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Sandro Galea
Humility is not something we often think about when envisioning how we can shape a better world. Changing the world is a pursuit we tend to associate with thinking big, with the boundless ambition we regard as necessary for accomplishing major progress.
Yet humility is, in fact, core to the success of these efforts. Humility helps us to listen and engage with respect, compassion and an openness to alternative perspectives.
Throughout COVID-19, we saw how hubris and closed-minded partisanship undermined, again and again, the possibility of such a conversation, hindering our efforts to support health. We need an approach to health that embraces humility, in order to build a healthier world.
The pandemic offered many opportunities for humility. One of the key features of COVID-19 was that almost everyone was wrong about something. Some were wrong about how long the pandemic would last. Others were wrong about the deadliness of the disease. Still others were wrong about how long it would take to produce a vaccine, or about the protective virtues of masks.
I, personally, was wrong about the extent to which scientific recommendations would become politicized during the crisis. I was truly surprised to see something as basic as mask-wearing during a pandemic become a partisan flashpoint.
These missteps reflected our limitations in understanding and influencing the world. They were reminders that, for all our knowledge, what we don’t know will likely always outweigh what we do.
The virus was far bigger than any of us, and its presence in our lives highlighted socioeconomic conditions that are bigger still. Facing these forces, we could do little as individuals — it was only through our collective effort, imperfect as it was, that we were able to muddle through the crisis.
We are not always naturally inclined to turn toward humility. It is far easier to turn toward pride, or achievement, or our sense of unlimited human potential. Turning toward humility often takes a personal or collective blow to shake us out of our easy triumphalism.
COVID-19 was such a blow. It forced us to confront influences larger than ourselves, influences over which we have little control as individuals, influences that deeply shape our health.
But humility is more than something that tempers our pride. It is an essential tool for building a healthier world, a world that is resistant to contagion. Humility helps us to lay the foundation for structures that generate health.
It seems perhaps paradoxical to suggest that we cannot advance knowledge without a keen sense of the limits of what we know. Yet this is precisely the case. One of the core principles of the scientific pursuit of knowledge is epistemic humility — the notion that our inquiries should be informed by the understanding that we do not know what we do not know.
After all, if we think we know everything, why learn more? If we are convinced our worldview is accurate in every respect, why leave our minds open to new ideas?
One of the reasons we are so uncomfortable with the experience of complexity and ambiguity is that we tend to see it as a temporary state, a detour on the road to the complete knowledge we feel our scientific understanding will ultimately deliver. Believing this, we see no reason to get comfortable with the feeling of doubt and incomplete knowledge.
Yet this belief has not served us well, as COVID-19 amply illustrated. We should not allow the triumph of vaccine development to cause us to forget that the story of the pandemic, in its entirety, was overwhelmingly about the failures of our current, medicine-obsessed approach to health.
The reason the race for a vaccine needed to be a race at all was because we allowed our society to become a place where contagion could easily take hold. We did this in large part by lavishing money and energy on creating better drugs and treatments while neglecting the socioeconomic conditions that shape health. Our pursuit of these treatments is, I would argue, a proxy for our pursuit of certainty.
When we think of a drug, think of something dependable, simple. The certainty of cure without the ambiguities inherent in prevention is appealing.
Yet through our pursuit of total certainty and our confidence that we can one day attain it, we have put off creating a world that is less vulnerable to poor health. We have advanced a fantasy of perfect cure, and made the perfect the enemy of the good, of the progress necessary for building a healthier world. To advance this progress, we need humility.
The importance of humility is clear when we take a closer look at just what our medical triumphalism was able to achieve during the pandemic. We should never forget that the world that gave us vaccines in record time also gave us, in the United States alone, hundreds of thousands of deaths and millions of COVID-19 cases. What was medicine able to do in the face of this? The honest answer is: relatively little.
This is the fault not of medicine, but of our willingness to prioritize medicine above all else in our approach to health. Not only does this approach undermine health but it even undermines medicine in the long run, by ensuring that the weight of our failure to adequately safeguard health will fall most heavily on our health care infrastructure when crisis strikes.
We have let this status quo persist because we believed ourselves able to master disease rather than engage, with humility, with the forces that allow it to emerge. This miscalculation and its tragic consequences during COVID-19 reflect the darker side of the absence of humility — the rise of hubris.
There is nothing wrong with pride in our medical abilities, a pride rooted in an honest appraisal of their strengths and limitations. But to turn toward hubris is to court the grandiose self-confidence that threatens to obscure an accurate assessment of what we can and cannot do.
When this lack of vision meets the natural ambiguity of a crisis, the door is open for the kind of mistakes that cost many lives. The long-standing conditions of our society, in which injustice and health inequities have allowed significant pockets of our population to face generations of preventable disease and death, constituted a crisis long before the spread of a novel pathogen beginning in 2019. COVID-19 was really a crisis on top of a crisis, exploiting the poor health that we, blinded by hubris, have allowed to proliferate in our society.
The existence of such a crisis, in addition to being a problem to solve, is yet another reason for us to remain humble. Because as long as we accept injustice, no matter how advanced our technology or sky-high our aspirations, we will be marked as a country unwilling to correct the fundamental problems in our midst.
Given our potential for both the best and the worst, we should proceed humbly, improving what we can, correcting our mistakes, and not allowing a healthy appreciation of our potential to blind us to how we have failed to live up to it.
We have a clear choice in this post-pandemic moment: We can yield to the temptation of hubris, ignoring what matters most for health in favor of an approach that opened the door to COVID-19. Or we can humbly understand that we do not know what we do not know, focusing on a vision for health that we can see only when we take our eyes off distractions.
How we choose will determine how healthy we are able to be in the years to come.
(Sandro Galea is a physician, epidemiologist and dean of the Boston University School of Public Health.)
Humility is not something we often think about when envisioning how we can shape a better world. Changing the world is a pursuit we tend to associate with thinking big, with the boundless ambition we regard as necessary for accomplishing major progress.
Yet humility is, in fact, core to the success of these efforts. Humility helps us to listen and engage with respect, compassion and an openness to alternative perspectives.
Throughout COVID-19, we saw how hubris and closed-minded partisanship undermined, again and again, the possibility of such a conversation, hindering our efforts to support health. We need an approach to health that embraces humility, in order to build a healthier world.
The pandemic offered many opportunities for humility. One of the key features of COVID-19 was that almost everyone was wrong about something. Some were wrong about how long the pandemic would last. Others were wrong about the deadliness of the disease. Still others were wrong about how long it would take to produce a vaccine, or about the protective virtues of masks.
I, personally, was wrong about the extent to which scientific recommendations would become politicized during the crisis. I was truly surprised to see something as basic as mask-wearing during a pandemic become a partisan flashpoint.
These missteps reflected our limitations in understanding and influencing the world. They were reminders that, for all our knowledge, what we don’t know will likely always outweigh what we do.
The virus was far bigger than any of us, and its presence in our lives highlighted socioeconomic conditions that are bigger still. Facing these forces, we could do little as individuals — it was only through our collective effort, imperfect as it was, that we were able to muddle through the crisis.
We are not always naturally inclined to turn toward humility. It is far easier to turn toward pride, or achievement, or our sense of unlimited human potential. Turning toward humility often takes a personal or collective blow to shake us out of our easy triumphalism.
COVID-19 was such a blow. It forced us to confront influences larger than ourselves, influences over which we have little control as individuals, influences that deeply shape our health.
But humility is more than something that tempers our pride. It is an essential tool for building a healthier world, a world that is resistant to contagion. Humility helps us to lay the foundation for structures that generate health.
It seems perhaps paradoxical to suggest that we cannot advance knowledge without a keen sense of the limits of what we know. Yet this is precisely the case. One of the core principles of the scientific pursuit of knowledge is epistemic humility — the notion that our inquiries should be informed by the understanding that we do not know what we do not know.
After all, if we think we know everything, why learn more? If we are convinced our worldview is accurate in every respect, why leave our minds open to new ideas?
One of the reasons we are so uncomfortable with the experience of complexity and ambiguity is that we tend to see it as a temporary state, a detour on the road to the complete knowledge we feel our scientific understanding will ultimately deliver. Believing this, we see no reason to get comfortable with the feeling of doubt and incomplete knowledge.
Yet this belief has not served us well, as COVID-19 amply illustrated. We should not allow the triumph of vaccine development to cause us to forget that the story of the pandemic, in its entirety, was overwhelmingly about the failures of our current, medicine-obsessed approach to health.
The reason the race for a vaccine needed to be a race at all was because we allowed our society to become a place where contagion could easily take hold. We did this in large part by lavishing money and energy on creating better drugs and treatments while neglecting the socioeconomic conditions that shape health. Our pursuit of these treatments is, I would argue, a proxy for our pursuit of certainty.
When we think of a drug, think of something dependable, simple. The certainty of cure without the ambiguities inherent in prevention is appealing.
Yet through our pursuit of total certainty and our confidence that we can one day attain it, we have put off creating a world that is less vulnerable to poor health. We have advanced a fantasy of perfect cure, and made the perfect the enemy of the good, of the progress necessary for building a healthier world. To advance this progress, we need humility.
The importance of humility is clear when we take a closer look at just what our medical triumphalism was able to achieve during the pandemic. We should never forget that the world that gave us vaccines in record time also gave us, in the United States alone, hundreds of thousands of deaths and millions of COVID-19 cases. What was medicine able to do in the face of this? The honest answer is: relatively little.
This is the fault not of medicine, but of our willingness to prioritize medicine above all else in our approach to health. Not only does this approach undermine health but it even undermines medicine in the long run, by ensuring that the weight of our failure to adequately safeguard health will fall most heavily on our health care infrastructure when crisis strikes.
We have let this status quo persist because we believed ourselves able to master disease rather than engage, with humility, with the forces that allow it to emerge. This miscalculation and its tragic consequences during COVID-19 reflect the darker side of the absence of humility — the rise of hubris.
There is nothing wrong with pride in our medical abilities, a pride rooted in an honest appraisal of their strengths and limitations. But to turn toward hubris is to court the grandiose self-confidence that threatens to obscure an accurate assessment of what we can and cannot do.
When this lack of vision meets the natural ambiguity of a crisis, the door is open for the kind of mistakes that cost many lives. The long-standing conditions of our society, in which injustice and health inequities have allowed significant pockets of our population to face generations of preventable disease and death, constituted a crisis long before the spread of a novel pathogen beginning in 2019. COVID-19 was really a crisis on top of a crisis, exploiting the poor health that we, blinded by hubris, have allowed to proliferate in our society.
The existence of such a crisis, in addition to being a problem to solve, is yet another reason for us to remain humble. Because as long as we accept injustice, no matter how advanced our technology or sky-high our aspirations, we will be marked as a country unwilling to correct the fundamental problems in our midst.
Given our potential for both the best and the worst, we should proceed humbly, improving what we can, correcting our mistakes, and not allowing a healthy appreciation of our potential to blind us to how we have failed to live up to it.
We have a clear choice in this post-pandemic moment: We can yield to the temptation of hubris, ignoring what matters most for health in favor of an approach that opened the door to COVID-19. Or we can humbly understand that we do not know what we do not know, focusing on a vision for health that we can see only when we take our eyes off distractions.
How we choose will determine how healthy we are able to be in the years to come.
(Sandro Galea is a physician, epidemiologist and dean of the Boston University School of Public Health.)
