“If we are to survive, we must have ideas, vision, and courage. These things are rarely produced by committees. Everything that matters in our intellectual and moral life begins with an individual confronting his own mind and conscience in a room by himself.”
Arthur M. Schlesinger, Jr.
“Grab one thumb with the opposite hand and SQUEEZE the lemons, SQUEEZE the lemons. GREAT!” “Now,” in a tone of voice reserved for gushing at small children and orphaned puppies, the grown woman kept on, “interlock your fingers and rub. GREAT!” My hands were dripping in hand sanitizer. Mimicking her exaggerated gesticulations, I squeezed my lemons, interlocked my fingers and focused on my cuticles – a common place for virulent bacteria to hide, especially if you wipe your ass wrong.
Confident about my new hand washing skills I had learned during the last hour in the Avian Influenza Pandemic Preparedness Training, I was ready for the real deal. “Excuse me, I need to use the toilet,” I said politely. At the sink, properly lathered and squeezing my lemons, my boss walked in. Following the unwritten codes of male behavior in the bathroom – spitting in the urinal before pissing, taking a peak, clearing your throat, checking yourself out - I looked at him in the mirror and asked if he knew how to wash his hands.
“Yes, I do. My mother taught me when I was 4.”
Yea, me too. No big deal. After washing my hands and still following the guy code, I scratched my balls. I wasn’t in here for the last 40 seconds rubbing one palm with the top three fingers of the other hand. I was taking a piss and doing something really smart.
We, a group of professional adults, stood in a conference room at the regional headquarters of an international agency and learned how to wash our hands. The teachers flew in from Rome to teach us. Somehow the hand washing instructions didn’t quite match the hype of the advertised mandatory training and my lemons withered thinking about my boss as a four year old.
The training was silly, but it did ask a very serious question that the world and I grapple with hourly: how can you change people’s behavior? How do you ignore the painstakingly obvious prescriptions in policy papers and public health guidelines and address the underlying, difficult-to-change problems.
Public health tries to do exactly this: tell people that if you wash your hands thoroughly with soap and dry them on a sanitary towel you will greatly reduce the odds of contracting a fatal virus during a pandemic. If you wear a condom, you are less likely to get HIV. If you eat a balanced, healthy diet and exercise regularly you will be healthier. If you wear red-tinted sunglasses everything you look at will be red-tinted.
When I was four, my mother taught me to wash my hands.
Often dressed up in book jackets, these obvious statements are dismissed by realists, scientists, rational minds intent on a more complicated diagnosis for epidemics of violence, disease, and stupidity that can be prevented or stopped by washing our hands, caring for the people next to us, wearing a seat belt, reading books about other parts of the world, wearing a condom. That plainly stated problems are not solved by known, effective, plainly stated solutions is difficult to understand.
When I tell friends that my brother and his wife work in a research lab the thought of them is often garnered in genius flowers. And they are smart, but not geniuses; they are products of their trainings who think about discrete problems with unique solutions. But the scientific method does not apply to social problems, as calculators try to find the square roots of negative numbers the answer is not real. In science, much of the work is done in preparation, knowing biochemistry, understanding protein behavior and how to catalyze or inhibit certain things as you best guess. If you can understand the problem, a solution is possible.
Public health, the brain, individual and collective action is different. Actors in the social sciences, development, public health, and politics fields are often given plastic, scentless leis and lumped in economy class. I think it is because the problems they spend time trying to fix are so obvious, so easy to understand, and their solutions never seem to work. This process is the reverse of science, the difficulty back loaded, the solutions not unique answers to discrete problems, but far more complex, irrational and difficult to get right.
What do you do with children who are not taught to wash their hands by their mothers when they are four years old? What do you do with crumbling, violent inner cities and young people who, in their rational mind, make choices that do not value life? What do you do about non-stop headlines of civil strife and children dying of preventable and treatable diseases?
I’ve always felt a sort of impotence in the liberal arts’ response to problems. I am going to feed that starving child, the child who I am looking in the eyes right now, by taking their photo with my expensive camera and writing about her on my blog. We must do more.
And we must do more still, but these pictures are important: we need to retain our humanity. We cannot continue to force scientific thinking into non-scientific disciplines. A little free trade, 5 days in bed, be sure to sign your international trade treaties, and call me next week if the rash/revolution doesn’t go away. As we continue to try to fix the world in spread sheets and economic regression models, our calculators are spitting out imaginary numbers, imaginary beneficiaries and imaginary improvements. Human suffering, smiles, laughter, weddings, and love are lost in statistical abstraction. We must do more with our hands and hearts and understand the fundamentally complex nature of our problems in an appropriate, non-scientific way.
Change takes time, it is not conceived, summoned by biochemical reactions, grants, bonds, aid or loans. Learning science is not easy and it requires patience and skill to be a good doctor or researcher but there are, often, absolute answers. In public health, in the world, in looking that girl in the eye, I can run as many SPSS cross tabs as I want, and I remain with a best guess.
We are fallible and we will be wrong, but we must try, and try again. We must invest in individuals, take pride in our choices, and understand consequence. Our guesses must be grounded in humility and humanity.
Excuse me, I need to go wash my hands.
2 comments:
You need a picture of you in that wonderful handwashing sanitizing immunizing outfit!
LETS DO MORE..
everyday for individuals..
but I do believe the regional buro of an UN office is not the right place to do that..
see you soon in the field and in the camps of the individuals of this hungry planet!
Great post.
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