Sunday, January 17, 2021

What the COVID-19 Vaccine Meant to Me

 Although I am not a front-line worker, I do interface with several dozen patients each week.  The COVID-19 metrics in Ohio are all coursing in the wrong direction.  Over the past few months, several staff at work and personal friends have contracted the disease.  I’ve had a few close calls with patients whom I learned after an office visit with me were infected.  Thus far, I’ve managed to dodge the virus.   What weapon have I used to repel the invader?  See photo below. 

Two weeks ago, I received my initial injection of the Moderna COVID-19 vaccine at my workplace.  I arrived at the appointed hour expecting to bare my upper arm for a quick puncture.  Not quite.  After entering the building, I was directed to the end of a long line which was trailing outside in the parking lot.  So, I took my place during the pleasant winter climate that all of us in Cleveland adore.

Once I advanced into the building proper, I discovered that the experience reminded me of Disneyworld.   I am not referring to costumed interpreters interacting with the crowd, or hearing ‘It’s a Small World’ piped in or a gift shop where I could purchase a Mickey Mouse doll with a facemask who blurts out ‘keep your distance’ if you cross the 6 feet barrier.  I am referring to the hidden winding lines that awaited all of us who were waiting.  As soon as we would turn a corner, another queue bank came into view.  Very clever.

Ultimately, I was face to face with a retired registered nurse who had come back into service to help the nation resist the virus.  After the inoculation of messenger RNA, I waited the required 15 minutes and then headed back to my car.


I’ve had dozens of vaccines throughout my life, but I will never forget this one.  It was an emotional experience as much as it was an immunological event.  There was a dreaminess about all of it.  There we were, there I was, participating in something so much bigger than ourselves.  The nation had been praying for a successful vaccine and scientists throughout the world broke all records and expectations and delivered.  And we represented the first steps back to normal life for everyone   

While vaccine distribution has been woefully inadequate, I hope that every arm who wants a vaccine, will receive one ahead of schedule.  The incoming Biden administration properly regards this as Priority 1.

So far, in the contest of COVID-19 vs Humanity, we are losing badly.  We will prevail.  Ultimately, the vaccine will vanquish the virus.  Until then, we must do everything to minimize our casualties.

As I reflect on 2020, our annus horribilis, the COVID-19 vaccines were the green shoots of renewal. We need to turn them into forests.

 

 

 

 

 

 

Sunday, January 10, 2021

Telemedicine is Here to Stay

Most of us recognize that Operation Warp Speed was the name given to COVID-19 vaccine development, which succeeded brilliantly and in record time.   Early on, no one predicted that by the end of 2020, two safe and highly effective vaccines would gain emergency use FDA approval. 

There were other developments that also rolled out at warp speed.  Telemedicine is now omnipresent.  Prior to the pandemic, telemedicine existed in pockets throughout the country, but most physicians and patients had never participated in it.  The plan was for it to gain a much larger footprint in the medical landscape in the years to come.  Instead, the transformation occurred in weeks.  Physicians and patients who previously would have rejected the notion of a distant and impersonal virtual visit were now enthusiastic participants.  Patients and caregivers of all ages became quite conversant with Zoom and other similar platforms.   



'The Doctor Will See You Now'

The urgency for warp speed adoption of telemedicine was to mitigate the pandemic.  By seeing patients virtually, we could protect medical personnel and the public by limiting close exposure with potentially infected individuals.  The more we limit close contact with others beyond our household, the more likely we will remain uninfected.

It soon became evident that telemedicine offered many advantages beyond viral mitigation. 

Indeed, telemedicine is not only here to stay, but its continued growth is assured.  Patients will have routine access to medical care from physicians who practice in other states or even in other countries.  Technology will continue to be developed to make the virtual visit more similar to a full office visit exam including a physical examination.   While this sounds heretical and fantastical, patients may undergo actual physical exams without a physician laying a hand or a stethoscope on the patient. Stay tuned.

Like with other technological advances, there will be a cost.  Intimacy and humanity will be sacrificed on the techno-altar of progress.  To those who want to hang onto the personal visit, with real eye contact. body language, palpation of your abdomen and interacting with medical staff you know and trust, I hope there will be a place for you.   But there is a transformation underway in how medical care will be delivered.  And telemedicine right now is the profession’s north star.   The old fashioned office visit will likely end up like the old fashioned hardware store – not exactly extinct but harder and harder to find.

Today, we buy (or download) books from our couches.  Yes, it is very efficient and those who do so routinely would never contemplate hauling out to a brick & mortar store.  But, what of the joy and pleasure of wandering through a bookstore’s aisles, checking out various titles and then leaving with a book or two that was not on your intended list?  Are you all about the destination or the journey?

 

 

Sunday, January 3, 2021

Happy New Year! -A Look Back & A Look Ahead

                                                                             Division                                                                                                                                                                                                                                                                                                                                                Heartache

                                                                                                            Death

                                           Pain

                                                                         2020  

                                                                                                                       Lies                                                                                                                                                                                                                                    Racism                                                                                                                                                                                                        Revenge


                                                                                             Tearing down


                                                            Vaccine

                                                                                            Unity

                                                                                                                                                                                Bipartisanship

                                                                                                        Honor

                                                                             2021

                                                                                                                                                                                          Statesmanship

                                                                                                                 Alliances                                                                                                                                                                               Forgiveness


                                                                    Repairing the world


Sunday, December 27, 2020

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 insidiously or abruptly, the individual rejects these protective measures and seeks liberation.   Keep in mind that nothing in the pandemic justifies any relaxation if mitigation efforts.  Conversely, as most states in the nation are reporting rising number of COVID-19 cases, experts have counseled a tightening of restrictions to attenuate what appears to be the raging of a 3rd wave of infections.  Paradoxically, Pandemic Fatigue is rising just as the virus is roaring back.



There is no Virus Fatigue


Pandemic Fatigue is a welcome development from the virus’s point of view.  As folks let their guards down, it makes it much easier for the virus to infect more of us.  So, you could argue that PF is actually showing kindness to a virus that has been the victim of so many vitriolic attacks.  Should we celebrate this viral empathy?

If you have had thoughts or heard statements such as those that appear below, then you are at risk of PF and should seek professional guidance very soon.  How soon?  How ‘bout Warp Speed soon!

“I can’t do this one more day!”

“I’m planning a huge family reunion.  We all need this desperately.”

“This is so depressing.  I’ve already missed out on 2 vacations.  I am not missing this wedding!”

“I am much more worried over my family’s mental health than the virus.  We need to go to a real theater to see a real movie to keep our sanity.”

“I’m zoomed out.  I need a hug.”

“Fauci?  What does he know?”

 

Are you a PF sufferer?   Remember, acknowledgment is the first step toward recovery.

 

 

Sunday, December 20, 2020

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!

 

 

 

 


Sunday, December 13, 2020

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 CAT scan was normal.
  • You won’t need surgery after all.
Paradoxically, I have discovered over the years that many patients are downright disappointed when they receive good medical news.  Gastroenterologists like me evaluate thousands of patients with chronic digestive symptoms, such as pain, nausea and bloating.  Although these symptoms are 100% real, diagnostic testing often shows no abnormalities.   I cannot count how many instances in my career that patients are upset to learn that the test results were normal.  Now, of course, these patients don’t want to learn that they have a serious medical condition.  But, they do want an answer and are frustrated that no clear explanation is apparent.  We physicians understand their frustration, but we are relieved that these patients are not facing a dire medical threat.

Here’s my profound summary comment.  Good medical news is a gift, even if it leaves some medical issues unexplained. 


Sunday, December 6, 2020

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 really needs to lighten up.

Deborah Birx’s scarves are soaked in bleach to repel coronavirus which is how she has escaped infection..

Donald Trump, a true statesman, attacked the pandemic without any political considerations.

Scientists predict a decline in viral infections in northern U.S. states in the next 2 months as the snowbird virus hates the cold.

Just like the ‘flu shot’, it is possible that the upcoming vaccines can actually cause COVID-19.

 

Choose the BEST answer.

Which of the following is the most effective method for avoiding coronavirus infection?


Using Lysol as a food additive.

Avoiding Chinese food.

Wearing a mask that fits snugly over your mouth and nostrils.

Joining an aerobics class since the vigorous kinetic activity will shake off any virus that lands on you.

Leaving the bar by 10:00 sharp which is an hour before the virus awakens.

 

 Our best hope for defeating this virus is:


President Trump reversing the election and continuing his leadership for another 4 years.

Having bleach brownies with a Clorox chaser every evening. 

Prohibiting masks which many people say might be making the pandemic worse.

President-elect Joe Biden.

Having friends and family from near and far come together during the upcoming holidays. The virus will respect our resolve and then fade away.

I hope that you performed well on this academic challenge.  Want some extra credit?  Wear a mask and keep a proper distance between you and others and I’m prepared to raise your score by a full letter grade. 

 

 

 

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