450 pound diabetic man who had fallen through the cracks of the American health care system. A care-coordination nurse tracked down his story and followed through to help him get bariatric surgery. He has already lost thirty pounds and with therapy, is starting to walk again after having been bedridden for over a year.

Later, we heard a little bit of her story, an immigrant from a war torn country, who struggled with diabetes and depression through school, but eventually became a nurse at CHC. The patient is on his journey of recovery, aided by a nurse who has taken difficult first steps in her journey to this country and her journey to becoming a nurse.

The story stayed in my mind Friday morning as I went to the funeral of a former classmate and co-worker of my wife. Emily was taken from us way to early, by complications from diabetes.

This week also saw important other steps in our life together as a country. The Supreme Court dismantled key parts of the Voting Rights Act, but it took away some restrictions on gay marriage. I watched the wedding ceremony streaming across the Internet where plaintiffs in the challenge to Prop 8, Kris Perry and Sandy Stier were married.

I read stories about Paula Dean and Rachel Jeantel and I thought about how much work still needs to be done before all people truly are treated equally in all states, no matter what their race or sexual orientation is.

I imagine that the 450 pound patient celebrated the first steps in his recovery as he sat back down and rested after the strain of those steps. Tonight, I go to bed emotionally weary, celebrating first steps, lamenting steps backwards, and mourning the death of a friend.