Thoughts on a Sunday…

It is 6AM on a relatively bright and crisp Thanksgiving weekend. Alpana checks her patient list as she heads to work to see a host of patients, some with COVID19 and others with the usual ailments that fill our plates at work. We talk about how the pandemic has affected us and its impact on society in general. The CNN headline on Japanese suicide rates, the resignation of a local health official over threats to her family and the increase in local spread among the community feature, as we look to the winter ahead with trepidation.

A bright spot in our thoughts, is the possibility that a vaccine might be a savior. But will it be too little, too late? Only time will tell. As more of our colleagues test positive, we look to our own safety. As more and more public officials, on both sides of the political spectrum, show support for preventative and safety measures, we look at the increasing fatigue that we (as much as everyone else) are experiencing in this new reality.

But wait, masks, distancing, washing hands? Restrictions? What restrictions?

As a proceduralist, these aren’t restrictions, these are my every day activities. As they would be for welders, mechanics, sanitation workers, doctors, nurses, respiratory therapists… you name it. And every occupation has its own.

When do these rules of behaviors become a restrictive burden?

I think the answer is in us.

They are “restrictive” as much as we want them to be.

We are “restricted” to breathe air, want for food, desire shelter and companionship.

We are “restricted” to need to care for family and friends.

We are “restricted” to the boundaries of our locale, city, state, country, planet, solar system and galaxy.

Most of all, we are “restricted” to the confines of this body, the most precious gift endowed us by our Creator.

In the face of these restrictions, what of the mere mask, the “6-foot rule” and the hand-washing? When seen from this overarchingly “restricted” life, these seem like just a fraction. But are they “just an increment” or “the last straw”?

Again, the answer lies in us. Despite the profusion of death and disease all around, many, including friends and family, move to the latter. Their attitude, one of defiance in the face of logic, as they abandon all pretense. Social media, the bane and savior of our isolated world, relays videos and pictures of indoor get-togethers, as families and friends gather in close embrace, singing and sharing.

How will this end?

Who knows?

Maybe the naysayers are right. Maybe this is all fake. Or #fake. Maybe this is just physicians trying to whip up panic to demonstrate their power.

Smart people discuss the ethics of caring for individuals that don’t isolate or take precautions. They even suggest that only “good” people deserve to be treated.

My take on this is as follows:

I am a physician who provides a service to those who need it. No part of this involves my judging their behavior or character. What’s more meaningful is that I am PAID to deliver said service. Just like, smoking, sloth, gluttony and pollution that keep our clinics humming, the pandemic is just another, newer, source of activity.

I plan to keep doing what I do for each patient.

Be the best physician I can be.

Dispense the right advice – for THEM to make the best decision.

Do what I can to help them, and let them do what they wish to do. The day that I am paid to police their activity and make their decisions for them, that is the day I leave medicine.

That said, as an individual I can judge and decide who I want to be friends with. That includes family members that I want to relate to and those that I don’t. Like any individual, I retain the freedom to be as arbitrary as I please in doing so.

So.

If you don’t want to wash hands, if you want to make a point of posting pictures and videos of indoor maskless groups, holding hands and in close proximity and if you think you are “tired” of this pandemic and all the “restrictions”, I am happy to be your physician, just not your friend.