BLOG: My patients, my heroes — ‘Doc, I believe in science’
“Have you received the COVID-19 vaccine, Vernon?”
“Of course, ” he answered, with pride and confidence. “Doc, you should know me by now; I believe in science and I trust my doctors.”
The above dialogue is a ritual I make sure to have with all my patients during their clinic visits. I am an endocrinologist, treating patients with diabetes and thyroid disorders, in addition to other hormonal and endocrine disorders. Clearly, I am not an infectious disease specialist. Still, during the last three surges of the COVID-19 pandemic in our area, I have seen hospitalized patients with COVID-19, when the treating physicians would consult me for associated endocrine diseases.
I feel obliged and responsible to ask about COVID-19 vaccination status for all my patients. Most of my patients report they have received the vaccine.
Few patients, though, reported they have not. Of those, few cite medical concerns, such as fear of a severe allergic reactions or other legitimate health concerns. Most of my patients who have not received — and will not get — the vaccine either do not wish to explain why, or they cite the usual stories we hear about from social media.
I do my best to have a respectful discussion with the nonvaccinated patients. For the most part, they insist on their positions, and I let it go. I never get angry with patients who raise negative opinions about the pandemic or the vaccine, stemming from what appears to be misinformation. I also avoid indulging any political discussions in my work: I always keep politics out of the patients’ exam rooms.
But inside, after these patients leave, I feel sad, frustrated and angry.
Recently, one such encounter left me depressed for days. The patient was someone I always looked forward to seeing for her annual visit. She is full of life, humor, compassion and humility. She has always been cheerful; we always joke back and forth during her visits. The staff would hear our loud laughs from the nursing station.
On this last encounter, her visit went exactly as always, until I asked her the ritual question.
“Did you take the vaccine?” I asked.
For the first time, her face became a bit flushed, and she became more serious.
She looked at me with a plea that signaled she wanted to stop the discussion.
“Please, Dr. A., don’t pressure me,” she said.
I stopped immediately and was temporarily speechless.
I felt a bit guilty, and obviously I noticed she felt sad, and perhaps likewise guilty, thinking I was disappointed or angered by her position on the vaccine. She has previously said she considers me her favorite doctor, and she drives over an hour to her clinic appointments.
On a brighter note, I recently had the best COVID-19-related clinic encounter so far. Vernon, aged 70 years, has been a patient of mine for a long time. He is a seasoned farmer.
Vernon told me about some dairy cows he purchased a few years ago. The sellers told him they would vaccinate the cattle for bovine respiratory disease, or BRD, also known as shipping fever. The seller, however, did not vaccinate the cows; of the 35 cows Vernon brought home, seven died.
After Vernon’s clinic appointment, I searched this topic. Bovine respiratory disease is the most common problem encountered in calves. So-called “shipping fever” causes severe pneumonia and respiratory failure, and it results in significant loss of livestock for farmers.
The most common causes of BRD are the bovine viral diarrhea, infectious bovine rhinotracheitis, bovine respiratory syncytial virus and parainfluenza virus type 3. Exposure to these viruses can cause severe damage to the respiratory tract of calves, creating opportunities for bacteria to then settle in the lungs. Fortunately, many of these viral infections can be prevented through vaccination programs.
Vernon purchased those 35 young cows, to add them to his 70 cows, on his 4-acre farm outside of town. His older cows were all vaccinated against BRD, and he assumed the new cows were also vaccinated, as the seller promised. Four weeks later, the new cows began to die one after the other.
Vernon called his veterinarian, who came to the farm and tested the new cows and found they were not vaccinated. So, Vernon gave the vaccine to all the remaining cows; they all survived. He thus eradicated the BRD mini-pandemic on his farm.
Sound familiar?
Vernon and I both believe that just like Vernon ended the BRD mini-pandemic on his farm by vaccinating all the cows, we too can eradicate the COVID-19 pandemic by vaccinating all the humans.
Still, many people here in the U.S. and worldwide refuse to be vaccinated. I wish all humans around the world were like my patient Vernon, who believes in science and trusts his doctors.
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