A Public Health Hero's Journey

Walking through the Georgia World Congress Center, I saw the sign that said, “Welcome Public Health Heroes.” Cool! I thought, mentally giving my American Public Health Association colleagues navigating the conference halls with me capes, light sabers, and one ring to rule them all.

I settled into the next session, and it occurred to me that, capes or no, we have been on quite the journey over the last several years. But was it a heroic journey, exactly? I googled “Joseph Campbell hero’s journey” to remind myself of what exactly happens to heroes on a journey, when I heard the presenter on stage positing that our issue with “presence” is that we all live simultaneously in two worlds: the physical world and the world of the internet. He asked for a show of hands. “How many of you could get on the internet right now within three seconds?” I slipped my phone back into my pocket.

Later, I learned that the hero’s journey is so ingrained in our collective psyches that it’s basically synonymous with good story structure. Even if you, too, would have to google the exact structure, you know how it goes from movies such as, well, all the movies.

The story begins in the before time. Act I. We see everyday life on Tatooine. Will Ferrell doesn’t know he’s not an elf yet. It’s 2019. Public health in Washington state was celebrating having recently raised the age to buy tobacco products to 21.

Then, on an ordinary day, the hero is called to adventure, but like any good hero, declines. Hobbits never stray far from the Shire. I remember reading about the novel coronavirus in China in November. My father-in-law asked me about it. I assured him that new viruses show up from time to time and pretty much fizzle out. Particularly if this thing is coming from animals, there’s no guarantee that people are even any good at spreading it. In January, the first case of illness from the novel coronavirus in the US was diagnosed in Washington state. People indeed seemed reasonably good at spreading it. I asked my team, “Does anyone remember what the role of Environmental Public Health is in something like pan-flu?” Not really. One person joked that our role is to drive to Montana, far away from this thing.

The hero is definitely not ready for this adventure, but then, someone who can help shows up. “You’re a wizard, Harry,” Hagrid says. “Wear a mask,” Dr. Fauci said. There is no turning back.

In the movies, Act II is where all the fun and adventure happens. The hero faces a series of challenges. The premise, no matter how absurd, plays out. What would happen if a loner girl could move objects with her mind? What would happen if the crew from Star Trek arrived on Earth in 1984? March 2020. Schools closed. Businesses closed. There was eerily little traffic on I-5. We did the work of a pandemic: testing, contact tracing, isolation and quarantine, health promotion, social media, regular media, mask mandates, guidance on the appropriate size of gatherings. We faced fearsome challenges: Remote work, remote school, scarce vaccine, vaccine hesitancy, Delta, bleach, ivermectin, travel restrictions, holidays, super-spreader events.

As we approached the climax of Act II, the public was exhausted. Misinformation was rampant. Public health workers were assaulted; their lives and families were threatened; they were unsafe in their own communities. The public wavered in its faith in experts, in science, in public health. The Omicron wave crashed over the country.

At the height of the drama, the hero slays the dragon. By November 2022, 97% of the country had some kind of protection from COVID—either from vaccines or prior infection or both. We did it! Over the next year, the federal and state emergency declarations ended. The COVID funding gradually started to dry up. Public health tried to move its attention back to all the other threats to health.

But you’ve seen enough movies to know this one is not over yet. Public Health Heroes, welcome to Act III.

In Act III, the hero tries to return home, but on the way, has to deal with the consequences of all that heroism. Maybe they’ve been physically hurt. Maybe they’ve hurt or neglected their friends and families. Maybe they’re dealing with loss, pain, changed relationships, changed environments. The hero has also been changed by the journey, usually for the good, but there is still at least one final challenge yet to come where the hero has to prove that transformation has been complete and has made them better.

Public Health, we are on the road home now. On our way, we need to deal with the consequences of all our heroism. Maybe we’ve neglected our bodies, or our friends and families. Maybe we’re dealing with loss, pain, changed relationships, changed environments. Now, the job of public health heroes is to rebuild trust with the communities we serve. To rest our teams. To connect with our friends, families, and communities. To listen and learn from our communities about the environmental injustices and health inequities that impact them. We are a changed public health system. What we do next in response to these challenges will tell us if we have fully learned the lessons of our journey and been changed for the better. And whether we are prepared for the (Coming Soon!) sequel: Climate Change.