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. 




Sunday, November 29, 2020

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?   "Didn't Dr. Fauci imply that airports were virus-free zones?" we recalled.  And all passengers on the plane, even the guy who kept coughing, were wearing masks, except when they were snacking every 15 minutes or so. 

The fight is only half over and I'm not sure we'll be able to endure 12 rounds.  Either we'll be knocked out cold or the referee will call a TKO.  

This is us with 6 rounds to go.

Perhaps, we should pursue a new strategy?

Sunday, November 22, 2020

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 current post-election chaos has been the widening of the expectation that an unwanted result must be wrong and should be challenged.  This is a departure from our heretofore general acceptance that findings and rulings by authorized bodies were correct or at least should be respected.  If this new practice is maintained or extended, it will threaten so many established norms that we have previously become accustomed to.  Consider some typical scenarios.

  • A student (and his parents) claim that his lackluster SAT score is wrong and demand a hand count.
  • A sports teams loses the final playoff game.  The manager suggests that the referees were biased and possibly corrupt.
  • A high school wunderkind loses in the final round of the National Spelling Bee.  His high school principal cries ‘fowl’ claiming that the winning contestant received a much easier word to spell.
  • A contestant in a juried photography contest loses in the first round.   He rejects the decision and hires experts who give attestations that the photograph has true artistic merit.
  • A presidential candidate loses but refuses to accept the results.  He responds by attacking the process, demanding recounts and pursuing a scattershot of legal attacks.

 Of course, outcomes may be unfair or wrong and we are entitled to pursue a cure when there is a reasonable basis underlying our claim.  But I maintain that the greater good, as well as our individual interests, are served better when as a general principle we accept the findings of our institutions.  And, if we wish to challenge a ruling or a result, then we are obligated to explain in advance why we feel that the process was tainted.  We should not have a right to an investigation hoping to find evidence of impropriety that does not currently exist in a quest to achieve a new outcome. 

Naturally, this is a nuanced issue and there are exceptions to everything.  But do we want to live in a society where every outcome is summarily rejected and assumed to be wrong?

When a loser graciously accepts a result, we all win.