Abstract
By the time you read this, Brexit might be a formality. Or then again, opponents of Brexit might have succeeded in thwarting Brexit by delaying it or forcing a second referendum. Either way, even at this late stage, the outcome is uncertain. Uncertainty is something medical professionals grapple with in most every task and every decision. Rarely is evidence clear-cut or a clinical challenge perfectly clear. Uncertainty is an ever-present for a profession that juggles risks and benefits. Yet, for many years, nothing seemed more certain than that uncertainty would be a component of medical practice in an interconnected world, where doctors and other health professionals collaborate across the globe to further medical science and improve people’s health.
That simple vision is at odds with isolationism, the seeds of which are growing most notably in the United Kingdom and the United States of America. For, however you explain the purpose of Brexit, the forces of isolationism were unleashed by it and, whatever the outcome of Brexit, the effect of isolationism will take a long time to disappear. I say this because isolationism is against the nature of science and medical practice. Collaboration and learning from others make both disciplines stronger, helping achieve better outcomes in research and patient care. Hence, it is understandable that medical colleges and societies are opposed to Brexit because of the damage it will cause to health.
Don’t take my word for it. You will find arguments and evidence for the value of an interconnected world in this and every issue of JRSM – as you will in the pages of other prominent medical and scientific journals. Hubbeling et al. remind us of the value that the diversity of European colleagues brings to clinical teams. 1 Our modern interpretation of therapeutic empathy is complex but better for the philosophical insights of Europe’s leading thinkers. 2 This month’s research paper provides early evidence in response to the paucity of data collection in the UK on sports-related injuries in children. Other countries were quicker off the mark in realising the importance of risks posed to children, particularly by contact sports when children can be the same age but physically very different. 3
Interconnectedness isn’t new. James Jurin, an 18th-century physician and polymath, advanced our approach to vaccination by learning from colleagues as he travelled across Europe. 4 Indeed, Winston Churchill, at the centre of a media controversy about his legacy last month, in later years grew accustomed to ‘Mediterranean warmth and light, particularly that of the south of France’. 5 The latest in our series on Churchill’s illnesses describes how he fractured his hip in Monte Carlo and the eventful treatment and recovery.
Our commentary this month analyses the new NHS Plan with a public health eye, reminding us that with a proud history in universal health coverage and public health the UK’s influence in improving health around the world is enhanced by interconnectedness. 6 On 1 April 2019, we may wake up less interconnected and more alone.