… Nothing To Fear …

I find that in some ways I’m not a good person to discuss Covid-19 with. My internal sensors regarding exposure and risk are set differently from that of many other people that I know. I am missing some of the fear that they describe. Not all of it, but some. This is not due to courage, since I have no more of that quality than anyone else, but it comes from repeated experiences over a medical lifetime.

On Christmas Eve of 1966 I was a pediatric intern on call. A critically-ill infant had been admitted that day with meningitis, and I was covering for the physician responsible for her care. At around 10:00 P.M. she suffered her first arrest, and I began CPR immediately using an infant-sized bag and mask and chest compressions. At her second arrest an hour later, the bag malfunctioned and became unusable, and someone had to be dispatched to another area of the hospital to retrieve another. In the meantime, I used mouth-to-mouth respiration. We were once again successful in bringing the child around, but by midnight she had died in spite of our efforts.

The next morning the lab reported out the causative infectious agent as meningococcus. The members of the team that had worked with her were prescribed sulfonamide tablets as prophylaxis, and I dutifully took mine for the designated number of days and that was that.

There was no pause when the mask failed, I believed that this is what doctors did, this was part of the “contract” I signed when I decided to become a physician, even if I hadn’t thought it through as fully as I might have.

Over the years there were less dramatic episodes, but the theme was always the same. We (members of the medical team) would protect ourselves as much as was possible, but we entered those sickrooms, gave those treatments, did what was necessary to do. It was our job and we adapted to that reality in our minds.

So I completely understand the concerns and actions of workers in hospitals today who have to work with scanty protective equipment. You don’t prize your own life any less, but you took on the job on a sunnier day and now you are working in a hailstorm.

BTW, not every health care worker I have met feels this way. Some of them begin looking for the exit at the first sign of danger. I recall when Yankton SD’s first AIDS patient showed up at the hospital with appendicitis. It was early in the course of the AIDS epidemic, when information about transmission was still pretty sketchy.

It took a while to round up an OR crew to do the surgery necessary on that Sunday afternoon. Some personnel refused to answer the call. But others did, the operation went well, the young man went on his way, and his caregivers suffered no adverse effects.

So I protect myself, those around me wherever I can, and I limit my exposures. But I am intimately acquainted with the knowledge that there are perils in the world. A viral particle, a frayed bit of electrical wiring, a car being piloted by an intoxicated person. If you think too much about all the hazards that life provides, it could be almost paralyzing, couldn’t it? But we all open those doors and leave those safe spaces when the need arises. We suit up and show up. You and I.

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While I’m talking doctor stuff, I have a true short story for you. On a summer Sunday afternoon in 1967, a very ill six year-old boy was admitted to University of Minnesota Hospitals with fever, lethargy, and a dramatic rash. None of us assigned to this patient recognized the rash, so we stat-paged the chief resident on dermatology to come to the admitting examination room.

Now, for the most part, stat pages are extreme rarities in dermatologists’ lives. It is one of the attractions of the specialty, along with regular hours, weekends off, and freedom to vigorously nag anyone with a suntan. So when the derm chief resident heard the page, he grabbed a piece of equipment to bring with him to what would possibly be the only emergency call he would ever receive.

My question to you is: what did he bring with him? (Answer is below)

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From The New Yorker

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He brought a camera.

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We watched the Democratic convention again on Tuesday and Wednesday night, on ABC live. It’s interesting how the “meeting” is being presented, and of course it is basically all scripted and managed. But still some of the speakers come through those LEDs and LCDs pretty well. So far my favorites have been Michelle Obama, Barack Obama, Kamala Harris, and Jill Biden.

ABC has George Stephanopoulos managing a shifting group of commentators sitting at a long and socially-distanced desk. So long that not all of them are in the camera’s view unless one pulls it back a good distance. They jumped into the discussions whenever there were pauses in the “convention” schedule. I found them largely annoying.

For instance, at this point in the history of the republic, I don’t really care what Chris Christie thinks – about anything at all.

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Smoke is in the air this morning, so heavy that we can barely see the silhouettes of the San Juan Mountains to the south and the Uncompahgre Plateau to the west. And the closest fire (below) is a hundred miles away from us, north of Grand Junction.

Another large fire near Glenwood Springs has closed Interstate 70 for about a week now, with no predictions as to when that vital highway will be open again. East-west traffic is being rerouted in several directions, one of them being through Montrose along Highway 50. When we returned from Leadville a couple of days ago, there was heavy traffic both ways on a road that is usually lonesome traveling.

It is truly crispy here in Paradise. The amount of rain we’ve received at mi casa this year wouldn’t make two pots of good coffee.

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