When the SARS epidemic happened in China, I was seven years old. Every day, newscasters would call health care workers “white-clothed angels” and would praise their courage for risking their lives for the sake of our country. As a child, I remember sitting in front of the television, terrified by the apocalyptic news broadcasts. Those on the frontline seemed almost supernatural to me — as if they really did descend from heaven to save us. I admired them, but I felt like I could never do what they do.
Fast forward 17 years: I am now a medical student in California. Suddenly, with the emergence of COVID-19, the world is once again turning to medical professionals to save us — except this time I’m training to become one of them. In China, at the height of the pandemic, the front pages of every major newspaper and website featured the stories of “those who go against the tide” — referring to the health care workers who went to Wuhan when everyone else was trying to leave. In the United States, people in neighborhoods around the country clapped and cheered for those on the frontline calling them “heroes.”
There is no doubt that health care workers are essential to society. Watching my mentors and peers respond to calls of service by working long hours in the hospital despite their fears, I’ve never felt more resolute in and proud of the professional path I’ve chosen.
Yet, I am worried that these stories of heroism are harming the very people they celebrate. By creating an ideal “health care worker” as an endlessly altruistic individual, it stigmatizes the medical workers who refuse to take on these risks — even though there are many legitimate reasons not to. I’ve talked to doctors in China who have watched their friends and colleagues die during the SARS epidemic, who have watched the government break its promises to support their families after their death, and who, as a result, are no longer willing to volunteer on the frontlines. I’ve watched videos of nurses in the United States crying after they were forced to quit their jobs because hospitals are not providing them with the personal protective equipment (PPE) necessary to keep them safe. Many of them said that they were afraid of getting infected and spreading the disease to their high-risk family members.
Who can say these are not real concerns? Who can call these physicians and nurses selfish and irresponsible?
Even as a medical student, there has been a tremendous amount of social and institutional pressure for us to step up during COVID-19 and begin working, even if we haven’t yet received the proper training. Schools even graduated medical students early so they could start working sooner. Completely well-meaning physicians wrote op-eds about how students should step up and treat the pandemic as a learning opportunity. Many of us — myself included — are very eager to help out. We have been signing up for volunteer opportunities such as hosting PPE drives, coordinating telehealth appointments in homeless shelters, checking in with elderly community members, and advocating for policies to support COVID-19 efforts.
However, several upperclassmen have expressed their concerns to me about being forced into a life-or-death situation during clinical rotations when they didn’t feel well-prepared; they were worried that they were putting their patients, their family members, and themselves at risk — not to mention the fact that they were using up precious PPE and requiring the time of physicians who actually had the skillset to respond effectively. This public call for medical heroism only increased the pressure that they already felt from both their superiors and fellow trainees. Ultimately, it may have hindered the early pandemic response.
The rhetoric of heroism also makes it seem like health care workers are taking on these risks willingly without questioning why heroism is needed in the first place. Celebration that silences questions can be used deliberately as a tool of oppression. For example, Dr. Li Wenliang, a 34-year-old ophthalmologist in China, warned his colleagues of a new “SARS-like virus” in his medical school alumni group chat early on in the pandemic but was summoned by the Wuhan police and forced to sign a letter of admonition for “making false comments” that had “severely disturbed the social order.” After this was revealed to the public, China’s state-sponsored media started calling him “a hero of the Chinese people” while continuing to ignore the calls for government accountability, transparency, and freedom of speech that arose in the aftermath.
After Dr. Li died from COVID-19, state-sponsored media once again published stories that discretely discredited him, highlighting the fact that he was not the first one to report COVID-19, and did not intend for his message to be spread beyond his alumni group. Although these facts may be true, Dr. Li stated publicly in an interview that he believes “there should be more than one voice in a healthy society.” His supporters have highlighted that he is admired not because he was extraordinary but rather because he was an ordinary person that acted in accordance with his values. How Dr. Li was treated by the state-sponsored media clearly shows the potential emptiness of the word “hero:” it is a label that the state can bestow on or withdraw from a person at will, and is often used to hide the injustices that necessitate heroism in the first place.
As someone who grew up in China, I have come to expect this kind of behavior from the Chinese government. Yet what truly disappointed me was the United States’ disastrous response to COVID-19. After it became apparent that our nation’s chronic underfunding of public health programs, science denialism, and profit-focused medical manufacturing industry have caused a severe shortage in PPE for our frontline medical workers, doctors and nurses were accused of spreading panic when wearing their own masks and fired for speaking the truth. The fact that for-profit hospitals laid off thousands of medical workers whose services were deemed “non-essential” further contributes to the cruel irony that during a time in which we need health care workers the most, private corporations are actively denying them of the tools and privileges needed to protect themselves and take care of their patients.
How is this not also a form of authoritarianism?
Treating health care workers as heroes does a disservice to our patients and the general public as well. The rhetoric of heroism risks placing medical professionals on a pedestal of inherent altruism, creating a “halo effect” in which a favorable impression of an individual or group formed in one context transfers to other contexts. When people believe health care workers to be heroes, they may assume that they will always act altruistically and ethically. Thus, they may be less likely to examine medical practices and research from a more critical lens. This cognitive bias is dangerous: from the horrifying experiments done by Nazi doctors to the Tuskegee syphilis experiments, history has shown that medical professionals can and do abuse their power and act unethically.
Even today, it remains difficult to hold medical professionals accountable, as evidenced the fact that an investigation by The Atlanta Journal-Constitution revealed that nearly half of a total of 450 physicians who were brought before medical regulators or courts for sexual misconduct or sex crimes in 2016 and 2017 remain licensed to practice medicine. Furthermore, systemic racism continues to pervade modern medicine. A significant number of medical students and residents still believe in myths about racial biological differences, and most hospitals still use race-based “correction factors” for eGFR and spirometry measurements, despite the fact that they were based on the racist beliefs that Black people have more muscle mass and lung capacity. In an era when COVID-19 continues to disproportionately harm Black people, it is important to remember that medicine and medical professionals are not above critique.
Seventeen years after the SARS epidemic, I now know that those “white-clothed angels” I saw on television are actually human. Just like everyone else — just like me — they fear death, make mistakes, and even cause harm to others. While their hard work and courage deserve to be applauded, the rhetoric of heroism places an undue burden on healthcare workers to be endlessly altruistic, obscures the underlying systemic issues that force them into heroism, and risks placing them on a moral pedestal above necessary critique. Instead of superheroes, we need to start viewing medical workers as our fellow community members who need our governments, our institutions, and our communities to support them, protect them, and hold them accountable.