By Zahra H. Khan, Yoshiko Iwai, Sayantani DasGupta

Throughout the COVID-19 pandemic, the “Healthcare Hero” metaphor has gained tremendous popularity, generating praise for healthcare workers as well as caution against the metaphor’s potentially negative consequences. In her recent article, Dr. Caitríona L Cox explains that, when heroized, healthcare workers face unfair expectations of personal sacrifice without adequate structural support. We use Narrative Medicine, a heath humanities field that contextualizes individual narratives of suffering in broader, structural contexts to argue that the “Healthcare Hero” metaphor wields militaristic language to valorize self-sacrifice, encourage anti-science discourse, and reinforce xenophobic nationalism.

Since March 2020, the U.S. has saluted healthcare workers with nationwide flyovers, sunset ovations, vibrant billboards, and a Fisher-Price collection of action figures. In exchange, healthcare workers have been expected to unquestioningly defend the country, sometimes costing them their lives. Since militaristic language is so embedded in medical education and training—from calling medical school “boot camp” and hospitals “frontlines,” to labelling hard working students “gunners”—it has become increasingly difficult to evaluate the degree of personal risk the job entails. While healthcare workers pledge to care even during times of crisis, military metaphors enlist them in a service of self-sacrifice. Risk of occupational death, however, is not part of their professional commitment to medicine, let alone during a global pandemic.

We came to this discussion as facilitators and scholars in Narrative Medicine. Narrative medicine workshops introduce creative or literary texts to a group of participants and encourage self-reflection and transformation through methods like close reading, writing, and sharing. In these workshops, close reading enables us to hone into language and consider its broader impacts. As “Healthcare Heroes” took over popular media in March 2020, we could not ignore its far-reaching ethical implications. As the field of Narrative Medicine grows across the U.S. and internationally, many young healthcare professionals have joined our courses and conversations. Even in working with humanities-trained or interested professionals, the deeply engrained militaristic framework becomes apparent in Narrative Medicine workshops and coursework. We realized that metaphors may be enabling this kind of thinking and rationalization which, in part, incited our paper in response to Dr. Cox.

Military metaphors also help engender widespread anti-science sentiment and a xenophobic nationalism. Despite hailing healthcare workers as heroes, medical institutions are systematically, and paradoxically, punishing their staff for speaking out about PPE shortages. President Trump not only ignored health experts, but accused them of over-diagnosing COVID-19 cases for personal financial gain. From calling COVID-19 the “China virus” to the “Kung Flu,” President Trump’s remarks have also illustrated the widespread anti-Asian bigotry and racism in the U.S., even while BIPOC communities continue to bear the disproportionate burden of death and disease from COVID-19. By ignoring scientific expertise and the pleas of essential workers, the U.S. government has revealed the utilitarian implications behind its cost/benefit analysis: in order to benefit the majority, some people will have to die. Not surprisingly, those forced into this utilitarian bargain are the nation’s most vulnerable: nursing home residents, incarcerated individuals, homeless populations, indigenous nations and communities of color, people with disabilities, undocumented families, transportation and delivery staff, and food supply-chain employees. Trumpian politics will not disappear with President-elect Biden taking office because racism, xenophobia, and white supremacy have thrummed beneath the country’s surface since its inception.

In our paper, we use a narrative medicine approach to discuss the moral and ethical implications of military metaphors in medicine and consider how we can advocate for demilitarized language to reduce harm and heal our global communities.

Paper: Military Metaphors and Pandemic Propaganda: Unmasking the Betrayal of “Healthcare Heroes”

Authors: Zahra H. Khan¹, Yoshiko Iwai¹, Sayantani DasGupta^{1, 2}

1. Columbia University, Narrative Medicine, New York, NY, USA
2. Columbia University, Center for the Study of Ethnicity and Race, New York, NY, USA

Funding: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Acknowledgements: The authors would like to thank Columbia University’s Program in Narrative Medicine for their support of this project.

Competing Interest: No potential conflict of interest was reported by the authors.