covid denial and the banality of evil

La Comunidad para el Avance Familiar Educacion (CAFE) organized this memorial last weekend outside their headquarters as part of their celebration of El Dia de los Muertos. It’s the first and only memorial to victims of the coronavirus pandemic in Wenatchee.

Amber, everything about this post is incredible. In your reflections on the Danawi study of unintended teen pregnancy and the Badr study of unsafe behavior among young adults during the pandemic, you touch on something particularly critical to discussions about health agency and numerous components of the HBM that often gets left out of the conversation: the power of normalization. As human beings, it doesn’t matter what the evidence says; if ‘everyone else is doing it,’ it must be fine, right? Right?

Excuse the pretentiousness of this but I will now quote Hannah Arendt in The Banality of Evil: 

Except for an extraordinary diligence in looking out for his personal advancement, [Eichmann] had no motives at all… He merely, to put the matter colloquially, never realized what he was doing… It was sheer thoughtlessness—something by no means identical with stupidity—that predisposed him to become one of the greatest criminals of that period. And if this is ‘banal’ and even funny, if with the best will in the world one cannot extract any diabolical or demonic profundity from Eichmann, this is still far from calling it commonplace… That such remoteness from reality and such thoughtlessness can wreak more havoc than all the evil instincts taken together which, perhaps, are inherent in man—that was, in fact, the lesson one could learn in Jerusalem.”

— Hannah Arendt, Eichmann in Jerusalem: A Report on the Banality of Evil, 1964

And this is the lesson one could learn in America during the coronavirus pandemic. If a harmful behavior is normalized and a person is remote from the reality of its consequences, then you have a recipe for great evil, and great harm. More than 2,000 Americans are dying everyday right now from a disease we have a vaccine for, a disease that could be stymied by small, simple sacrifices of individuals. One died under my hands only a few days ago – one who was too young, and left young children behind. But we don’t value the common good enough in this country, and we refuse to acknowledge that our individual actions directly affect the safety of others. As Arendt said, it’s so banal it’s almost funny – except that it also makes me despair. What is wrong with this country, this county, this town, that person – I don’t like having thoughts like this. I don’t know how to de-normalize selfishness. 

Arendt, H. (1964). Eichmann in Jerusalem: A Report on the Banality of Evil. Rev. and enl. ed. Viking Press.

notes on nursing

I got a close look at critical care nursing for the first time while working on the prone team at Central Washington Hospital this past winter. This scene – a nurse washing, combing, and braiding the hair of a patient who had been sedated, paralyzed, and ventilated for two weeks and would die only a short time later – was something I witnessed on one of my very first shifts, and I will never forget it. It’s what I picture when I think about the heart of the nursing profession and the reason I’m so proud to be a part of it.

I’m here because I think human suffering in any form is the greatest evil we allow to persist in the world. But human suffering is a really big, really complicated problem to solve. Per the health belief model, one of the primary barriers to action is an assumption that effort is futile, that the problem is too big or complex for one change to make a difference. As nurses we spend every day combating suffering caused by intractable problems like health disparities from social inequity, the complexity of our healthcare system, and barriers to accessing care, such as cost or geographic region or health literacy. And critical care especially is a field of sad endings.

Fighting suffering in a setting of so much futility means finding value in effort regardless of outcome and maintaining a “pessimism of the intellect and optimism of the will,” to quote Dr. Jim Kim in Bending the Arc. It requires humility and stubbornness and a conscious awareness of the traps of victory narratives – anger, burnout, arrogance, and despair. And it means caring for the humanity of patients as much as we care for their lives – and sometimes understanding that one must give way to the other, in the end.

A tension exists in medicine between “care” and “cure,” and in this scene we see the power of nursing to bridge that gap. You have my favorite witchy bits of medicine – the outsourcing of bodily functions to miracle machines and medications, the management of which demands critical thinking and extensive education and training – but we also see the heart of medicine: the way nurses care for the human within the body by prioritizing comfort, identity, and dignity, even in the setting of immense complexity and overwhelming futility. 

Nursing is deeply anonymous and humble work that requires intellect and skill, and humanity above all. It brings to mind a quote by an organizer named James S Kumen: “I am not a leader, you understand. But leaders cannot seize and occupy buildings. It takes great numbers of people to do that. I am one of those great numbers. What follows is the chronicle of a single revolutionary digit.”

References

Kunen, J. S., & Kunen, J. S. (1969). The strawberry statement: Notes of a college revolutionary (Vol. 34). New York: Random House.

, ,