Since the first cases of COVID-19 started trickling into the U.S. in January 2020 (or December, depending on what sources you believe), leaders have made confident statements promising containment, to eradicate the virus, to provide resources for hospitals in need, to research and identify treatments that work, etc. I think that we can agree that no matter what side of the aisle you are on, having a highly charged controversial presidential election amid the starting pandemic probably didn’t help facilitate a unified response. Drawing up fighting lines early on and allowing this health crisis to become so politically charged has left a gaping wound in the fabric of our society. Online videos of doctors questioning the CDC guidance and downplaying the severity of the illness made the rounds through email and social media, while newsreels of semi-trucks being loaded with bodies from a New York City hospital painted a grim picture. Doctors and leaders on one side swear by controversial treatments like ivermectin and hydroxychloroquine. At the same time, state medical boards and groups from the ABMS have sent notices to physicians that there will be consequences potentially, including loss of board certification or even their medical license for supporting these medicines as reasonable treatments. Advanced mRNA sequencing techniques have allowed for novel vaccine development in record time, while those opposing “the jab” have made it their mission to scare everyone away. I never imagined navigating this type of thing in my medical career. While the first cases in the county where I practice in Southern Washington occurred early in March of 2020, many people living in the surrounding rural areas felt no immediate effect or threat of the pandemic. Rather, they had months and months of seeing what confusion and chaos it was causing on the news and social media before they started to see friends and loved ones be hospitalized and, unfortunately for some, lose their lives. What was the American public to think seeing one doctor with all the right letters after their name stating that this was a grand conspiracy, while doctors with the same letters after their name told everyone to mask, distance, and stay home? What were they to think when the guidance from governmental agencies kept changing on a weekly basis? The spin cycle of “data,” “facts,” “truth” has hastened and enhanced the complete loss of trust that many once had in medical and political authorities. The lightning-fast information exchange via social media has not helped. While I have found it sometimes tempting to be irritated with patients or acquaintances who have come to conclusions about the pandemic that seem extremely far-fetched, even crazy (i.e., “If you get the vaccine, I can’t be around you because you will emit nanoparticles that will infect me and erase the gene that allows me to love Jesus.” No, seriously, someone really said this), I can’t say that the non-medical public is to blame for our lop-sided, divided response to this sometimes asymptomatic, sometimes very deadly virus. Every crisis is an opportunity for leaders to rise up and help everyone else find the way forward. True leaders know how to bring a team together. They lead by example. They exhibit courage and resolve. Pride is a leading killer, and it shows itself in many ways. Fear, reactionary emotionality, inability to trust those around them, and doing everything necessary to keep face, even if it means being dishonest. The defensiveness, name-calling, lambasting, and criticism that has occurred among our political leaders and the medical community has hamstrung us. It is as though everyone has expected iPhone speed answers to a problem that has continued to shine the light on the limitations of our human understanding. I think most of us believed that we should have answers and come to know all there is to know about COVID quickly. This is the 21st century, right? Unfortunately, this bug keeps proving: we still do not know much. How do we admit to the people looking to us for answers that “we don’t know”? When was the last time you admitted to a patient that you made a mistake? I believe I am a good doctor, and in general, I feel that my patients share this sentiment. However, I am not perfect. I have made my fair share of mistakes before and since finishing my training. I imagine most of us had at least one attending in our training tell us: “You will kill someone. It’s not a matter of ‘if’ but ‘when.'” The fear of accidentally harming a patient should keep us sober-minded and conscientious. I am afraid that some of us have been gradually swayed by the bean counters that the more important thing is to avoid getting you or your institution in trouble for making a mistake. One time, I had gotten through an in-depth conversation with a patient about their concerning lab results. And after ordering more labs and prescriptions, I realized I was looking at the wrong chart. So what do I do now? Play it off, reorder labs and congratulate them when the repeat labs are all normal and say the initial labs were erroneous? Tempting — but no. I got my ego ready to be slapped and said, “I’m so sorry, I made a huge mistake. These actually aren’t your labs. I was looking at the wrong chart.” Not too surprisingly, the patient was very forgiving and mostly just relieved that they didn’t have anything seriously wrong with them. “What happens if they find out I actually don’t know as much as they think I do?” Have you ever wondered that since getting into medicine? After finishing residency, it was a daily thought of mine. It took a year before it was no longer a daily occurrence. It still happens to me plenty, though, now almost six years into practice. And yet, through this pandemic, I have caught myself many times ridiculing under my breath “the misinformed,” the ones who seem to bend science to serve an agenda, the non-medical political leaders, the gynecologist posing as a virologist, etc. I have seen extremely intelligent, well-meaning men and women descend to the exchange of verbal blows and emotional reactions. I have seen the best and brightest of our discipline, blind with bias and pride, unable to consider another viewpoint. We tout our extensive high-powered studies only to be told months or years later, “Oh, that was a crappy study because of … etc.” This hasn’t been happening just over the last two years. It is, dare I say, a medical tradition. Do we approach the data honestly? How do we lay down our biases? The advancement of medicine has many times come through friction and disagreement. Can we maintain this rigor without demonizing each other in the face of the current pandemic? We are always going to be asked to do more than we can in medicine. Medicine will take all the time you give it — and then some. Burnout waits around the corner for us all. How do we deal with division and discord? The “too much information to stay on top of”? The people who have come to radically different conclusions than we have? Do we bury our heads in the sand? Do we align ourselves with whatever tribal group agrees with most of our sentiments on the matter? Do we make it our mission to quash all “disinformation”? Whatever it is you decide to do, I would offer this suggestion: First, take a step back and remember that while we know so much about human science and the world in which we live, there is likely more in the category of: “We don’t know.” Can we remember how to be wrong and how to do it graciously, not grasping so tightly to “being right” that we leave a trail of mayhem and relational discord? I write this on the first day of 2022. The year of The Great Resignation has come to a messy close. I don’t pretend to know why all the people that left their jobs did. I have a hunch that the issues I am writing about played a part in some of the departures. The way forward cannot be “being right at all costs.” We must choose honesty, humility and doing what we can to end division and support one another. “We are all on the same team.” The words of my residency mentor continue to ring true. Source
