Editorial from Stories in Medicine – JHH 17.1 by Professor David Peters

The pandemic seems to be the only story in town. We are shaken by its suddenness, by the urgency of our responses; shocked to be made so abruptly aware of our personal vulnerability. We feel powerless, fearful, angry. In our communities we have become more isolated, suspicious of strangers and prone to speculate darkly on the collapse of the world order. It’s a true story of vulnerability and human limitation: of being literally locked in, unable to go out or do our normal work; of money worries and loss of social identity. At a planetary level, with borders shut down and international transport frozen, we depend more and more on technology for communication, and on the goodwill of retailers and the mercy
of our health services. As we go slowly stir-crazy in lockdown, mental health, family life, friendships and community coherence suffer collateral damage. Planet-wide, already over-leveraged economics, globalised trade and the carbon-heavy costs of fuelling them have all taken a heavy hit.

I believe there is a holistic upside to all this: another way to understand this story and what the pandemic is telling us about our vulnerability, limitation and dependence. Should we not be seeing the virus as a health warning from the planet? Indeed the systems we depend on are very vulnerable, and we are in a crisis whose outcome we don’t yet know, but we can be pretty sure it won’t be business as usual. We speak of bouncing back from hard times, but true resilience grows when adversity forces us to learn and change: species, people and cultures evolve by bouncing forward. Realising we are vulnerable, we can boost self-care, and cultivate an inner life if we can reframe confinement as an unasked-for retreat. Accepting interdependence, we stand together, knowing that divided we fall. And how will awareness of nature deprivation change us, longing as we are for landscape as we stand gazing from our balconies? Jogging down the tarmac do we occasionally notice how quiet and clean the spring air is?

Although we prefer not to think about them human vulnerability and suffering are facts of life. A compassionate society would tackle their biological and their psychosocial roots. Austerity has been a major vector for ill-health and loss of wellbeing, yet huge reserves of altruism are rising up along with new respect for low-paid workers who keep supermarkets, online deliveries, and care homes going. And we feel profoundly grateful for
the self-sacrifice and courage of the NHS frontline. Paradoxically, social limitations are renewing our friendships, neighbourliness and community spirit.

Having learned the lessons of our inter- dependence and vulnerability, can we drop the illusion of separateness and control? Will we see humankind for what it is, a vulnerable and limited component of the natural order on which it depends. We urgently need such stories to fire our imagination and feed the political will for a good society, where the well- being and resilience of all species become politicians’ only compass. As we learn how better to guard against future pandemics will there be renewed enthusiasm for benign state intervention, greater commitment to pro-environment policy and alternative forms of economics and trade? Will excessive wealth accumulation and exploitation have to be constrained? Will more of us have come to value spiritual time out, social creativity and freedom from the 9 to 5? Grateful though we are for acute clinical medicine are we also ready to accept that it cannot create health?

The pigeons have come home to roost. The pandemic is surfacing primordial anxieties about our mortality, insignificance and belonging – the timeless unease that goads us to seek safety and certainty at any cost. To soothe them we have narrowed the focus of science, sleepwalked into the political fantasy of taking back control, been moulded into ‘consumers’ and seduced into adopting fundamentalism as a defence against meaningless. Now it’s payback time and we have to ask what comes next. Perhaps I’m deluded, but I believe we can start a pandemic of the imagination, cross-infecting one another with stories that create the world we want to live in.