Skip to main content

Covid19--can we really just drop everything? #mycoviddiary

Still vigorously healthy, thank you. I sneezed once yesterday afternoon and my voice was just a wee bit gravelly. Today my nose runs when I'm out in the cold. It always does that. No exposures that I'm aware of.

My clinic is functioning as well as it can, consistent with keeping almost everyone out of our waiting room. We have agreed to keep meetings to no more than 10 people with everyone at least 6 feet apart. We have all been instructed to self screen every morning for new significant cough, sore throat, shortness of breath or fever over 100. Most of my patients have been phone visits rather than in person but I saw a few. I do a better job in person, but spending a good amount of time with someone on the phone is not without its benefits. The counselors and psychiatric nurse practitioners will be working from home until this is over. They had one day to figure out how to do this. Their patients are kind of reeling. Nobody had typical coronavirus symptoms. Things are kind of slow right now.

Thoughts:
One good thing: Our patients at the clinic where I work are often grindingly poor. No insurance, no income, burned bridges everywhere. I have no idea how they afford the cheap hotel room where they sleep or any food at all. The government--not just Andrew Wang or Bernie Sanders, but even conservatives--are talking about giving all US citizens a check for maybe $2000 as an economic stimulus. This would be amazing for our patients. It would make all the difference in the world. And not just because of coronavirus. They could fill up the tank of the car that they call home, buy shoes, maybe pay a bill or two. There are patients for whom the safety net provides no safety at all.

A few bad things: 

  • "Thank god we have our phones."  The internet is becoming the source of all joy. AARRGH! Yay Zoom conferences. Computer games. YouTube videos. Endless memes. I don't recall saying this was OK.
  • Unintended pregnancy: people talk about how they wish they'd gotten a haircut before all of these businesses closed their doors. What about an IUD or other long term birth control device? All this being cooped up with ones near and dear ones with nothing to do will lead to little unintended bundles of joy. I see so clearly in the office how much of being unhappy comes from having been born to a family that didn't really want or need a baby. Family planning is a gift. I wish we'd gotten more birth control done before we went to telephone visits!
  • Xenophobia=fear of the other: We're mad at all the countries that caused us to have an epidemic by having as little foresight as we do now. Everybody else shoulda known. We were getting more adversarial with other countries before this happened which is part of why this whole epidemic mess was not contained to a few areas. Finger pointing seems to be one of our most entertaining hobbies. Really understanding our shared humanity is one of the most effective ways to prevent war. 
It's weird to be a doctor who isn't busy, in a time when globally my skills are needed. If I were a plane I'd be in a holding pattern.



Comments

Chikan said…
All the years following your blog one or two comments I have left. It is always refreshing to read what you have on your mind. I am glad you are continuing to write and want to thank you and wish you health and happiness on this Spring morning.
WB

Popular posts from this blog

How to make your own ultrasound gel (which is also sterile and edible and environmentally friendly) **UPDATED--NEW RECIPE**

I have been doing lots of bedside ultrasound lately and realized how useful it would be in areas far off the beaten track like Haiti, for instance. With a bedside ultrasound (mine fits in my pocket) I could diagnose heart disease, kidney and gallbladder problems, various cancers as well as lung and intestinal diseases. Then I realized that I would have to take a whole bunch of ultrasound gel with me which would mean that I would have to check luggage, which is a real pain when traveling light to a place where luggage disappears. I heard that you can use water, or spit, in a pinch, or even lotion, though oil based coupling media apparently break down the surface of the transducer. Or, of course, you can just use ultrasound gel. Ultrasound requires an aqueous interface between the transducer and the skin or else all you see is black. Ultrasound gel is a clear goo, looks like hair gel or aloe vera, and is made by several companies out of various combinations of propylene glycol, glyce

Ivermectin for Covid--Does it work? We don't know.

  Lately there has been quite a heated controversy about whether to use ivermectin for Covid-19.  The FDA , a US federal agency responsible for providing unbiased information to protect people from harmful drugs, foods, even tobacco products, has said that there is not good evidence of ivermectin's safety and effectiveness in treating Covid 19, and that just about sums up what we truly know about ivermectin in the context of Covid. The CDC, Centers for Disease Control, a branch of the department of Health and Human Services, tasked with preventing and treating disease and injury, also recently warned  people not to use ivermectin to treat Covid outside of actual clinical trials. Certain highly qualified physicians, including ones who practice critical care medicine and manage many patients with severe Covid infections in the intensive care unit vocally support the use of ivermectin to treat Covid and have published dosing schedules and reviews of the literature supporting it for tr

Actinic Keratoses and Carac (fluorouracil) cream: why is this so expensive?

First, a disclaimer: I don't know why Carac (0.5% flourouracil cream) is so expensive. I will speculate, though, at the very end of this blog. Sun and the skin: what happens If a person reaches a certain age, has very little pigment in her skin, and has spent lots of time in the sun, bad stuff happens. The ultraviolet radiation of the sun does all kinds of great things: it makes us happy, causes us to synthesize vitamin D which strengthens our bones and it gives us this healthy glow until we get old and wrinkled and leathery. And even that can be charming. The skin cells put up with this remarkably well for a long time, partly aided by melanin pigment which absorbs the radiation, which is why we tan and freckle, if we are fair skinned. Eventually, though, we absorb enough radiation that it injures the skin and produces cells which multiply oddly. It also damages the skin's elasticity which creates wrinkles. The cells which reproduce in odd ways peel, creating dry skin or