Fence vs. ambulance: A reflection on what comes next

By: Robin Cogan

I am sitting in the middle of every feeling imaginable as I reflect on what has happened these past 2 years. Part of me is numb, and at the same time, I am angry, tired, and have moments of contemplating retirement. The other part of me is incredibly proud of how we have weathered this never-ending storm. The decrease in positive cases is a much-needed break from the deluge of COVID. It is the Yin and Yang, the duality of before times anticipates after times.

So what is next? We are sitting on the edge of the cliff again, as mandatory universal masking is being lifted in school districts across the country. Mandatory masking in buses is also being lifted and every school district is cherry picking its own policies. COVID testing is dropping and some school nurses are being instructed to accept verbal reports of negative test results with no accompanying evidence. Quarantining for both illness and exposure is now up to parental choice in many school districts. The proverbial Pandora’s Box is wide open.

As my feet dangle over the edge of the cliff, I can’t help but think of the prescient poem and public health parable, An Ambulance Down in the Valley.

The Ambulance Down in the Valley

by Joseph Malins (1895)

‘Twas a dangerous cliff, as they freely confessed,

Though to walk near its crest was so pleasant;

But over its terrible edge there had slipped

A duke and full many a peasant.

So the people said something would have to be done,

But their projects did not at all tally;

Some said, “Put a fence ’round the edge of the cliff,”

Some, “An ambulance down in the valley.”

But the cry for the ambulance carried the day,

For it spread through the neighboring city;

A fence may be useful or not, it is true,

But each heart became full of pity

For those who slipped over the dangerous cliff;

And the dwellers in highway and alley

Gave pounds and gave pence, not to put up a fence,

But an ambulance down in the valley.

“For the cliff is all right, if you’re careful,” they said,

“And, if folks even slip and are dropping,

It isn’t the slipping that hurts them so much

As the shock down below when they’re stopping.”

So day after day, as these mishaps occurred,

Quick forth would those rescuers sally

To pick up the victims who fell off the cliff,

With their ambulance down in the valley.

Then an old sage remarked: “It’s a marvel to me

That people give far more attention

To repairing results than to stopping the cause,

When they’d much better aim at prevention.

Let us stop at its source all this mischief,” cried he,

“Come, neighbors and friends, let us rally;

If the cliff we will fence, we might almost dispense

With the ambulance down in the valley.”

“Oh he’s a fanatic,” the others rejoined,

“Dispense with the ambulance? Never!

He’d dispense with all charities, too, if he could;

No! No! We’ll support them forever.

Aren’t we picking up folks just as fast as they fall?

And shall this man dictate to us? Shall he?

Why should people of sense stop to put up a fence,

While the ambulance works in the valley?”

But the sensible few, who are practical too,

Will not bear with such nonsense much longer;

They believe that prevention is better than cure,

And their party will soon be the stronger.

Encourage them then, with your purse, voice, and pen,

And while other philanthropists dally,

They will scorn all pretense, and put up a stout fence

On the cliff that hangs over the valley.

Better guide well the young than reclaim them when old,

For the voice of true wisdom is calling.

“To rescue the fallen is good, but ’tis best

To prevent other people from falling.”

Better close up the source of temptation and crime

Than deliver from dungeon or galley;

Better put a strong fence ’round the top of the cliff

Than an ambulance down in the valley.


Time will tell what will be, but for now, I am going to marinate in all that has happened and hope that I regain my sense of wonder, belief in humanity, and a sense of hope and purpose. They all feel very distant at the moment.

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