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“The victims of this now distorted concept of liberty are ones that we physicians encounter every day. The one that inspired this essay for me is an 11-year-old boy that I saw three weeks ago. He is a patient of mine in my pediatric practice who came to see me with typical respiratory symptoms that led to a diagnosis of COVID-19. While he recovered uneventfully, his father got sick the next day and died from the same illness five days later. Like the vast majority of people who die from COVID-19 now, he was unvaccinated, believing that getting vaccinated was unnecessary and part of a greater effort to undermine his personal liberty. His son is now dealing with the unimaginable grief of losing a parent at such a tender age and asking his mother if he killed his father by getting sick and causing his death. This happens every day now in our communities across our nation. These are wounds that will never heal for this generation of kids.”
Jason V. Terk is a pediatrician.
He shares his story and discusses his KevinMD article, “The dimming of the shining city.”
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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.
Transcript
Kevin Pho: Hi, welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show we have Jason Terk. He is a pediatrician, and he wrote the KevinMD article “The dimming of the shining city.” Jason, welcome to the show.
Jason V. Terk: Thank you very much. I’m very glad to be here, Kevin.
Kevin Pho: We’ll get into the article in a little bit, but first off, can you share your story and journey to where you are today?
Jason V. Terk: Sure. I’m a pediatrician, as you mentioned. I practice in a suburb of Fort Worth, Texas, within a large integrated pediatric health care system that I absolutely love. I wouldn’t want to be anywhere else.
My journey to getting here: I did my medical school at the University of Texas Medical Branch in Galveston and did my residency in pediatrics at the Mayo Clinic in Minnesota, which was really influential in the arc of my development as a pediatrician. Recognizing the collegiality there was very important. It’s what I find very refreshing here, practicing in an environment where we all trust each other and we’re very aligned to taking care of the patients.
I’ve been married for over 20 years. I’ve got two grown kids now, and I’m recently an empty nester. But being a parent, for most pediatricians, is very important in what we do for our own patients. And so I’m also very active with respect to advocacy for children’s health issues, especially vaccines. I serve in roles that bring me to my state capital for advocacy on children’s health issues, and I also serve on the American Academy of Pediatrics Committee on Federal Government Affairs and do some work in D.C. on that stuff as well.
Kevin Pho: So you mentioned your work with advocacy with children’s health issues, specifically vaccines. Tell me some of the challenges that you face in that role.
Jason V. Terk: Well, they are substantial, and it’s been very challenging, because as things have evolved over time, our grip on what we decide is a good representation of reality has slipped quite a lot. We’ve drifted from an environment where we still trusted science and understood that science was a process by which we understand the reality around us, to a situation in which reality and truth are really how most people agree they are. And so that history has resulted in public figures who are of that same sort of like mind. And so having science be our foundation of reality, and of how we discern how we need to be making policy, has been really challenging in a setting where science is now devalued.
Kevin Pho: All right. You talk more about that in your KevinMD article. It’s titled “The dimming of the shining city.” Now, for those who didn’t get a chance to read your article, can you just walk my audience through it and share the story of why you decided to write it?
Jason V. Terk: Well, I decide to write things when I have something inside of me that is an irritation, sort of like a piece of sand in my soul, as it were. In the midst of the most recent Delta variant surge, a young man came to see me. We were just balls-to-the-wall busy with patients at that time, like many of my colleagues, and he is an 11-year-old kid who had typical respiratory symptoms and, like many of his peers, had COVID-19. He recovered. Unfortunately, the next day his father, who was unvaccinated, got sick, and he died four or five days later.
And this poor young man is now grieving the loss of his father but worried that he killed his dad, because he got sick and then his dad got sick. That’s a toxic stress and a burden that will be very difficult for him to overcome. And quite frankly, you can imagine this happened thousands of times across our nation in the midst of this pandemic.
Kevin Pho: Now, you talk about misinformation that has led to that mistrust and distrust of science. Tell me about the evolution of that. You’ve been practicing for a little while now, and there wasn’t always that mistrust of science. So tell me about that evolution to where we are now.
Jason V. Terk: Well, again, there have been a lot of factors and variables that have come together, I think, to create the reality that we’re in now. I think it’s been catalyzed by social media and online activity and the ability of people to coalesce around similar worldviews. Many of us know that sort of creates electronic social media echo chambers, which amplify and validate their perceptions, however erroneous they may be. Birds of a feather flock together, and that happens in the physical space as well as the online space. And then, unfortunately, it’s been validated and reinforced by political people who choose to leverage that reality for their own political gain, and it ends up being a positive feedback loop.
And so we as physicians, who are trying to do the best thing we can for our patients, are left to try to, on a patient-by-patient basis, push back against some of that disinformation and reinforce the relationship and the trust that we still hopefully maintain and have with the families. It’s exhausting. It takes a lot of time, and you’re weary at the end of the day, but you realize that you have to continue to do that if you want to have a chance at preventing illness and saving lives.
Kevin Pho: Can you share a story or an example of how this misinformation a family may read on, say, a social media site has seeped into the exam room in one of your encounters?
Jason V. Terk: Well, I think most recently, with the COVID-19 vaccinations that have now come out, which are wildly successful as far as their efficacy is concerned and have a very reasonable safety profile, there are agenda-driven actors who have put out falsehoods about the vaccine. One of the more common ones that I hear is that the COVID-19 vaccination is a risk for fertility.
And as they say in politics, if you’re explaining, you’re losing. But it takes time to disentangle and unpack the untruths that are associated with that myth that is widely circulated, which I have to do practically every day when I’m talking to my families now about the wisdom of getting themselves vaccinated and getting their children vaccinated. And so I have to kind of explain it and the history of that, and why it’s so important, and why they need to be more afraid of the reality that’s before us, which is the disease, as opposed to any imagined risks.
Kevin Pho: So if you’re in the exam room with a family and they share some misinformation that you read online, and you’re explaining your stance from the perspective of science in general, what are some reactions that you get from that family?
Jason V. Terk: Well, really rarely, there might be a hostile reaction. I actually had a father ask me what my agenda was, and I had to remind him that my agenda was the safety and health of his child and that I didn’t have any other agenda whatsoever. I reminded him that I’ve been taking care of his child for 10, 12 years, and I don’t think I reached that person. But that’s not a common event.
More often, I will have a family hear what I’m having to say, and they will politely accept what I’ve had to say. But I ask them to thoughtfully consider. They’ll often then revert to, “I need to talk to my husband or wife,” that stakeholder that’s not in the room, and I hope that they will give some thoughtful consideration to what has been said.
Happily, many times when you’ve engaged a family on their level respectfully and talked to them about how important it is, they will realize, after they’ve stated what their concern is and you’ve addressed it respectfully, that getting vaccinated is the right thing to do. And so we do have those wins. It’s not always a beating-your-head-against-the-wall experience. And even if it’s the minority of the time, that’s worth the effort, because you want to try to prevent tragedies.
Kevin Pho: So I think what you’re describing is happening in millions of exam rooms across the country. It certainly happens all the time when I see patients in my internal medicine primary care clinic. Tell us, what are some of the techniques that have worked for you in the exam room?
Jason V. Terk: Well, I think the first thing is, internally, you have to frame it correctly, in your own mind and in your own heart. We have to still maintain compassion and professionalism with our families if we want to be able to reach them effectively. The way I frame it in my mind is that the folks who are coming in with really ridiculous concerns oftentimes are not stupid. They’re not trying to do the wrong thing. They’re victims of disinformation, and it’s my duty and role to try to persuade them that what they think is true is not correct. And so maintaining that compassion and professionalism internally is really important.
Hearing and asking permission is actually a very important part of this. Asking if it’s OK to talk about what their concerns are puts them at ease and lets them know that I’m trying to be respectful and I’m willing to take time with them. And when that permission is granted, I ask them to tell me what it is specifically that they’ve heard that causes them to be concerned or hesitant about vaccination, whether it’s COVID-19 vaccination or HPV vaccination or MMR, whatever it is. Then getting that out on the table in the middle of the room to talk about it, as opposed to some nebulous fear, is terribly important.
Jumping into a recitation of data about how this vaccination is X percent successful and the minimal frequency of side effects isn’t effective until you get to the heart of the matter. And then once you’ve been able to address that, things are more likely to be successful.
Kevin Pho: We’re talking to Jason Terk. He is a pediatrician, and he wrote the KevinMD article “The dimming of the shining city.” Jason, what do you think in terms of the future when it comes to misinformation? You mentioned a few things, like tribalism and everything being politicized, and from my vantage point, I don’t see things getting a lot better in the near future. But I wanted to see what your take is when it comes to misinformation and patients coming to the exam room with this misinformation, making our job a little bit more difficult. What’s your perspective?
Jason V. Terk: I’m generally an optimistic person. I try to be hopeful, and that’s really the only way I can survive sometimes. But I have to say I’m pretty pessimistic. I don’t really see where we are, or the vector in which we’re traveling, as one in which we can easily turn the corner and go back to a place where our concept of reality, our ability and our willingness to have a rational and logical approach to discerning reality, is going to be what we use. I think it’s going to take a very large event, a negative event, for people to wake up and maybe make a decision that this is not the right path. And if we survive that event, I’ll be very happy.
You know, I’m in my mid-50s, and I’ve lived a very happy and successful life up to this point, and I hope to live many more years. But what I mostly hope for my kids is that the dark place that we’re in right now, politically, as a culture, and with our lack of affection for each other as a nation of people, can change without too much of a tragedy happening, or more of a tragedy than we’ve already experienced. That’s the best answer I can give you. I wish I had a more hopeful answer, but I think it’s not recognizing reality.
Kevin Pho: I think millions of physicians across the country are encountering similar situations to the encounters that you describe. So let me ask you, what keeps you going? What keeps you going to the clinic every day, despite some of the pessimism that you articulated?
Jason V. Terk: I honestly try to suck the marrow out of every positive experience in my practice: the smiles that I get, the hugs that I get, the fact that I am appreciated by many of my families and patients, the good that I do when I’m good enough on that day to do it, when my skills are good enough to make an important call diagnostically to potentially save the life of a child, and then all the illnesses and injuries that I prevent on a day-to-day basis, being preventive care types of physicians. You know, that’s what keeps me going.
And maybe that’s a trick in framing for myself, but that’s what I have to do to keep going. I try to create my own sort of microenvironment here, where I’m trying to do the best I can, and it makes whatever difference it makes. But it’s what I’ve got to do, and that’s the only thing I can do. It’s the best I can do.
Kevin Pho: And my final question. What are some of your take-home messages that you want to leave with the KevinMD audience?
Jason V. Terk: I guess the take-home message that I would like to leave with your audience is this: It’s easy to become overwhelmed by the reality, the larger reality around us. All we can control is what we do with our voices and with our hands and with our skills, and I do my very best to do the best I can with those tools. If more do that, then we have an outsized influence than what we can do individually. So keep trying, keep working at it, stay positive, leverage the successes that you have to keep you going for the other, less successful encounters, realizing what we do matters, and be that trusted voice. And that’s all we can do.
Kevin Pho: Jason, thank you so much for sharing your time and insight, and thanks again for being on the show.
Jason V. Terk: Thank you so much.
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