As I See It

I am responding to questions posed by the author of an As I See It feature in your publication of December 18, 2021. At issue was COVID 19, and how best to respond to it. From a plethora of questions, I want to address a central one:

What is “science?”

A Webster dictionary definition of science: (1) Knowledge about the natural world that is based on facts learned through experiments and observation. (2) An area of study that deals with the natural world.

Fine, but a bit ponderous.

Try this: A scientist seeks to understand truths established by God and Nature.

A corollary: S/he does not let personal beliefs interfere with recognition of facts.

A physician is and must be, above all else, a scientist.

Fact: The virus known as COVID 19 is unnecessarily killing millions of people all over the world. We actually know how to mitigate its fury. What is lacking is adequate application of that knowledge.

Prediction based on Facts: The longer a pandemic continues, the more likely it becomes that variants will appear, with the chance that each might be better able to avoid one’s immune system.

A question in the article asked, “Why can’t we just depend on our own immune system?”

Even when one’s immune system is first rate, it takes time, days, even weeks, from first exposure to a new virus for full immunity to rev up and control it. That interval leads to illness.

That’s how it works.

Call the situation akin to equipping soldiers with rifles … one’s innate immune system … BUT: “We’ll send ammunition to fit them as soon as we can get around to manufacturing it.” … antibodies created by one’s body that are specific to the virus.

A vaccine makes the ammo before the rifle is issued or the soldier goes into battle. The immune system prepares antibodies in advance of exposure to the live virus.

A looming consequence of this pandemic is sheer fatigue among frontline health care people. Doctors, nurses, techs, cleaners, ambulance drivers. Those who must accept all the dead bodies. When a doctor or nurse is on duty for thirty, forty hours in a row, strange things happen within one’s brain. I know from experience. Judgment sags. It becomes hard to concentrate. Weird lights flicker in your field of vision. Balance suffers. In 1957-58, the influenza strain known as Asian flu first reached the northland. It was so potent, so contagious, so new, that everybody got sick at the same time. Including me, as the only doc for a very long ways. Nurses and techs were just as ill as I, while we coped with a deluge of patients. I learned literally to sleep “on my feet.”

Was that good for my patients?

During those terrible four or five months, I once asked a lady a question, and as God is my witness, within seconds, I fell soundly asleep while she was answering, nearly falling off my chair. We are not engineered to function under such stresses.

As of this date (December 26, 2021), Minnesota’s own Dr. Michael Osterholm is predicting “a blizzard of omicron variant virus infections during the next few weeks in anyone who is not fully vaccinated.” He has been on target in his past predictions. Among his deepest concerns is that medical care providers will be among those decimated, further crippling access to care for the rest of us.

Every human being shares thousands of similarities with everyone else. When I must do an operation for appendicitis, teaching and experience assure me that opening up the patient’s tummy is a better place to find his appendix than, say, in his left foot. BUT: there are also thousands of subtle differences, one person to another. I have brown eyes; some folks have blue eyes. It happens that the complex cascade of events an immune system uses to fight a new infection is one where important differences can occur, person to person. “We don’t all react the same way to a given infection.” COVID seems to thrive as a lethal force in part because of such widely varying responses. From: “I tested positive? But, I don’t feel a thing.” Others, more than 800,000 fellow Americans at latest count, suffer rapid respiratory failure and death. The “why’s” and “how’s” of such disparity are subjects of frantic research, but for now we must use what we DO know. Familiar advice: masks, distancing, avoiding large crowds, regular testing, and VACCINATION. A magic pill? Not really. Not yet.

I hear sputtering to the effect that getting immunized is a personal choice and no one else’s business. If that person were the only one to suffer as a result of the choice, sad maybe, but fine and dandy. Every doctor has seen patients who lived (or died) from just such choices. BUT: when infecting those with whom you come in contact in order to exercise that “choice” …

I must say a good word for our community. Regularly, Cook County has the highest percentage of its population who have been fully vaccinated in the whole state of Minnesota. Bravo, take a bow, folks, including all those who provide our health care.

I wonder what impact the writer might have were she to turn her considerable eloquence toward helping steer our nation away from the vaccine-avoidance death march on which so many of our citizens have embarked. Every doc does a slow burn over TV ads hawking some cute new medicine in which a “disclaimer” is, “Ask your doctor.”

Perhaps, in this case, if the author of the piece were to do just that …?

Roger MacDonald, MD