The problem with going around pointing out the harmful things people are doing to themselves is not just that you end up being such a buzzkill and so unpopular, but that people will invariably get upset and blame you for everything that went wrong thereafter.
No one wants to hear how much damage alcohol does to the human body at a wine-tasting party.
Who wants to hear about the carcinogens in burnt meat at a barbecue?
And at this stage in the US, no one wants to hear more warning about the rapid spread of the Delta variant when all we want to do is get back to our normal.
So I've learned to keep my mouth shut when I attend social events unless I'm asked about something in particular. But sometimes, when I care enough about the people involved, I would speak out and offer unsolicited advice, especially when I can see that my advice would make an appreciable difference in people's life or death.
A long time ago, patient Mary S. told me she just got a job as a dog walker that would give her some extra income. Instead of congratulating her on her new income stream, I became alarmed and warned her against it. Mary was a very thin 72-year-old Caucasian woman who I was treating for, among other conditions, osteoporosis. I could just see her being pulled in multiple directions, being entangled in a leash, falling down, and breaking something. Which was not the worst-case scenario but a very likely outcome.
2 days later, Mary was admitted to the hospital with a broken hip and a broken wrist. When I came to the hospital to see her, her first comment to me was "You jinxed me! This would not have happened if you hadn't cursed me." I smiled at her, in my most annoying I-told-you-so face. "I did not jinx you, Mary. I just have 20 years of experience working with little old ladies like you and could see this train wreck coming from a mile away. I see that you didn't listen to my advice. " Mary underwent ORIF (open reduction, internal fixation) surgery for both her wrist and hip and spent the next 6 weeks in the rehabilitation center. She lived alone and could hardly be able to take care of herself with 1 arm and 1 leg. So I learned then to speak out whenever I can or should.
When the Covid-19 pandemic first started, and then-President Trump had reassured the nation that the caseload would go down to zero and the whole thing will disappear, so many patients would come in repeating that drivel. Over and over, I had to explain how coronavirus works, how rapidly it mutates, how easily it spreads from person to person, how we can spread the disease for days to everyone around us before we develop symptoms if we ever do. There was just no way this pandemic was going to end before we develop a vaccine, which was estimated to be 12-18 months at that time. We all need to be patient, I had warned, this is not a quick battle type of epidemic like the plague or cholera, but a prolonged war like measles and chickenpox, just more deadly. I don't see the virus going away until either all 7 billion people on earth have been vaccinated or have had the disease.
For all of us in the medical profession, it was so much more exhausting battling the constant campaigns of misinformation and lies than it was battling the disease itself. First, it was the it-will-go-away-like-a-miracle talk, then it was the hydroxyquinone-cures-it-like-a-miracle talk, then it was the it's-no-worse-than-a-cold talk, then it was the alcohol-and-bleach-will-cure-it talk, then it was the I-don't-need-a-mask-cause-Covid's-not-real talk, then it was the I-don't-need-a vaccine-cause-I-have-an-immune-system talk, then the I-don't-need-a-vaccine-cause-there's-a-new-pill talk, then it's the I-don't-want-the-vaccine-because-it-may-make-me-sick talk, and then the I-don't-want-the-vaccine-cause-I-don't-trust-the-government talk.
At this point, I have given up on trying to talk anyone into getting the vaccine. I can only do my best to protect my most vulnerable patients against unvaccinated spreaders.
Seriously, I explained to these patients, you have the right to decide the manner of your illness and death, whether it be via covid infection or the vaccine or any other treatment. So long as you are aware that ALMOST ALL CURRENT COVID DEATHS IN THE US ARE FROM UNVACCINATED PATIENTS. And so long as you have the correct information given to you by a medical professional and not some rumor spread by the lady at the hair salon or the man at the bank. Clearly, what goes into your body is your business. However, what you breathe out of your body becomes the business of the person next to you. And since I have many elderly and diabetic patients in my practice, please do not come into my office or visit anyone at the nursing homes, and please do not go out in public without wearing a mask.
For my most vulnerable patients like the very elderly, I would explain that as vaccinated people, they should be well protected from Covid infections and death. However, the 95-98% efficacy of the best vaccines means that there is a 2-5% failure rate where we can still see a small percentage of patients getting hospitalized or even dying from it. But if the person you encounter or live with is also vaccinated (and carries only a 5% chance of getting infected), then that reduces the chance of you getting infected to 0.05 x 0.05 = 0.0025 or 0.25%, for the older variants anyway. So far, most of the vaccines except J & J, seem to have similar or a little less efficacy against the new Delta variants.
My hospital has a cool sign when you walk in the door. It says " Courage is not the absence of fear, but the judgment that something else is more important than your fear. " I do hope all the nurses and staff at the hospital take that to heart and got vaccinated. I would hate to send my elderly patients in to be taken care of by someone who may be breathing the new Delta variant virus onto them.
