REPORT FROM THE HEARTLAND

 

 

 

 

 

I met Mr Ford for the first time in February of 2022.  This was in an exam room and I, the physician, had a mustache, beard and pony tail.  This didn’t seem to phase him a bit.  After all, we were in Oklahoma and he was dressed quite casually, being bearded himself.  I felt quite comfortable and we proceeded through the ritual of history and physical exam. We dug deeper into his life and circumstances.  He was in his 70’s as was I.  His wife had nearly died several weeks ago from the omicron variant of Covid.  She had been intubated but now was breathing on her own, thank God.  She was slowly getting stronger and was deemed ready for placement in a rehab facility.  The problem was there were no such beds available just now.

“I’m very sorry to hear of about your wife, we’ll be watching her closely when she comes out of the hospital.  We can get home health for support.  That will make a lot of difference at home if she can’t find a rehab facility.  But to you the tell the truth, it’s you that worries me the most.  You’re 74 and diabetic, your lungs have been weakened by years of smoking.  You’re not svelte like the old days and these are all risk factors for severe Covid.  Your chart says you didn’t want the covid vaccine and I respect your right to refuse any care you wish but I feel a duty to try to discuss this with you.  It’s likely to be the only time we meet and sometimes a magical understanding and trust can form when people speak from their hearts”

He looked at me with a face that reflected respectful defiance.

“Trust,” I said, “that is what is needed in this confused world today.”  I was hoping to become a beacon of light and instill the best advice I could give him based on the latest latest scientific evidence.  Perhaps no one had ever dug so deeply to reach him in a medical setting.  I felt a missionary zeal to protect him from misinformation and the virus, two elements of the plague that swept our country and world.

He looked at me with conviction and said.  “Who can you trust, that Fauci is the worst.  He says one thing and then another.”

I now knew this would be a hard case.  He was at high risk for death and his wife had nearly succumbed just 2 weeks ago.  The whole program of political distortion of medical advice had penetrated him to his core.  He was committed, out of reach of my efforts to bring light to the discussion.  He didn’t understand that science changes as new facts emerge.  That evolution of thought and knowledge does not refute past competence.  We must simply proceed with the best information we have.  This real time plague had startled many among us with the need to adjust advice to circumstances.  Medicine had long been evolving slowly on the wards and clinics with mainly professionals absorbing and applying the insights and discoveries made.  Now the most vital medical issue of our time was being managed in the public square on television and other media outlets.  What he said next astounded me.

“I have somebody I trust. My neighbor is a doctor”

“What kind of doctor is he?” I asked.

“He’s an MD.  He is against the vaccine and uses ivermectin.   We believe in him, we’ve seen it work.”

So much for me trying to be a voice of reason.

“How old is he?” I asked, looking for a clue to his competence.

“Younger than us,”

So now I knew that the misinformation had penetrated beyond patients to some of the doctors themselves.  I had seen outliers like this on television and some sanctions had been considered by medical boards.  These were scientists who had abandoned expert interpretation of empirical realities.  I had seen the occasional provider who had deviated from the mainstream to embrace odd theories throughout my many years of practice.  Usually they were loners applying their own strange theories in a private office where no oversight occurred.  But in a crisis such as we were in, it was shocking to see how deeply the antiscientific sentiment had penetrated the public consciousness.  I should have known, but I had been out of circulation so long that the shock was palpable.  There was no hope or purpose in trying to convince Mr Ford.  It seemed rude to persist and I yielded to his defenses.  My country, which had seen the aggregate life expectancy of 45 years in 1900 surge to well into the 70’s in our time, was losing faith in science.  The very science that was so largely responsible for this remarkable extension of collective life. The progress of vaccines had been a vital part of this success and now scorn was being heaped upon those who advocated its use.  Perhaps the fortuitous speed with which the new vaccine had emerged from the knowledge of years of prior research made it appear suspect to the uninformed.  But the safety and efficacy in avoiding severe disease and death were incontrovertible.  It was true that long term complications might emerge in the future, unforeseen morbidities, but this was unlikely based on past experience and nearly a million US citizens had already died in the present from the virus itself.  Sadly scorn was being stirred in a public cauldron by cynical politicians.  Many of these were well educated and I suspect knew better.  Yet they waved the flag of “freedom” in the face of common sense while their constituents died in droves.  Here, before me was the result of such misinformation and I could only hope that he would continue to survive.  His life, his choice.

That was just a  part of the lessons my journey to the heartland had revealed.  I knew that as the plague subsided, people would forget that we had lived on the fault line of trust and ignorance.  When the danger from  covid finally subsided, it would no longer seem a relevant issue and the chasm would fade somewhat into memory.

When I arrived home after the harrowing drive from Oklahoma to St Helena Island South Carolina, through ice storms pulling a U-haul trailer, the car packed with 3 cats, 1 large dog who hates the cats and of course my loyal and beautiful wife Lisa, I was exhausted.   Yet the azaleas knew renewal was beginning..  They were blooming, it was Spring and we were alive. We were home. We had done our best.