Archive for April, 2020

Defiance of Death: How Medical Breakthroughs Shaped Emotional Distance to Disease and Dying

There is a trajectory to humanity’s relationship with death that runs in tandem with the rise and belief in science. When there was no knowledge of bacteria or viruses, and death could come from being cut by a rusty tool, death was an inevitability in a person’s life. Childbirth, measles, cancer, heart disease, could and did take our forebears with a regularity that made the invisible world of death a daily shroud. One worn as casually as you might wear a favorite shawl.

As science and medicine matured, and the invisible became visible in the form of microscopic enemies to be defeated, people became convinced in the possibility of outwitting death. Indeed, the discovery of hand-washing alone became a game-changer in the outcomes of many who would have otherwise succumbed to sepsis or infection from cross-contamination between patients.

As a historian who studies and teaches the Civil War, I have a fascination with my students’ general lack of appreciation for the way combat medicine advanced the field of medical knowledge in the mid-nineteenth century. Instead, students are appalled by what they deem egregious lack of sanitation knowledge in field hospitals and army camps alike. Students know only a world where a malady can be repaired, cured, erased, healed, with what they perceive as an almost willful disregard for death. Death, when it happens today in a hospital, under ideal sanitary conditions, is an anomaly. It is an inconceivable outcome in a world of science, order, and knowledge.

In a field course I’ve taught about cemeteries and the changing perceptions of death in America, one of my lessons is about this very topic. That our rational distance to death, the proximity of our mortal lives to death, are in exact proportion to the extent that we believe science and medicine can and will save us in the event we need it to. We witness mass refutation of the pandemic that rages around us. Individuals, cities, and entire states refuse to follow stay-at-home orders. This attitude persists in direct evidence of climbing death rates in places like New York City, Seattle, and New Orleans. Newsfeeds are overrun with personal stories of loss, of battling the virus, of being near death, and still the public goes to Home Depot to get mulch, or Walmart to pick up a bathing suit, in willful ignorance of the seriousness of the situation. Perhaps this disregard stems from an inherent belief that our modern existence is so infused with science we cannot be unsafe.

This blatant defiance of the stay-at-home order got me thinking about the underlying cause for such behavior. Yes, there is a backlash to the order by some who claim the orders violate their personal liberties, and I do anticipate that we’ll have to be particularly vigilant about requiring our local, state, and federal governments to reassert our freedoms and privacy when this emergency abates. But the behavior also reflects an imperviousness to infection, a cavalier attitude to COVID-19 that even if a person gets sick they’ll be fine. More concerning, are those who outright refuse to believe the pandemic is happening at all, that it’s a conspiracy of some sort. Stories about hospitals running out of sedation medication necessary for intubation, not having enough ventilators to treat the worst of the ill, doctors and nurses succumbing to COVID because they haven’t protective gear, mobile morgues. These are all scenarios out of science fiction. They don’t register as personal unless a loved one or an individual is faced with the reality.

We believe so fully in the ability of medicine and science to cure all that ails us that when faced with a pandemic to which we have no immunity, no cure, no way to miraculously heal the afflicted, we reject the severity of the illness. For so many years science and medicine acted like the miracles we needed them to be. We’ve been able to distance ourselves from the reality of death because, for some of us, a week’s worth of antibiotics have fixed us right up. The flu shot, though not perfect, gave us the armor necessary for facing the day.

This isn’t a perfect world. And many who need medical care never get it. The American healthcare system is broken and unfair to most. Insurance companies take decision-making out of the hands of caregivers. Those who can’t afford insurance, go without even basic care. Healthcare suffers from racism, ageism, ethnocentrism, gender disparity. For many of us in the US the healthcare system is complex, terrifying at times, frustrating, and heartbreaking. And yet, we still collectively believe in the science behind current medicine. We still unfairly imbue doctors and nurses with the ability to cure anything, and expect this outcome, and reject failure when it comes.

Healthcare providers and scientists work with the tools, knowledge, and skills they have available, and that is a considerable wheelhouse from which to draw. But the truth is, that even with top scientists researching new medications, dedicated doctors and nurses tirelessly working the front lines, diseases exist that will come along and devastate us like this current novel Coronavirus. It will rock the scientific community to its core. It will decimate a generation of caregivers. And yet people will still believe they are somehow impervious, because we’ve lived in a world dominated by medical miracles. Older generations remember grievous illnesses like polio, and the way medicine and science saved lives, making them particularly susceptible to believing this current virus is not as threatening as it is. But we also have younger generations who have never lived in a world where disease seemed threatening, making them vulnerable as well. The reliance on medicine to provide an invisible shield between us and death has been growing with each new advancement. Historically, as we gained the upper hand over seemingly incurable diseases, we became less comfortable with death and dying, distanced from the event. Death didn’t live with us daily and so we could ignore it. For the most part this ignorance came with little consequence.

Today, death could be on our Amazon package, could be lurking on our doorknobs, could be on our hands, literally. Death is a droplet expelled from one’s lips. Death is one kiss, one sneeze away. We can’t process this. Recommendations to wash hands for twenty seconds as one of the top ways to prevent illness should be a laughable order, but we’ve become so inured to death and disease, we don’t even do that regularly. The breakthrough discovered over one-hundred and thirty years ago that my students always seem to be most shocked by—washing hands as the prevention of infection—has become a novel way to battle this new virus. That should tell you something about the current complacency of people’s fear over infection. We’ve forgotten that the simple act of hand washing was the medical breakthrough for a generation of medical providers. Our brains can’t process that science may not happen quickly enough to save all of us this time, and so people go about in reckless defiance of the specter that may inevitably visit.


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