Re: OOPS --- not so fast


hari kumar
 

Michael: I have sympathy with the physician (Dr Leap) writing that piece that you linked to. Of course the people concerned are not 'stupid'. All the examples chosen ("Why does a patient with diabetes come to the emergency department with a blood sugar over 500, having failed to take insulin for 2 weeks? Why does the patient with lung disease continue to smoke two packs per day despite struggling to breathe around the clock? What prompts the elderly patient with abdominal pain to sign out and go home to be with her dog? And for heaven's sake, why do young people take that first hit of heroin or methamphetamine?") - have socio-political dimensions that Dr Leap tries in teh limits of the article, to show.

As a paediatric-newborn intensivist I saw much of that, and it is very emotionally draining, and in practice very difficult to deal with. Another vignette:  hopeless brain-dead or terrible prognosis (95% and up certainty) infants in Philly - and parents refusing to take infant off ventilators inflicting huge suffering of both child, family - and staff. Explanations? Long legacy of  medical distrust to AA community; echoes of Henrietta Lachs, and Tuskegee-neurosyphilis etc; etc.  All that relevant history being said - the care team still has to deal with it in that compassionately in that concrete situation without benefits of a vast social engineering.

I agree that Dr Leap reaches for some social aetiology, and even perhaps some social remedy. But there are a couple of  things that are - I think - quite naive in the current situation:
i) The interaction of the purely biological-medical crisis with the class-social intensification of struggles, that prefers to use the problem as an excuse for short term political gains. Obviously the near fascists or fascists (such as AfD Germany) are the key examples  I have written on this at BerlinLeft blog, and I believe I have posted links at this blog, before now. (The site is undergoing re-working right now so some links temporarily down).  
I think there is a class basis identifiable for some of this with petty-bourgeois elements feeling this (down to direct profit gain functions included eg restauranteurs/on-line marketing for bogus 'medicines'/selling merchandise). 
All amplified by anti-'social' media - untrammelled by state agencies. 
ii) One obvious gap in Dr Leap's article is the exhaustion of many care-workers (especially nurses) - and the difficulty of helping wilful anti-vaxxers through a medical crisis including invitation in an ICU. All very well to reach to them about their 'Hippocratic' Oath (not actually utilised in practice as far as I know anywhere) and all that. Tell that to someone who has done this time and time gain. And in the UK gets offered a pittance wage/insulting 1% wage increase/no PPE/under-counted COVID deaths in their peers from work transmission....  and so on and on.  

This may not be welcome but I ask anyway. Why are jobs supported in any way by state resources, not mandating Vxx for work? I gather some Trade unions oppose this. I do not think that is progressive in any way. I had no choice in Philly or Canada but to be vaxxed for flu - even though the mutability and unpredictability of this yearly vaxx was quite variable o my understanding. but it was (and is) the right thing to do. 

Anyway, it is worth talking to you and many others who are on this list. However those that raise statistical issues and then when challenged on statistics blather Mark Twain's dinner party joke about 'statistics, damn statistics and damn lies' etc... are mere provocateurs in my opinion. 
Hari 

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