Home > Knowledge Hub > News and Updates > President’s Bulletin: “THE ETERNAL RECIPROCITY OF TEARS.” – Welcome to 1917, but there is a way out of the mud.

President’s Bulletin: “THE ETERNAL RECIPROCITY OF TEARS.” – Welcome to 1917, but there is a way out of the mud.

Updated on: 01 Apr 2022   First published on 01 Apr 2022

Author:  Dr Alastair McKinlay 

I was talking to Ian Penman, our VP for Endoscopy, who has led so much of our response during the COVID pandemic. Considering our current predicament, with rising cases and struggling hospitals, he said succinctly, “It’s like we are stuck in 1917.”

The pandemic was supposed to be over by Christmas 2020. All struggles are supposed to be over by Christmas.  It seems inconceivable that a conflict, or pandemic, could extend into yet another year. We desperately want things to be over by Christmas, but it rarely works out that way.  Pandemics have no internal clock.

COVID has been a bit like the opening of the First World War. The troops going to the front in 1914 were wildly optimistic and queued up to join their regiments. The initial phase of the war moved quickly. It would be over by Christmas, then everyone got stuck. There were numerous attacks and counter attacks but by 1917 everyone was exhausted, demoralised, and quite literally stuck in the mud. It was a very dark time.

We need to be clear. COVID is a heavy burden but it is not a war, in the real sense that others are enduring at this moment. We are stuck in the mud as new variants appear like Omicron and A2, that keep us at the front line doing the general medicine, staffing the wards, coping as colleagues get sick, or have to isolate. NHS staff are exhausted and want it to end. The public is already convinced that it is all over. Perhaps the view that we have to get on and live with it is true, but to those of us in hospital medicine, it has a hollow ring at present. We are stuck in the mud, we are back in 1917. But it will end. Pandemics always do.  It is not a war.

If we are to restore normality, we need to get back from the front line as soon as we safely can, and resume the day job. Many colleagues, however, are finding that their job plans have mysteriously changed.  How can we resist the inexorable creep of unscheduled care and general medicine?

Documenting our work load through the Workload App is one step that we can all take. 

Lobbying at a local level is another.  Talking to commissioners, refusing to sign job plans that attempt to make temporary changes permanent. Talking to MPs and councillors. Involving the BMA when terms and conditions are breached. Nationally we will also attempt to talk to politicians, but it is not always easy and not always effective.

There are new possibilities on the horizon. Diagnostic and treatment centres, and endoscopy academies all need staff. All offer hope to consultants, trainees and nurses, of new ways, new challenges and some better times.

I do not have all the answers. The answers in the end always come from our members, which is why BSG Live is important. We have missed networking and the social contacts that share ideas. The BSG is more important than ever as we recover and it is why taking the opportunity to meet face-to-face is critical. Registering for the meeting may seem like an act of faith at this time, but please do so.  There are huge hidden benefits to being face-to-face and networking:

  • Good for us, as doctors
  • Good for our trainees, our nurses, and our GI Scientist colleagues
  • Good for research and cooperation
  • Good for our patients

1917 seems depressingly relevant as we think of Ukraine. Like most professional groups, we have issued a statement, abhorring the use of violence against a peaceful state. As a charity, we cannot give directly, but we can encourage members to go through agencies such as the Disasters Relief Committee. We will support Ukrainian health workers who come to the UK with CPD and education. We will assist the Royal Colleges and Government to help Ukrainian colleagues find work.

Ukraine’s torment has been public, but Russian mothers have also lost sons. Remembering the dead on both sides does not condone the actions of the Russian government or its military. It is, however, an integral part of compassion. In the NHS, we face moral injury, PTSD, long COVID and exhaustion. In Ukraine, civilians and combatants on both sides face physical injury, death, starvation, and intense psychological trauma.

The people who promote war have always had the ability to turn a blind eye to suffering. It is a recurring theme throughout history.

“But cursed are dullards whom no cannon stuns,
That they should be as stones.
Wretched are they, and mean
With paucity that never was simplicity.
By choice they made themselves immune
To pity and whatever moans in man
Before the last sea and the hapless stars;
Whatever mourns when many leave these shores;
Whatever shares
The eternal reciprocity of tears”.

Insensibility by Wilfred Owen


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