by “How vulnerable do you feel as 2022 draws to a close?” wonders Kamran Abbasi, editor of the British Medical Journal, addressing the medical profession in his Christmas op-ed. “How worried are you about family and friends? How much more vulnerable are your patients in a world of fading safety nets?
In the not too distant past, “vulnerability” was considered the condition of infants and children, and of those with physical and mental disabilities. This condition has gradually expanded (accelerating during the Covid pandemic) to include the elderly, people with “underlying health conditions”, members of black and minority ethnic communities, those suffering from mental health issues, up to swallow the entire population. From the BMJ’s perspective, a sense of “vulnerability” now also afflicts physicians, whose historic calling has been to alleviate their patients’ particular vulnerability to disease.
What evil forces have reduced a once powerful and confident profession to such a state of fear and trepidation? A glance at the pages of the BMJ reveals a sense of impending doom leading to paralysis in the face of threats from climate change, pollution and potential new pandemics. In the prevailing mood of pessimism and despair, the BMJ’s editor can take little comfort in the successes of medical science and public health in containing the rigors of Covid-19.
Indeed, the medical profession has done much to promote the climate of fluctuating anxiety to which doctors themselves have now succumbed. The inflation of health to include a widespread state of “well-being” suggests the achievement of personal physical and psychic harmony as the goal of human existence. But if well-being is established as a life goal, it is no surprise that a growing proportion of the population experiences the vicissitudes of life as mental illness and requires professional intervention in the forms of therapy and medication.
Promoting “awareness” – of the risks of various forms of cancer, heart attacks, strokes and numerous other conditions – encourages people to closely monitor their bodily functions and to undergo regular medical inspections, screenings and investigations. This heightened awareness of physical symptoms is making people sick — from anxiety, overdiagnosis, and overtreatment. It is also making doctors ill from the stress of meeting the unsustainable demands they have assiduously promoted. A retreat from the medicalization of life would reduce the vulnerability of both patients and physicians.
A little kindness goes a long way in the health service
The spirit of surgeon Dame Clare Marx, who died of pancreatic cancer at the age of 68, offers an alternative to the BMJ’s misanthropic narrative. A pioneer throughout her career, Dame Clare was the first female consultant in the notoriously male-dominated world of orthopedic surgery, the first woman to chair the British Orthopedic Association and become president of the Royal College of Surgeons. As the first woman to chair the General Medical Council, in July 2021, she released an emotional farewell message following her diagnosis with pancreatic cancer.
Dame Clare paid tribute to colleagues who have helped her overcome the petty prejudices she has encountered in her stellar career. She also acknowledged the health service’s response to the Covid pandemic, indicating that “perhaps the greatest triumph is not what was done, but how it was done – through camaraderie, communication and collaboration.”
His wish for the future was for this spirit to continue, “so that every physician and every patient experiences the compassion that defines first-class care.” His heartfelt farewell message to the medical profession was that “in a service short of time and resources, there is no excuse for being short of kindness and courtesy.”
