During the COVID-19 pandemic we’ve seen the meme of doctors and nurses holding signs that read, “I stayed at work for you. You stay home for us.” This refers to health care workers willingly putting themselves (and their families) at risk to perform their work under more hostile than usual circumstances. When asked why, many will say they are, “just doing their job,” or that this is, “what we signed up for.” But this is not truly the reason they continue to show up. No one is purely following a blind sense of duty, especially not highly educated professionals who pride themselves on autonomy. This situation requires a more complete understanding.
The helping professions, ones defined by moving toward rather than away from crisis, present an existential problem for those who perform them. Quite literally, they have chosen to accept the risk of personal harm in order to help others. Under typical circumstances in health care, this risk is low. There are certain times, though, when this reality becomes clear, such as when faced with the threat of a potential fatal infectious disease. The threat is even more apparent for soldiers, police officers, and firefighters, whose risk of physical harm is more immediately threatening.
A person faced with an existential problem has the option to either proceed, assuming the risk, or to change course. The actions, and their outcomes, hinge on this choice. When the problem involves another person in need, the choice could be thought of as between the “I” and the “other”. Of course, when choosing “I”, one may be thinking of their children, spouse, or future ability to help in other ways. When considering the “other”, one may project the realistic outcomes the other person faces, their likelihood of survival, let alone their quality of life thereafter. If afforded time to think, one can weigh these things. In the moment, however, this is often not possible. And, as illustrated time and again, via heroic efforts, we most often choose the “other”. Why is this so?
The 20th century philosophy of Existentialism helps us understand the problem another way. It is posited that our actions become our practical identities, they determine our existence. When faced with an existential problem, we are confronted with the possibility of our “nothingness”. Because our identity is defined by the actions we take, inaction is synonymous with embracing the death of “I”. Conversely, to act is to choose “freedom”, experiencing the transcendence of one’s being in the world; living for something greater than the self. When thought of in this way, the question one faces is not, “Who do I choose?”, but rather, “Who am I?”. Answering the latter will immediately resolve the former.
Bringing this back to our health care workers, the risk of actual death to the self is of lesser importance than the death of the experience of their existence, in keeping with the identity they have chosen and the actions that support it.
At the risk of oversimplifying an entire school of philosophy, I put forward that health care workers care not because of their sense of duty, but because doing so is the manifestation of the freedom of the self, fulfilling the deep need to identify as part of something greater than themselves. This is as authentic as humanity can be.
To all those who care and protect us, putting yourselves in harm’s way, thank you. Your willingness to help is the greatest example of what it means to be human.
Be well.