I Am Angry!

This will let me in for some criticism, so too bad.  I am angry, very damn angry over our response to the Corona/Wuhan/Covid-19 virus.  

On 9/11/01, when I saw that the second tower had been hit, my first thought upon realizing this was an attack, was that the power and reach of the federal government would be increased.  Sadly, I was more right than I could have imagined.  My support of Authentic Medicine is first and foremost based on my belief in, and respect for the individual.  To the extent that the CDC, health departments, and focused, sober, non-hysterical government action support individual health and freedom of action, I’m on board.  But when the government, self-interested politicians, virtue-signaling companies, and the media start to ping off each other to amplify panic, I am out.  Nearly every reader in their training and career has been scared out of their mind during a real-time clinical situation, and I am no different.  Less from natural talent and more from training, I have learned to keep it together, lower the tone of my voice, and exhibit calm to staff and patients, especially when my fear level shoots up.  I say with no hesitation that it is one of the primary jobs of a physician to maintain calm and composure, particularly in more concerning circumstances.  It is my opinion that the public members of our profession via a hyperventilating media have done a great disservice to our society by contributing to a sense of panic.  Constantly bombarding all airwaves and internet sources with needless worry has caused more damage already, I suspect, then the virus itself will cause.  Moreover, I predict though I know not how, that this “crisis” will further infuse government into the practice of medicine and further constrain our abilities to use our best judgment in the service of our patients.  Mandatory yearly testing, preemptive quarantines, a new CME industry, new arbitrary core measures…one can only guess.

I have seen pediatricians on TV actually advising parents to instill fear into young children over this, and I’ve seen FPs and ER docs dutifully nodding along when the anchor (pick the network) adds somberly, yet not soberly, that normal daily activities and gatherings be curtailed or banned.  About now, some esteemed readers will be dismissing me or questioning my professionalism:  to them I say, yes, this virus should be taken seriously, but without panic.  Yes, the elderly are at greater risk and should exercise more caution (or have it exercised by their family).  But closing schools indefinitely, ending major sporting events, and hoarding toilet paper are the sort of seemingly temporary reaction that can cause long-term harm.  Shall we do this every year, or for every widespread virus that does not show far-ranging and immediate mortality?  What does this do to the psyche of individuals?  How many more will be harmed by not being able to work, or being unable to buy the daily staples of life because the frightened neighbors have already cleaned out the stores?  What other ailments will be unleashed on the at-risk due to pervading, 24/7 anxiety unrefuted by our profession?  

Think I’m overplaying this?  I work for a company that staffs rural hospitals, some critical access, which provide the only care for their areas.  Generally, our facilities are hard to staff, and we don’t have a very deep bench.  If I’m asymptomatic but required to be Covid-19 tested, what do they do with me if I’m positive?  Do we tell the next doc to come in and work 48, or 72 hours until she is infected (made more likely by physical exhaustion)?  What then?  The chest pains, respiratory distress cases, occasional trauma, and yes, nursing home patients will keep coming in.  Nervous moms with non-flu, non-Corona, virus spewing toddlers will still come in.  Do we shut the hospitals down for lack of staff?  What happens to the other patients then?  “Ship them up the road” will only add to the greater burdens of regional medical centers in more populous areas.  I don’t want to be an unethical jerk, and if I do develop a fever and dry cough, I certainly don’t want to expose an at-risk patient, but virtue signaling and calling in infected won’t keep our doors open.  This isn’t self-importance, this is a very real risk.  

I’m no virologist and could be wrong, and if so, feel free to hurl your barbs later on, but I think that once the widespread infection rate is documented, the mortality rate will drop.  The deaths so far and those that are coming are each and everyone sad and matter, but that does not justify the mass, reflexive panic we are seeing.  I think physicians should everywhere be advising everyone to calm down and live their lives, and I think we are failing badly in that respect.

Seventy-five years ago, the Marines were mopping up on Iwo Jima, and we were on the verge of the greatest scientific, economic, and living standard expansion in history.  Today this nation looks more like a neurotic person on a chair, shrieking at a mouse.  In a society where medicine developed to aid and improve the individual, this is shameful.  We should be better.

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Pat Conrad MD

Pat Conrad is a full-time rural ER doc on the Florida Gulf Coast. After serving as a carrier naval flight officer, he graduated from the University of Florida College of Medicine, and the Tallahassee Family Medicine residency program. His commentary has appeared in Medical Economics and at AuthenticMedicine.com . Conrad’s work stresses individual freedom and autonomy as the crucial foundation for medical excellence, is wary of all collective solutions, and recognizes that the vast majority of poisonous snakebites are concurrent with alcohol consumption. 

  18 comments for “I Am Angry!

  1. Frank Rubino MD
    March 22, 2020 at 3:41 am

    I would like you to outline all the steps you would have taken to manage and direct the USA health care system as it exists today starting with January 1st 2020. Pretend your are the head of the CDC and list your solutions.

    • Pat
      March 22, 2020 at 9:13 am

      Certainly.
      1. Suspend all travel from China, and subsequently, and other hot-spot countries. And yes, I would have closed the Mexican border except for specified commercial traffic. Ditto the ocean-going Petri dishes otherwise known as cruise lines.
      2. As the predicted spread was outlined, tell retirees, the immuno-compromised, and anyone else with any greater susceptibility to stay home and self-quarantine. I would put the onus on them and their families, and not the greater public. Yes I understand the “flattening the curve” and I agree with it, but…
      3. … I also recognize that crashing the economy is the exact sort of panic that should be avoided, and would cause a huge degree of harm, if not greater harm, than would deaths due to the virus. As we have learned in medical training, it is quite often not the pathogen, but the body’s reaction to the pathogen, that causes the real harm.

      I would try to dissuade the sort of panic that has now depleted our gas stations and grocery stores, not due to need or broken supply chains, but to fear amplified by media and government. A great many of us have it, as will be apparent in the coming weeks, and a great many of us will recover. Whether people’s lives will is another matter, and an open question. If one is to use the tired old “You can’t put a price on peoples’ lives!” line, it falls on deaf ears. That is the sort of general emotionalism that the speaker deems inarguable, even in the face of very specific, mounting costs.

  2. March 18, 2020 at 2:59 pm

    Yes. YES. I’ve been saying this for the last week or more. Very well written, Pat!

  3. arf
    March 17, 2020 at 2:54 am

    https://oilprice.com/Geopolitics/International/Iran-To-Become-Essential-Hub-In-Chinas-Belt-And-Road-Initiative.html
    https://thehill.com/opinion/international/487357-how-china-set-forth-the-global-coronavirus-crisis-into-motion
    https://www.euronews.com/2019/03/24/china-and-italy-sign-silk-road-project

    Just wondering………is it a coincidence that both Iran and Italy were early and major players in the China “Belt and Road” initiative?

    Setting the politics aside, did “Belt and Road” turn into a pathway to spread this virus? Not saying it was deliberate, given that the biggest victim hs been China itself, but still, Iran and Italy were hard hit.

  4. David Dierks Fitzpatrick
    March 16, 2020 at 9:22 pm

    Amen

  5. March 16, 2020 at 8:50 pm

    I concur. The level of fear response seems far out of proportion to the reality. 2009 H1N1 infected 59 million Americans and 260,000 hospitalizations, 12,000 deaths. Our hospitals didn’t collapse nor did the entire economy shut down. It also took months to get a vaccine together.

  6. Davis Pitt
    March 16, 2020 at 4:56 pm

    Pat & Y’all, I’ve been following a virologist turned financial guy, Chris Mortenson, whose website is ” PeakProsperity.com”. He seems to have a good head, he says it straight and even throws in some financial tid-bits. One of his overall points is that infectious diseases that let loose in populations (countries included) that have NOT done a good job preparing and controlling for an outbreak (like Italy and the USA) usually follow a logarithmic growth curve. We, in the US, are just entering the steep upswing part of the curve, ie. “batten down the hatches” in your Navy lingo (I was Army, so hunker down works). Singapore & Hong Kong, though small sized, are given as examples of the right way to control an epidemic…..EARLY!. Chris realized that CoViN-19 had bad potential and has been covering it since late Jan. He uses some great analogies and examples to ‘xplain his thoughts. Give it a look and see what you think. Chris also says that the US will shut down when the case load skyrockets, in 2-3 wks. One of his favorite lines, Stay the fuck home! (and start a survival garden)

    • arf
      March 16, 2020 at 6:05 pm

      Is it just me?

      I tried your PeakProsperity link, and my antivirus software blocked it, saying the site is infected with a trojan.

      Anyone else notice this?

      • Pat
        March 16, 2020 at 10:29 pm

        Me too.

      • Pat
        March 16, 2020 at 10:40 pm

        Me too

      • Davis
        March 23, 2020 at 2:17 am

        Wow arf & Pat, I hadn’t a clue, I use Brave and it wasn’t noted, sorry ’bout that & no harm I hope. Chris also posts his blogs on “you tube” if there’s any interest left.

  7. arf
    March 16, 2020 at 4:49 pm

    Wandering through a cemetery in small town Oregon. A very beautiful but isolated spot.

    The cemetery had many pioneers with Civil War-issue veteran graves. People who, I like to think, decided to Go West Until They Ran Out Of Country, so they settled down where they could get as far away from that crap as they could.

    In addition to many graves from the past 150 years, were a LOT of graves with a death in 1952.

    Then I noticed they were all children. I was not aware of the great polio epidemic of 1952, the worst in USA history.

    57,628 cases
    3,145 deaths
    21,269 were left with mild to disabling paralysis

  8. arf
    March 16, 2020 at 3:19 pm

    I have this picture in my head. If Pearl Harbor happened today.

    The Democrats and Republicans yelling, virtue-signalling, fingerpointing.

    I have this picture of a heated debate with both sides nose-to-nose like a baseball rhubarb.

    In the background, completely unnoticed by the politicians, Japanese soldiers quietly planting rising sun flags.

    Waving to the camera as he walks off with the Stars and Stripes.

  9. Jesse L Belville Jr,PA-C
    March 16, 2020 at 2:57 pm

    Goes along with modern hysteria, maybe a way to collapse the economy and blame it on corona virus instead of worldwide Humongous debt bubble in China,Europe, South America,,USA, Australia,Canada. recession/Depression 2020 is here.. Buy Land,Precious metals and stay in cash. No stocks or bonds.
    Avoid crowds, Buy some extra canned goods if you can. stock up on water. Have a way to purify it.. flavor it cause humans get tired of same old taste.
    Look at history. Something always happens,Famine,Plague,War Natural Disaster.. being a boy/girl scout prepared for all the crap life might throw at you. Then you do not need to Fear. Do your best with what you got.. Go Do Live and this is an opportunity for new life,new direction, new knowledge and skills.

  10. Steve O'
    March 16, 2020 at 2:12 pm

    Every American who gives a damn should read the Federal and State statutes describing the emergency powers available to those who see the need for emergency powers. Like Federal or State executive authority from the Chief to involuntarily quarantine without further orders, no habeas bullcrap. See CDC We no longer vote for people to represent us – we vote for Big Papi who will do whatever (s)he wants, in her/his limited cognitive capacity. Shame on us.

    • Davis Pitt
      March 16, 2020 at 5:04 pm

      editor, Sorry, Plz remove the second of my comments, the one WITHOUT the closing, “(and start a survival garden) Thanks, D

  11. Gary Pearce MD
    March 16, 2020 at 1:20 pm

    Well written…..the country is slowly shutting down…..if you test positive, you should be able to work until you are spewing droplets. Of course by then you probably will not feel like working. My dad was a GP, so I grew up washing my hands constantly. I would hope you and your staff do likewise. I am a solo ophthalmologist. So I run a business. I work because I have to, and because I enjoy it. Needless to say, I do not want to kill my patients. I see no need to be tested unless i am symptomatic……and i called the ER yesterday……they do not have any tests- it has to go through the Health department!

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