Matt Morgan: Hold onto your red threadBMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1500 (Published 21 April 2020) Cite this as: BMJ 2020;369:m1500
All rapid responses
Please allow me to hold on to my thread. It impels me to talk to my Prime Minister through you.
Dear Mr Johnson
I appreciate that short slogans win elections. But seriously, have your medical advisors not told you that outside a closed room, WIND blows. And wind will carry the virus. Fast. In just one direction (except for a whirlwind).
So, two metres social distancing is meaningless.
As far as supermarkets, airport terminals are concerned, please arrange for the air to be sucked UPWARDS, and get clean air pumped in. All at speed suitable to keep people safe.
The same principles apply everywhere.
This to start with.
Competing interests: Old chap. Vulnerable, they say. Hence struggling
As a congenital sceptic I am holding on to MY RED THREAD.
I have lived through the end of war (WW2, of course), bonhomie with Josef Stalin, quickly replaced by the Red Peril, and the US search for commies in the sceptics. Then we had the Cuban Crisis, then the Soviet Nuclear Threat.
Every time, Her Majesty’s Government was aided and abetted by the majority of the British Press. And any voices to the contrary were described as treason.
Now we have Covid-19.
The Government has been seeking to deflect attempts to probe its failures to, prepare for a pandemic by promoting public loyalty. How much do we owe our NHS? Of course a lot. Who has been whittling away the NHS? The Govt. How often has anyone raised a cheep about it? Except for a political party or two, unloved by the Great British Public.
We love our NHS staff, and other Care Staff. Every Thursday we clap, loud and clear.
Yet the Govt and the patriotic press have said not a word about giving untrammelled rights of residence to the foreigners WORKING here and putting their lives at as much risk as the True Born Englishmen.
We have heard about the imminent arrival of BRITISH “tests”. The imminence is repeatedly postponed.
Is this not a deliberate attempt to dampen down criticism?
Ah, but there is world wide shortage of raw materials. It seems to afflict only the UK?
Germany? Oh but they have an established chemical industry. Pray tell me, dear Prime Minister, WHO stopped the UK from producing its own chemicals?
We will have our vaccine very soon, produced in our very own OXFORD, proclaimed a newspaper.
Then all goes quiet.
Competing interests: No competing interests
As a psychotherapist I have talked with many stressed or highly traumatised doctors, dentists and nurses including during the hard times of the junior doctor strike and now of course Covid. The DoH funded PHP has flourished during that time as well as the offerings of the RMBF charity and BMA through DocHealth. Tea and Empathy has also gathered grass roots pace. Within all of this I have witnessed the use of many stress communication metaphors for stress and resilience management. Few are systematically examined empirically as to their usage.
Dr Morgan’s piece now brings additional help at a crucial juncture. I think his choice of the metaphor of the red thread (borrowed from the classics) is likely to stay helpfully in the mind in a way which some other metaphors used within stress management may not feel quite right now. The oxygen mask (put yours on first before for you help another) and the flat battery top up and recharge (resilience/ adaptability) are oft cited and clearly still useful for many.
There is room for interesting debate as to which others could offer value. Our imagery and words matter much in a field which has to sometimes rely on nebulous concepts. We may also borrow from the usage within fields such as clinical hypnotherapy and the medical humanities too.
What is important is that in times of added difficulty or challenge we have a good method of delivering our own ready formed methods of self help and reaching out. This provides self efficacy. Thus the ‘red thread’ take is memorable, linked to what we can hold and what we have already developed for ourselves both in history and currently. It is so well crafted as a anew method of stress communication.
Competing interests: I run a stress clinic for doctors dentists and vets and a creativity site ( non commercial) to help those in medicine called cRxeate.
There is an urgent need for a Covid mental health response to plan and coordinate services for the general population. We know from the 2008 recession that there will be a big escalation in psychosocial related morbidity and mortality during and following Covid. The psychiatric services are not meeting basic needs as it is, and are in no position to cope with the huge escalation in mental illness that is approaching. Forward planning and mathematical and epidemiological modelling for psychiatric illness needs to mirror what is happening with the somatic side of Covid. Governments are managing the viral curve but they need to be ahead of the curve to prevent an even more devastating surge of mental and social illness.
Competing interests: No competing interests