When the president of the United States contracts a dangerous disease, the story is big news. When the same disease has taken the lives of 200,000 people and the same president has been under fire for grossly mishandling the response, the tale takes on a much bigger, almost biblical significance. Americans have been on tenterhooks since the news broke that Donald Trump tested positive for COVID-19, and emotion and speculation is flying fast. That it is a disruption of the election process, another blow to the economy, and a threat to our national security, is without doubt. Depending on who you are, it is a plot and a conspiracy, or else a cautionary tale and a comeuppance that is a long time coming.
Whether you believe this is karma, divine retribution, or simply the expected and natural consequence of defying scientific principles and recommendations, one cannot deny its irony. As physicians, we process the news on both a professional and personal level. When faced with a medical question, our spidey-sense tingles, and almost automatically, we begin to break it down to patterns of symptoms and reduce it to studies and statistics. We analyze the data to arrive at the correct answer. With conflicting information being released to the public, we must reverse engineer the facts to assess the seriousness of the situation. The little information we have points to an experimental therapy that does not yet have strong data behind it, one that many of us had not even heard of despite closely following the research. Why was such a therapy instituted before more tried and true treatments? Does the treatment indicate that his condition is more serious than he lets on? When was he truly diagnosed? These are questions we may never have good answers to, though we can form some very educated guesses.
For months we have been on this collision course between public health and politics. We have seen thousands of patients who have already been where the president is now. And we have watched those patients suffer, without the benefit of a presidential level of care, patients who were treated in makeshift rooms with rationed medication and supplies. Patients who died alone without a last look at their loved ones. And we know much of that suffering was preventable. We have called on our policy-makers time and again to do what is necessary to gain control of the spreading disease and been ignored. Given the constant vilification physicians have endured during this pandemic, and the disregard for medical advice that has led to its spread, it is not surprising that some of us feel a sense of vindication for the struggles of our patients and colleagues. Maybe now someone will hear us, we think. Maybe now things will change.
But how the nation’s response changes in light of these developments remains to be seen. Could this be the turning point we have been waiting for? Will those who questioned the seriousness of the disease now realize that no one, not even the president is immune? Will they then take it to heart and do their part to finally make things right? One can only hope that personal experience with the disease brings with it some empathy for the suffering of millions of Americans and their families. And yet as the story unfolds, we continue to see signs of the same misplaced priorities and farcical bravado that has marked our course from day one. Time will tell if this will become a tale of redemption or extreme hubris.
As physicians, the situation tests our character and our commitment to our profession, and we ask ourselves if we can separate Donald Trump, the patient, from Donald Trump, the politician. It’s not a new question. We are faced with such dilemmas routinely as we treat alcoholics who continue to drink despite their liver disease, or perpetrators of violence who are injured while committing unspeakable crimes. Is it truly possible to hate the sin but heal the sinner? Ethical questions such as this have been at the heart of medicine since the beginning of time, and within the four walls of the hospital, the answer must be yes. We are honor-bound to value human life, even when the bearer of that life does not.
Beyond the hospital, as citizens of this nation, we can see Donald Trump, the politician, for the man that he is and acknowledge his part in this American tragedy. We can honor the hundreds of thousands of lives lost. Hospitals are not meant to dispense justice. The place for that will be the ballot box.
The author is an anonymous physician.
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