Keep Calm and Read On

Keep Calm and Read On

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Even before coronavirus, there was an urgent need for clear communication, for translating science into plain language, for demystifying medicine and for reducing stigma around disease and disability. This type of science writing is even more critical during this global pandemic. 

In Jacob Bronowski’s 1973 book The Ascent of Man, based on the television series, he talks about the danger of an ‘aristocracy of intellect.’ He warns that keeping scientific knowledge only amongst such an aristocracy could “destroy the civilization that we know.” He writes:

“If we are anything, we must be a democracy of the intellect. We must not perish by the distance between people and government, between people and power, by which Babylon and Egypt and Rome failed.  And that distance can only be conflated, can only be closed, if knowledge sits in the homes and heads of people with no ambition to control others, and not up in the isolated seats of power.”

He really had a way with words.

That quote has always resonated with me because much of my job in medicine is explaining scientific and medical concepts to my patients. Also, I love popular science books; I closely follow science journalism and now I spend some of my time writing about science and medicine topics for my book projects.

Another book I’ve been thinking about recently is Daniel Defoe’s A Journal of the Plague Year, a fictionalized account of London’s plague outbreak in the late seventeenth century. It’s not a science book exactly, but it certainly could be shelved under the history of medicine/public health section. The book begins by detailing how the cases and deaths from plague rose with growing speed over the early weeks and months of the epidemic. People were afraid of the illness and of the strictly enforced quarantines. He writes that “From the first week in June the infection spread in a dreadful manner, and the bills rose high; the articles of the fever, spotted-fever, and teeth began to swell.”

Fear, superstition, and panic took hold and caused Londoners to desperately seek remedies as the “terrors and apprehensions of the people led them into a thousand weak, foolish and wicked things.” Soothsayers, fortune-tellers, and quacks flourished, as they sold false hope and fake cures to the frightened and gullible. Defoe observed that “it is incredible and scarce to be imagined how the posts of houses and corners of streets were plastered over with doctors’ bills and papers of ignorant fellows, quacking and tampering in physic.” Terrified families broke out of quarantine, fled London and died by the thousands.

In the end it took strong leadership and guidance from health professionals to confront the plague. Eventually the Lord Mayor of London “ordered the College of Physicians to publish directions for cheap remedies for the poor,” which, Defoe observed, “was one of the most charitable and judicious things that could be done at that time, for this drove the people from haunting the doors of every disperser of bills, and from taking down blindly and without consideration poison for physic and death instead of life.”

I love Defoe’s other novels, but it was A Journal of the Plague Year that formed the central inspiration for my book on the opioid epidemic, The Age of Fentanyl. True story. I knew I wanted to write a book about my experience in addiction medicine, but I wasn’t sure what form it would take. Then I was flying to Toronto for a conference and brought along Defoe’s book hoping it would provide some form of inspiration, and it did. I ended up using some of Defoe’s description of the plague to shape my discussion of the opioid epidemic. What is so remarkable is how apt those same descriptions are now, for the coronavirus pandemic. 

In many ways, we are well-prepared by technology for the quarantines and lockdowns which are taking place across the world. I am writing this from home after spending every day with only my wife and two children for the past week. I will send this to the staff at Dundurn who are themselves working from home, and many of you will read this from home. We have the technology to read any book and watch any movie from home. But there is less time in a day for such pursuits when you are looking after your kids or your sick family members. And it’s hard to focus on fiction when you are scared.

We are all obsessively reading the news, looking for answers, learning about new cases of coronavirus and hoping for good news. Many people have already lost their jobs and many more people will. People are afraid, as they were during the plague in the seventeenth century. What we need is for our leaders to clearly communicate the situation as it is, what to expect in the future, and what steps we can all take to get through this together.

In The Age of Fentanyl I draw lessons from the successful strategies used against the HIV epidemic, and I try to show that we can also take steps towards ending the opioid epidemic by using a broad array of strategies including clear communication, just as the College of Physicians did in the seventeenth century. The same holds true for coronavirus. We will defeat the virus through science, through basic public health measures, and through drawing on the lessons from previous outbreaks of disease. 

And as Bronowski would have counseled, to prevent a revolution, those in power need to make sure that everyone understands what is happening, that the science is clearly communicated, that this “knowledge sits in the homes and heads of people with no ambition to control others, and not up in the isolated seats of power.” He really did have a way with words.

 

 

Brodie Ramin

Posted by Kendra on June 18, 2019
Brodie Ramin photo

Brodie Ramin

Brodie Ramin is a primary care and addiction physician. He is an assistant professor at the University of Ottawa and a Diplomate of the American Board of Addiction Medicine. Dr. Ramin lives in Ottawa.