Written by Dr Jonathan M. Sackier | Concerned Surgeon
I am not a fatalist, I do not believe things happen for a reason, but I do believe we can find reason in the things that happen. In 1815, Mount Tambora erupted and caused global climactic changes. The following year, later known as the ‘year without a summer,’ gothic writer John Polidori, poets Lord Byron and Percy Bysshe Shelley, and his future bride, Mary, were holidaying by the shores of Lake Geneva. The weather was foul and, as a result, a suggestion was proposed that they each write a ghost story. Mary was then 18 and, perhaps inspired by the death of her first child, the proximity of Castle Frankenstein, and the surging interest in galvanism, wrote what is, perhaps, the best-known horror book: Frankenstein; The Modern Prometheus.
This relates the story of a man-made monster who is rejected by his creator and seeks revenge. Littered with implausibilities, such as the fiend learning to read and interpret Milton’s Paradise Lost merely by surreptitiously listening to a rural family interact, it is an allegory, with roots all the way back to biblical creation. Humans need to tell stories, we need to find reason, from opening act to resolution. But real life is not a story. The monster we are now facing, the virus causing COVID-19, is every bit as scary as Mary Shelley’s creation, but there are some key differences.
First, the virus was not, I am certain, created in some secret laboratory by a mad scientist. In the novel, Victor Frankenstein hides his creation from the world, ashamed at what he has brought to life and the harm it has caused. Was information shared as rapidly and transparently as possible by China? Maybe not. Was this an act of commission or omission? My late father taught me that if something looks like a conspiracy it is usually incompetence, as people are not that smart, nor are they good at keeping secrets. I recently stated that misinformation was far beyond mischievous: it could have profound negative consequences. Now is not the time for political manoeuvring or finger-pointing; let us co-operate and communicate honestly and with expedition. To those people promulgating such nonsense, please go back to looking for UFOs or the abominable snowman: much more fun and less likely to induce unforeseen consequences, like racist finger-pointing. To do otherwise will result in unnecessary suffering and deaths.
Doctors and other professionals use a specific and precise language; for instance, diarrhoea means faeces containing a higher proportion of water, not frequency of defaecation. There is no hyperbole, no arm-waving in medical discourse. Anybody who enjoys either consuming scientific literature, works of fiction, biography, or even cartoons, understands that not only is the content important, but so is tone and manner. In the context of the pandemic, I find it deeply objectionable to read about ‘fighting a war’ or, even worse, for individuals to ‘do battle against the disease’. If someone succumbs, must we then assume they were lily-livered or weak of will? As those in healthcare know, if comatose and ventilated there is no ongoing thought process that can influence the outcome. This pandemic is due to a miniscule particle, so small and bizarre it defies definition as a life-form. It is not ‘vicious’, it does not ‘choose’ whom to infect. One cannot ‘fight’ it with guns and violence; we need wisdom and consideration. Nor does ill-informed, narcissistic, political hyperbole work. We, the public and healthcare professionals, choose by our actions or inactions to be infected and affected, or not.
And this disaster is not ‘unprecedented’ as so many media commentators and politicians are saying; the word means something that has not happened, been done, or known before. We have had countless viral pandemics, including the so-called Spanish flu of 1918–1919, whether it was 30 or 50 million who lost their lives. That was an H1NI influenza virus, similar to the one that killed between 151,700 and 575,400 people worldwide in 2009. And there was SARS. And MERS. And Ebola. And HIV–AIDS. It has not been a matter of ‘if’ but ‘when’, and how severe it would be. Check out or watch Contagion, the 2011 movie. Or read Albert Camus’ 1947 novel, The Plague. Or. Or. Or. Can you imagine being this unprepared as a doctor? “Sounds like a myocardial infarction, so why bother with an angiogram, let’s just give some drugs, any will do! It will probably be fine.” Except it won’t.
So, I am asking my fellow doctors and all in healthcare to be a loud voice of reason; set aside politics and openly correct misstated and utterly inappropriate opinion, set aside personal perspectives and do the right thing. Maybe the following is a partial list:
- Follow the physical distancing guidance and encourage your patients, relatives, and friends to stay at home. The is quite powerful in imagining that each ping pong ball is a human life. And ping pong balls break easily.
- Every member of our profession needs support, not just with equipment and finances, but emotional assistance. As we know, the nature of this disease is demoralising and if you personally feel stressed or you see colleagues who are suffering, ensure they have support.
- Practice random acts of kindness to others, especially those in harm’s way, still at work in various industries. Also, those affected in your community might need a little bit of extra help with tangible things like groceries, or intangible things like a friendly voice over the telephone, especially those living alone.
- Develop what the eloquent Mo Gawdat describes as ‘committed acceptance’. Yes, there is a tiger in front of us and sensible action is required. But remember the years of wonderful life that preceded this moment, and the likelihood of many more to come. Be a source of positivity to those you care for.
- Pulse oximeters are widely available and it may be shrewd for people at risk to keep one to hand, as well as a thermometer. If symptoms of COVID-19 develop, such as fever, headache, chills, and incessant cough, keep an eye on temperature and blood oxygen levels. If the former is rising and the latter falling, urgent hospital treatment is merited.
- Refute nonsensical posts or articles, refuse to circulate dubious information, and squash damaging ‘water cooler talk’. Yes, these are frightening and uncertain times, but we are still here so let’s celebrate the beauty in our lives. After all, would a pilot honestly tell their passengers continuously about the risk of crashing? A friend has added a tagline to his email signature that I really like: knowledge is the vaccine to prevent stupidity.
- Develop a daily routine to combine physical exercise, your typical work (as much as possible), social contact (which is why I dislike the term ‘social distancing’ and prefer to substitute ‘physical distancing’), good sleep, and one or two projects you had set aside for some indeterminate future time. This way, when the time of COVID is over, you can have a positive memory or two and can inspire others.
- Honouring our war dead – all our dead – is in our DNA, but is it not better to live? Please read what I say carefully; I am not belittling human sacrifice, I just wish there was less of it. In many ways, World War I poet Wilfred Owen’s dual sonnet Dulce et Decorum Est, addressing the horrors of a chlorine gas attack, eerily parallels SARS-Cov-2’s assault on our respiratory tracts. Both appeared stealthily, induced an “ecstasy of fumbling,” and caused an awful death “obscene as cancer, bitter as the cud”. Owen’s vitriolic diatribe closes by quoting Horace’s lyric poem and the “old lie” that it is sweet and fitting to die for one’s country. But just as war may be avoided, or harm mitigated by political discourse or creative thinking, dying for one’s nation from COVID-19 and other pandemics to come can be obviated, with fewer needing to succumb. Please do your part.
