In England Now
1
609 Health Watch COLLECTIVE MADNESS SoME of our fellow human beings (but never we ourselves!) react bizarrely to unusual and inexplicable social stimuli. When we talk about panic and mob actions, we imply that the ordinary intellectual processes are temporarily suspended. Nearly 150 years ago Charles Mackayl described how combinations of fear, greed, and ignorance could generate large-scale patterns of behaviour totally inexplicable in intelligent terms: "Whole communities," he wrote, "suddenly fix their minds upon one object, and go mad in its pursuit ... millions of people become simultaneously impressed with one delusion." By way of partial explanation he quoted from Schiller: "Anyone taken as an individual is tolerably sensible and reasonable-as a member of a crowd, he at once becomes a blockhead." But his instances (the Mississippi Bubble; Tulipmania; the persecution of witches) were the result of genuine delusions-ie, there was no basis in reality. More often, groundswells of fear and panic do have some reasonable basis. In today’s world, one would think that ignorance or lack of scientific information as to the cause or cure of disease would be an unlikely cause of riotous reactions and mob panic. But it is not the intellect that controls these fears. About ten years ago, a panic in the United States originated among the scientists themselves-a cluster of virologists and epidemiologists who perceived a threat of an influenza pandemic. A soldier had died after becoming infected with an unusual variant of influenza virus, and a Republican presidential candidate, on the advice of scientific associates, ordered mass immunisation. The public to a large extent resisted the urgings of the professionals, which was fortunate since the mass immunisation had tragically disabling and in some instances lethal consequences. This swine-’flu incident had a long-term side-effect as well: people are now more sceptical about public-health advice and are wary of "authoritative" pronouncements. The latest manifestation of fear, prejudice, ignorance, and professional disarray has been generated by the acquired immunodeficiency syndrome (AIDS). While there is ample cause for anxiety about causation, mechanisms of transmission, and lack of effective treatment, the mounting hysteria must be attributable in no small part to mixed and contradictory signals emanating from the scientific community. In the media, sober advice offered by knowledgeable authorities is viewed sceptically, not least because some other authority will usually contradict the advice almost immediately. This in turn fuels popular fears and stimulates absurd and panicky behaviour. The high prevalence of the disease among homosexuals has caused an already suspect, heretical, and despised minority to suffer greatly. For some religious fanatics, AIDS is the judgment of God on these flouters of His law; and among vindictive and self-righteous haters of homosexuals, great satisfaction is taken from this evidence of divine (or earthly) punishment. In the United States, over 90% of the cases of AIDS can be accounted for through activity in which the bloodstream can be invaded by AIDS virus-sexual activity, intravenous drug use, blood and blood-product transfusions, transplacental infections. Transmission by means other than the blood route has never been proved, yet AIDS-virus-infected children are barred from schools on the suspicion that saliva may carry the germ; churches contemplate abandonment of the communion cup; in California realtors advise the membership of their association to notify prospective buyers of the former residence of AIDS patients in houses up for sale; and, even more strangely, blood collection centres have noted an alarming drop in blood donations (over one-third of those polled believe AIDS can be contracted from giving blood). Four New York City policemen charged an AIDS patient with "assault with intent to murder" because he spat on them. For those who are already wildly paranoid, the AIDS epidemic offers a field day. The National Democratic Policy Committee (which has nothing whatever to do with the Democratic Party) published a pamphlet which accuses the Federal Reserve Board and the International Monetary Fund of deliberately infecting American citizens with the African virus for some unexplained nefarious reason. The President is also accused of a cover-up in collusion with the Soviets. W. I. Thomas, the American sociologist, suggested that ifa a proposition were considered to be true its consequences were real. When people believed in witches they were bound to hang old ladies. Doctors owe their patients precise information, reassurance, and sober and realistic assessment in situations of this kind. With a few exceptions, the profession has played a laudably balanced and humane role. Unfortunately, as the American developments reveal, the fears and prejudices that make up integral parts of human behaviour are not always responsive to reason. Institution for Social and Policy Studies, PO Box 14A Yale Station, New Haven, Connecticutt, USA GEORGE SILVER, Professor Emeritus of Public Health 1. Mackay C. Extraordinary popular delusions and the madness of crowds. London: Bentley, 1841 (republished by Harmony Press, New York, 1980). In England Now WHEN I met my psychiatrist friend, he had a slightly bemused air about him. More so than usual, perhaps. It transpired that one of his long-term patients, an elderly lady with loosely held delusions, had returned from her weekly visit to the nearby market town in a state of extreme agitation. Normally, on reporting back, she gave him a detailed account of her visit to the museum and art gallery, the quality of her afternoon tea, and the type of magazine she had bought. On this occasion she told him she had spent the afternoon flying around and over the hospital. Not only were there some slates missing, she said, but two fanlight windows were broken and a chimney stack was so cracked and leaning that it was in danger of crashing into the ward below. The more the staff agreed with her Mary Poppins adventure the more angry and excited she became. Thoughts of tranquillising drugs crossed my colleague’s mind. In desperation and against his better judgment he summoned the master of works. He explained the situation and, ignoring the growing disbelief on that gentleman’s face, ordered him to inspect the roof. In due time the man came back. He looked puzzled. Slates were indeed missing, the fanlights were broken, and the chimney stack had only been spotted in the nick of time. Doctor, nurses, tradesman looked at each other and back to the old dear in wonderment. How had she known? The answer became clear later that evening when the telephone rang. A local farmer was inquiring if the lady was all right. There had been a local air display for charity and she had purchased a flight in his light aircraft. Her special request was to be flown around the old mental hospital. Only after they landed had she told him she was a patient there. He was rather worried if the experience had upset her. In the event, it was my friend who was considering the ingestion of a few tranquillisers.
Transcript of In England Now
609
Health Watch
COLLECTIVE MADNESS
SoME of our fellow human beings (but never we ourselves!)react bizarrely to unusual and inexplicable social stimuli.When we talk about panic and mob actions, we imply that theordinary intellectual processes are temporarily suspended.Nearly 150 years ago Charles Mackayl described howcombinations of fear, greed, and ignorance could generatelarge-scale patterns of behaviour totally inexplicable in
intelligent terms: "Whole communities," he wrote,
"suddenly fix their minds upon one object, and go mad in itspursuit ... millions of people become simultaneouslyimpressed with one delusion." By way of partial explanationhe quoted from Schiller: "Anyone taken as an individual istolerably sensible and reasonable-as a member of a crowd,he at once becomes a blockhead." But his instances (theMississippi Bubble; Tulipmania; the persecution of witches)were the result of genuine delusions-ie, there was no basis inreality. More often, groundswells of fear and panic do havesome reasonable basis. In today’s world, one would think thatignorance or lack of scientific information as to the cause orcure of disease would be an unlikely cause of riotous reactionsand mob panic. But it is not the intellect that controls thesefears. About ten years ago, a panic in the United Statesoriginated among the scientists themselves-a cluster of
virologists and epidemiologists who perceived a threat of aninfluenza pandemic. A soldier had died after becominginfected with an unusual variant of influenza virus, and aRepublican presidential candidate, on the advice of scientificassociates, ordered mass immunisation. The public to a largeextent resisted the urgings of the professionals, which wasfortunate since the mass immunisation had tragicallydisabling and in some instances lethal consequences. Thisswine-’flu incident had a long-term side-effect as well: peopleare now more sceptical about public-health advice and arewary of "authoritative" pronouncements.The latest manifestation of fear, prejudice, ignorance, and
professional disarray has been generated by the acquiredimmunodeficiency syndrome (AIDS). While there is amplecause for anxiety about causation, mechanisms of
transmission, and lack of effective treatment, the mountinghysteria must be attributable in no small part to mixed andcontradictory signals emanating from the scientific
community. In the media, sober advice offered byknowledgeable authorities is viewed sceptically, not leastbecause some other authority will usually contradict theadvice almost immediately. This in turn fuels popular fearsand stimulates absurd and panicky behaviour. The highprevalence of the disease among homosexuals has caused analready suspect, heretical, and despised minority to suffergreatly. For some religious fanatics, AIDS is the judgment ofGod on these flouters of His law; and among vindictive andself-righteous haters of homosexuals, great satisfaction istaken from this evidence of divine (or earthly) punishment.In the United States, over 90% of the cases of AIDS can be
accounted for through activity in which the bloodstream canbe invaded by AIDS virus-sexual activity, intravenous druguse, blood and blood-product transfusions, transplacentalinfections. Transmission by means other than the blood routehas never been proved, yet AIDS-virus-infected children arebarred from schools on the suspicion that saliva may carry thegerm; churches contemplate abandonment of the
communion cup; in California realtors advise the
membership of their association to notify prospective buyersof the former residence of AIDS patients in houses up for sale;and, even more strangely, blood collection centres have notedan alarming drop in blood donations (over one-third of thosepolled believe AIDS can be contracted from giving blood).Four New York City policemen charged an AIDS patientwith "assault with intent to murder" because he spat onthem. For those who are already wildly paranoid, the AIDSepidemic offers a field day. The National Democratic PolicyCommittee (which has nothing whatever to do with theDemocratic Party) published a pamphlet which accuses theFederal Reserve Board and the International Monetary Fundof deliberately infecting American citizens with the Africanvirus for some unexplained nefarious reason. The Presidentis also accused of a cover-up in collusion with the Soviets.W. I. Thomas, the American sociologist, suggested that ifa a
proposition were considered to be true its consequences werereal. When people believed in witches they were bound tohang old ladies. Doctors owe their patients preciseinformation, reassurance, and sober and realistic assessmentin situations of this kind. With a few exceptions, the
profession has played a laudably balanced and humane role.Unfortunately, as the American developments reveal, thefears and prejudices that make up integral parts of humanbehaviour are not always responsive to reason.Institution for Social and
Policy Studies,PO Box 14A Yale Station,New Haven,Connecticutt, USA
GEORGE SILVER,Professor Emeritus of Public Health
1. Mackay C. Extraordinary popular delusions and the madness of crowds. London:Bentley, 1841 (republished by Harmony Press, New York, 1980).
In England Now
WHEN I met my psychiatrist friend, he had a slightly bemused airabout him. More so than usual, perhaps. It transpired that one of hislong-term patients, an elderly lady with loosely held delusions, hadreturned from her weekly visit to the nearby market town in a stateof extreme agitation. Normally, on reporting back, she gave him adetailed account of her visit to the museum and art gallery, thequality of her afternoon tea, and the type of magazine she hadbought.On this occasion she told him she had spent the afternoon flying
around and over the hospital. Not only were there some slatesmissing, she said, but two fanlight windows were broken and achimney stack was so cracked and leaning that it was in danger ofcrashing into the ward below. The more the staff agreed with herMary Poppins adventure the more angry and excited she became.Thoughts of tranquillising drugs crossed my colleague’s mind.In desperation and against his better judgment he summoned the
master of works. He explained the situation and, ignoring thegrowing disbelief on that gentleman’s face, ordered him to inspectthe roof. In due time the man came back. He looked puzzled. Slateswere indeed missing, the fanlights were broken, and the chimneystack had only been spotted in the nick of time. Doctor, nurses,tradesman looked at each other and back to the old dear inwonderment. How had she known? The answer became clear laterthat evening when the telephone rang. A local farmer was inquiringif the lady was all right. There had been a local air display for charityand she had purchased a flight in his light aircraft. Her specialrequest was to be flown around the old mental hospital. Only afterthey landed had she told him she was a patient there. He was ratherworried if the experience had upset her. In the event, it was myfriend who was considering the ingestion of a few tranquillisers.
