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Uncertainty

schmidt

If nothing else, this Covid experience has taught us a lot about how we all deal with uncertainty. I hope you have learned your own limits with the beast.

Medical training teaches us practitioners to pursue certainty. The fact of a diagnosis used to mean the certainty of prognosis was narrowed. We, the white-coated authorities gave the grim prediction to the patient of days, months, or years of life remaining. We could recommend treatments but hedge them with learned uncertainty that wouldn’t (we hoped) harm our position of authority.

Many things have eroded this authority, this modified Corona virus common cold is just the most recent. Many people suffered with ill-defined pain and fatigue and since we, the medical profession had found some cures here and there, we felt the pressure to continue to cure. Alas, the refrain of learning to “live with” the chronic condition is not a cure most seek.

Make no mistake, many things are very curable. Pneumonia still kills, but we have many drugs that can and do cure. When diagnosing cancer, it used to be we were like poker players, understanding the odds of when and where the disease was discovered, the ameliorating odds of our treatments, and then we, but really, the patient, played the hand dealt. Nowadays we have some incredibly curative treatments for the “Big C”. That game has changed for some.

But when COVID popped up, nobody knew the cards in the deck, or even the rules of the game. We had to discover them as the disease unfolded around us, taking some in the first wave, maybe less in the second, and now even less as it mutates and changes, as we so slowly modify, not our genetics, but our behavior in the face of it.

I took my granddaughter to the hardware store this weekend. She’s only three and unimmunized. Her mom, my daughter, an ICU nurse, has taught her to wear a mask in settings like this. Her mom has cared for many ventilated, critical, even dying patients. I’ve been to that store a dozen times in the past few weeks and didn’t wear a mask. I’m immunized and boosted. I keep my distance but feel pretty safe amongst those people I don’t see too often. But she wore a mask last Saturday, so I did too. I realized I was doing it to support my granddaughter. I didn’t feel like a sheep, though I had to take my glasses off as they kept fogging up.

This virus is evolving faster than we can calculate the odds. In the early wave of infections one out of a thousand infected would die from it. Those odds are now much lower, but the odds of getting the virus have gone up significantly. How do you want to play your hand? Maybe more important, how do you see this game as won or lost?

If you, unmasked and unimmunized surviving and your neighbor with the mask and shots dying means you win, then we might be a doomed species. I just don’t see life as a poker game with the pile of chips giving a sense of satisfaction, even glee. We humans have not easily grasped the concept that we are all in this together.

This uncertainty, this disease spreading silently among us, should be giving us an opportunity to show our character, our natures to our neighbors.

Medical training did not teach me to deny death. In fact, I had to come to accept suffering as a part of the human condition. But I found I needed to work daily to ease the pain, ease the suffering of my patients and myself if I was to have any peace in this world. I wish that for all of you too.
 

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