As Boris Johnson was being treated in intensive care, Dominic Raab expressed his confidence that the Prime Minister would defeat Covid-19 and return to work because ‘he is a fighter.’ The press howled in opposition to these hopeful words. Things culminated in BBC Newsnight’s Emily Maitlis, disdainfully telling viewers: ‘You do not survive the illness through fortitude or strength of character, whatever the Prime Minister’s colleagues will tell us’. The video clip achieved its intended virality, and was picked up by cable networks around the world. But we need to set the record straight.
She’s wrong. Medically wrong. Dangerously wrong. As a critical care physician, I can say from both clinical experience and from scientific literature, courage in illness matters. It matters for survival.
In ‘Man’s Search for Meaning’ the Austrian psychiatrist and holocaust survivor, Viktor Frankl, describes a crystallised behaviour pattern among concentration camp inmates who lost the will to live:
‘Something typical occurred: they took out a cigarette from deep down in a pocket where they had hidden it and started smoking. At that moment we knew for the next forty-eight hours or so we would watch them dying.’
No one blames such people for giving up hope, of course. And obviously, many people who never gave up hope perished all the same. Even so, Frankl observes the converse clearly: every single person who gave up hope died.
I see the same of patients in the throes of life-threatening illnesses. Sadly, no amount of optimism and pluck will cure terminal conditions like stage IV pancreatic cancer. But with infectious disease, there is some proportion of cases that could go one way or the other. In my experience, if the patient decides to let go of life, they really only go one way and never the other.