First they came for the Jews and I did not speak out because I was not a Jew. Then they came for the Communists and I did not speak out because I was not a Communist. Then they came for the trade unionists and I did not speak out because I was not a trade unionist. Then they came for me and there was no one left to speak out for me.
We often see particular relevance in quotations and prose and it maybe useful to consider more deeply why some words and phrases evoke and impact more than others. The real events behind this short piece seem confused and unclear when you search for details. But for me the meaning is clear and evokes a sadness and committment. These lines speak of a connectivity between people. To ignore poverty, torture, brutality and discrimination and to justify that by believing it’s not your concern or business is fundamentally flawed. We are all connected. I remember what we were all taught at the beginning of my clinical career, ‘imagine it’s your father, mother, sister or brother in that bed’. While I understand the sentiment behind the words the idea is false. misleading and provides places to hide and shirk responsibility.
The patients we care for are not our mothers, fathers or siblings and so reality creates a space that allows us a get out, a deep-rooted escape in that challenging moment. Perhaps if we changed that easy, yet emotive, line from basic training to something that stood the test of reality we may better progress the debate on quality care. As committed carers and human beings we don’t need to imagine patients are our relatives. They are fragile connections and relationships that matter in just as fundamental way, they are strangers, and perhaps that matters even more. Caring for your family stirs a variety of emotions and pressures; duty, longevity of relationship, social expectation etc. Caring for strangers requires a deeper acceptance of need, vulnerability and ultimately of meaningful human connections. There are some very real expectations and pressures as well as an understanding of the duty of each member of the NHS to rise to the test. Deliver quality care to the stranger not because you imagine them as a member of your family but because they are worthy of your care in their own right. We are all connected and the words from Niemoller offer an opportunity to consider the shared experience, risk and heartache of life that binds rather than separates us.
That’s not to say that in my busy life I don’t stand by at times and see the misfortune of others and take no action. But I don’t delude myself either, I know what has happened in those moments. I have not been courageous enough or I have made other choices. What I don’t do is convince myself that it was not my concern. If we can only deliver quality care to our patients by pretending they are somebody they are not, then our relationships with them is vulnerable and weak. They are who they are and that matters. Despite the best efforts of mankind to separate us by race, creed, religion, politics and wealth we are all connected in some way, and we are all vulnerable. One day I will need help, and the delivery and quality of that assistance will be dependent on how those who are capable see me, a true human connection, an imaginary false relationship, a mundane task or non of their business.