The resonance between what is happening this year with COVID-19 and what happened and the events described in Decapitation of Care is too great to ignore.
A plague helped do in Charles I of England. Then it was The Plague. It struck in 1641, primarily affecting London. As the monarch, Charles was the person who decided on a quarantine or not. Despite the fact that the plague routinely took away up to 30% of the citizens of a town or city, the merchants of London figured a quarantine would be bad for business and opposed the King when he tried to impose one. The recently established Royal College of Physicians initially sided with the King but they knew what side their bread was buttered on and switched sides.
London then was by far the largest city in the world, double the size of Paris and nowhere else was even a fraction the size of Paris. The people cleared a few decades earlier from the commons (countryside) had ended up in London and were the zero-hours or gig economy of the day. They were more sympathetic to the England-first Puritans than the Europhile Royalty. The Puritans were allied with London’s merchants and both believed that wealth creation was a sign of God’s favour.
The result was a deepening split between the Puritans in Parliament and Charles that led to Civil War and Charles Decapitation in 1649.
The monarchy was restored in 1660, probably the year Daniel Defoe was born. His most famous book, Robinson Crusoe, written in 1719, seems to have had Crusoe shipwrecked in 1660 on a voyage to Africa to gather slaves for his Brazilian plantation.
One of Defoe’s other best-known books, A Journal of the Plague Year, was written in 1722 but set in London in 1665, when the City was again ravaged by the plague. A great deal of what we are living through now is there in the Journal of the Plague Year – the fear, the insouciance, the profiteering from others misfortune, the businessmen struck down, the oracles, conspiracy theories, the hawking of miracle cures, the cures that poisoned, the turn to God, the turn away from God. Remarkably recognizable today.
The stock market was only coming into being then. Before Crusoe was written, a stock market crash had helped wipe-out the national wealth of Scotland forcing its unification with England – an event Defoe witnessed at close quarters as an English spy in Edinburgh. South America was the place to be as Crusoe was being written and Defoe based him in Brazil. Just after publication (Crusoe sold his plantation in Brazil after his rescue), the South Sea Bubble wiped out a great deal of British wealth and led to a suspension of trading in company shares for over a century.
By 1666, William Petty and John Gaunt had begun to build the first maps of lives and deaths in London and Dublin from which the models that have shaped today’s public health (or political medicine, as Petty called it) responses to Covid-19 have come. These model-based responses seem to swing wildly all over the place in a way that is astonishing if, as most of us likely figure, we have gotten vastly more rational in the last 350 years.
The Decapitation of Care starts with the execution of Charles I and charts the evolution of political medicine from there to the present day. It’s a trailer for The Shipwreck of the Singular that will appear later this year.
Covid-19 was nowhere in sight when Decapitation was written or the lectures based on it were delivered. But turning up on cue, it brings home the interpenetration of politics, economics and medicine that we seem to have lost sight of as countries risk bankruptcy from expenditures on uneconomic health services while neglecting healthcare.