I spent yesterday in the emergency department of the Ottawa hospital. I was being treated for atrial fibrillation — the uncontrolled, rapid beating of my heart — and episodes of syncope (fainting) that left me unable to stand. These events were connected to my cancer treatment, and I will explain how in another post. There’s little to do in a hospital bed, so I spent a lot of time reading news, most of which was devoted to President Trump’s hospitalization for COVID-19. There were many references to the President “fighting” COVID. In this post, I want to comment on how you fight a disease.
I have been grateful for many messages of support during my time with cancer. Some writers have cheered me in my ‘fight’, and one exhorted me to “whip cancer’s ass.” Patients, in this trope, are in combat with the disease. I have mixed feelings about this.
On the one hand, being a cancer patient is a struggle. Your life doesn’t stop: you have to maintain everyday self-care habits and close emotional connections with others. You must keep your life going in the face of exhaustion, pain, and, for many, acute nausea. All this tests your character, and if framing your struggle as combat helps you, do it.
On the other hand, fighting to preserve your life isn’t the same as fighting the disease. Surgery, radiation, or chemotherapy destroy tumours, not your willpower. Similarly, the President can tweet as aggressively as he wants, the coronavirus won’t be reading it. Although patient self-care is vital in healing, we do not have direct voluntary control over our bodies’ resistance to disease processes. We have to adapt to diseases, endure the treatments as best we can, and hope for the best.
Moreover, there is an effective way to fight disease. It isn’t what an individual patient does in a hospital bed. It’s what we do, collectively, through public health. We can fight oropharyngeal squamous cell carcinoma — my cancer — by getting every youth vaccinated for human papillomavirus and getting people to stop using tobacco products. We can fight COVID by wearing masks, keeping an appropriate distance, supplying adequate personal protective equipment to long term care facilities, implementing testing, contact tracing, and a host of other activities.
And, finally, something is enraging about the talk about Trump fighting COVID. It was his job to lead the public health response to the coronavirus. He gave up that fight.*
*Is it wrong to criticize someone with a disease that might kill them? No. My immediate response to learning that the President was ill was to pray for his recovery. I am a practicing Christian, and my prayer was sincere. Read the Gospels: you will discover that what Jesus mostly did was teach and heal. He healed everyone he encountered, regardless of their moral status within their communities. I have also studied with Buddhist teachers and received the Bodhisattva Vow from my lama. According to the Tibetans, the greatest bodhisattva is Chenrezig, and I had the unmerited fortune to receive the Chenrezig empowerment from His Holiness the Dalai Lama. A bodhisattva works to free all sentient beings from suffering. In both of these traditions, everyone means everyone.
Likewise, from the viewpoint of professional ethics. I am a professor of epidemiology. Epidemiologists value everyone’s well-being and suffering equally in assessing population health. However, I first trained as a psychologist. Like other health care workers, psychologists are committed to caring for everyone. We make no judgments about whether people deserve care. Again, everyone means everyone.
Therefore, I sincerely wish President Trump full recovery of health. Nevertheless, he is morally responsible for the suffering he has caused, and it is just to hold him accountable for this. This has nothing to do with whether he should suffer from COVID-19. Because health care isn’t just for the righteous, there is no inconsistency in praying for his health and well-being.