Some of us are in professions that require the taking of an oath. We ask it of doctors, of soldiers, of public servants. Of those we elect to represent us. Of people we entrust with power.
Our doctors swear to ”respect the hard-won scientific gains of those physicians in whose steps I walk… and apply for the benefit of the sick all measures required… to remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug…to prevent disease wherever I can for prevention is preferable to cure.”
Oaths are not administered on the battlefield. They aren’t taken while a patient is on the operating table. No one raises their right hand while someone is bleeding in front of them. Oaths are administered after study, training. Commitments are made in safety, while we are filled with confidence and enthusiasm for our call.
Oaths have meaning. To commit oneself, body and soul, to something larger — to make a declaration — is to issue a blank check to a cause or purpose. Those that pledge themselves to a greater purpose, and use honor as collateral, we call heroes. New York Governor Cuomo announced today that 76,019 healthcare professionals, including many retired doctors and nurses, have volunteered to assist overworked and understaffed New York hospitals. This despite the lack of personal protective equipment. Our health care professionals are our heroes now.
Hard decisions in a time of scarcity
Every day we make decisions that impact the lives of others. One young person gets a scholarship, another does not. One person is promoted over someone else. One group is resourced, another dismissed. One celebrated. Another ignored. One country gets life saving aid, while another is punished. One child gets your attention while the other waits. If we could see every impact, every aspect, and all of the implications of what we choose, in these moments and every day, we would be frozen. Unable to do anything.
No matter our jobs, or our position in society, we are all profoundly connected, and our fates are permanently intertwined. Most of the time we can’t see the endless ripples of our choices, but that doesn’t mean they aren’t there.
The nature of a disaster is this: it illuminates. Suddenly our choices are starkly visible, in all of their harsh implications. Whom do we save.
Moral suffering occurs in every disaster. The moral suffering of rationing. The moral suffering of parsing phrases to control panic. The moral suffering of saving one, rescuing one, treating one, helping one — - and not the other.
I’ve made a career of studying those who have stared into the abyss of hopelessness. Of understanding despair beyond rescues and losses too terrible to name. Those people that go on are those that spend little time on blame. Their own journey has humbled them. If they made it out of the hell of war, or displacement, or epidemic or genocide, they were forced to make gruesome choices. They’ve earned their humility medals. And they spend little time accusing others.
A week ago, on CBS Sunday Morning, a physician was asked about the scarcity of ventilators. If there is only one ventilator and two patients, which patient gets one? How do you decide? The doctor cried. The story moved on.
A friend of mine, who served with Doctors without Borders, told me this about her time in Sudan: “I knew that when I slept, people would die. And I had to sleep.”
Our frontline health professionals are making these brutal choices now. Bound by oaths and dedication, trained and conditioned to respond, they place themselves at the scene and choose. And because of the resource allocation choices that we made through our federal government, states, and health departments, their choices are now much more difficult. Choosing the well-being of their patients over their own, and over that of their families. Choosing who gets the ventilator. Torturous.
Power to allocate resources
If you’ve ever been in a position of leadership, with power and responsibility, especially in a mission driven organization, you’ve wondered if you were brave enough, or strong enough to make difficult allocations. To accept responsibility for tough choices. Some of us have had to face those we could not help. Those we were forced to abandon. Those we forgot.
Honest leaders regularly look back to a moment of decision-making and cringe over our own limitations and omissions. I recognize that I have sometimes forgotten about people with disabilities. I use language and advocate for responses that leave out those who move about differently, sense differently, those whose bodies don’t serve them the same way mine serves me. Perhaps, we all sit at the center of our world and turn around in a circle, assuming that what is in our range and reach is all there is to know.
We ask of leaders who come after us, do you possess both the humility and humanity to accept your limited understanding and insufficient foresight? And will you own the consequences?
This past week, I spent hours on the phone with social sector leaders — many at the heart of our ground level response to this disaster. These are the folks who are required to pick up the people, and the pieces, abandoned by all the broken systems. Disasters aren’t fair, and they don’t spare those who were already struggling. Those that were already alone and sick. Disasters are cruel that way. One catastrophic condition is not insurance against another.
Nonprofit leaders make painful decisions every day. What to fight for. What to sacrifice. They are choosing now. Is it better to risk infection and feed people? Or close the doors knowing that some will go hungry? Create necessary social distance, but house fewer people.
In some ways, I’ve found them more prepared for this than their for profit counterparts. Profit making entities have just one scorecard metric. Now, many are making choices at odds with the card. Lowering their score, preserving their humanity.
The oaths we take call us to service — to others. There are no oaths administered to “serve ourselves”. To tend to our needs. To bind our own wounds. It is assumed we will do this.
I believe this is one of those times that we are asked to be like mothers. To be a womb. To hold and protect, to nourish and serve. To try to contain all that is human. So that in a few months we can rebirth it.
You’ve been trained to be a good human being. To tell the truth. To stand up for others. To protect the innocent, and the vulnerable. To share what you have. To use your gifts. Don’t waste this illuminating moment by anything as petty as complaining or blaming or raging. You are being called.
Be an oath taker. Commit now — if you haven’t already — to people beyond your own family and loved ones. Let this disaster, this calamity of scarcity, illuminate for us the strength in service, and foster in us the courage to be responsible for and to one another.
In this moment of illumination we say “we are all in this together,” and pray prayers of togetherness and sing in appreciation. Voluntarily sacrificing for one another, we close our businesses, shutter our schools. We sew masks and make meals. For one another.
Let’s promise to remember these lessons and our oaths. The teachings of the virus: our health and wellbeing are part of an interconnected whole.
We were and will be capable…always. it is not a matter of learning to love. To care. It is our nature, to such a degree that even without the “How to Love in a Pandemic” manual, we find our way to these human(e) gestures…Reflexively, at this moment of great clarity, we have reached out to one another. And we are holding on for dear life.
I wrote this for me and maybe for you too.
Angela Blanchard and William J. Allen authored this — the result of many important conversations about meaning and purpose and difficult choices.