Just a few months ago our priority in Europe were the holidays, the begin of the flu season and politically local elections in France, maybe a national government in Belgium, migrant crisis at the borders of Greece, and the presidential election in the US. Some democracy challenging evolutions in Hungary or Russia completed the self-energizing protests in Hong-Kong. 

Human rights were understood differently in different corners of the world and we asked ourselves how possible it is to see the truth through so many ways. It could be the clash between generations: while the youth was marching for climate, older generations were advocating for stronger armies and economies to produce more with less human investments. We have never had so many connecting tools (social media) to watch and eventually to understand these generations believes but even with this desire to be reunited, we’re still building up the self-development, the individual right or the own happiness. The idea of “I” became the rule even if the community marketing ideas were built around the concept of “We”. 

Meanwhile we all enjoyed a better life by living longer or having less fatal diseases. The norm was to chronicize the disease and through this medical approach to minimize its impact on our life. Medication was preferred in cases of chronic diseases even when lifestyle, according to World Health Organization, was the causing factor in least 80% of them (cardiovascular disease, stroke, diabetes type II to name a few). Could you blame us for it? We wanted to keep our health the same daily rhythm imposed by technology. As physicians, we faced much more informed patients even if not necessarily with evidence-based facts about vaccines, nutrition or other lifestyle chapters. The public health system was facing deficits because it was asked to deliver profits, but much as a company which welcomed the (health) failures called chronic diseases instead of investing in health promotion and efficient health interventions. The latter are more successful economically in the long term, and as a nation’s capacity of facing worldwide crisis: SARS-CoV, Ebola or MERS, to name the last health warnings.

A few years ago, in a Ted Conference speech, Bill Gates advised us to invest in health-related experts interventions instead of armies, which were efficient as fighting tools in the past, but which could be less efficient in a new world war. He even gave as an example of the Ebola crisis which was limited because it didn’t appear in urban areas. The Semmelweis reflex, or the tendency to reject new evidence or new knowledge – the importance of lifestyle in certain chronic disease-because it contradicts well accepted norms, beliefs, or paradigms, was working perfectly in our chronic diseases and public health politics. Not much as a surprise when the decisional norm in societies was the populism and not the expert’s word. We kept facing chronic diseases with physicians trained in the same way as one hundred years ago, even if in ultra-modern laboratories. We built elderly homes, where we almost abandoned our relatives instead of adding real life to their last years. Certain medical specialists were paid extremely well because of their expertise in technologized medicine. We invested less financially in emergency medicine, epidemiology or microbiology fields, not to even mention primary-care. 

As a lifestyle medicine trainer, you share from the beginning the importance of motivation in our long-term health decisions related to chronic diseases. We must understand that our patients are the experts of their lifestyle choices, which is less taken in account by our medical institutions. Knowing the habits of your patients, you know their reactions when they are facing an illness. Their habits are based on their cultural scripts, spiritual beliefs, education, health experiences and social media. How often are we questioned about these chapters of our lifestyle choices when we are in a medical office?

The actual pandemic is a mirror which shows the ugly face of our health reality: lost politicians, lack of efficient first line caretaker systems, hospitals as houses of disease, and elderly people victims of our incompetent chronic diseases management. Luckily, our human nature and surviving reflexes have made us to take some measures which will limit damages and set aside the reality mirror for a while.

If we want to be able to find the long-term solutions for the causes of the actual pandemic, we must give up the principles which we thought define modern democracy: charming and populist politicians, the freedom to travel anywhere, the right to be yourself no matter the costs, and maybe even the right to vote at term. If we want to survive and be able to live with future pandemics, we might accept a new living system in which the dictatorship could have a new ideology: everything in the name of our health. If you find the system repulsive or futuristic, you just need to look around you to see what we have accepted to stay healthy: confinement in our homes and limited movements around it, no travel, fear of personal contacts, closed churches and cultural institutions, government communication as press reference, essential commerce’s are considered just the basic needs and, of course, the pharmacies in a hope for a universal medication. 

Few years ago, James Hurowitz, an American physician, gave us an analysis of how we could live in a healthocracy as the result of capitalism, democracy and health as main ideologies. The model could have been seductive in the past and in certain cultures, but today there is need to re-healthisize the basis of our society: hospitals need to become houses of health (promotion), primary care to have a different financial model than the specialized medicine, emergency care to be the rapid health interventions teams of the country and chronic diseases treatments to be built around lifestyle as first interventions and afterwards medication. The elderly facilities must be rethought if we want to make them more than pre-cemeteries. The political system should be built with a team of health experts responsible about the health of a nation. The European Union, if she wants to keep itself legitimate, should be able to build a European medical intervention team or institution which could manage differently than today the health, financial and cultural impact of a future health crisis. As the Italian writer, Paolo Cognetti required in a recent interview to set up a European Union common Public Health system.

By lacking long-term goals built around the health of a nation and continent, we will just walk with a mask on our whole face, alone and with fear of a political system which will legitimate the dictatorship of health, however we will call it. Fear of illness will become our life and it is a question of time until opportunistic politicians will use this as an ideology to justify their democracy burning actions.

Since almost one year, there have been night construction works in the car tunnel next to the place where I live. There were no fliers or any information whatsoever about these works, so you can imagine the pleasure of being woken up in the middle of the night by the noise from construction machines and having no idea when these works will end.

I tried to contact the authorities in charge. They recommended an ombudsman, a polite person who gave me some information and deadlines. Deadlines which were never respected. All he kept on telling me was to have patience one more month, and again one more month …

Afterwards, I contacted the biggest French speaking newspaper - Le Soir -explaining them the situation and asking for their opinion about a problem which had disturbed many people ‘s sleep during the night. No answer. Thus, I took the decision not to follow anymore a newspaper that is more interested in investing in new layouts than in listening to its readers.

I tried to understand the logic behind the disrespectful attitude to perform construction works during the night. The ombudsman told me the works were planned during the night because otherwise they would affect the daily car traffic. So health issues - that is, quality of sleep - of the people living in close proximity to the tunnel are less important than car traffic. This is the attitude in Brussels, in a city where you officially care about the well-being of people and where car free zones are encouraged …

I contacted the Minister of quality of life, Celine Fremault (CDH), in Brussels and there was no answer. After months of noisy nights, I finally read in the newspaper that the Minister of Mobility, Paul Smet (Spa) will celebrate the end of the construction works in the tunnel with a big party accompanied by a big speech. I read many times that speech, hoping to find a deadline for the works which are still going on, by the way, and for a polite gesture to say thank you to those who had to bear the negative effects of the night disturbances. Nothing. A party in the tunnel was cooler. Image.

The elections are coming and even if a politician told me that the trendy topics are now climate change, retirement, I thought to do an experiment to help me decide, and eventually those who read me, which way to vote for on Sunday. 

The experiment was a letter (in French) sent on 18^thof May 2019 explaining the situation about the construction works and asking each party or political alliance to give me their answer to a solution (see the list below).

Which climate issue should we talk about when cars are more important than people? What image is Brussels promoting when people can’t sleep during the night because there is noise coming from construction works? Why should I care about big promises when in my everyday life I don’t even have an answer from a politician who is paid also from my taxes?

By now, these answers came back in response to my letter: 

-       Listes Destexhe: the reply was fast, personalized and empathetic. It was mentioned that on their election list 88% of the candidates never participated in an election process. They read my letter.

-       Défi: a confirmation of receiving my letter and that it will be forwarded to the president of the party. Nothing more.

-       Groen: polite message but it promotes the goals of the party. Good marketing.

-       A personal letter from the Minister Pascal Smet, not in the name of his party (One.brussels-sp.a) but of the Brussels government; he spoke in general terms about the schedule of the construction works and that they ended on May 1st, 2019, but the normal maintenance of the tunnel will be going on for approximately two nights per month. Even if the personal response is appreciated, the reality looks slightly different from how it was formulated in the letter: the construction works often produced noise during the night and my neighborhood had not received any visible information about the schedule of the works. There were no apologies whatsoever or any thanks for our patience.  Elegance and empathy would have compensated for the endured stress. Lack of empathy.

-       NVA: the reply was in Dutch; it was a standard text saying that because of so many emails received it is not possible to reply to all of them. No solution.

- DierAnimal: empathy for the situation and promoting the goals of the party. They read my letter.

The conclusions of my experiment are deceiving: of 21 letters sent only six answers came back, so 25%. The minister took the time to reply personally to my letter— a nice gesture — but he lacked empathy. Is it considered apologizing a weakness instead of a human gesture?

I consider myself to be educated and well informed about politics, it’s true, more on a European level. I do recognize populist parties and their lack of real solutions to society’s challenges. But more and more people, myself included, want solutions to our everyday problems, we want communication channels so that our politicians can be who they have promised to be.

Even if the conclusions are not optimistic, the experiment was a good lesson for me: listening is very important. I try to do my best as a medical doctor, but my expertise in lifestyle medicine also obliges me to be more involved in the life of society, and this by writing and promoting solutions for a healthy lifestyle in the capital of Europe.

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List with the parties/alliances I sent the letter to: Ecolo, Groen, Open VLD, MR, CDH, CD&V, Parti Populaire, NVA, Vlaams Belang, Défi, PTB, Listes Destexhe, PS, One.brussels- sp.a, PVDA, Agora, Act-Salem, DierAnimal, Plan B, Be.One, Collectif Citoyen.

There was no contact information for Hé. 

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