The Beast is Still With Us

Just this week, Governor Lee announced that the Safer At Home order will expire on April 30^th, allowing the reopening of businesses across the state. This will be a “phased reopening,” details of which are steadily emerging.


I don’t expect schools to reopen and the spring sports seasons have already been abandoned. There is lots of speculation about fall sports. I think we just need to wait and see. But things will be changed. Lots of folks will be reluctant to get in the middle of a crowd of people for a long time.


This doesn’t mean that we’ve beat this thing. We haven’t. The things we’ve done (hand washing, social distancing, businesses closing) have just slowed it down. Slowed it down so that hospitals could prepare. Slowed it down so that hospitals wouldn’t be overwhelmed by the huge surge in Coronavirus cases that has happened all around the globe.


As the world has dealt with this pandemic, we have learned a few things. We have learned that it has hit hardest in densely populated areas. We have learned that it is most dangerous for those that are physically or medically vulnerable.


I must say that I’m SO proud of our local hospital for the rapid preparations that they made to get ready. And I’m equally proud of our community that stepped up to help the hospital prepare and to help their neighbors. Stories of food sharing and drive by birthday parties abound.


The Governor weighed the need for getting people back on the job with the impact on our healthcare delivery system and potential risk for those affected by the Coronavirus. It’s not an easy decision and there are passionate folks on both sides of the discussion. I’m not here to take sides or to convince you that either side is right or wrong. People are hurting. Now is not the time to judge.


But here’s the thing—you can expect an increase in the cases, and yes, the deaths, from Coronavirus as rules are relaxed. That’s anticipated. That’s why it is SO important that we continue to follow all the guidelines that we’ve been under for the past few weeks.


We need to continue to wash our hands and keep our hands out of our mouths. We need to continue to practice social distancing. I expect those “non-essential” businesses to follow the same rules that the essential businesses have been following: Limiting the number of people admitted to a business, marking the floor at check-out lanes to ensure proper distancing, and providing screens between checkers and customers.


It’s easy to get complacent, as the number of new cases dwindles. Instead of assuming the worst is past, we should understand that this beast is still out there. I see far too many people not doing what they are supposed to. That’s a mistake. This thing is a monster. Talk to anyone in New York City.


I see young people that feel they are invulnerable and who ignore all the precautions.  Yes, it’s true that young healthy people will not likely die from this. But they can carry it to the old, the young, the weak. This thing is as sinister as anything we have faced in healthcare.


Those at risk should still stay at home. Those most vulnerable are our oldest, our youngest, those that are immunosuppressed, those with asthma, COPD, or other lung problems. Those with diabetes. Those with any medical conditions that compromise their ability to fight off disease.  STAY HOME!


The rest of us--respect others by wearing a mask in public places. Avoid crowds. It’s not yet time to return to stadiums or church pews. The best advice I’ve had is to pretend that you have it and do the things necessary to avoid passing it on to someone else. And pretend that everyone you encounter has it and do what you need to do to protect yourself. You never know.

TeleHealth Today

I struggled this week to find anything to write about that was NOT about the Coronavirus. That’s all anyone is talking about. In healthcare, it dominates every waking thought.


Something that you’re probably hearing more and more about is Telehealth. It has been around before we had ever heard about Covid-19, but this pandemic has certainly brought it to the public consciousness.


What is Telehealth? Most simply put, it is the delivery of healthcare when the provider and the patient are in different locations, usually using a computer or a cell phone to communicate.


Before Covid-19, it was most often discussed in really remote locations. Colleagues in Montana, where lots of people live many miles from the nearest neighbor and even further from health care providers, have been doing Telehealth for years.


It has been addressed in the Tennessee legislature in the past and would likely have come up this year if the legislature hadn’t been sent home early. Fortunately, Governor Lee has relaxed restrictions on Telehealth and opened doors that needed to be opened.


The Coronavirus pandemic has brought Telehealth up to an all new level. It has become an essential part of healthcare delivery. It is allowing those most vulnerable among us to get the care that they need without having to leave the safety of their homes.   


There’s a good chance that your Primary Care Physician (PCP) is utilizing Telehealth. I know the orthopedists are. In some ways, it is the only way to deliver much needed medical care. In physical therapy, we are using it to follow up with patients who can no longer come to our offices and to work with new patients without ever being in the same physical location as them.


Please understand that this is still healthcare and there is a charge for the service. For many practitioners, it is their only source of income. The state and federal governments have changed the rules about Telehealth reimbursement and there’s a good chance that your insurance will pay for Telehealth services.


On a different note, I saw something this week that resonated with me. This writer was asking people to be less judgmental. It hit home when someone I know was being critical of a man getting mulch at the local garden store. She thought it was unnecessary and irresponsible.


But this writer had a different opinion. He said that guy getting mulch might be an alcoholic who is stuck at home and has to keep busy with yardwork to avoid a relapse. Or the lady buying flowers who suffers from depression and working in her flower garden is what keeps her safe and sane.


You see, we can’t judge others in all this. I really struggled with stopping bike riding with a group. It is one of the things that keep me sane during a time when the Coronavirus has taken away a lot of the other things that keep me sane. But my concern for others means I now ride alone. I have friends that are still doing the group rides and that’s OK. I refuse to judge them.


I caught myself yesterday judging a grandfather and his grandson. They were in a store where the employees had taken very few precautions—no masks, no social distancing. And yet they were there, walking together, without masks. I had to stop and remind myself not to judge them. Was the grandfather not concerned about exposing his grandson to Coronavirus? That was hard.


It all boils down to the fact that we just need to love each other. Respect each other. Walk in somebody’s shoes before you criticize. But please, please, please do your part to stop this thing.

It's Not About You

I’ve never been much of a worrier. Oh my mom was. If she didn’t have anything to worry about, she would worry that she didn’t have anything to worry about. I’m not that way. Almost to a fault.


I’m not afraid of much either. I’m not afraid of the dark. Not afraid of noises in the night. Not afraid to go into a strange neighborhood. I’m not really afraid of the Coronavirus either. Let me explain.


I’m in several at-risk categories. I’m 66. I’m a healthcare worker. I’m still working, out in the public every day, seeing patients and doing my job. The chances of me being a carrier are above average. Certainly above those that are quarantined, without contact with the rest of the world.


I do respect the Coronavirus—I just don’t fear it. Not for me personally. I may be a senior citizen but I’m in quite good shape, for a man my age. I’m getting more sleep than I have since I was a teenager. My blood pressure is under control. I’m eating well.


I’m not naïve and I’m not stupid, but I’m confident that my physical condition and health practices will help me if I did get Coronavirus and I’m confident that I will get the care that I need were I to be hospitalized. In the meantime, I have a job to do.


I’m doing my part to protect myself. I usually wash my hands often, before and after every patient. Now I’m adding in a squirt of hand sanitizer every time I pass a dispenser. Washing my hands whenever possible. I wear a mask when in the clinic and when I’m in a public place.


I practice social distancing. My desk has been moved so that I’m a good distance from anyone else. I’m giving more than the six feet of recommended space. I avoid other people except when absolutely necessary. It’s not impossible for me to get Coronavirus, but I am doing everything that I can to protect myself. I feel pretty good about my chances.


But that’s not what worries me (yes, I do worry a bit, sometimes). What worries me is that I will be a carrier without even knowing it and will give it to someone else. A patient. A coworker. A family member.


Because of that, I am completely isolated from my family. With a newborn in one household and two physician parents in the other, all risk needs to be minimized. And since I’m a possible carrier, despite all I’m doing, I stay away from all of them.


I’ve quit riding a bicycle in a group not for fear of being contaminated by someone else but for fear of being the reason someone else gets it. Let’s face it—being in healthcare means I am at risk, regardless of what I do. I accept that and go on. But I cannot allow myself to be the reason someone else gets it. I have a social and professional responsibility to protect others.


Now I’m going off on a rant…. Every day, I see people being very cavalier about this. People standing around talking without masks or social distancing. People sitting at a picnic table having lunch like there isn’t a raging pandemic out there. People wearing gloves and using that as an excuse not to wash their hands (folks, all you’re doing is carrying this stuff from one surface to the other and protecting no one).


If that’s you, if you aren’t washing your hands, keeping your hands out of your mouth, and practicing strict social distancing, WAKE UP! You may not be concerned about your own personal safety but what about others? Your grandmother, your infant niece, your immunosuppressed cousin that had cancer not that long ago, your friend with diabetes?


YOU have a responsibility to THEM. If you don’t think it will get you, that’s fine. I guess that’s your business. But don’t be the reason someone else gets it. We simply must put a stop to the spread of this disease. Before someone you know or love gets it.

The New Normal

The “New Normal.” If I’ve heard it once, I’ve heard it a hundred times. Yes, we’re living in a different world right now. Our world will be forever changed because of this pandemic.

It will take the economy a long, long time to recover. There will be way too many bankruptcies. The hardest hit segment may be restaurants. It’s tragic but we will all survive.


So how do we work this New Normal to our advantage? How do we emerge better than before? How do we even begin to think in those terms when there really doesn’t appear to be a light at the end of the tunnel?


We learn how to deal with each other better. A lot of families are isolated at home. Some are quarantined.


By its very nature, this will force families to grow together and get to know each other better. Or just the opposite. Our daily structure and routines are completely turned upside down. Those of us (me included) that depend on that structure will struggle but will surely adapt. Or drown.


Like you, my whole lifestyle has been changed. My routine is work, ride a bike, sleep. Do it again. Avoid people. Shop for essentials only. Carryout is part of the New Normal. I’m inside my own brain more than anytime in my life. It’s scary in there sometimes.


We learn creative and productive ways to use our time. Ways that do not depend on being entertained. We have to learn to entertain ourselves. Restaurants and movies are closed. Amusement parks are shuttered. A lot of folks are reluctant to go to the grocery store so cooking at home has become rather creative.

We have had to learn to cook what is in our cupboard or freezer. Even if we venture out to the grocery, there’s no guarantee that what we want will be in stock.


We get closer. Not physically, at least not right now. Social distancing has ended the warm hug or firm handshake. But shared difficulties bring people together.


It has been amazing to see the outpouring of love that this community has demonstrated in the past couple of weeks. Churches feeding people. Others making masks and gowns for use by our hospital. Offers of running errands for others abound.


I saw where a local insurance agency sent a stack of pizzas to the BMH Emergency Department this week. Surely those folks, at the forefront of the crisis and heroes in every sense of the word, deserve it.


We learn to appreciate what we have. I now know what’s at the bottom of my freezer. I get virtually no time with my grandkids so cherish those FaceTIme moments and messages that they send me. I appreciate my health maybe more than ever.

We understand that we should always wash our hands and keep our hands away from our mouths. We understand that we have to do everything we can to keep from passing on this virus to others.

We discover that exercise, eating better, and getting enough sleep actually does make us healthier and help us feel better.


We learn what is really important to us. Family. Friends. Time together. Those hugs and handshakes. Real conversations. Our health. Freedom. Smiles. The little things.


We appreciate that problems on the other side of the world do have an impact on us. We truly are global now. It’s a cloudy, stormy day, but by looking for the silver lining, we have hope and faith that good days and better times will soon arrive.