I am perplexed by two different needles which, when viewed together, illustrate the irrational themes which dominate our shared humanity. They inform me that, despite being a doctor for more than twenty years, I honestly feel dumber each day about human behavior. If, unlike me, you have somehow figured out more along the way, good for you.
The first needle which vexes me was the one stuck in my arm on Saturday, December 19, 2020. My COVID vaccine came from the first batch at the Berkeley Medical Center in Martinsburg, WV. A beloved nurse friend, Tiffany Sommer DNP, gave me this shot and we hugged hard afterward. I was intimately aware how this vaccine offered life-saving protection and a way back to normalcy in The Mountain State.
When I learned on Monday, November 9, 2020, of the vaccine’s existence, I cried actual tears of joy and could not wait to get immunized. I had worked the pandemic’s frontline since Friday, March 13, 2020, when the governor sent my kids home for, what turned out, the rest of the school year. A vaccine against this virus was, by any way you measured it, a triumph—for science, medicine, and humanity. Despite the political and social rancor which dominated 2020, we had a robust stash of scientific R&D to access in our moment of crisis. Thank God we had this tucked in the bottom drawer. The alternative? Millions more people dead across the world. Maybe you. Or your grandmother. Or me.
After being vaccinated, I did not anticipate the hostility that dominated the next year of my life. I am a primary care internal medicine doctor in my hometown, and I spent countless hours talking to my patients about the pros (many) and cons (very few) of the COVID vaccine. I wanted my patients informed so they could make their best choice. This was done without hyperbole, judgment, politics, or shame. When done right, I employed tact, competence, and trust. There were other days I did not do a good job explaining as I was exhausted. But, make no mistake, I tried—Lord knows—my best.
You probably know what happened to me, though I must say this experience was worse than you might imagine. For the first time in my career, I was called “a complete idiot” by patients. I was accused of being involved in—get this—an international political cartel. I was told to my face that I did not understand the human body, and that this vaccine was a “radical idea.” I struggle to this day as to how I was stuck in this position. We knew then that the vaccine was safe and effective, and time has borne this out. For almost everyone, the COVID vaccine pros are enormous and cons are miniscule.
I had not come to terms with this needle when a second one came along, so very different than the first. As Life Under COVID slipped away and brought me to an equally strange Life After COVID, I did not, could not, dream of Ozempic. And, believe it or not, this latter needle was more surprising than the former.
I probably said the words “GLP-1 agonist” and “injectable hormone” fifty times during this past week. Patients asked for this drug by name, as it is now famous, and for good reason. The same R&D that brought us the safe and effective COVID vaccine also brought us Ozempic, Wegovy, and Mounjaro. And make no mistake, these medications are a triumph. For the first time in my career, I have an option to offer my patients, one which is safe and effective at weight loss. Many of my patients ask, “So—does this stuff really work?” and I say, “Yes, from what we know so far, it is very effective at helping patients lose weight.” They light up with excitement and want to know (read: beg) if I will prescribe it. Almost invariably, my answer is, “yes.” If a patient has a substantial amount of weight to lose, these medications are likely a very good option to consider.
The contrast between the reluctance to take a vaccine—once—that could, possibly, save one’s life and the giddy desire to inject a hormone—weekly, maybe for years—for weight loss could not be more profound. This dichotomy is not easy for me to digest, but I keep thinking there is a deep lesson here.
Both needles, and the drugs contained therein, are, as far as we know, safe and effective. Each of them was tested rigorously before being made available to the American public. And this is critical because I explain to patients what we know and what we don’t know. What gets me is how people hardly care about how long Ozempic might need to be taken. And how we don’t know about its long-term effects—no one does.
It is likely the near-magic effects of weight loss effectively turned off rational thoughts inside my patients as they focused on this incredible possibility. I’m not criticizing because I felt the same way about the COVID vaccine. I saw the near miracle of this vaccine and immediately realized the benefits, not just for a single person, but our entire community. I knew, because I did, in fact, understand the immune system, that great outcomes were possible if we took this vaccine. “Just take the vaccine, and let’s all get to Life After COVID,” is what my brain told me. “Come on, people!”
Many of my patients knew precious little about their own health, and because they were scared shitless by misinformation, they never had the opportunity to see the true benefit of the COVID vaccine on an intellectual level. This is in direct contrast to their intuitive understanding that weight loss would be profoundly beneficial to them. And because they know, deep down in their bones, that obesity is slowly killing them, a medication which can dramatically change the outcome, that is worth doing. And once I provided my blessing that I, too, believed Ozempic was safe and effective, well, “Just give it to me, doctor!”
The COVID vaccine and Ozempic, and their associated needles, are scientific marvels that can improve health. How you emotionally connect with their potential benefits likely determines if you take a pass or get jabbed by the sharp end. Either way, the benefits are real, whether you understand the science or believe any of it.
Ryan McCarthy is an internal medicine physician.