The Number of Ambulances Passing by the Bull

These days, we are quite preoccupied with Mpox and West Nile Virus. The debate over whether or not Mpox has been seen in our country is almost enough to start a fight. Yes, I must admit, we have learned to politely call Mpox "M-pox." However, we do not fully know whether it exists in the country or not. Once again, the words of my late British professor in similar situations come to mind: "Who is counting anyway?" He would immediately add, "Father (God), forgive them, for they do not know what they are doing."

Whether it is in our nature or not, our relationship with data has always been strained. I think this is unfortunately because our relationship with the truth is also quite sour in some places. A similar situation existed in the early days of the Covid pandemic. It was impossible to reach the real patient numbers. Although the Ministry of Health had established a Scientific Committee, unfortunately, this committee did not have much of a relationship with data either.

The task fell to me. It was still the beginning of the pandemic. I contacted the executives of a holding company with tens of thousands of employees and made a suggestion. In short, we would take a random sample of ten thousand people from among the holding's employees and monitor this sample carefully over time. No blood or anything would be taken from anyone. We would only meticulously record the number of those who could not come to work during certain time periods due to Covid. The holding official was listening with interest, but as far as I could grasp, a bit reluctantly. "Collecting data by monitoring employees over time in large organizations like yours is a well-known method in the West. In the last century, very valuable data, especially on heart disease, was collected through studies conducted among employees of the Eastman Kodak company in the US, and more recently, Boehringer-Ingelheim in Germany. By the way, let me state immediately: You might think that your holding's employees would not generally form a good sample of our society, and therefore problems would arise in generalizing the results of the data we collect to the entire society. You are right in a way, but remember: The study I am proposing to you has an advantage, precisely for the reason you mentioned. That is, the data you surely keep meticulously regarding your personnel—such as age, gender, education, and income level—will shed light on the extent to which the planned study can be applied to the general public for those who will evaluate the study data. This information is also very valuable. Naturally, an ideal study would be to take a random sample from the entire society and monitor them. However, for reasons I assume you know better than I do, we cannot do this. Finally, let me state that your holding taking the lead in such a study would both be a valuable service to the country and bring great prestige to your holding."

Yes, you are thinking correctly. The holding official called me 1-2 days later and informed me that they could not participate in such a study. The main reason for his negative response was that the study I proposed would violate the confidentiality rules of labor legislation. Two or three years later, I brought up the subject with a patient of mine who is a high-level official at another organization that also has a large number of employees. He laughed mischievously. "Professor," he said, "both the holding you mentioned and we have always collected this data. However, we have always kept the data we collected to ourselves."

I must mention that, in the meantime, an important initiative in the course of Covid was to calculate the increasing number of burials over time through municipal cemetery records. The data from this initiative was published regularly for a long time on the website of the Science Academy's Sarkaç journal, and even very recently abroad (I. Kayi et al., Healthcare, 2024). This data is naturally very valuable, but on the other hand, it is also an indicator of how difficult it is for our society to express the truth. After all, we can only collect more solid data about disease frequencies after we lose our citizens to that disease. I really do not know what to say.

In the meantime, you may rightly ask, "Professor Hasan, you worked at Cerrahpaşa for years, you trained students and professors. Why don't you share these concerns and projects there?" This question has been asked to me many times, and every time it brought to my mind these lines from Nazım's Epic of Sheikh Bedreddin: "In the bazaar, every guild had lost hope in its own master, it was in ruins." I have always given the following answer to those who asked, or I wanted to give it and held my tongue: "Leave Cerrahpaşa and Çapa. Go, sit in the cafe across from the famous Bull statue at Altıyol in Kadıköy between certain hours of the day and drink your coffee or tea. In the meantime, record the number of ambulances passing by the Bull properly. The increase or decrease in the frequency of Covid can also be monitored that way. As long as the location of the Bull and the route of the ambulance do not change."

Between us, the number of ambulances passing by the Bull seems to be increasing again in recent days.