Editorial Note: In her comment, reproduced below, Sally was the person who best got to grips with what I was struggling with in last week’s post and this week’s and for the next few weeks. Drug induced injury is one sphere in which we get injured. Turning to other spheres may give us some ideas about how to handle the dilemma of a treatment induced injury – how to avoid being singled out the system, how to build a community that can resist and seek redress.
The Silver Lining Clouds the View outlined how working with mercury can cause a distinct psychosis or tremor or confusion that clears when the person leaves work.
But what about when a worker gets an illness like tuberculosis? This is not a specific industrial injury.
For fifty years around 1900, North Wales had the biggest slate quarries in the world. At a time when deaths from tuberculosis were falling in Britain, these quarries had increasing rates of tuberculosis and deaths. Repeated enquiries reviewed all options. Quarrying gave the workers silicosis. Did silicosis make tuberculosis more likely?
Local doctors said no. The problem was down to poor diet. The modern housewife spent too much time at school and her only domestic skill was the ability to use a tin opener. These medical views passed muster as the considered judgments of scientifically trained men.
Silicosis does predispose to TB. But, just as the mirror workers in Furth fifty years earlier took their chances with mercury, so too the quarrymen kept quiet about their chest problems. They steered clear of doctors. There was no other employment in the area if they were signed off. Both workers and employers knew that jobs in the mines were dying out.
You don’t have to silver a mirror or go down a mine to appreciate the psychology and politics at play here. You just have to take a medicine. Drugs come with risks. Even when things go wrong on treatment, short of being invalided, most people opt to cope with it, often silently, rather than own up. Owning up, especially if there is no treatment, makes you a loser, and the herd leaves losers behind. The injured worker or patient is like a dog barking at the passing caravan.
Your point being?
Sometimes truth is not something you dig for.
The link between treatment and injury may be a social one. The entire community may know what is going on. But the doctor will see a picture where it is not proven what causes what, and one of his options is to take your moral failings into account. This is often the most convenient option – for him, especially if you’re a woman.
This is a delicate world, a world in which there are no accidents if by accident we mean random events. An unexpected or unintended event is not an accident – although we use the word that way when we are knocked down by a car, and lawyers advertise their expertise in accidents. But Road Traffic Accidents, no less than Drug Traffic Accidents are rarely Acts of God.
An Act of God is when a cow jumps over a ditch and onto your car. In Road Traffic Accidents or Drug Traffic Accidents, someone has always been careless. It may be like the carelessness that started with the American Civil War when rifles that could hit a target at long range replaced muskets that couldn’t and all of a sudden troops could be picked off by a sniper. Being picked off by a sniper sounds almost random, but after the first time it happens, the military top brass are responsible for your death if, having seen what can happen, they do nothing to prevent it happening again.
If the event is not random, the question of responsibility comes into play. Before 1800 roughly we used to be able to attribute misfortune to God or Fate. It is now down to us. If I didn’t intend to hurt you, I am unlikely to concede that something I did in fact did hurt you. The bystanders, those with a superficial knowledge, will side with the likely winner rather than the likely loser, unless forced to delve deeper. Everybody takes steps to avoid being the person responsible, or on the side of the person responsible.
In nurseries for 4 year olds now if a mother brings in a cake on her son’s birthday, the staff will not let other children have a piece because they cannot validate her cake-making. A piece of cake will be put in a take home bag for the children, whose parents can let them have it, if the parents take responsibility.
For the loser in games like this, beyond the injury an identity is destroyed, as surely as if acid has been thrown in a face. I am now marked as a loser and the only people who can understand that are those marked in the same way. But no-one, not even a loser, likes the company of losers. The loser in the lottery of life will also likely lose any contest about what has happened her.
In the world of treatment induced injuries, God fails as an explanation. The modern replacement for God, Science, also fails. We are Shipwrecked and on our own.