© 2022 Pulse - Voices from the Heart of Medicine, Inc. All rights reserved.
“He pulled his Dobhoff again.”
The pager’s words echo on my retina as I indulge in a prolonged, beleaguered sigh. These are the five-minutes-til-sign-out pages that are going to push me to start Amlodipine (a blood pressure medicine) before I’m thirty.
He’s ninety-six years old. He doesn’t remember his name, where he is or what year it is. He has no proxy or next of kin. He’s not talking.
We start with only two pre-booked patients, a mom and her six-month-old baby, but by forty-five minutes into the morning, the schedule is full. I take my own COVID test (negative) and joke with the medical assistants about how they resemble pregnancy tests. Already wearing scrubs and N95 mask, I suit up with face shield, disposable gown, stethoscope and gloves. I breathe.
“Seven little soldier boys chopping up sticks; one chopped himself in halves and then there were six.
“Six little soldier boys playing with a hive; a bumblebee stung one and then there were five.
“Five little soldier boys going in for law; one got in chancery and then there were four.
“Four little soldier boys going out to sea; a red herring swallowed one and then there were three.”
I retired at age 89 from a primary-care internal medicine practice of nearly six decades. Medicine as service has permeated my bones, my mind, my spirit. How can I still contribute, without a medical license, without a prescription pad? Especially in the age of omicron, with uncertainty abounding everywhere?
Perhaps examining the reality of uncertainty, and how my fellow clinicians and I learned to adapt to it, will be of some value.
Although I wasn’t the last kid picked for teams in gym class, captains never clamored for me, either. That was sensible, given my nominal athletic skills. In softball or kickball, my defensive strategy consisted of trying to psychically deflect incoming balls from my sector of the outfield, desperate to avoid letting down my team with an embarrassing miss or fumble.
The news is full of reports about the havoc omicron is wreaking on our health-care system. But last week I was on vacation, and as I sipped my daily latte and strolled on the beach, COVID-19 seemed like a distant memory. As soon as I checked my work email after getting back, however, my vacation bliss shattered—boom!
My country—Brazil—leads the world in the worst COVID consequences. That fact is so outrageous I feel uncomfortable using the verb “lead,” as it’s usually associated with positivity. But Brazil holds global records in infection and death from SARS-CoV-2, including maternal deaths and child and adolescent deaths. “COVID killed a child aged 5 to 11 every two days in Brazil” stated a recent news article based on epidemiological data. A parliamentary investigation found evidence that hundreds of thousands of deaths could have been avoided if not for decisions by politicians.