Key West Lou / A DOCTOR’S EARLY ON IMPRESSIONS OF THE CORNAVIRUS ATTACK

I was fortunate to make the acquaintance of several new persons this season. I say “fortunate” because due to the COVID-19 problem there were fewer people in Key West.

Two of those persons were David and EB Berger. David is a retired anesthesiologist. EB is short for Ennid. EB a nickname that has followed her for years. She is a retired attorney.

A charming and interesting couple.

David’s professional career was in the New York metropolitan area.

David and EB own a home in Key West.

During one of our conversations, David mentioned he had dome some writing a few yeas ago. For his pleasure alone. Never published any. I asked if he would send some to me. He did.

David was retired by the time coronavirus hit. He wrote concerning his impressions. What follows is a piece he wrote in the third month of the virus in April 2020.

I thought it worthy of sharing. He titled it Battle Lines.

BATTLE LINES

The Coronavirus pandemic has been an unprecedented stress on health care delivery. There are more patients, sicker patients, requiring more resources than seems possible. The specter of health care workers becoming infected has introduced an element of fear that most practitioners have never even imagined. As a recently retired anesthesiologist, I have stayed in touch with my colleagues in the New York metropolitan area to get a gauge on their day to day existence.

I have heard accounts of many health care workers who are conflicted on whether they should enter the fray or whether to sit this one out for their own safety and for the safety of their families. I myself wonder what I would do if I were not retired, with multiple risk factors and luckily isolated in a relatively safe zone. I know of several people who are sitting this one out, but just as many who have had to step up their hours as well as the intensity of work to meet the challenge.

We see accounts of health care workers in urban hospitals who are overwhelmed physically and emotionally, who are realistically fearful of getting sick because there is inadequate personal protective equipment for all practitioners. I’m sure these accounts are true, and am hard-pressed to understand how these situations developed. My heart goes out to those people who are sent to war without weapons.

Fortunately, the health system which I was associated with has exceptional resources, and I have not heard horror stories from my colleagues. The gist of what I have heard is that my colleagues are treating this just like any other challenge they have encountered in their careers. This challenge is unquestionably unique as the sheer unrelenting volume and intensity of disease has never been experienced except during wartime. The challenge is met through established channels of cooperation and decision making. That is because health care is a team effort. It requires resourceful administration and emergency planning. It requires the cooperation of multiple hospital departments in order to deploy services where they are required as well as to develop novel solutions to problems on the fly. It requires the dedication of health care workers to work harder and longer than they ever have before. In the trenches, teamwork is the only thing that gets people through the day and the only thing that gives people strength to get up and do it again the next day.

Today I saw a Facebook video from my hospital of a patient who was being discharged from the hospital after 17 days in the ICU. The entire hospital staff was lining the walls wearing masks and applauding the patient. There was a shedding of tears, but no hugs, just an occasional gloved fist-bump.

Everyone has seen a video like this. The difference for me was that I know this guy. He has worked at my hospital for 30 years and every person in the hospital knows him. In a week where many patients were dying despite the heroic efforts of the entire staff, he survived. It was a moment of victory in a season of death. The loss of countless patients was put in perspective by one friend who was saved. Health care workers must find a sense of detachment in order to stay sane. For a moment, that detachment was overwhelmed by the fact that health care is very, very personal. That experience provided the motivation to keep on going.

David Berger MD

Key West

April 2020

 

David has a talent. He should write more.

Staying with doctors for a moment, I visited Dr. Norris yesterday. He wanted to check how the gout problem was coming along. I had telephoned him to complain the pain had left me days ago. However, the swelling of the foot and ankle was getting larger. Extremely so.

Saw the good doctor. Gout is gone. My problem now is water retention. I have been on water pills for years. He took me off them 2 weeks ago. Something to do with getting rid of the uric acid.

The swelling extends up through my calf.

I am back on water pills. Can’t wait for the “swelling” to go down. The swelling is so significant I am unable to wear my normal every day shoes. The foot would not fit. I was back to crocs.

I also gained 5-6 pounds during this time.

It is amazing how many people have had gout. It has monopolized many of my written and face to face conversations recently.

Found a new place for lunch. Actually, to get a sandwich at any time.

It is called The Moose Pit. Located at the back of the Moose Lodge building on Eisenhower.

It is absolutely nothing appearance wise. Typical old fashioned Key West. A hole in the Moose building for cooking. Seating outside at several picnic tables. Each covered with a huge umbrella.

I make a point. Expect nothing fancy. It is the food that will return you to the place.

The specialty of the house is Pit Beef sandwiches. Seven variations. The meat, cheese and a dressing.

The sandwich on a huge soft roll. I had the Pit Beef with cheddar and house made island sauce. At least 2 inches high. $10! The best deal in town.

I have to believe 98 percent of the people in Key West are upset with the cruise ship bill passed by the Florida House and Senate. It is on its way to the Governor for signing. He will sign it. I would be shocked if he did not.

Following are 3 comments in this morning’s Citizens’ Voice critical of what has occurred.

“Yes, Republican Senator Jim Boyd stated that his bill to over turn the cruise ship referendums would ‘protect’ Florida citizens, but from whom? Key Westers voted for the referendums and the cruise ship crowd got the State legislature to vote for them!”

“Big money wins today (most are not local) as they get to have the daily mega ships come into our port.”

“Where do I sign up to greet cruise ships with “Unwelcome signs?’”

The stone crab season ends tomorrow. As a practical matter today as there can be no harvesting after May 1.

Stone crabs…..One of the world’s greatest foods. The season is from 10/1 to 5/2.

An interesting election today in Texas.

A Republican Congressman from Texas died and this election is to fill his seat. Twenty three candidates running. Includes the dead Congressman’s wife. No party distinction. All 23 run on the same line.

The victor must receive 50 percent of the vote. If not, there will be a run off between the highest two.

Texas has not elected a Democrat to the seat since 1983. However, the numbers have been getting closer and closer. In the most recent election, the Congressman won by only 3 percentage points.

Texas has been moving Democratic. This may be the time for a politically significant result.

Joe Manchin. I am not saying I am tending to dislike him. I have reached that point already.

Excuse the vernacular, the man is a pompous self-serving ass.

Biden needs every Democratic vote to achieve his goals for America. One Democratic Senator voting with the Republicans and Biden’s proposed legislation is defeated.

Manchin has already said loud and clear he will not vote to eliminate filibuster. In addition, he now advises he does not support statehood for Washington D.C. nor a bill to overhaul federal elections.

Big day today! The Kentucky Derby! The race is scheduled to start at 6:57 pm.

Today represents the 147th running of the Kentucky Derby. A 2 minute race. It is considered the greatest 2 minutes in sports.

Don and Chris are back. Been a while since we have been together. I am meeting them tonight at 6 at the Pier House Beach Bar.

I wish the Pier House would reopen the Chart Room!

Enjoy your day!

 

David Berger # 1

Posted: 01 May 2021 08:40 AM PDT

One of the themes of DaThomas Paine’s “Common Sense” is that there needs to be a balance between man’s pursuit of liberty and the government’s responsibility to maintain order for the common good.

The great thing about America is that everyone is allowed to have their opinion. Exchange of opinions is what defines a democracy. Democracy, atits best, is the distillation of the spectrum of opinions and the establishment of a compromise which accommodates that span of ideas. In most eras of American history, this democratic process has worked, primarily driven by statesmen who serve the common good.

The First Amendment right to free speech is the cornerstone of our national ethos. Nonetheless, I was dismayed to see protesters in multiple states take to the streets to oppose the self-isolation orders imposed by their state and local governments, at the direction of the federal government. Even though I cannot fathom the logic of their protest, I fully support their right to express themselves.

As a retired physician from the NY metropolitan area, I know that many, many people are dying of Covid-19 and that my colleagues are stretched to their physical and mental limits trying to manage this disease. I understand and empathize with the fact that many people have been badly injured, both emotionally and financially. I also understand that not every part of the country is affected to the same degree by the pandemic and that easing of self-isolation rules will roll out at different rates across the country.

What I cannot understand or tolerateis that in congregating without any regard to the spreading of disease in direct violation of rules formulated to keepthe disease in check, these people are putting themselves AND OTHERS in danger by ignoring basic common sense. Social distancing was instituted because the disease is spread from person to person by contact that is by no means intimate. Furthermore, people may not get sick for a very long time after they are infected and are infective; some do not get sick at all. The only way that this disease can be checked without an effective vaccine is by avoiding contact with other people. VERY SIMPLE. Do not gather in crowds to express your opinion. Use social media, traditional media and contact your representatives. Do not risk other people’s lives because you are overdue for your haircut. Do not block health care workers from getting to work.

Lastly, the behavior of politicians who have politicized these protests and egged on the protesters is contemptible and misinformed. The concept that lives must be sacrificed for the economic recoveryis beyond common decency.

At this moment, the solution to opening the country involves widescale testing of the entire population, both for Covid-19 positivity (active infection) as well as blood testing for antibodies to the virus (indicative of active or previous infection). In combination, these tests can better approximate the extent of disease so far (current estimates are likely far below the real infection rate). People who have reliable evidence of prior disease and who have recovered can reasonably reenter the economy without risking others. Careful analysis of the data derived by pooling these results can help us understand how the virus travels and how to identify regions at imminent risk.

Thomas Paine’s “Common Sense” remains valid in modern times. This pandemic will continue for the foreseeable future. We all need to continue to use self-discipline, common sense and the guidance of scientists rather than to rush blindly into reopening the country.

David Berger MD

April 2020