I don't want to think about it

A few things lately have brought the concept of complacency to the forefront of my mind:

The first is work-related. I'm taking my required summer-full-time-student class right now, Emerging Diseases. One of the factors for emergence, and especially re-emergence, of diseases is complacency towards the risk. For example, the first deaths thought to be due to West Nile Virus in New York City were birds noticed by a vet at the Brooklyn Zoo, but the officials pretty much patted her on the head and told her to go back to the fuzzy animals where she belonged. If you were in the US in the last 5 years, you probably know how that ended.

Today we were discussing the (lack of) government response to Hurricaine Katrina and its cause, which was a combination of complacency and politics as usual. There are myriad examples in public health (interesting fact from today: 1 in 4 middle-class suburbanites has genital herpes) of a disease or issue being ignored because, well, we can't be bothered to change. Grr.

And then there's the opposite of complacency towards disease. After hiding SARS and H5N1 infections from the world, allowing dangerous spread of dangerous diseases to avoid losing face, China has decided to fight back. Is beating 50,000 dogs to death going to stop rabies? Maybe. Is it the way to go? NOOOOO! Bad China! Bad! My instructor (a rabies control expert) mentioned that there was talk of trying to eradicate rabies in a developing country. China was an option, but she didn't think it was a good idea (I think in part because, as she said, she'd rather go to Tanzania). Are they trying to show their fitness for an eradication campaign? 'Cause if they are, don't suggest eradicating AIDS to the Chinese government.

The second thing that got me thinking about complacency was a weekly email devotion that arrived today. At first I was a little wary of the opening citation, Lebanon weeping etc., but the commentary was amazing. Really, part of the problem in the Middle East is complacency in the citizens, a refusal to step up and say that they want peace, a self-denial of the extremism that is running their respective countries. If the people who are being bombed etc. were to raise their hands and say they want peace, would terrorism go away? Of course not. Would it lose its mandate in Lebanon, Syria, Palestine, Israel, Iran, or any country being ruled by violence? Maybe. Would something change? Definitely.

Complacency extends far beyond war and disease. In a fair amount of cases of poverty and dispossession, the poor are complacent because 'what can they do?' while the non-poor are complacent because they're not struggling. In those cases, development workers need to educate the poor and non-poor alike if they hope to effect change.

The third thing to get me on the issue of complacency is my mother having breast cancer. She was diagnosed yesterday, after a routine mammogram sent her to biopsy-world. No, she wasn't complacent. I want to be. Really, I want to be able to ignore how serious this whole situation is. I want to pretend a double mastectomy is a minor procedure with no risks. I want to believe her prognosis is excellent. I want to go on trusting my mom to be there. I want to be complacent. I can't be. Curse you, medical training!

I deplore complacency that allows disease and war and poverty to spread, but I think I'm starting to understand it.