What Public Health Could Learn from the Making of Pirates of the Caribbean

This is a guest post from Michelle Vogel, the content creator behind the sensational travel & life blog  Mishvo In Motion.


If you haven’t watched the Behind the Scenes from Pirates of the Caribbean: The Curse of the Black Pearl, please do so now.

The Behind the Scenes is cut in 4 parts. Above, the first part.

 

When I watched the Behind the Scenes the other night after Netflixing Pirates with my boyfriend (and shouting out my favorite one-liners I remembered from when the movie came out and I watched it a million times [“You best start believin’ in ghost stories, Miss Turner – you’re in one!!”]), I couldn’t stop thinking: why doesn’t public health work like this??

Okay, okay, I know that’s a weird thought process to have because what do swords, swashbuckling, undead ghost pirates marching on the seafloor, etc. have to do with public health? Allow me to explain how public health could learn a thing or two from the making of Pirates of the Caribbean:

1. Making money motivates progress

But in public health, we’re not in the business of trying to make money, right? We want to save lives. The problem is, unfortunately money is an excellent motivation for getting shit done. The skilled people we need to really move things forward can’t (or won’t) always work just to get a good conscience – money solves this problem.

A hundred and forty million dollars were dropped to make Pirates of the Caribbean. The people in Hollywood/Disney didn’t drop this kind of money just for the sake of art and cinema; they did it because of the promise of making back the $140 million and then some (which they did).

Public health doesn’t have a problem dropping large chunks of change (e.g. the $2 billion spent on fighting malaria each year) but it does have a problem making progress towards its goals. I think if people were actually getting something out of their investment – and not just saving the lives of people they never met and don’t actually feel emotionally attached to – there would be more motivation to actually get things done.

Now, I’m not denying that “making an entertaining movie” is an easier task to accomplish than “eradicating malaria” – it totally is. Eradicating malaria should cost more money and take more time and effort than making an entertaining movie.

But what if we found a way to make money doing public health? What if there was a bottom line? Don’t you think people would work harder, collaborate more, and innovate more to come up with and implement solutions? I do.

2. Have a visionary and delegate mindfully

Public health is all over the place. I get that it’s a huge field that encompasses a million different specializations. And that violence is public health, nutrition is public health, influenza is public health – it’s ALL public health. But I would argue we have more than enough organizations out there working simultaneously towards the same goals but not in a cooperative manner. They don’t even know the other exists, let alone what the others’ strategies are, what tools they have access to…It’s like a crazy puzzle trying to figure out what’s going on out there. And it shouldn’t be.

In Pirates, Gore is a visionary. He has a lot of power and control, but isn’t a dictator: he delegates and entrusts his department directors and other movie personnel (P.S. I don’t know anything about making movies besides what I just watched in this Behind the Scenes) and they, in turn, trust him and his vision for the entire movie.

Now don’t freak out, I know it’s scary to think of lots of top-down control like this. But public health is bogged down. It’s bogged down by bureaucracy within organizations (see: the criticism WHO got regarding their response to Ebola) and “too many cooks in the kitchen” amongst organizations.

What if there was someone in charge of malaria (just going to keep using this one since I already did), someone in charge of zika virus, someone in charge of obesity – I don’t know! I’m probably being crazy right now – and each director had a producer and a set of department heads who he/she entrusted to lead the department along the vision of the visionary?

“But, Michelle, silos!!!” Okay, I know but if we try to solve EVERYTHING at once, we’re going to solve nothing. “But, Michelle, the whole world can’t unite like that to get rid of disease!” Well, why not? Have we tried yet?

3. Innovate. Create solutions, not problems.

Back to the making money thing for a second. Because public health is not a money-making venture and it also isn’t an art (at least as it is most commonly practiced), people are not motivated to take risks or innovate.

When Pirates of the Caribbean came out in 2003, there hadn’t been a movie of its kind in a while. As they say in the Behind the Scenes, they had developed new technology since the last great pirate movies had been made, and they experimented by taking pirates into a new dimension with the ghost-story bit. Well, it worked!

We must stop relying on the same processes in public health or we will never make progress. We must critically examine what we are doing and how we are doing it and bravely and creatively propose new, different, and risky solutions. Instead of concluding with, “X is a problem and we must do something about it”, I would love to start seeing academic journal articles that conclude with, “X is a problem and we must do something about it. Here are some things we can do about it: A, B, C.” We don’t propose solutions because we’re afraid of being wrong. But we’re never going to progress if we never take risks.

Let’s propose solutions, not problems.

4. Get emotional

Did you feel the feels whilst watching the Behind the Scenes? You watched it and you felt the emotion behind the team’s dream being realized. They made the movie they envisioned making. It took years but they did it.

Where has all the inspiration gone in public health? I know people are out there doing public health with good intentions. I know that people joined the public health tribe in the first place wanting to save the world.

But then young public health folk started feeling like they’re trying to walk through sludge, with the slow-moving IRB approval system, the needlessly complicated bureaucracy, the inefficiently-run organizations. Public health young professionals become jaded. We don’t feel the feels anymore and that itself makes me feel super sad!

Maybe if we do all the stuff listed above we can recapture that inspiration, that emotion that brought us here in the first place. Humans aren’t computers; we are driven by emotion, whether we like it or not. Evidence and p-values are nice but they don’t make you feel things.

If we can remember and conjure up our own personal public health dream maybe we can become a visionary; maybe we can think outside the box and propose risky and new solutions; maybe we save lives and make money at the same time – I don’t know. But I believe in it, I believe in us. Let’s commandeer this ship and steer it into new waters.

Pirates and privateers

What do you think?