Final project example – The Frontline: Defensive Medicine

Rachel Fox, a 4th year medical student at Peninsula Medical School, University of Plymouth, completed this final project as part of the Medical Humanities Summer School 2021:

The ‘tyranny’ of money in healthcare, moral ‘injury’, a ‘battle’ with cancer, working on the ‘frontline’ – in a profession which values compassion and empathy, why are we so drawn to combative metaphor? War and battle metaphor and euphemism have appeared throughout the range of talks and exercises this week, from literature and history to legal medicine and politics. This has prompted a personal reflection on the discord between a healing profession and its apparent defensive narrative. Why are our healers and carers being posed as combatants, and against what are they fighting? Is it helpful for patients to be motivated with hybrid medico-defensive language? How does this affect our approach to health and well-being? Should we expect of our healthcare system what we experience in war, fatality, conflict, and trauma?

This piece has helped me to explore these questions and delve into the contradictions of military vocabulary in health. Looking forwards, perhaps the advent of coronavirus and the associated change in public discourse and vocabulary may stimulate a landmark change in the communication of health. We may be faced with a ‘black swan’ opportunity to better our communication of the personal and collective experiences of illness and health with the depth of emotion and veracity idealised by Virginia Woolf, to better convey a values-based healthcare system.

Over the week I have also been working on this poem, which I would like to share with you. I have written this as a considered perspective from a patient newly entering the ‘battlefield’ of ill-health.

We will fight this, they command
From behind their veneered rostrum
Metaphorical comradery
For a battle fought alone

Dispatched suddenly, a foreign battlefield
Parachuted into a desolate unknown
Without armour I stand
To defeat an unembodied foe

Distant cries from fervent supporters
Call in innocent bliss
Yet serve to greater isolate
My solitary campaigns

Surrender or submit, a choice
I teeter on a frontline
Wavering between past and beyond
The unwilling volunteer