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Pandemic Fatigue Threaten Recovery

One of the most challenging symptoms that physicians and patients grapple with is fatigue.  It is exceedingly common and elusive.   In general, medical studies do not identify a cause and the symptom remains unexplained.  And, failure to identify an explanation only compounds the frustration. I have been frustrated recently over a new iteration of fatigue, a malady that has crept onto the national scene over the past few months.   This illness, spawned by the COVID-19 plague, is called Pandemic Fatigue (PF) and it is spreading aggressively. As of yet there is no vaccine to prevent it or any proven therapeutic agent to combat it.   Scientists thus far do not even understand how one contracts the illness.   Judging by the rampant community spread, one would suspect that it is highly contagious, but no infectious agent has been identified. The disease seems to follow several weeks of adhering to public health guidelines to mitigate the spread of coronavirus.    At some point, either

Whistleblower Holiday Cheer 2020!

  ‘Twas the night before Christmas And Trump was still lyin’, Hark!  What’s that sound? Is Pelosi blow dryin’.!   The nation is split Divided we stand As Trump tells his millions He’s still in command.   The election was rigged! The votes must be stopped! Except for the states, Where Trump was on top.   While the world welcomed Biden, One leader was rootin’, For Trump to prevail, Vladimir Putin!   And with Trump in the ditch, And becoming quite moody, He turned to that savior, We know as Rudy.   And as Trump trashed the system. The Dems are all sissies! The brave GOP Threw Trump lots of kissies.  For a profile in courage I have the sense That the man for the ages, Is Vice President Pence.   The virus roars on There’s no place for hidin’ We’re turning to you Vice President Biden. Joy and Peace!        

Do All Patients Want Good Medical News?

It is a pleasure to give patients favorable medical news.  It’s an even greater pleasure to receive it.  Technology has replaced so much of our wholesome and human interactions.  Book stores are disappearing.  Handwritten thank you notes?  Nearly extinct.  The corner hardware store where the owner knows your family?  Today, we have Big Box warehouses where, if you hire a private investigator, you might be able to find a hiding salesman.  Need a salesman?  Hire Sherlock! The joy and relief that a patient and family feel when the physician says that all will be well has no technological equivalent.   We have all had anxiety about our own health or the well-being of those we care about.   When the physician enters the room to deliver news, there is fear and tension knowing that lives may change after just a few sentences are uttered. Fortunately, the vast majority of the news I deliver is just what patients and families want to hear. The biopsy result was benign. The

Test Your Knowledge of COVID-19

Many of us have sought distractions from the rising fears and frustrations of the pandemic. Why do you think it’s nearly impossible to buy a jigsaw puzzle now?  They are all on back order as the supply cannot meet the demand.  Board games are also more popular than ever.  Even I've competed in a few rounds of Boggle.  And binge-watching various television series has become a welcome oasis from the surrounding chaos. Jigsaw Puzzles - Endangered Species As a medical professional and an ordinary person, I am well aware of the health and economic horrors that the virus has wrought.   Yes, the upcoming vaccines represent a monumental scientific triumph, but there will be many dark months before they are widely available. In this posting, permit me to offer readers a lighter look at COVID-19 to provide a few minutes of deserved distraction. Here’s a COVID-19 quiz to test how current and accurate your knowledge is.   True or False Anthony Fauci, MD is obsessed with masks.   He

Thanksgiving Day 2020 - COVID-19 vs Us

This is not really a fair fight.  In one corner of the ring sits the novel coronavirus.  It's invisible and can attack without warning.  Moreover, when it lands a punch, the victim may not even feel its impact for several days.  It can fell even a highly trained athletic competitor.  And it has proven expertise in psychological warfare.  It's opponents - us - are scared that we might become tomorrow's victims.  The virus clearly understands and exploits the power of fear.   And with deepening pandemic fatigue, the virus gains a strategic advantage as we tire of practicing recommended public health mitigation efforts.   And in the opposite corner sits us, with a mask dangling loosely below our nostrils.  We thought that heading into the mall or to a friend's party would relax us before the competition.   After all, how much risk could there to be to have a quick drink at a coworker's house?   Or flying to another city to join with family at a Thanksgiving reunion?   

The 2020 Election was Rigged!

How often have we heard or read after a courtroom verdict, ‘we are going to appeal’, issued by confident lawyers who claim that their crusade for justice will yet be realized.  Indeed, I think many of us misunderstand the appeals process.  You cannot successfully aim to appeal a verdict simply because you reject the outcome.  There is no automatic judicial do over.   The losing party must offer convincing arguments to an appeals court that there were errors in the trial that rendered the proceedings unfair.  In other words, the error(s) must be material and not simply a harmless error.  Obviously, any trial or human endeavor will include mistakes that have no bearing on the ultimate outcome. For example, if a physician like me mistakenly records a patient’s height to be a half inch shorter than the true height, then the error is not consequential and won't affect the patient's care. 'I lost? I demand an appeal!' One of the many regrettable developments in the curren

How Honest Are You?

What is your threshold for speaking up?  Most of us claim to hover at an upper orbit of personal integrity.  But for many if not most of us, the boundary can be wavy.  We see and hear every day how political leaders use different sets of weights and measures depending upon political considerations.  Let me make this plain for readers with the following brief example. “When your guy does it, it’s corrupt and dishonest!” “When my guy does it, it’s completely ethical!” Test your own integrity as you peruse the following list. "Hmmm, what do I tell mom?" Is it a lie to tell your mom that her meat loaf was great when it conjured up visions of Ken-L Ration? If you catch your kid plagiarizing a term paper, do you contact the teacher? If a friend divulges that he is working under the table to avoid paying taxes, do you notify the IRS? If a coworker asks you to punch the time clock for him to hide a late start, do you simply refuse or also notify the manager? Have you vi

Election 2020 - Time to Change the Rules?

Four years ago, the country was shocked at the outcome of the 2016 World Series of Politics when the darkest of dark horses triumphed over the establishment.   In that contest, the New York Elites came up short against the New York Six Packs.   The final score of the decisive game was Six Packs 7 and the Elites 6 – a clear victory. The Elites and their supporters were incensed and bitter. “This is not fair!” they proclaimed.   “We got more hits than they did,” explained their team captain. “Who cares?” replied Captain Six Pack.    “The rules only count the runs, not the number of hits.” Over the next 4 years, every time Elitists referred to the prior lost contest, they always added, “We got more hits than they did.”   In fact, many of them began murmuring that the unfair rules should be changed such that the number of hits should now determine the winner.  Fairness, they grumbled, demanded a rules change. Let the Games Begin Anew! It's four years later and we are all spel

Election Day 2020 - First Step Toward Healing?

Two days from now is Election Day, which heretofore had been a demonstration of the majesty of American democracy.  Her Majesty has been dethroned.   Millions are wailing for a change in presidential leadership and millions of others demand that the current administration be granted another term. We are an angry people who seem willing to fight over everything and anything.   No issue is too trivial to demand someone’s cancellation.   Has the current administration caused these seemingly irreparable angry divisions or simply revealed them?  What is the pathway back to civil life? Those who support Vice President Joe Biden do so in part because they believe that his decency and empathy can serve as a national healing elixir.   I pray that this is the case, but I have deep doubts in his capacity to turn a lumbering ocean liner around with only a set of oars.   The healing, if it is ever to occur, will have to come from within.   And we have to want to be healed.   If an angry person

Will a Coronavirus Vaccine Heal the Nation?

Presently, your humble scrivener is situated in Atlanta, Georgia, the destination of a long road trip from Cleveland, Ohio.   Tucked safely inside our car, we were insulated from the novel coronavirus as well as the storm surge of seething of the nation.   As of yet, there is no vaccine or truly effective therapeutic agent available for either of these afflictions.   My sense is that the virus will be sooner and more easily vanquished than will be the malignant divisions that are threatening our society.    Am I being serious here?   Do I actually argue that a scourge from an invisible warrior that has wounded millions will be more easily defeated than our vile and vindictive politics?   Is reaching across the aisle or across the street or across the table such in insurmountable task? Here’s why the virus, as wily and destructive as it is, will at some point be the first to be defeated. Our politics, in contrast, will be more like arthritis and diabetes, long term and progressive d

Portland Protesters Topple Statues of Lincoln and Roosevelt.

To note that our nation is seething with anger – although deeply disturbing – is certainly not Breaking News, except on CNN where Breaking News flashes even when they are breaking for a commercial.  It is not that the nation is angry over a handful of controversial issues; we are angry over every issue.  Indeed, part of my dismay and fascination is how even a trivial event or utterance can provoke rage.  A few decades ago, if a person provoked or insulted someone, an argument might ensue.  Today the same provocation can have a fatal outcome.  Let me offer a very bold pronouncement.   I do so under my own name and stand ready to accept a searing rebuke.    Ready?   Humans are not perfect. Yet, when we judge current political leaders, historical figures, athletes, law enforcement personnel, writers, musicians, educators and the rest of us, any flaw discovered may generate outrage.   The paradigm is not to consider any surrounding circumstances or the context of the time that might

Dr. Sean Conley - White House Physician - a National Mentor

 In one’s profession and in life, we strive to improve our performance.  There are so many pathways available to progress on this journey.  One of the best ways is to emulate others.  Athletes, artists, musicians, writers, parents, tradesmen, educators, clergy, law enforcement personnel and even physicians can better their performance by imitating others.  And while it might seem axiomatic that our best role model is one who is more proficient than we, this is not necessarily the case .  The team captain can learn much from a rookie.  The Jewish Talmud expresses the truth more eloquently.                                                 Who is wise?  One who learns from every man. Over my career, I have tried to improve my practice of medicine from watching other physicians and nurses in action.   As an example, I have heard medical professionals having difficult conversations with patients which taught me how to do this better. So, when President Trump’s doctor recently led several

Trump has COVID-19: Our Year of Disaster Marches Onward

The year 2020 has been an annus horribilis and it's not over yet.  Seemingly out of nowhere a virus, heretofore unknown, has seeped over the globe like hot molten lava leaving a wake of destruction and despair.  The fatalities here in the U.S. have been staggering and the death count continues to rise.  Millions here have been infected and have suffered greatly with severe illness, hospitalizations and intensive care unit treatment.  Those who have so far escaped infection are anxious that their fate might change at any moment.  All of us have been affected. And, we have had a catastrophic economic melt down from which we may never fully recover.   Furloughs, layoffs, bankruptcies and permanent closures have affected nearly every sector of our economy.   The airline industry – the nation’s circulatory system – now has a very weak pulse, as one of countless industry examples.   Job losses have crippled much of the nation which has caused consequences to real people and families f

Ruth Bader Ginsburg Lights the Fuse

Before Justice Ruth Bader Ginsburg’s death certificate was signed, Judicial Warfare commenced. Both sides, of course, were prepared for this moment.   Justice Ginsburg, seemingly indefatigable, was well into her ninth decade and had numerous collisions with cancer.   It’s cruel, but entirely expected, that the nation was not given a proper opportunity to honor her legacy and accomplishments which should command admiration from all Americans.   One need not agree with her judicial philosophy or her opinions to admire the breadth of her accomplishments, her work ethic, her intellect, her vision and her humanity.   Indeed, her storied friendship with the late Justice Antonin Scalia shows a nation overflowing with anger what is possible. The efforts to recall her legacy were soon subsumed in partisan warfare.   The Democrats accused the GOP of monumental hypocrisy as they juxtapose their statements in 2016 when Judge Merrick Garland was nominated to their current proclamations that con

Stopping Coronavirus on College Campuses

Perhaps, October 31 st will be an inflection point in the pandemic since more folks will be wearing masks on Halloween. I assume that the annual ritual of trick or treating will be suspended this year, as have so many of our performances, celebrations, concerts and athletic event spectating.    It has been my observation in Ohio that more folks are masking up, although there are exceptions everywhere.   Our governor has directed concern for some rising case numbers toward college youth, who astonishingly haven’t followed the rules.   Just because one is a college student doesn’t guarantee that his decisions will be graced with wisdom.   And, if there is to be any chance that college kids who are drawn toward campus parties like iron filings are attracted to a strong magnet, there will need to be sure and certain enforcement.   What if a college made students aware that violating public health rules would result in expulsion with no refund of monies spent?    Yes, I know this sounds

Dealing with Angry People - Better to Do Right than Be Right

 The nation’s racial upheaval, particularly vis a vis law enforcement, has shown us the value of the skill of de-escalation.   A situation arises and several outcomes are possible, although some are clearly preferred.  The specific technique and approach utilized may determine the end result.  A range of options are often available.  What can make these situations so difficult to unravel afterwards is that an option that may lead to escalation may be deemed to be acceptable, according to the training protocol.  In other words, even the approach taken was acceptable, there may have been a better way. Obviously, we all endorse training and practices that has the highest probability of bringing calm to a potential combustible situation.    I expect law enforcement – the professionals – to pursue de-escalation as their default mode.   But, the citizenry can and should do its part to de-escalate.     If all parties share the desire for a calm denouement, then it is much more likely that t

Labor Day 2020

Labor Day is a time to pause, reflect and to thank all those who keep this nation vibrant. You are the guts of the country. Labor has battled many adversaries over the decades.  It has sparred with management.  It has railed against 'right to work' legislation.  It has struggled to compete against low wage workers in foreign countries. But this year it has been sucker-punched by the most formidable adversary that has ever entered the arena. And Labor is still reeling.  And, so are the rest of us. An enemy like no other It will be a slow grind, but it will lumber forward.  Yes, we will reach the other side.  How will we get there?  Of course, we will need our medical and scientific community to put the virus in its place.  And everyone will have a role to play.  But, the grit, sweat and determination of Labor will be a major force leading us out of the abyss.

Why I Don't Tell Alcoholics to Quit Drinking.

  I have seen many alcoholics during my gastroenterology career.   It is likely in the majority of cases that I was not aware of their abuse history.   Patients often deny or minimize their alcohol history when queried.   “Do you use alcohol regularly?” “Only socially.” At this point the physician and the patient engage in a linguistic tete-a-tete on the precise meaning of ‘socially’. Patients are more forthright about their habits when they have a medical condition that has a clear an obvious connection to alcohol, such as jaundice or liver injury.   And, if family members are present, they often serve as fact checkers and truth tellers. What is my approach to these patients?    Do I wave my arms and preach like an evangelist that they should throw their bottles away?   Do I tell them that they must quit or face medical damnation?  Do I threaten to sever them from my practice if they persist with their addiction?   I have adopted a rather different approach.   I do not advis