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(28) 5 Oct 2021

Best of Times, Worst of Times

“It was the best of times, it was the worst of times.” Most high school students recognize these words as the opening lines of Charles Dickens’, A Tale of Two Cities, written in 1859. However, few students and many adults are not familiar with the lines that follow, “it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of light, it was the season of darkness, it was the spring of hope, it was the winter of despair.”

It is an understatement to acknowledge that the Covid-19 pandemic has changed the world as well as the medical profession. The counterpoints expressed by Dickens in 1859, resonate today just as loudly during this crisis. Let us review them.

Best of Times/Worst of Times

3600 health care workers lost their lives caring for patients during the first year of the pandemic. Medical students, retired physicians, nurses and other health care professionals were recruited to care for patients during this ordeal. Through this tragedy, the pandemic reminded us of the finest tradition of our profession-caring for the sick.

Age of Wisdom/Age of Foolishness

This phrase was nowhere better demonstrated than during the interchange between physician-senator Rand Paul and Doctor Anthony Fauci over the wisdom of wearing masks. Let every urologist endorse Doctor Fauci’s response to the misinformed ophthalmologist, “Masks are not theater. Masks are protective.”

Epoch of Belief/Epoch of Incredulity

There were some who eschewed science and replaced belief with incredulity. Chloroquine, hydroxychloroquine, bleach and u-v light were all proposed, by some, as potential Covid cures. The epoch of science prevailed.

Season of Light/Season of Darkness

Some of our elected officials rather than leading us into light, led us into darkness. Nowhere was this more apparent than as the delta variant emerged. Misguided governors like Ron DeSantis and Greg Abbott placed economic and political considerations above the health of their constituents. In Florida, school leaders were threatened with loss of pay if they mandated mask wearing in schools. In Texas, bars and restaurants were reopened prematurely. In both Florida and Texas and some other states, the lack of leadership and recognition of the consequences of the delta variant further stressed already overburdened hospital systems.

Spring of Hope/Winter of Despair

The CDC, as valuable as it has been, has had an uneven record during this crisis. In retrospect, the potential for aerosol spread of the virus should have been recognized much sooner. The call for testing should have been earlier and more strident. The national initiative should have been much more effectively coordinated. Nonetheless, the rapid development and deployment of not just one, but several effective vaccines stands as a remarkable scientific achievement.

One of the major themes of the Tale of Two Cities is resurrection. I think as urologists and Americans, we should embrace that theme and learn from it. The last 20 months have not been easy for anyone, but if we have learned anything, it should be that our collective survival is based on a unity of purpose, both nationally and globally. If we have achieved that insight, then this may well have been the best of times, indeed.

Kevin R. Loughlin, MD, MBA Associate Editor
Boston, Massachusetts, USA
© The Canadian Journal of Urology™; 28(5); October 2021