Responding to the emerging conflicts that divide us

Commentary. By Leonard J. Marcus, PhD, and Barry C. Dorn, MD, AMNews contributors. Dec. 17, 2001.

COMMENTARY

Observations on the state of medical practice and medical life

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The initial moment of crisis is over. Fading now are the searing images of Sept. 11, the immediate grief and the raw emotions that overwhelmed us. Fading, too, are those first reassuring portraits of our coming together. In recent weeks, the front pages and headlines have conveyed a new sense of conflict and turmoil on the home front. We cope now with "what's next?"

There are numerous examples. New York firefighters and policeman scuffling at ground zero. Ethnic and religious leaders arguing about "taking sides." Health care managers pointing to insufficient "preparedness" resources. And the electorate, which at various times has become impatient with public officials accused of releasing either too little or too much information about public health threats.

The aftermath of the initial anthrax letters and the fear of smallpox have put the health system straight into the middle of this international conflict. While it is certainly not in our purview to resolve larger global disputes, we very well can play a role in managing the issues and disputes that we find in our midst.

It is human nature to seek a guilty party when a catastrophe occurs. We want to point a finger, punish the perpetrator and, with that, assure ourselves that the crime will not be replicated. There is a calming effect in capturing those responsible, bringing them to justice and resuming a semblance of normal activity.

This rather straightforward instinctual response has been complicated by the events of Sept. 11 and subsequent bioterrorism. Early on, we focused squarely on one man. But Osama bin Laden is an elusive and baffling menace: He and his al Qaeda network are not a tangible place, a recognized country or a typical antagonist. In this conflict, the front lines are not an ocean away. The front-line danger has been as close as our own work place mailroom, and, with that, we have begun to blame one another. [...]