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John R. Adler, Jr., M.D. - March 2, 2020

Right now it is impossible to ignore the financial markets panicking, the breathless coverage by news media, the fearful buying at Costcos everywhere, and so many friends and family now worried about the emerging Covid-19 pandemic. Predictions of what might come next raise the specter of an historic pandemic that could literally kill millions or dare I say tens of millions before it runs its course. We are clearly living in an “interesting” time.

Media often nurtures the collective myth that modern medicine is capable of miracles, and in recent years some in Silicon Valley even implied that humanity could be on the cusp of conquering death itself. Fueled by so much optimism, we, and especially the young adults among us, live in a world grown complacent about premature dying and now finds itself shocked at our shared reality; modern medicine has not solved the “death problem.” Philosophically speaking, and as a physician who has seen more than his fair share of deaths, I do not necessarily find our communal predicament tragic. Yes, it is quite possible that countless individual tragedies will abound in the months to come, However, as my neurosurgical profession taught me at a young age, death is never far away, even though we may have chosen to believe otherwise.

What is not a surprise, or should not be a surprise, is that the Covid-19 pandemic is occurring in the first place. Human beings are merely one life form among many on earth. Why then should we think of ourselves as being exempt from the fundamental principles of biology? As human numbers approach 8 billion there is an increasing need for urbanization, and with urbanization massive densely populated cities have emerged. Not unlike the situation on factory farms, high population density of any life form is a set up for the rapid spread of infectious disease. It takes heroic and often unnatural public health efforts to compensate for such ecological pressures, much like the antibiotics used in animal feedlots. Meanwhile, modern medicine enables a continuously growing elderly or otherwise infirm population to keep on living and it is these individuals who are far and away the most susceptible to Covid-19. As a 65-year-old man, I am not unaware of the fact that 100 years ago life expectancy was little more than 30. The huge population of elderly and other individuals with compromised health who are alive today would not have lived a century ago, yet they are a natural target for infectious disease. There are reasons to celebrate urbanization and growing old, yet our species should not be unmindful of the infectious disease opportunities that these changes engender. If not Covid-19, other pandemics can and will emerge. That is our human reality that medicine will be hard pressed to ever “solve.”

So what to do? Sorry to say, there is no solution. Rather my simple advice would be to use the present pandemic as a wake-up call to appreciate whatever life we have before us. As Steve Jobs famously once said, “Death is very likely the best single invention of life.” Let’s wisely use that which remains.

And don’t forget to wash your hands!