In this series, AMS Healthcare addresses the challenges facing healthcare today – particularly in light of the COVID-19 pandemic. The AMS Community promotes compassionate care, development of the leadership needed to realize the promise of technology and the understanding of how our medical history influences the future of our healthcare. A new piece will be posted every Friday on Healthy Debate.
The order of business for most countries today is responding to the COVID-19 pandemic and preparing for what may come before a vaccine is available. Governments and nations are focused on essential tools such as hospital beds, personal protective equipment and physical distancing while also worrying about how to stave off economic disaster.
However, the success or failure of this battle will not only be determined by material readiness, which is of course essential. There is one other factor that will make the difference: Character, both of individuals as well as the collective.
We have been engaged in an effort to highlight the impact of character-based leadership on the practice of medicine. The pandemic has brought this important but sometimes neglected element of medical education to the front and centre.
History has much to tell us about how nations survive pandemics. As Western societies, we often boast of the Athenian roots of our brand of democracy and Athens can teach us an important lesson in the importance of character-based leadership in pandemics.
In 430 BC, the city-state of Athens was a dominant force politically, economically and culturally and its citizens saw themselves as morally superior and enlightened. Then came the great plague of Athens that devastated the city. As the historian Thucydides chronicled, “When it attacked anyone, it was beyond all human endurance. The bodies of those dying were heaped on each other, and in the streets and around the springs half-dead people reeled about in desperate desire for water.” Almost a third of the city perished.
What followed was a breakdown of social order. Athenians became despondent, demoralized and unhinged and their sense of decency, virtue and honour withered. Those few whose character, courage and selflessness drove them to help others suffered the highest mortality and this weighed heavily on people’s consciousness. Many refused to behave honourably because they did not expect to live long enough to enjoy the rewards of a good reputation. The pre-pandemic Athenians who were sure of their moral grit and virtue came to face a different reality and abandoned the values that had been at the heart of their civilization. Ultimately, it was not only lives that were lost but eventually democracy as well.
As historian Katherine Kelaidis put it, “For Thucydides, the death and suffering of a great epidemic (just like war) test the moral health of individuals and of societies. And a people who are not morally strong, when they become afraid, quickly slip into lawlessness and sacrilege.”
Thucydides saw the collapse into immorality as being latent and only exposed by the plague, “Men who had hitherto concealed what they took pleasure in, now grew bolder.”
This sounds all too familiar today. The great toilet paper wars, the gun-toting demonstrations in support of re-opening and the betrayal of our seniors in long-term care are all signs of character gaps made manifest by this pandemic, not created by it.
Crises and situational pressures don’t only unmask the character of societies but of leaders as well. Athens had Pericles, who despite horrifying conditions commanded the people’s trust. When they lost their character, Pericles helped them regain perspective. He implored Athenians to reaffirm their values and rise above their selfishness: “You must therefore put aside your private sorrows and concentrate on securing our common safety. Hatred is short-lived but the brilliance of present deeds shines on to be remembered in everlasting glory.”
Thucydides reports that Pericles was an effective leader because he resisted giving in to the base desires and fears of people and instead inspired (at least some of) his followers to a more noble vision. Pericles himself was to die of the plague the following year.
Today, we have leaders in health care and politics who have modeled the very best in character and have inspired their followers to rise to the challenge. And we have others who have chosen to stoke anxieties and fears and encourage racism and xenophobia. The pandemic did not create those leaders, it merely revealed them more plainly for everyone to see.
So what are we to learn from all this? We as a society, our leaders, and our educational institutions have focused our efforts on competence, science and technology and have lost sight of the importance of developing character. This neglect may go without consequences for some time but eventually a situational pressure, a crisis, will come along to reveal the gaps. A circumstance will inevitably arise for all leaders in which their characters are tested, and if left wanting, will undermine their ability to lead. The work of protecting our nations from the ravages of the pandemic begins, but does not end, with material readiness.
We must refocus our energies on the importance of nurturing character once again. The last decade has seen significant movement on this front, notably the Ivey Business School’s Character-Based Leadership model. A group at the Schulich School of Medicine at Western University is adapting this model to medical education.
Through a renewed sense of importance of this topic, a future generation of leaders can emerge understanding the importance of character and, more importantly, manifesting character so that instead of future crises revealing disgraceful gaps, they will reveal a depth of character of which we can be proud.