Permission & Pulling Yourself Together.

I remember the first time I ever saw a patient in a cholera ward. Raised in a prosperous, middle-class family, in a large Western country, with relatives who had gone through at least some of the excesses of the 60’s including the exhortation to ‘let it all hang out,’ I was, to some degree, emotionally unequipped to respond properly. The smell (a cholera sick room smells like nothing else, you never forget it), the heat, the sunken eyes and cheeks and the strange, parchment like skin of a severely dehydrated person all contributed to my one shameful moment of freak out.

I didn’t want to be there. I didn’t want to die there.

A nurse pulled me aside none too gently and said: “Get yourself together, or get out.”

Some years later, I had a similar moment of awful, existential dread when I sat at the bedside of a very close friend who was in the last, terminal stages of full-blown AIDS. This time, I didn’t show what I felt, but for several minutes, I had to fight with every shred of interior fortitude not to burst out crying and run from the room. But the nurse’s words came back to me.

It’s funny how the stern look and a single sentence from a total stranger managed to work its way so deep into my psyche. But, reflecting back, it was easier in those days. Our social tolerance for public displays of temper, hysteria, and general flakiness has grown considerably since the 1990s.

Twenty years later, a large proportion of our TV programming is made up of reality TV shows which have ‘real people falling apart’ as the most notable aspect of the drama. People swear at each other on news programs, people feel they have the right to say absolutely anything, no matter how reprehensible or uncivilized, through the anonymity that the internet now affords.

The ‘strong silent’ type has become a cliche. Our movie heroes and heroines vent and rant and we consider it more ‘naturalistic,’ probably because it is. These days, we give ourselves permission to fall apart all the time.

So, I guess it is hardly surprising that there is a small, but considerable minority of people in the Western World, but mostly in countries were ‘venting’ is in vogue’ who seem to have absolutely no control of themselves, their fear, or their over-reactions when it comes to a legitimately frightening thing, like Ebola.

Time reports that “2 Kids from Senegal Were Beaten Up in NYC by Classmates Yelling ‘Ebola’”. Now, admittedly, children can always be relied upon to be cruel, but it is also fair to say that they take their cues from their parents, from the media and the culture that surrounds them.

And let’s face it – Ebola is a scary disease. It’s especially scary in places like West Africa where only 18% of infections are being treated in medical environments, and those are under staffed, under resourced, and overcrowded. In Liberia, Sierra Leone and Guinea, the mortality rate is running at between 50-70%.

But in the US, where 9 people have been treated, only one has died so far – and that patient might very well have lived had he not been sent home the first time he presented with symptoms at the hospital. What seems quite clear is that

1) No one has been infected through casual contact. The only people infected in the US were two nurses, both of whom were dealing with copious body fluids while the patient was very, very sick.

2) Patients who are treated quickly after the first symptoms arise seem to survive the disease and recover well.

3) Even modest medical assistance such as the monitoring of fluids, managing electrolyte level and bringing down fever can significantly improve the rate of recovery of patients.

4) Getting plasma from another person who has already survived the virus seems to be helping.

5) As it stands, the morbidity rate for Ebola in the US is around 10%.

People, and the media, should be noticing these facts, considering them, learning from them and calming the fuck down. True, this is a disease that no one would want to get or wish on their worst enemy, but not only is the hyperbolic level of fear and public panic unwarranted, it is deeply unhelpful. We’ve spent decades progressively giving ourselves more and more permission to ‘let it all hang out,’ spouting the very first things that come into our head, and emoting all over the place.

I don’t want to advocate we all cinch up our corsets and become Victorians again. But, the one thing I do know is that all that permission to boundless self-expression is absolutely useless in a crisis. It doesn’t make us more careful, or thoughtful, or more capable of making good decisions. So, tonight, I’m tipping my hat to the strong and the silent. To that dying breed of introverted people who still seem to have some vestige of restraint and self control, who think before they speak and act.

These days, we need more of you.