I really admire all those on the front lines of this surge (ED, ICU, etc etc). I'm on the primary care middle-lines and I've aged a decade in the past six months.
This pandemic *has* made me think a lot about a joke people tell, ruefully, in medicine, especially primary care, after doing something trivial (filling a Rx for a statin, or taping someone's toe): "another life saved."

Primary care saves lives, ideally, in a lot of ways....
although not directly, immediately, like in the acute care specialties I mentioned above. But we refer, diagnose, treat, image, test, & sometimes pull people away from the jaws of death.

I like to think that being there for them is a life-saver too, sometimes. It's hard to know.
I've made a few condolence telephone calls in the past week, I always thank the family for the privilege of taking care of their loved one. That's a kind of bringing to life too, one of memory.

Just keeping on. Just keeping the lights burning.

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More from @DrZackaryBerger

13 Jan
Excited to be watching this #WeSupport #CovidSafeWork Teach-In by @MarkedByCovid.
@MarkedByCovid Great point by @gregggonsalves: it's not about a microbe, it's about the environments we live and work in, and it's about which people are considered disposable. It's also how we want to end the pandemic, who we want to include/exclude in the response.
Recounting his history in the HIV epidemic, @gregggonsalves says we have to be careful whom we write off. Those with multiple medical conditions, front-line workers, teachers, those in warehouses, high-proximity nonWFH jobs -- for so many, vaccines are not enough.
Read 39 tweets
13 Oct 21
Emily Oster is still making categorical judgments about how we should approach age differences in Covid risk -- even as we lack information about case transmission from schools to communities.
And all the Osterites saying "Covid risk is the same order of magnitude as other respiratory viruses, but we're treating it SO DIFFERENTLY" are the same people who go gaga over contextless p-values. Stats means nothing without a brain and a heart. Use them.
Not only *should* we care about child mortality out of proportion to the number, but we *do* evince such disproportionate care when kids die of other things, too. And we change society around to address it.
Read 4 tweets
12 Oct 21
Food manufacturing workers are striking.

Media workers are negotiating better contracts.

And health care workers?

Told to live off resilience.
Part of the reason has to be doctors.

For too long now we've thought the world of ourselves. We're a guild!! We're autonomous!! We're independent!!

Except we haven't been that for a while. (Nor should we be.) We're health care workers getting a bit less shaft.
Can MDs stop being lackeys of medical centers and start working in solidarity with colleagues from other disciplines?
Read 6 tweets
14 Oct 20
"I encourage everyone to continue to live the healthiest life they can. A balanced diet, fresh air, and vitamins really are vital to keep our bodies healthy" -- so about this/1
encouraging a "healthy lifestyle" is really a moral directive unless ppl in power address the things that make healthy living possible. a "balanced diet"-- for those without $ to shop?; "fresh air" except when people put incinerators in ppl's back yards?; "vitamins" -- are BS/2
this is a capsule of what it means to conceptualize health as wholly dependent on the self. her son is a "strong teenager" so did well; she "lives healthy" & took vitamins, so got better. no mention of the fact that they direct gobs of resources and have doctors down the hall/3
Read 4 tweets
24 Aug 20
I have nothing against #PlasmaTherapy for Covid. I've looked at the data. It might be helpful. We need a trial.

Now, imagine if the attention paid to this *one potentially marginally helpful therapy*....

...was devoted, as well (not even "instead") to those sick with Covid. /1
What I mean is this. I'm a believer in biomedical interventions. Heck, I'm a board certified internist. Biomedicine is part of what I do.

But only a part.

So much of the help I try to give patients is not available./2
Not because "it's not my expertise" or any such Pinkerian BS. It's because our priorities are off.

Can we pay workers to stay home?

Can we cancel rent?

Can we give food to the hungry?

Can we make Covid care free?

Darn right we can. /3
Read 5 tweets
2 Jun 20
Someone asked how I could go to a protest today. Wouldn't Rona be there? Thread:

In general -- in my practice as a physician and in my educational/research/books -- I have tried to be as comprehensive in my understanding the possible reasons that lead people to weigh risks. /1
Because the tricky part about epidemiology and public health is this. Risks are population-based. Decisions are individual. In time of Covid, I have tried not to wax snarky about people seeking haircuts. People have reasons, they always do, even if they are not your type./2
From a public health perspective, would there have been more careful ways, a priori, to organize a demonstration like that? Perhaps (I have seen pictures from Israel of a demonstration with people separated by 6 feet). /3
Read 5 tweets

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