All patients are vulnerable, but some patients are more vulnerable than others. Take, for example, those with learning disabilities or mental health diagnoses, or elderly, physically disabled or dying people. These groups of patients are more likely to be marginalised, neglected or silenced. In palliative medicine, my speciality, the most extreme form of silencing occurs when a patient literally loses their voice – perhaps because a cancer has invaded their larynx, or, in the case of Covid, because they are too desperately in need of oxygen to be capable of squandering any on the act of speech.
I would meet these patients with haunting frequency on the Covid wards. Glassy-eyed, exhausted, sometimes writhing with the effort to make themselves heard. You did what you could to communicate. Your gloved hand might close around the clamminess of theirs, that a sliver of human warmth might cross the barriers of PPE. You might set up a family videocall on an iPad. Or you might shout your own words above the roar of high-flow oxygen, hoping to bring a fragment of solace. “Robert, I am going to help you.” “I’ve just spoken to Mary and she sends you all her love.” “Would you like me to give you some medicine to help you feel less breathless?”
There might be a nod, a twitch of the hand in yours, a glimmer of tears. And then, briefly, your own heart would leap, though more with relief than anything. Although your patient was dying – and probably in a matter of hours – you had managed to convey, or so you hoped, that they still mattered, were still deserving of care and attention, were emphatically not an expendable beast in a herd.
Watching Boris Johnson perform at the UK Covid inquiry, I realised he wanted us to believe he was using words with the weight and sincerity of a first-rate clinician. He was basically cosplaying being a doctor. Gone were his usual tactics – the bluster, bombast, comic riffs and jaunty Latin. Instead, he gave us contrition, solemnity and heartfelt humility, not to mention an extraordinary degree of amnesia in one so young without a diagnosis of early-onset dementia (“I don’t recall” was repeated like a mantra).
But two things united new, funereal Boris with the rambunctious clown of old: cowardice and compulsive lying. First, he sneaked into the Inquiry three hours early, seemingly in order to avoid the relatives who had lost loved ones in the pandemic and had travelled from all over the UK to be there for his testimony. It was an act of staggering churlishness. A direct and callous rebuff to bereaved members of the public who expected the former prime minister at least to walk past them, if not to look them in the eye.
Then there were the lies, obfuscations and convenient lapses of memory. Though too numerous to recount in full, one example bears close scrutiny: Johnson’s apparent contrition when questioned by lead counsel Hugo Keith KC about informing the nation that he had shaken hands with Covid patients in a London hospital as the pandemic was taking hold. This extraordinary claim was made during the UK’s first national Covid press conference on 3 March 2020.
Yet on 1 March, the day of Johnson’s hospital visit to the Royal Free, there were only 35 confirmed cases of Covid in the UK. Covid was still being managed as a “high-consequence infectious disease” (HCID) in specialist and infectious disease units. Clinical staff wore full, high-level PPE with all of these patients: FFP3 mask, visor, full-length gown, double gloves – the works. Do we really think that doctors at the Royal Free permitted the prime minister to saunter over to known Covid patients and merrily pump their hands?
Even at the time he made it, Johnson’s claim was seen as transparent nonsense by anyone who knew the first thing about infectious diseases, an absurd impromptu Johnsonian confection. I remember watching in horror as he ad libbed away, sending out the disastrous televised public health message that physical contact between Covid patients and the wider public wasn’t merely safe, but something to brag about.
Against that backdrop, Johnson’s seemingly meek admission yesterday that he “shouldn’t have” shaken hands with people but instead “should have been more precautionary” was nothing of the sort. Johnson continued to perpetuate what I believe is a larger lie, that he ever shook the hands of any Covid patients in the first place – made in his first ever national Covid press conferenc and repeated now, immediately after swearing an oath on a Bible to tell the whole truth. The entire performance is a house of cards.
For me the most salient lesson from Johnson’s testimony is not an insight into pandemic management but one into the exquisite pain that the misuse of words can inflict on the public. His brazen denials of parties in Downing Street were wretched enough for anyone who had lost a loved one to Covid. Worse still was his “let the bodies pile high” mentality, as evidenced during this inquiry by multiple senior figures, including Sir Patrick Vallance, the government’s chief scientific adviser. Now, in his own testimony, Johnson is demonstrating again to distraught and traumatised relatives that he will not show them the courtesy of truth or sincerity.
How can you possibly move on, how do you heal, in the face of contempt like that? Yesterday, Aamer Anwar, the solicitor representing Scottish bereaved Covid families, stated that Johnson had treated people who died with Covid like “toxic waste”. As he dodges and lies to their bereaved families, it is clear that nothing has changed.
Rachel Clarke is a palliative care doctor and the author of Breathtaking: Inside the NHS in a Time of Pandemic. Its ITV adaptation will air in 2024
