Man, I love a good dystopian movie.  If you want to go full-bore, it’s tough to beat “1984” starring John Hurt and Richard Burton, or the “Blade Runner” Director’s Cut.  Lots of grays, gloom, drizzle, and a pervading pall both indoors and out.  More recently, I recommend “The Barrier” series on Netflix.  It depicts a neo-authoritarian Spain in a post-viral pandemic era, where the healthy and wealthy are happily quarantined from the (presumably) more infectious.  Health care lurks in every episode, from an underground vaccination experiment, to mystery antibodies found in one living child, to a power hungry minister of health, racing to find a final vaccination for the entire populace while using her goodness as the rationale to subject unwilling citizens to experimentation, and even murder.  Throughout, physicians and nurses cower in the background, shuffling health commissars frantic to carry out government edicts.  Can’t imagine what drew me to watching this clearly impossible plot line (Be warned, the series is in Spanish, the only word of which I speak is “cerveza”, so enjoy the subtitles).

One of the more popular dystopian settings is the United Kingdom, maybe because life would imitate art.  The London Telegraph reported last month that “Scientists in the UK working as advisors for the government have expressed regret for using what they now admit to be ‘unethical’ and ‘totalitarian’ methods of instilling fear in the population in order to control behaviour during the pandemic.”  Well, well.

Comments released from “a sub-committee of the Scientific Advisory Group for Emergencies (Sage) the government’s chief scientific advisory group” advised the government to whip up the fear, [which] should “drastically increase ‘the perceived level of personal threat’ that the virus poses because ‘a substantial number of people still do not feel sufficiently personally threatened’.” 

“In March [2020] the Government was very worried about compliance and they thought people wouldn’t want to be locked down. There were discussions about fear being needed to encourage compliance, and decisions were made about how to ramp up the fear… The way we have used fear is dystopian.”  Golly.

“Another separate scientist on the subcommittee professed ‘You could call psychology ‘mind control’. That’s what we do… clearly we try and go about it in a positive way, but it has been used nefariously in the past.”  Yikes.

The rest of the article describes the government’s wish to use fear as a substitute for an as-then unavailable vaccine, no doubt with the best of intentions.  And like the cowed doctors in “The Barrier,” the overwhelming body of U.K. physicians – paid by…? – have gone right along with official government policy based greatly on this charlatan’s non-proven recommendations.  But that could never happen here, right?

But U.S. physicians were muzzled by their corporate, government-funded employers, and prevented by state governors from trying experimental if desperate treatments.  Physicians here have had to toe the line on ostentatious masking, and recommending vaccination to all comers despite vastly varying risk: benefit ratios.  There are some disparate voices here and there, and the fear seems to be ebbing.  But this will all have been an even more compounded tragedy if our profession does not learn a lesson greater than those dealing with spike proteins and the average mesh porosity of a surgical mask.  Physicians need not be anti-government, as we are not in the exam room to preach politics.  Nor should physicians be pro-government, as a lack of skepticism on our part is antithetical to our training and mission.

What we should be in each and every instance is pro-patient, which by definition requires our independent judgment.  We should regard ourselves as free to share with our patients what we think is correct or incorrect, dumb or smart.  Participating, even passively, in government fear campaigns makes for great movies, but betrays both ourselves and those who look to us for guidance. 

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