This week we said goodbye to John Prine. The last few days, his voice has replaced the podcasts that typically form my soundscape for gardening and housecleaning. What a loss. We lost him to a combination of tobacco addiction and COVID19 (in my opinion). Two preventable illnesses. The idea of having no more of his particular poetry because we didn't act courageously enough to these two public health scourges seems karmically fitting and yet tragically unmooring.
This week also revealed mass graves to bury the unclaimed dead in New York City. I read this article through tears with John's music in my ears. What a gut punch. Every casket just one bead on a rosary of horror. Each one tells a story of a person dying without the comfort of a known loved one, of a family who lost a person they valued and counted on, of hospital workers witnessing a torrent of sickness, struggle, and death, of a nurse holding a hand while she also held her bladder and realized it would be another shift before she ate, because putting her needs ahead of the dying just wouldn't be any comfort to her right now. A pharmacist who turned over all the rocks searching for another supply of narcotics to make being on a ventilator survivable and worried about what torture would result when the supply ran out. A doctor racing from one emergency to another, reading lab tests and interpreting thousands of pieces of information with a sleep deprived brain, wondering if the mistakes they were certainly making would be caught in time to prevent a bad outcome and if it really mattered. A ward clerk watching the ward fill and overfill and staff falling apart and chaos reigning in what could on a normal day be almost kept orderly. I can't help but think that this was all unnecessary, that we could have prevented so much of this. We have known for a hundred years that this could happen. If it happened once, it could happen again. Not just once has this happened: Sure there was the influenza pandemic of 1918/1919. But there have been others. As a medical student in the 1980's, I had a front row seat to the last major epidemic/pandemic of HIV. A much more slowly unfolding health and vitality-robbing disaster we also botched. Nearly every year or two there is another thing that makes public health leaders ask, "Is this the year?" Anyone in medicine or nursing who hasn't been watching for the next unfolding, at least with peripheral vision just hasn't been paying attention. There was SARS and MERS. And various strains of influenza. So many people preparing, making plans, stocking up with things we would need, speaking out. This SARS Co-2/COVID 19 did not just come out of nowhere. Public health folks have been watching this particular virus and shouting warmings since December, with increasing alarm and volume. We could have been ready. We could have mitigated the harm. It is so sad to me that we are actually paying a larger economic and social cost than we would have paid by doing things earlier. Is it possible that we have the wrong kind of brains and social/governmental structures to respond effectively to challenges like this? Will we learn enough from this to do a better job of responding to Climate Change? The similarities of the situation, its seriousness and our resistance to changing our lives are pretty stunning to me.
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AuthorElizabeth Alleman, MD is a family physician, acupuncturist practicing and pondering in central Missouri Archives
February 2023
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