Pandora's box

When we open a Pandora’s box, we start something that will cause many unforeseen problems. That's putting it mildly. According to Wikipedia, when Pandora’s box was opened, “sickness, death and many other unspecified evils were then released into the world.”

There’s a bit in Natalie Haynes’ discussion of the myth, though, which I hadn’t thought of before. In her book Pandora's Jar, Haynes suggests that one reason why the myth has endured is that it provides reassurance. We can look at the world, see how terrible it is, and blame something that happened long ago - that we were powerless to prevent - for the present terrible state of affairs. Here is what she says:

“Everything used to be okay, but then a single, irreversible bad decision was made, and now we all live with the consequences forever. It’s reassuring in a way: the problem was caused long before we were born and will persist long after our deaths, so there’s nothing we can really do about it”

This description of fatalism – and how it sort of lets us off the hook – made me think of the way we sometimes look upon the “big problems” facing the NHS. We often treat them as if they have been problems for ages already (based on decisions or events that took place long ago) and they defy resolution because they possess this enduring, unresolvable quality.

I have a vivid memory of attending a Nuffield Trust seminar on unscheduled care about nine years ago and noticing that every contributor in the room described the problems using the words “whole system” and “complex”. And I remember thinking that the more we label a problem as "whole system" and "complex", the more likely it will become a problem that’s "whole system" and "complex", and therefore the more likely we’ll fail to resolve it.

I think a lot of us ‘reassure’ ourselves by believing a story that says that we’ve inherited this mess, that this mess will probably outlive us, and therefore we shouldn’t get too stressed out trying to solve it because it’s probably unsolvable.

The Pandora’s box that unleashed all these unsolvable ills doesn’t have to have been a conscious decision or an actual act by someone in the past. It can just be the way that forces outside our control (demography, politics, culture, whatever) just happen to have combined in the past. And we’re left with the unsolvable legacy of that.

As it happens, I myself don’t buy into this passive acceptance of terrible-ness. It’s slightly weird, this, because in many other aspects of my life I'm decidedly fatalistic. But with healthcare problems - particularly unscheduled care and patient flow - I’m an optimist. I don't think that it’s all – to quote Valmont in Dangerous Liaisons – “beyond our control”. Instead, I keep battling away. And I take some solace in a detail that’s often left out when the myth of Pandora’s box is retold.

Not everything in the box was released. One thing stayed in the box, and that thing was hope. The gods had decided that we shouldn't be left without hope.

I like to think there was some data left inside that box, too!