Douglas Waugh, former executive director of the Association of Canadian Medical Colleges, is a freelance writer living in Ottawa.
Canadian Medical Association Journal 1995; 153: 969
It seems reasonable to assume that the person who coined that aphorism was inspired by AIDS, the terrifying plague that arrived during the terminal quarter of the 20th century.
That a hitherto unknown fatal infectious disease could appear and spread around the world, defying our best efforts to combat or even control it, is almost beyond belief given the technologically sophisticated societies that exist today. Our preoccupation with AIDS -- Canada has already set aside the first week of this month as National AIDS Week -- is probably a reflection that we don't have nearly as many inevitably fatal or almost inevitably fatal diseases as we used to, and that helps make this new one so frightening.
In earlier times, however, AIDS would have had to compete for attention with other scary, high-mortality epidemics such as smallpox, plague, tuberculosis and poliomyelitis, each of which could and did strike terror around the world. These diseases, although not so inevitably fatal as AIDS, were accompanied by a high enough death rate to cause widespread alarm and panic if outbreaks were severe and widespread.
Now that we have learned to control the major infectious diseases -- and even eliminate them, as in the case of smallpox -- along comes this new one that has caused fear and loathing around the world. It's scary enough to drive one either to celibacy or safe sex -- equally distasteful alternatives to some among us.
And what a field day AIDS has provided for the finger-pointing moralists. For them it is a simple case of just deserts for the morally lax, as the moralists have been telling us all along about other sexually transmitted diseases. (Other than life itself, of course, because that is sacred!)
This brings me back to our unknown aphorist, who recognized the transience of life and the inevitability of death, from whatever cause. The contemplation of death is quite easy if you restrict yourself to thinking only in statistical terms. After all, one can always exclude oneself from the statistics -- which most of us usually do. It is only when the lightning strikes right beside us that we are likely to admit that fatal risks are real and proximate.
I do think that those of us on the brink of the 21st century view death rather differently than most of our forebears did. To them, the hazards of living were the potholes on the road of life, and we were all going to tumble into one or more of them, eventually with fatal consequences. These were the unavoidable facts of life that our ancestors recognized and accepted.
Today, medicine allows us to avoid many of the potholes, and even when we do fall into one there are doctors to help us out on the other side. Our generation, even if it can't contemplate immortality, can at least take a much more optimistic view of life than could our predecessors.
It is this fact, I believe, that makes us so unwilling to accept AIDS: this is indeed one pothole we cannot climb out of, even if there is an army of doctors beckoning from the other side. Our parents and grandparents could accept with equanimity that many diseases were fatal and offered little chance of survival, something we are no longer prepared and willing to do.
However, when you think of the road we have travelled in the last century, life really isn't so bad -- even if the end result is still the same as it was 2000 years ago.
In the end, it's all a matter of perspective, and even in this age of AIDS, aren't we lucky to live in a time of generally improving health outlooks? With luck, these improvements will continue.
See also:
The politics of despair: AIDS and the failure of treatment