I arrived in Boston last night (and yes before you say it another working weekend) to attend a meeting where I am discussing viruses and MS. A topic close to my heart. Boston was gridlocked as a result of several anti-Trump protests. My taxi driver and US colleagues have post-election blues. What is happening in the US is not too dissimilar to what happened in the UK post-Brexit. In fact I have still have the ‘Brexit Blues’.
On Thursday night my wife read me Aaron Sorkin’s open letter to his daughter. Whilst she was reading it I realised that herein lies the problem. Sorkin’s letter and its tone is arrogant and self-obsessed. My epiphany is that Sorkin, and his attitude, is the problem. The arrogance of ‘the haves’ is why we have Brexit and Trump. The race to the top, and the race to the bottom, largely driven by the effects of globalisation, have disenfranchised large sections of society. Social mobility is stagnant and the wealthy and highly-skilled have taken over the asylum to make sure their offspring stay on top. In London, the wealthy game the system that makes it very difficult for children from poor families to climb the ladder. Falling living standards coupled with low job satisfaction and limited prospects has fuelled the discontent of the ‘have-nots’. Democratic protest via the ballot box has now delivered us to this point. In the past we would have had civil unrest and militant revolutions. If we don’t take these democratic protests, delivered via the ballot box, seriously the next forms of protest won’t be so benign.
We need to go back to first principles, reassess things and reconsider how we want to live our lives and how we want our society to work. I am not a politician but I realise that I need to seriously consider how each of my decisions and choices affect others, particularly those less privileged than myself. The fourth arm of our Brain Health Challenge is wellness. Although this is rather a ‘soft’ part of the challenge, it has, in view of recent events, become the most important aspect of the challenge. At the heart of wellness is our interaction with society and our environment. How do my decisions, about the way I live, cascade through society and affect the environment?
Do I really want to support an uberised world? As a Londoner one of the most satisfying things you can do, particularly when you are tired, harassed, or when it is raining, is to hail a black cab. I agree it is a luxury, but why not? The other night my wife and I were out at dinner celebrating our anniversary (we have been together 35 years) when we decided to call a cab. When we went onto Uber the closest Uber car was a minute from the restaurant; we were literally in the middle of colony of Uber ants. As we hadn’t yet paid our bill we decided to call a black cab via Hailo. Hailo is one of the many Apps available to call a black cab, or traditional hackney London cab, which was developed in response to Uber. The closet black cab on Hailo was 4-5 minutes away so we booked it. Despite Hailo quoting a fixed-price, derived by some cloud-based artificial intelligence (AI) engine, our Cabbie put on his meter. I would like to think he did this out of habit. When we finally got home the metered price for the ride was almost double the price we had negotiated via the Hailo app. Most people would have said great you got a good deal. But had we? As cabbies incomes have dropped, I am sure the quality of their lives have deteriorated and they have become more dissatisfied with their lot and society at large. I am sure cabbies, as a group, are more likely to have voted Brexit. And that’s the rub.
London cabbies and their battle with Uber may be a soft target, but the same story is being played out in the recreation, retail, service, education and health sectors. As we devalue jobs and services in the name of efficiency are we not destroying what we value most? Do people with MS really want to be managed by an App, or a robot, driven by artificial intelligence, or do they want a human with compassion and empathy to share the journey with them? What type of healthcare system do we want? What type of society do we want to live in?
It is a great tragedy that the xenophobes, racists, misogynists, anti-gays and other lobbyists have high-jacked the Brexit and Trumpist agenda. At the heart of the issue is need. Just as Maslow defined a hierarchy of needs modern society has a hierarchy above these that makes it work. Ambition and aspiration are as important a driver today as were in the past. Unless we can reignite the sparks that have made our societies so successful we will regress. I suspect we are regressing already, things don’t feel the same anymore.
|Maslow’s hierarchy of needs (picture from Wikipedia)|
I agree that it is time for bold and brave political leadership that addresses the needs of the ‘have-nots’, but the real task at hand is with us as individuals. Next time you make a choice ask yourself how it is going to affect society at large, particularly those at the bottom of the pyramid. I for one am grappling with how can we keep the human element alive in the NHS. People with MS and their families need HCPs with empathy, or at least compassion. At the moment both these fundamental attributes that underpin caring healthcare are evaporating. Any suggestions would be helpful, these issues need to be debated and widely discussed.
Despite his protests we gave our cabbie the largest tip we have ever given a cab driver; we simply paid him according to his metered rate. Rather than feeling like we had missed a trick, we felt happier and more liberated than we had in a long time.
CoI: Up until now I live a charmed and very privileged life.