Survivor guilt, scientist guilt

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Artwork by Mark Palfreyman

What and how much must scientists do, to feel that they’ve done enough?

Survivor guilt is defined as a form of moral trauma, often a symptom of post-traumatic stress disorder, in which people who have come through life-threatening experiences unscathed blame themselves for the death of others. Whether they are soldiers who survived the death of comrades, bystanders to a natural disaster or deliberate atrocity, or merely the residue of a mass workplace layoff, those affected tend to be tormented by the same questions: Why was I spared when others weren’t? Was there something I could have done to change the outcome? Could I have done more?

That guilt – especially the sense of not having done one’s duty, not having done enough – is a powerful enough emotion that simply its imagined state has been leveraged for political purposes. A British military recruitment poster from World War I cynically depicts a troubled father staring at the viewer as his daughter asks, “Daddy, what did YOU do in the Great War?

Whatever the man did, the poster suggests, it wasn’t enough, and the thought haunts him still.

The coronavirus pandemic represents perhaps the first-ever global biomedical emergency. It’s not wholly without precedent, but similar crises have not had the same immediate reach or terrifying unknowability – the HIV/AIDS pandemic didn’t immediately engulf all of society when it first emerged in the 80s, SARS and MERS were more geographically restricted, and the annual toll exacted by influenza lacks the same fear factor because of its relative familiarity and predictability. Science has really only been a profession since the mid-20th century, so this is the first time the global scientific community, in its entirety, has been confronted by a global biomedical catastrophe.

So what should we, as scientists, be doing right now? What is our duty? What and how much must we do, to feel that we’ve done enough? Should we be trying to contribute directly, or should we first and foremost be responsible, informed citizens who simply stay at home?

It says a lot for the sense of community amongst scientists that most, regardless of their specialisations and regardless of where in the world they’re based, are asking what they can do to be of help. At the same time, it also says a lot about the extraordinary diversity of the scientific enterprise that so many feel guilty at not being able to do more, or even do anything. The truth is that not every research specialisation is of direct use.

Unlike medicine, science is not a discipline where everybody, regardless of their ultimate specialisation, receives more or less the same basic training. The worlds, thoughts, and tools of theoretical physicists and cell biologists barely coincide – in fact, it’s quite easy to fill a room with scientists who are mutually unintelligible, so wide and varied are the areas of enquiry. Even within biology, a gulf separates those with expertise in topics of direct relevance to the pandemic (virology, epidemiology, host-pathogen interactions, immunology, to name but a few) from those without it. This is not like the carnage of World War I, where any able-bodied male was deemed sufficient for service on the front line.

And it’s those scientists specialising in areas outside virology, epidemiology, and so on who are currently wrestling with something akin to survivor guilt. How much direct help can such scientists actually provide? Assisting in diagnostics is one option, but even there it’s been surprisingly difficult to apply relevant expertise without falling foul of regulations.

Others have sought to pivot the focus of their research, dropping what they were doing beforehand and switching to work on aspects of SARS-CoV-2. It’s a laudable impulse, but in some cases rather naive, no matter how well-meaning. The notion that an outsider with little to no previous experience of the field or its various sub-disciplines can instantly make a seminal contribution is optimistic at the very least, and at worst, could lead to erroneous claims. The fallout over the proposed use of hydroxychloroquine for COVID-19 is a stark illustration of the consequence of raising hopes prematurely, and the growing glut of coronavirus preprints being uploaded already risks an unhelpful level of noise.

After all, what would be the reaction if you were told at a hospital, “Dr. Johnson will be carrying out your brain surgery today. He’s actually a gynaecologist, but there’s currently a shortage of brain surgeons and he really wants to help”?

The point being, specialisations are important, and no matter what’s going on right now, we still need the gynaecologists.

It’s a thought that invites another reading of that World War I propaganda poster. The trade unionist Robert Smillie, closely aligned with anti-war campaigners of the time, commented that his response to the little girl’s question would have been, “I tried to stop the bloody thing, my child”. The right response to the poster’s question is not necessarily (in this context) the “manly” one. The poster disingenuously seeks to shame men for not sacrificing themselves at their government’s behest, but in fact the right reaction might actually be the opposite of the one the poster implies.

In science, that means that the right response may not necessarily be pivoting research to focus on COVID-19, or trying to do diagnostics. Science, after all, is not just research.

In fact, all scientists, regardless of their specialisations, can do a lot. Simply being a trusted conduit of information for family, friends, people online, and all those groups’ wider circles of acquaintances, is of use. Rebutting and quelling the flood of misinformation, conspiracy theories, and ill-judged speculation that is sometimes being propagated from the highest levels of national governments is important. Helping to dampen expectations from the stream of preprints that are still awaiting peer review but often, and irresponsibly, being promoted as suitable for immediate use is valuable.

As Darren Dahly of University College Cork noted, “I wonder if we grossly overvalue the importance of academic research, and grossly undervalue academia’s role in creating an informed citizenry”.

It’s easy to forget that science isn’t just research. The poster’s misguided appeal to masculine pride makes the same mistake. All scientists, regardless of specialisation, can be of use during the pandemic.

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