Understanding your enemy to the point that you love them

I watched the movie “Ender’s Game” the other night along with some friends. In it, a child named Ender is chosen to take on the task of confronting an alien threat. He is chosen because of his intelligence and his ability to confront a threat immediately and disable it (e.g. killing) so prevent future attacks. This is shown in two scenes. In one, a bully confronts Ender and picks a fight. Ender wins the fight but continues to beat the bully, killing him. (Ender is never told that the bully dies.) In another scene, another bully picks a fight with Ender in a shower room. Ender offers a diplomatic solution, telling the bully that Ender will lie and say that the bully won the fight. The bully wants none of that, so Ender defends himself and nearly kills the bully.

After the second incident, Ender goes to Earth to talk to his sister. He tells his sister that the military is training him to kill the alien threat, but, in doing so, the military is also allowing Ender to understand his enemy. He and his sister agree that understanding his enemy allows Ender to love his enemy. In essence, when you think like your enemy, you love your enemy because you also come to know how your enemy loves themselves. This is the position I find myself tonight, as I look out the window to a city that refuses to go to sleep.

In all this time that I’ve been confronting and refuting anti-science people in general, and anti-vaccine people in particular, I’ve come to learn more and more about them. Little by little, I’m starting to understand them, and, in doing so, I’m starting to care about them. I’m starting to “love” them, for lack of a better term.

Consider, for example, the anti-vaccine mom whose children are autistic. She has been told by people with medical and scientific credentials that her children’s autism is because of vaccines and nothing but vaccines. Sure, there are other explanations for the autism running in her family, but things like genetics and prenatal exposures put the blame on her. That, or they do not allow her to do anything about it. For that mother, treating or “curing” the genetic autism in her children would be like trying to change skin color. It’s doable, but ultimately futile.

Instead, if the autism is caused by vaccines, then maybe there is some “treatment” to detoxify her children. Or, if nothing more can be done, she can be an activist and spare other parents the “hardship” of having an autistic child. Because that’s another thing that you need to understand about our not-so-theoretical mother… She suffers in her heart and mind from having to deal with autistic children. In her world, mothering should have been a thing of joy and fulfillment, not a daily chore of adjustments and schedules.

Then I got to thinking about Andrew Jeremy Wakefield. Imagine living in that nightmare of a world. You go to school, work hard to make the grade and be a physician, get to be one, and then it all comes crumbling down. At that point, you would have a few choices to make. One choice would be to accept that you’re no longer a physician and move on to something else. Or you could do as Andrew Jeremy has done and continue to live the posh life, being adored by many fans who would come out in small-but-strong numbers to support you. You’d get compared to Jesus and to Nelson Mandela. You’d live in a mansion and travel the country to be adored even more, held in the highest regard (regardless of who the adoring fans are).

Or put yourself in the shoes of The Kid. From a very young age, your own mother tells you that vaccines made you the way that you are, and the way that you are doesn’t quite fit with the world around you. You’re bright, passionate, and can focus on things like a laser beam. Will you work to stop epidemics of disease around the world? No, you’d focus on vaccines and write things about them and the people who support their use, whether or not you had all the evidence you need to back up your assertions. You’d write even more when you realized that a lot of people agree with you and have nothing but praise for your writings. And you would attack anyone and everyone who dared question the way you think. Because, hey, you’ve been this way all your life due to those goddamned vaccines.

The list of people go on and on, and I find myself shaking my head at the things that say or write and the lies that they so wholeheartedly defend. Sure, it makes me angry when I see the damage to public health that they can do. Yeah, I get angry when they attack my friends and colleagues. And, of course, I get defensive when they accuse me of doing unethical and illegal things, even if they don’t have a shred of evidence against me. But for a few minutes after I do my research in order to counter them, I end up understanding them, and I feel the sadness/anger/despair that they feel. I can almost feel the horror that they feel in realizing that what they have said or done is a lie, and that they need to keep on doing it because acknowledging the truth means losing a lot of friends, a lot of admirers, and in some cases a lot of money.

If you’re an anti-vaccine activist reading this, know that I love you like you love yourself, because I’ve come to understand you. I’ve come to see how horrible it is to devote so much time and effort to a lost cause. Vaccines have been around for almost 300 years, and they will be here for 300 more. You and I will long be dead and buried and forgotten, and humanity will continue to vaccinate. Medical science will continue to move forward. And all those memes, and all that Twitter activity, and those blogs, and stealing pictures of people will not have made a single dent in the work that we in public health have been doing for decades.

God, it must be horrible to want to end vaccination and knowing that it’s only expanding and saving more lives. Big hugs to you, and I wish you peace.

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3 thoughts on “Understanding your enemy to the point that you love them

  1. You must know the enemy as you do yourself; or else you are a fool and will meet defeat in every battle.~Sun Tzu

  2. One of the hardest lessons in medicine is one that has no lesson plan, no course work, but it is mentioned.
    Not to internalize the problems of a patient. It’s taught as, “It’d not *your* problem, it’s the patient’s. Treat the illness or injury, but do not make the patient’s problems your own problem or you will do no good for your patient”.
    I’ve watched EMT’s, paramedics, nurses and physicians cry after losing a hard waged battle to save a life, especially hard hitting, when it’s a child.
    To successfully treat some injuries or illnesses, pain may be necessary to be inflicted. Setting a fracture isn’t pleasant, placing a dressing upon a sever wound is excruciating in the extreme. Doing so on a child can be traumatic to the child and the person administering the necessary care if the patient’s issues are internalized.
    Those who cannot divorce themselves from the patient’s problem fail to become successful health care providers and soon gravitate to other branches where they can avoid internalizing those problems.
    Those who do succeed are a special breed, they can work on the most complex and agonizing injuries and help the patient’s body repair itself. They can withstand the imprecations lavished upon them by a patient in pain. They can tell family members to get the hell out of the room so that they can address the patient’s dire needs.
    They also learn when the cause is absolutely hopeless, when no effort will succeed, when relieving pain is the best that they can do. They learn when the best care is no treatment beyond palliative and when no treatment at all is the best treatment.
    To the outside observer, one would think that the one administering that care doesn’t care at all, possibly even sociopathic.
    That isn’t true, many are extremely saddened when the cause is hopeless, help is attempted, but failure is expected and only rarely is the effort fruitful.
    During my clinical rotation, I was providing care in a geriatric oncology ward. DNR orders were on the board, signed by the patient, for each and every patient. They knew their condition was dire or even hopeless.
    One of my patients was a 90 year old man, who weighed 98 pounds, who was dying of cancer and had a pressure ulcer in his hip where one could literally drop a softball into it. I learned that the pressure ulcer was acquired during care by his family, where his immediate caregiver was forced to leave her retirement and take work to make ends meet due to the cost of his care.
    He was on a morphine pump at the highest level possible for his frail body weight. He was moaning in pain during his stupor.
    That was the day I learned to not make the patient’s problem my own.
    It was also the day that my mind was made up that if a terminal patient wants euthanasia, our society should not prohibit them from doing so.
    The elder received his palliative care, his wound being treated by nurses and surgeons, he survived past my rotation.

    The willfully ignorant are in a similar predicament. They refuse the treatment of education, preferring their own false faiths that bear poisonous fruits.
    So, I engage not to treat the willful ignorance, but in the hope that a new recruit or one they’ve generated curiosity in will learn something and not become so entrapped.
    For, the willfully ignorant will rarely become educated, as then they’d have to admit that they were wrong and likely caused harm.
    Let the willfully ignorant have their opiate, but we can interrupt the recruitment of the ignorant who can tolerate education.

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