Emergency medicine locum tenens physician Ripal H. Patel, MD, MPH, shares his experiences treating COVID-19 cases among the unvaccinated and makes an appeal for the future.
Sympathy vs. empathy?
I sat there shifting uncomfortably during my first medical school interview. The physician interviewing me was also named Patel. He had black, oversized frames that were disproportionate to the size of his head. They kept sliding down his nose. He looked menacingly at me as he waited for a response. I spaced off.
“So, what do you think the difference is between the two and how will that relate to how you take care of patients?” he asked.
I sat there silent, yearning to scratch my back from the uncomfortable suit that kept tormenting me. Years of studying, drowning myself with coffee, sleepless nights, and exam after exam, all of which lead to this as my barrier to medical school.
I don’t fault that younger version of me not being able to answer it. It is an incredibly tough question and unreasonable to expect an answer from a college graduate about to embark on the road to medicine. It’s deep, multifaceted, and it would take me many years to truly come to a cogent answer.
An unnecessary tragedy
Then the pandemic of the unvaccinated hit. And that lingering question came back.
The patient I stood over had been wheeled in from his truck. His oxygen levels were 39%. Generally, that is incompatible with remaining alive. But COVID pushed us to new extremes in understanding what the diseased body is capable of withstanding. He looked emaciated, pale, exhausted, and drenched in sweat. He had a thick beard that was dominated by more greys than browns, tired eyes, and several chains around his neck. As he was taken back to the resuscitation room, he was talking to me, telling me how his family had been in this town since the 1850s, that he had tended to this land with love. He kept going, and his oxygen kept dropping.
He was of course positive for COVID. He had listened to false news outlets and tried to treat himself with Ivermectin he purchased from an animal store and other unproven therapies. He was not vaccinated and opposed it.
As we connected him to machines that pumped 60 liters of oxygen into his lungs and placed a mask over him — also aimed at filling his lungs with oxygen — his levels came up to 88%. We had maxed out our reserves before having to pull the trigger and place him on a ventilator. I talked to him for a bit. He said he felt great. He kept quietly thanking the staff, and I stood looking over him with tears welling into my eyes. He was tiring out and would soon crash. He was eventually paralyzed and placed on a breathing machine.
The struggle to relate
I looked over at him and felt deep sympathy — but not empathy. To me, empathy embodies being able to truly understand, relate, and connect with what he was enduring. To sympathize is simply to feel sorry for. And I felt truly sorry for him, for succumbing to a nefarious virus that could have all been prevented with a simple and readily-available vaccine. A free shot just down the street. And further, to have filled his mind with false science, false news, and false medical advice, that could potentially take his life. After seeing so many die from this pandemic pre-vaccine, now to see someone young die like this so unnecessarily is unbearable and difficult to connect with.
This is how I feel many physicians survived emotionally during the worst of the Delta surge. The vaccines were there, the science was sound, but there remained a portion of the population that refused to budge. And I can say, four months into the Delta surge, EVERY single patient I admitted to the hospital — and everyone that died — was unvaccinated.
I stopped trying to educate many of them, simply because they refused to listen. They only wanted information that reaffirmed their own false beliefs and scorned anything that countered it. How did vaccines and science become politicized, and how many lives has it cost?
A life-saving vaccine
To counter this, many weeks later, a home health assistant sent me a 90-year old male. The only reason they had sent him to the ER was because his oxygen levels read low. He had so many medical problems listed that my finger became tired scrolling down his chart.
When I examined him at bedside, he smiled, had no symptoms, and wished to go home. His levels were 94%. He had been vaccinated fully but had tested positive again. A COVID reinfection. And despite this, his blood work, x-rays, and vital signs were all completely normal. I reexamined him again and asked if he felt comfortable going back home since his work-up here was negative despite being positive for COVID. He nodded his head and begged it. Simply put, the vaccine saved his life. This same patient during the rise of the pandemic pre-vaccine would most certainly have suffered and expired.
Compassion fatigue
COVID post-vaccine has hardened medical professionals; something psychologists refer to as “compassion fatigue.” I saw it in my nurses, my technicians, and often, myself. So many people sick, dying, and clogging up the hospitals because they refused to accept the science or the science of masks and social distancing.
Meanwhile, as hospitals became full, admitted patients backed-up and waited in the ER for their bed. Then patients that needed to be seen in the ER couldn’t because no beds were available. The waiting room explodes, and a catastrophe is inevitable.
We became sympathetic to those that got sick, but our empathy often was lacking. The pandemic of COVID transformed to the pandemic of the unvaccinated, and our empathy turned more to all the other pathologies — heart attacks, strokes, traumas, missed pediatric appointments — that had care jeopardized because no beds or staff were available. The healthcare system was reaching its breaking point from hundreds to thousands that refused a simple shot. And there we were, back to the start of the pandemic again.
Faith and trust
As I tell my patients, especially the ones that were anti-vaccine but open to hearing my side, we must have faith. We have faith our GPS will guide us to a location, faith our pilots will get us from point A to point B safely, faith a 911 ambulance will come for your emergency. We trust these people and their services, so why not trust your physician? I don’t ask my plumber about questions regarding the AC in my home, so why would I accept information from non-physicians about a vaccine?
The vaccines have saved lives and are the best tool we have to getting back to normalcy. Science has proven it, and I have witnessed it on the front lines. I pray more people will accept that faith and trust their providers and the information they provide, so that one day we can truly contain this pandemic and achieve some level of normalcy in our lives.
