It has been worse and it can get better!

In 2019 a book was published entitled Epidemics and Society from the Black Death to the present. It was written by Frank M Snowden.  It is fascinating to learn that only half a century ago two infectious disease departments of renowned US universities were closed under the misguided belief that their job was done.  The fact that we are now in the midst of a worldwide pandemic, rates of measles and mumps are rising and even newer infectious diseases are appearing should shake us from that previous complacency.

Snowdon’s book suggests that infectious diseases, over history, have shaped society in ways that are as critical as other crises such as wars, revolution, famine, shortage of water, or economic collapse.  Given that, perhaps we need to give this topic a great deal more attention.  A table can help to put it in historical context (see below).  It certainly indicates that pandemics have been around a long time and highlights how deadly the Justinian plague, the Black Death, and the Spanish Flu were compared to all the rest.  It is salutary to realise that those who survived the killing fields of World War I also endured the deadly Spanish flu that followed it.  In case we thought our present generation was particularly blighted by disease it is worth remembering humanity has seen much worse days.      

A quick look at the WHO disease outbreak page today,  provides an urgent wake-up call. The war-torn Democratic Republic of the Congo is suffering from more than Ebola (fatality rates of 90%). There is also a measles outbreak, and a circulating strain of polio that mutated from the live, weakened one in the oral vaccine. It is worrying to discover that the old enemy of humanity, plague broke out in Madagascar in the last five years. It is endemic in that country, but has been successfully brought under control by the concentrated efforts of International bodies and local government.  It is worth understanding the vocabulary used in discussing diseases.  I have to confess I only recently understood the difference between endemic, outbreak, epidemic, and pandemic.  For something that has impacted us all on so many levels, it is worth understanding these words precisely.

Between March and July of 2021 there has been an outbreak of Middle East Respiratory Syndrome coronavirus in Saudi Arabia.  Although only 810 deaths have occurred, this disease has an eye-watering fatality rate of 35% (Covid 19 is around roughly 2.5%).  In reading the information about this outbreak the WHO declares (WHO)

“Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine, or eating meat that has not been properly cooked.”

You are no doubt relieved to hear that your personal risk of catching this disease from eating camels or drinking camel urine is low!  Camels can be easily avoided by most of us, but don’t feel too relaxed this MERS-CoV has demonstrated the ability to transmit between humans too. Indeed other species of animals and creatures are also perfectly capable of spreading diseases to humans.  Monkeys are responsible for the Monkey B virus with a horrendous fatality rate of 42%. Well, I say responsible but if we didn’t hunt, keep, kill and eat such animals we might be fine.  Bats are responsible for horrid diseases with huge fatality rates ranging from Marburg virus at 50% to the Nipah virus with a 75% rate.  Worryingly even the tiny simple Tsetsy fly can cause the African Sleeping disease which has a 42.5% fatality rate.  The cute sounding Dear mouse can cause Hantavisus pulmonary syndrome with a fatality of 36%.  Not to mention bird flu whose fatality rate is also in the region of 20-40%.  Then finally, to freak everyone out there is the Brain-eating amoeba which lives in warm fresh water and enters our body through our noses and results in a 95% fatality rate.  I suspect your feeling of relief at the start of this paragraph has just about dissolved by now.  

There is of course good news on many fronts and I’ll just mention three. 

• When the world collaborates and works together to fight a deadly virus, as in the case of Smallpox, it is incredible what the world can achieve. This virus caused 500 million deaths in its last 100 years of existence but a united humanity managed to eradicate it in 1980.  However, it did take 200 years from the discovery of a successful vaccine for this to happen.  The signs are that the world has been able to speed up this process considerably as shown by the recent Covid 19 pandemic.  However, without a unified approach communities left unprotected from any disease are not only more vulnerable to this disease but also provide a perfect breeding ground for new variants/viruses which can undo all that has been achieved. 

• The other good news is the range of treatments now available for so many of these contagious diseases and this has helped reduce the fatality statistics mentioned earlier.  Providing good timely medical treatment is such a no-brainer we should be supplying it to every human being in need. We should certainly not be allowing immune systems to be weakened through lack of food or access to safe water.  Prevention is not only extremely cost-effective it helps us use our medical interventions in a more targeted way.

• It is excellent to know that our own bodies have a system of defence that is truly breathtaking.  Our immune system has huge groups of cells designed specifically to defend the body from illness and infection. These are crack troops designed to fight pathogens, viruses, bacteria, and mutated cells that seek to do us harm.  We actually have two separate armies to defend us one innate and the other acquired through previous exposure. One army is excellent at attacking quickly, the second is battle-hardened troops who have successfully fought this enemy before.
  
  
  

        

Keeping your immune system functioning normally, via the right nutrition, is a simple preventative step that makes so much sense (mayo clinic advice).  Researchers have also found considerable evidence that positive emotions boost the immune system, while negative emotions act to suppress it. 

        The more you think about the human body and how all the major organs work to keep it healthy perhaps a similar pattern is necessary in a world community working to address the important problems we face.  Diseases can shape societies as history has shown but they also force us to think globally as one people on one planet. 

“The bedrock of a strategy that can engage the world’s population in assuming responsibility for its collective destiny must be the consciousness of the oneness of humankind.” 

Bahá’í International Community

Lying in Style

Was with a small group of junior youth (10 to 13 year olds) at a day camp here in Malta. My role was purely supervision. They had been given a task which they had 45 minutes to complete. All the teams where handed a sheet of information which they had to prepare a presentation on. At the end of the 45 minutes they would all have to present what they had learnt to the plenarily session. It helped we were all outside seated at a park in the sun working at a table.  Another big help was the A2 coloured sheets of cardboard, Sellotape, glue, colourful pens etc. What was an issue was our particular topic, wind erosion. Nearly all of them had already covered this topic at school and were reluctant to become involved with it again.  As they spoke about their school, their total boredom with the educational process leeched into the atmosphere. When I asked them to get started, one covered an area of the cardboard with glue and poured a handful of soil onto the sticky surface. Determined to be encouraging I praised this initiative and asked how they could show it blowing in the wind?  Immediately, a small girl starting work with large arrows but was restrained by the rest, "Do it in pencil, In case you make a mistake”, they said. She drew arrows in light pencil checking with her peers as to size and position. 

My heart sank. What is it about our systems that they kill creativity but bolster self-doubt and and the need to avoid criticism at all costs. The group was concerned that too much space had already been used up by the soil and arrows. “How would they get the rest of the information on the page”. This was combined with various cries of “No way, am I saying anything during the presentation”! The only heated discussion was on who would claim the role of holding the poster. That obviously was a nonspeaking role and much sought after. Since, the wind erosion affected rocks, I suggested perhaps we could include this on the poster I lifted a large pebble and put it on the corner of the poster. The group was horrified. It's far too big!” Followed by, “It'll never stick!” One courageous soul got going with masses of Sellotape and the rest grabbed their own stones and got sticking. Glue turned out to be useless, but by means of half of a roll of Sellotape all succeeded in placing their own rocks. They insisted on checking stability by holding the poster up right and doubling Sellotape on a pebble which showed signs of movement. Water waves erosion of sea arches was captured in a series of five pictures beginning with an arch and ending with two solitary pillars pointing skyward. Rain and it's effects was beautifully drawn in intricate coloured tear drops of rain falling abundantly above a stuck on pebble. 

It reminded me of how I used to spend ages colouring in the sea in history maps for homework. On one on the Spanish Armada I had had tiny blue lines extending out around the entire European coastline.  I cannot remember a single historical fact about the Armada but I recall with pleasure the intricate blue lines faning out from Cornwall in the south to the Hebrides in the north. It took me hours and my history teacher was not over enthusiastic about my efforts. So, when critics began complaining about how many raindrops the girl had drawn, I countered with ample enthusiasm for more! She purred purred in delight and did 10 more of the multicoloured drops. 

We were left with all the knowledge in diagram form but no words. An entire 30 minutes had already passed and there was now growing rebellion about speaking in public. They all looked at the poster's assortment of sketches, stones, arrows and soil. At one point tiny branches of trees had been added to the sides by someone unable to find an appropriately sized pebble. I could see why they were doubting their creation and dreading the public humiliation of having to show it to the wider group.  

I advised them to take one fact each and talk on that. That way each person would only have one sentence to say in public. They reluctantly agreed that this might make it easier. They had a diagram to point to for each fact so that would also help.  There were many doubtful looks at each other. Obviously, they figured their poster would be more confusing than helpful. I pointed out that half the difficulty in explaining the different processes involved was the stupid names given in the text. 

“How about each of you rename them and when you explain to the group use your name instead of the technical terms.”  

There was shocked looks around as if I'd asked them to lie in public. “You mean just make them up!” One shouted. 

“Sure as long as you know what it means, what odds what you call it? You're more likely to remember your own chosen name for the things anyway.” I added. 

This was greeted with howls of laughter and delight. They all came up with ridiculous names.  Wind blowing soil and sand across the landscape was renamed Wind-oh!  (pronounced wind dash oh). Rain water falling into cracks in stones was called H2O Sponge formation. Water freezing in the cracks as ice and causes bigger cracks was renamed Aquacracking. And so it went on. Strangely knowing that they could use their own 'made up' names, all were eager to present their idea. The deliciousness of falsehood in public was heady. So pleased were they with their new terminology they decided to end with a quiz to test if the audience could remember the new words. 

The young presenters had a field day. Each spouting on about about their names. Getting the audience to pronounce it properly. Spelling it aloud so everyone could appreciate it’s cleverness. During the quiz the entire audience remembered each term perfectly, the team was ecstatic! In triumph, they stormed off. One concerned whistleblower stayed and warned the audience that all these terms had been made up. That they didn't actually exist. Just in case someone used them in school. 

“You mean all of them!”  One boy in the front row asked in despair. None of the adults there noticed or questioned the strange terminology. We have long grown accustomed to new terminology and are willing to swallow it down wholesale. 

But it struck me that isn't that what most education is about?  The memorisation of facts and terms and the regurgitation of the same in tests. Knowledge of these code words means passing and ignorance of them failing. Isn't it mostly a complete waste of time that just sucks creativity out of every topic. Education becomes fence jumping, teaching entails training the horses to jump higher and faster over a known obstacle course. Those who mastered this useless skill are called the intelligent among us and go on to further education. More advanced fence jumping takes place. Astute at swallowing terminology wholesale, with excellent memories and obedient regurgitators when faced with the end of term exams. They used to say only the cream of the cream get to university 'the rich and the thick'. Now I have begun to question everything we commonly accept as education. When did we think the information conveyed mattered more than the purveyor or the recipient? Exactly what do we celebrate on their graduation? My son and nephew refused to go to their graduations. At the time, I resented not having the ceremony, the photographs the shared celebration. But, in hindsight, I reckon it was a statement about how little any of that actually meant. Three years of what exactly? The brains that emerge from many of our educational systems are stultified by its regime. Somewhere, along the way they lose that most vital of all things. The passion for truth and discovery. Jaded and unsatisfied they become excellent folder for this world. Hungry for things to buy to fill the void.  We have forgotten that when a horse gallops it does so instinctively, it was born to run free across its landscape. Perhaps, we have forgotten the purpose of education.  If our system converts curiosity into apathy we must ask how can we recapture the joy of learning?  

May your pain be short and your pleasure long!

I have always been bad with pain.  The tiniest cut, from an early age, brought forth howls of despair. Usually, this would be followed by requests for bandages, the bigger the better.  At times my mother was placing bandages on wounds that were so small she could not even see them.  As I grew older, I became aware that I had a remarkably low pain threshold.  Watching other children in school fall and bleed only to get up and run off amazed me.  As I progressed through adolescence my mother would remark, “What on earth are you going do when you have to give birth?”  It was one of those questions that an adolescence feels a parent asks just to manipulate you.  Akin, to her other favourite, “You must learn to cook and clean now because one day you will have your own house!”  To this I always smugly replied, “Don’t worry, I’ll always have servants!”  This must have been particularly abrasive to my sweet mother who carried trays of breakfast to all of us in bed every morning, while Don Williams filled the house with his songs.  I only have to hear one of his songs to find myself hungering for tea and toast on a tray.

Being a coward about pain I asked everyone about what giving birth was really like.  One said it was the most amazing experience of her life.  Another babbled on about this small baby and how beautiful it was.  A third said ominously that one soon forgets the pain.  My mother said, in her day, you were expected to give birth in silence, a slight whimpering was tolerated but not for long.  You were expected to approach birthing in a ladylike way.  She looked at me with a forlorn expression before repeating, “I really don’t know how you will ever get through it!”  When I was pregnant people became much more honest.  One friend told me it was like having a knife plunged into your innards and twisted.  This was altogether too frighteningly honest I felt.

True to form, I was racing to hospital with every little twinge convinced the birth was imminent.  Surely, such excruciating squeezes meant the baby was on their way.   Medical staff said, in ominous tones, I would know it when the real contractions began.  Then, when the murderous contractions actually kicked in I understood exactly what they meant.  I distinctly remember not being ladylike about the whole business.  When asked about pain relief, I retorted “give me everything you’ve got and if that doesn’t work get a big club and knock me out”. At one point, I remember clearly instructing the medical staff to cut off my head and haul the baby out that way.   

My sister-in-law had an even more painful birth but within a matter of hours was saying she would be happy to have another baby soon.  It was as if her memory had selectively eradicated all the pain and suffering.  Today when reading a book, it suddenly all made sense.  It is by Daniel Kahneman, a Nobel Prize winner, entitled Thinking Fast and Slow.  It helps you understand why we make the choices we do in life.  In one section they carry out an experiment on a group of subjects.  The experiment was simple; each person would have their hand immersed in cold water 14 degrees for 60 seconds and at the end would be given a warm towel.  The second experiment lasted 90 seconds, the first 60 seconds was identical to the first and then for the last 30 seconds warm water would be bringing the temperature up by one degree.  The third experiment subjects were told would be a repeat of either the short or long experiment.  They were allowed to choose which.  A surprising 80% chose the 90 second immersion.  Despite this being obviously longer that the first.  What was going on?  According to Kahneman,

“The subjects who preferred the long episode were not masochists and did not deliberately choose to expose themselves to the worst experience; they simple made a mistake.  They chose to repeat the episode of which they had the less aversive memory.  Their decision was governed by a simple rule of intuitive choice: pick the option you like the most, or dislike the least.”

We are strongly influenced by the peak and the end.  That feeling of warming water was such a relief after the pain of the cold it managed to over-ride our rational brain.  Obviously, endings when dramatic/traumatic enough reach parts of our brain that have little to do with rational fact but are emotionally powerful.  Our intuition has lead us to make a mistake.  So too, the pain of giving birth when followed by the joy of a baby is simply edited out.

I used to find when teaching a class you could give a truly awful 40-minute lesson, boring, stilted with little content and follow it with a five-minute exciting game to end.  The classes would invariably close with kids laughing delightedly and a feeling that the lesson had been brilliant.  They had been fooled by the end.  It had dominated their experience and effectively wiped out the previous dire 40 minutes.  This influence also indicates why coping with dementia or a pain filled death etc. creates such an overriding despair in relatives.  A whole lifetime is forgotten and the agony of the last months or years over rides everything.  It almost manages to wipe out every joyous memory of a loved one. 

Our intuition is a powerful tool but also a flawed one, on occasion.  Or, as Kahneman puts it,

“It seems an inconsistency is built into the design of our minds.” 

Our memory has evolved to register the most intense moment (pain or pleasure the peak) and the feelings at the end of the episode.  This neglect of the duration will not serve our desire for pain to be short and pleasure to last.  In other words our instinctive preferences may be seriously flawed.  He ends with this warning.

“This is a bad case of duration neglect.  You are giving the good and the bad part of your experience equal weight, although the good part lasted ten times as long as the other.”

My wish for you - May your pain be ever short and your pleasure exceedingly long!

Self Discovery and balloons

At a certain age you make discoveries about yourself.  Above fifty you realize mirrors are far too prevalent.  You have begun to appreciate comfort over appearance.  So clothes and footwear reflect that.  It is the slippery slope, which will end eventually with you shopping in your pyjamas and slippers, but you have decided to be realistic instead of in a state of denial.  

Other people become sources of amusement.  The types you recognise bring a knowing smile to your face.  Those you don’t bring a curious welcoming grin to your face.  Those who you vaguely suspect you know but may have forgotten get an odd smile but with raised eyebrows.  Small children and babies are delightful to watch and bring a strange happiness to your heart.  After all, it seems only yesterday you were climbing frames and sitting on swings yourself, shrill with excitement. 

Your grown up children now view you as unreliable, forgetful and naïve.  When did they stop needing you to hold their hand crossing roads and suddenly start lecturing you on traffic safety?  It was only yesterday you were terrified of them being abducted by strangers.  Now, they lecture you on directions, details of time, appointments and behave oddly protective of you in crowded city centres.  You took them for their jabs for measles etc now they ask in cross tones ‘Did you remember to take your medication?’  They are embarrassed by you on a regular basis because you have no longer the self consciousness of youth.  Not giving a darn about what others think has severed the control reins.  Things that used to embarrass you no longer make a dent in your ego.  It helps that the balloon-like ego of your youth has gone.  That feeling of being brighter, chosen, special has sunk down to a wrinkled prune.  Making a dent means just rearranging the folds and has little effect.

The good news is you understand how quickly life passes.  You can appreciate good friends because you know how exceptional they are.  Reasonable health is a call for celebration and thanks because you know how rare that is.  No longer taken for granted.  You have more relatives and friends in the next world than in this one.  That makes dying less fraught.  It also makes living a sweet privilege.

You don't suffer from youth’s primary complaint – boredom.  A scene in your head or a taste can bring alive your past.  A scent can drag memories out of the shadows.  When you meet old friends you greet each other like veteran warriors, sharing stories of triumphs and displaying wounds of bitter defeats.  You lift your cheek to feel the breeze, to soak up the sun’s rays and sigh with the bliss of it all.  To be alive and to relish each second that passes.  What a richness!  If life is wasted on the youth it is embraced and enjoyed by the rest of us.