March is a significant anniversary. On 1st March 2020, we decided to delay the Annual Conference because a new virus; SARS-CoV-2 appeared to be more significant than we had initially thought. I will not go over what followed. Delaying a meeting turned out to be the least of our problems. In fact, thanks to Mark Hacker, Sarah Linnington, and colleagues at the BSG office, we mitigated that loss and responded with two virtual meetings and an extraordinary series of webinars.
Some things are more difficult to mitigate. Personal loss for example. My father-in-law died in Glasgow without his family being able to be beside him.
The late Donal O’Donoghue at the RCP, who I had only just become properly acquainted with, and would like to have known better, died 1 year ago.
BSG members have had to cope with a lot of personal grief. Family, colleagues, and friends, taken away by an inanimate, indiscriminate, rapidly evolving bundle of protein and nucleic acid. A virus that sought out those with pre-existing illnesses. Which exploited differences in the immune system and so constituted a greater risk to the old, to men, and to people from certain backgrounds. It also has to be admitted that it exploited deprivation, poverty, and misinformation as well. We know that COVID simply responds to Darwinian principles, so that strains that are more effective at spreading are selected for. We know that the virus is not “subjective” in its actions, but it still hurts, and it still feels personal. Some friends and colleagues contracted COVID and became very ill. Some have not fully recovered.
Our trainees rose to the occasion as we knew they would. Our nursing colleagues looked after everyone irrespective of their background. Some nurses and nursing assistants paid the ultimate price. It is not possible to mitigate grief.
So perhaps it might seem frivolous to suggest that another significant casualty might be “the truth”. Going to Barnard Castle to get your eyes tested now seems almost comical, were it not for the fact that it represents such a blatant breaking of the rules at a time of national crisis. The BSG as a medical professional society kept all the rules. As President, I was clear about that. My “civil servants”, my colleagues at the BSG office, not only kept the rules, but briefed me correctly and anticipated the restrictions.
Inevitably we come to “Partygate”. A Prime Minister who had nearly died, if it had not been for the NHS and the dedicated staff who cared for him, is pictured in the garden of his house, in lockdown, attending, what for all the world appears to be a party, or as we now know, parties. As Theresa May said in Parliament, “had he not read the rules, did he not understand them?”
Truth has suffered in other ways. Some people believe what they read on Twitter, or Instagram. As a professional society, that makes our role even more important. We must present the evidence on medical conditions and assess and explain it truthfully, honestly, and as independently as we can. We must support our journals and their editors and never compromise on the integrity of what is published. If errors come to light, we must highlight them and clarify them.
We obey the law. We must follow our scientific principles. We must always put patients first. When things are published or spoken that are untrue, we must call them out.
It is tempting to mourn the decline of truth in public life. That is understandable but not enough. “Truth”, in truth, is a strange entity. It is not entirely binary. One person’s “truth” is another person’s “rumour”. What appears to be true at one time, may turn out not to be as clear later, when new evidence comes to light. “Truth” is a bit like Schrödinger’s cat. Sometimes it remains in a state of superimposition, neither one thing or the other, until the box is opened and it is examined in detail, in the light of new evidence or experience. Demanding “the truth” at all times is tempting, but not always possible.
Integrity is something different. Integrity is about trust. It is about having a set of principles that are adhered to. It is about finding a way through to truth based on evidence. It is about recognising previous faults and being open about them. It is about abiding by principles, so that people know what a person or organisation stands for and can, therefore, trust what they say and do. It is about a body of previous experience that tells the public that even if an organisation makes a mistake, it will be open and will genuinely take action to correct that error.
Though “truth” may sometimes be difficult to define, integrity is a quality worth fighting for and preserving.
This means you. This means us. This means everyone.