The river metaphor

People who are drowning in a river need to be rescued. Without our help, they will get seriously injured or worse, die.

People at risk for drowning in a river can be given a life raft to pull them out of harm’s way. There might not be enough room for everyone on the raft and some people will be too far gone to get in it, but it can help avoid drownings.

If we go upstream and see why people are going into the river in the first place, we’ll have a better chance of stopping people from entering into the water and prevent the need for rescuing those who are drowning.

This is a metaphor for the work many of us do.

If we work downstream, always rescuing people moments away from tragedy, always catching people just before they fall, or picking them up after they’ve stumbled, we’ll never get a break. But, if we look upstream and see what’s causing people to fall, to get sick and to suffer, we can avoid the unnecessary rescuing we’re so used to.

Until we place more value on prevention, the upstream work of seeing, mitigating and stopping problems before they cause harm, we’re going to continue to struggle with hallway health care, unnecessary disease and the chronic stress that comes with rescue work.

Saving people is a value many of us hold dear. I get the appeal of watching paramedics, firefighters, police officers and ER workers do their thing. Like many people, I’m also drawn to the ‘high’ feeling brought on by stress and adrenaline. In fact, I’ve become so comfortable with feeling stressed and being surrounded by illness that it seems unnatural when I’m not.

As much as we love the idea of saving lives, that’s not what health care is all about. People don’t want to get sick and injured. They don’t want to suffer.

People need our help. They need us to work with them, without judgment and help them change what they can before it’s too late.