29 votes

‘I’m sorry, but it’s too late’: Alabama doctor on treating unvaccinated, dying COVID patients

28 comments

  1. [10]
    AugustusFerdinand
    Link

    “I’m admitting young healthy people to the hospital with very serious COVID infections,” wrote Cobia [...] “One of the last things they do before they’re intubated is beg me for the vaccine. I hold their hand and tell them that I’m sorry, but it’s too late.”

    “I try to be very non-judgmental when I’m getting a new COVID patient that’s unvaccinated, but I really just started asking them, ‘Why haven’t you gotten the vaccine?’ And I’ll just ask it point blank, in the least judgmental way possible,” she said. “And most of them, they’re very honest, they give me answers. ‘I talked to this person, I saw this thing on Facebook, I got this email, I saw this on the news,’ you know, these are all the reasons that I didn’t get vaccinated.

    “And the one question that I always ask them is, did you make an appointment with your primary care doctor and ask them for their opinion on whether or not you should receive the vaccine? And so far, nobody has answered yes to that question.”

    23 votes
    1. [9]
      Rez
      Link Parent
      Since she's writing about young healthy people here - how many of them are going to have a substantive relationship with their primary care doctor? Why would they unless they had some issue that...

      “And the one question that I always ask them is, did you make an appointment with your primary care doctor and ask them for their opinion on whether or not you should receive the vaccine? And so far, nobody has answered yes to that question.”

      Since she's writing about young healthy people here - how many of them are going to have a substantive relationship with their primary care doctor? Why would they unless they had some issue that brought them in regularly? As far as I'm concerned, mine is basically just a random doctor. I got the vaccine back in February but whether or not my personal doctor approved of it wasn't really a factor.

      Having some medical background with some understanding of the daily lives of physicians in the modern workforce, it's not like I would expect her to have in-depth knowledge about Israel's Pfizer studies, or a deep understanding of mRNA vaccine technology. I have no reason to go out of my way to solicit her opinion.

      Now I wonder what it would be like for young, healthy people if their doctor was the one to first call them. That would truly be the wake-up call a lot of people might need, one that demonstrates the gravity of the situation we're in and the importance of the issue - your doctor calling you unprompted to inquire about your COVID vaccination status and plans or lack thereof, with the hope she's nonjudgmental so the patients' emotional defenses aren't raised. The most outreach I've gotten is one generic email addressed to "valued patient" from the hospital network encouraging me to get the vaccine, which just melts into the digital noise like all the rest of pro-vax coverage. (I don't know if there are any regulatory issues in the way of that, but the fact I have to say that sort of speaks to how impersonal the health care system can be and why people may not really care to solicit the opinion of a doctor they have so little of a relationship with - plus doctors may be worried about bad reviews and complaints if they try to raise the issue unprompted with anti-vax clients).

      Given how slammed physicians are at work, even a nurse or some administrative assistant making the call to arrange a meeting could have an impact (...and then the patient would have to inquire if it would cost them anything to have that appointment, if they can even find a time that works for them). Something that has a human touch rather than one generic email not even addressed to my name or with the signature of my doctor. I would implore that doctor to talk to all the PCPs she knows to have them (or their office) reach out personally to all the patients on their roster.

      16 votes
      1. [7]
        Gaywallet
        Link Parent
        Why are you putting the impetus on solving the problem on this woman who's already overworked and burnt out? Have you not considered that she's perhaps the last person that should be shouldering...

        I would implore that doctor to talk to all the PCPs she knows to have them (or their office) reach out personally to all the patients on their roster.

        Why are you putting the impetus on solving the problem on this woman who's already overworked and burnt out? Have you not considered that she's perhaps the last person that should be shouldering this burden?

        Why is your attention directed at her, instead of the entire media empires devoted to spreading misinformation? At the representatives for places like Alabama who continue to push for legislation to remove science education? At the people who are spreading misinformation throughout their social networks? At Facebook and other large platforms for allowing this to spread? At the bad actors throughout the entire system?

        Instead, you are chastising someone who's job is to save people who willingly didn't want to be saved? Why?

        20 votes
        1. [6]
          Rez
          Link Parent
          Because if she's going to complain about it - and chastise people herself - this is the solution I'm offering. Trust is a two-way street. People read signals, but they also read what isn't...

          Instead, you are chastising someone who's job is to save people who willingly didn't want to be saved? Why?

          Because if she's going to complain about it - and chastise people herself - this is the solution I'm offering. Trust is a two-way street. People read signals, but they also read what isn't signaled. And what wasn't signaled is that in my personal experience, no one in my personal health care network ever meaningfully reached out to me about the vaccine, despite it being the biggest public health crisis we've had in a century. That speaks to how little a personal relationship I have with my health care providers, which is why I connected it to the fact she's complaining people didn't actively go out of their way to set up an appointment with their doctor to talk about the issue. No email of "hey, your doctor here, set up your free consultation so we can go over whatever you want about the vaccine, we can easily do it over telehealth where you'll be able to bring up any articles or information you have!" The fact they're overworked isn't mine or any patient's fault. Health care workers become overworked in a public health crisis. I was overworked. And this doctor is going to have even more work in the future, work (and literal death) that might've been avoidable had there been work at some point to engage in personal outreach to talk to patients about the vaccine in the hopes of convincing them to get it. When you engage in victim blaming of people who don't want to be saved, that messaging accomplishes nothing and only hardens their views. I have personally assuaged Trumper friends and family into getting the vaccine. What I think would accomplish something is personal outreach. The fact this might be difficult in the context of the modern health care system isn't really my problem to solve, but clearly this isn't a problem that stakeholders are trying to solve either.

          7 votes
          1. [5]
            Gaywallet
            Link Parent
            Why is your experience representative of every single point in the system? Why are you asking a doctor, a single point in the system, to solve the system? You say this is a two way street - when...

            Why is your experience representative of every single point in the system? Why are you asking a doctor, a single point in the system, to solve the system?

            You say this is a two way street - when did you reach out to your care provider? Are you not equally at fault?

            You say she's complaining, yet this is not an article not written by her - this is someone taking quotes of what she said to weave a narrative. How do you know that she is complaining? Even if she is complaining, how are you factoring in the fact that she is overworked and burnt out into consideration as to whether you should be chastising her in the first place?

            How do you know she is not engaging in personal outreach? The article highlights how she is having conversations with the family and telling them to get vaccinated. This seems like at least some level of outreach to me. She didn't have to do this and I know many who haven't. Why are you mad at her for being compassionate?

            I'm not sure about you, but I was struck by the amount of compassion this person is willing to give someone with a differing viewpoint, one which invalidates her very worth as a human. I'm not left with a feeling that you're giving her the same in return - it feels like you're jumping to a lot of conclusions here and I don't think it's fair to treat her that way when we know so little.

            18 votes
            1. [4]
              vord
              Link Parent
              Don't forget there's also a financial disincentive: If it's not a regular wellness visit, it'll likely cost a copay. If uninsured tremendously more. It's a waste of money, considering that any...

              You say this is a two way street - when did you reach out to your care provider?

              Don't forget there's also a financial disincentive: If it's not a regular wellness visit, it'll likely cost a copay. If uninsured tremendously more.

              It's a waste of money, considering that any doctor that isn't a quack will say GET IT (unless very specific circumstances which person is likely already aware of).

              2 votes
              1. [3]
                AugustusFerdinand
                Link Parent
                Having run physician offices, PCP included, the self-pay (uninsured) visit cost is barely more than the copay that most insured patients pay. Not to mention the financial disincentive, that should...

                Having run physician offices, PCP included, the self-pay (uninsured) visit cost is barely more than the copay that most insured patients pay.

                Not to mention the financial disincentive, that should be part of their thought process, of contracting COVID and being hospitalized. There's a financial disincentive to maintaining your automobile, taking it to a mechanic can be expensive to have the regular maintenance performed, but not doing so is stupendously more expensive and akin to hospitalization. So it's most certainly not a waste of money in either case.

                5 votes
                1. [2]
                  Micycle_the_Bichael
                  Link Parent
                  There have been times where I've avoided seeing a doctor because the $20 copay for the visit would be completely draining my bank account, I'd have to take off work to do it which meant I wouldn't...

                  There have been times where I've avoided seeing a doctor because the $20 copay for the visit would be completely draining my bank account, I'd have to take off work to do it which meant I wouldn't have my normal paycheck which meant I'd either not be eating or I wouldn't be making rent, and I'd have to figure out how to get there which would inevitably cost more money that I didn't have. I know and knew that putting off seeing a doctor was potentially going to cost me more in the long run, but I didn't have the money to gamble on "what if it gets worse." You just cross your fingers and hope it gets better. And that's when I was actually sick and knew I needed a doctor. No way in hell was I doing regular checkups or going to go see them if I was anything short of dying.

                  12 votes
                  1. AugustusFerdinand
                    Link Parent
                    Ok. I'm not saying that going to a doctor doesn't cost money or that people can be too poor to do so (I've been there too), but the venn diagram that contains willing to ask their doctor, but is...

                    Ok.

                    I'm not saying that going to a doctor doesn't cost money or that people can be too poor to do so (I've been there too), but the venn diagram that contains willing to ask their doctor, but is too poor to do so on one side and believes COVID is a hoax on the other is going to have a negligible overlap in the middle.

                    4 votes
      2. j3n
        Link Parent
        I wonder what percentage of people even have a primary care doctor? I've gone over 10 years since getting out of the Army without any PCP whatsoever. It's only very recently that I've decided I'm...

        Since she's writing about young healthy people here - how many of them are going to have a substantive relationship with their primary care doctor?

        I wonder what percentage of people even have a primary care doctor? I've gone over 10 years since getting out of the Army without any PCP whatsoever. It's only very recently that I've decided I'm old enough that I should probably start getting an annual physical done. I was well-insured throughout the last 10 years, I just didn't have any reason to go see a doctor.

        9 votes
  2. [8]
    Gaywallet
    Link
    I find myself in a weird predicament as of late with regards to misinformation and people who've been brainwashed. On the one hand, I understand they are humans and I have nothing if not for...

    I find myself in a weird predicament as of late with regards to misinformation and people who've been brainwashed.

    On the one hand, I understand they are humans and I have nothing if not for compassion for a fellow human. On the other hand, our society and the globe is quickly headed to destruction in the hands of many misinformed humans. I find myself with a contradictory viewpoint, much like this doctor holds - disdain and dismissal of these individuals and compassion for their plight. Perhaps the way to disentangle the contradiction is to think of it in abstract and concrete terms... the idea of them suffering does not bother me because they are reaping what they sow, but the people themselves I do not wish to see suffer.

    I hope the end result of all this suffering is that we accelerate a bit towards a better society.

    10 votes
    1. vord
      Link Parent
      I feel much the same, I even think that given time to heal, even the most bigoted and ignorant can be reformed. However, we're growing ever short on time. At some point compassion must stop...

      I feel much the same, I even think that given time to heal, even the most bigoted and ignorant can be reformed.

      However, we're growing ever short on time. At some point compassion must stop because the ignorance has litterally reached the point where it is killing people.

      IMO the civil war has already started. At least my side will likely be able to win with polio outbreaks.

      6 votes
    2. [6]
      skybrian
      Link Parent
      Historical context: in Europe there were religious wars for hundreds of years where by modern standards, extremists on all sides believed in dangerous nonsense. These wars didn’t stop because...

      Historical context: in Europe there were religious wars for hundreds of years where by modern standards, extremists on all sides believed in dangerous nonsense. These wars didn’t stop because people stopped fervently believing nonsense, but rather because religious tolerance became widely accepted.

      There are arguments that modern civilization can’t afford this because it’s more fragile, but the habit of believing that you must convert the other side at all costs raises the stakes in a way that doesn’t seem like part of the solution.

      I think that those of us who are vaccinated can afford to relax a little. There is of course plenty still to be done to vaccinate people worldwide, but framing things as “the globe is quickly headed for destruction” and thereby making conflicts worse doesn’t seem like part of the answer?

      3 votes
      1. [4]
        HotPants
        Link Parent
        For thousands of years we had evolutionary forces that kept our population under control. In the 1900's, our population quadrupled from 1.5 billion to 6 billion. Death rates fell, but birth rates...

        For thousands of years we had evolutionary forces that kept our population under control.

        In the 1900's, our population quadrupled from 1.5 billion to 6 billion.

        Death rates fell, but birth rates did not.

        Consumption and pollution has also increased.

        Either birth rates must fall dramatically, or death rates must increase dramatically.

        Can you see a humane path forward? I can't.

        And with the increase in pandemics and natural disasters, it looks like a path will be chosen for us.

        As an individual, I am grateful that COVID is under control, and that most people were spared.

        But fear we are only delaying the inevitable.

        So I am strangely at peace with what is happening in America right now, which has always prioritized individual responsibility over government control.

        3 votes
        1. spctrvl
          Link Parent
          The humane path forward is that birth rates are already falling dramatically on their own, as a result of female empowerment and education and easily accessible birth control. Neomalthusianism is...

          The humane path forward is that birth rates are already falling dramatically on their own, as a result of female empowerment and education and easily accessible birth control. Neomalthusianism is pseudoscience that's going to lead to a lot of unnecessary human suffering if it's not kept well in check, as did similar thinking embodied in eugenics in the last century.

          13 votes
        2. [2]
          burkaman
          Link Parent
          Why? The global population growth rate has been falling for 50 years and will almost definitely continue to fall until population peaks in the not too distant future. "Keep doing our best to stop...

          Either birth rates must fall dramatically, or death rates must increase dramatically.

          Why? The global population growth rate has been falling for 50 years and will almost definitely continue to fall until population peaks in the not too distant future. "Keep doing our best to stop people from dying" seems like a humane path forward.

          5 votes
          1. Kuromantis
            Link Parent
            Birth rates for reference. I personally think we shouldn't do our best just to keep people from dying, but just try to get contraception and whatever improvements to living we can to the 3rd...

            Birth rates for reference.

            I personally think we shouldn't do our best just to keep people from dying, but just try to get contraception and whatever improvements to living we can to the 3rd world, since from what I've seen the only thing that seems to clearly make people have more children is general misery/poverty and if they live better lives, they will have less children.

            3 votes
      2. Gaywallet
        Link Parent
        Apologies, I didn't really expand upon this point. This was more a reflection upon a culmination of problems caused by people denying science. Problems like global warming.

        framing things as “the globe is quickly headed for destruction” and thereby making conflicts worse doesn’t seem like part of the answer?

        Apologies, I didn't really expand upon this point. This was more a reflection upon a culmination of problems caused by people denying science. Problems like global warming.

        3 votes
  3. [10]
    knocklessmonster
    (edited )
    Link
    It's like the phrase "you'll never find an atheist in a foxhole." Ignoring the obvious religious implications, it's more to do with looking for hope when it's too late. These people were of the...

    It's like the phrase "you'll never find an atheist in a foxhole." Ignoring the obvious religious implications, it's more to do with looking for hope when it's too late. These people were of the mind that they wouldn't get COVID because of some bullshit they'd read, and then suddenly had the strongest piece of evidence to prove them wrong, and rapidly changed their tune. You can see it on /r/leopardsatemyface and various other related subreddits where people seem to get off on people suffering the consequences of poor decision making.

    That isn't to say I think any of them deserve this. We can talk about critical thinking until the cows come home, but to be honest, it isn't necessarily everybody's strong suit and this trait shouldn't be treated as a failure on their part, but as a crime by the people who would manipulate these individuals.

    I think the doctor in the article has the best response with her last question, however:

    And the one question that I always ask them is, did you make an appointment with your primary care doctor and ask them for their opinion on whether or not you should receive the vaccine?

    If you are going to take something on blind faith, you should at least ask somebody who is both qualified and trustworthy, but then the issue comes when individuals arbitrarily choose who meets these criteria. The issue is, as far as I can tell, the sorts of people who aren't getting this vaccine are also the sorts who don't go to a doctor until something happens, so they're also unlikely to go just to have a discussion about getting a vaccine they already feel is unnecessary.

    7 votes
    1. [9]
      Bear
      Link Parent
      If they want to grasp at straws after they're diagnosed with COVID-19 and ask for the vaccine right then, then yeah, not only is it way too late (since vaccines only work before you get whatever...

      If they want to grasp at straws after they're diagnosed with COVID-19 and ask for the vaccine right then, then yeah, not only is it way too late (since vaccines only work before you get whatever they protect against, and they take a decent amount of time to become fully active), but why ask for the vaccine at all? Not only is it massively hypocritical, but they deserve to reap what they sow.

      This thing has killed millions of people across the world, and if they thought that it was no big deal, then their suffering should be no big deal.

      We spend years educating people. We have access to the sum total of humanity's knowledge on supercomputers in our pockets, etc.

      If you are an adult, some of the basic tools to navigate daily life is the ability to think critically, to separate facts from opinions, and to weigh how much to trust a research source. If you've failed to get those skills, then you are in danger, and you should get them now.

      5 votes
      1. [4]
        archevel
        Link Parent
        No. People do not deserve to die because of their beliefs no matter how misguided those beliefs are. That is quite frankly an horrible position to take. The price for stupidity should be mitigated...
        • Exemplary

        Not only is it massively hypocritical, but they deserve to reap what they sow.

        No. People do not deserve to die because of their beliefs no matter how misguided those beliefs are. That is quite frankly an horrible position to take. The price for stupidity should be mitigated by society as much as possible. Not only is n the case of Covid but just as a general principle. Next time I might be the stupid one and if possible I'd like it if the consequences of my stupidity wasn't a possible death sentence.

        25 votes
        1. [3]
          etiolation
          (edited )
          Link Parent
          This would be an easier answer if deniers harmed only themselves. Surely you would agree that if anyone has to suffer the consequences of COVID, it would be preferable for it not to be the...

          This would be an easier answer if deniers harmed only themselves. Surely you would agree that if anyone has to suffer the consequences of COVID, it would be preferable for it not to be the careful, the considerate, and the rational rather than the reckless, the selfish, and the stupid. There are vulnerabilities in each category, but when the latter group is actively making life more dangerous for the former, can't you see apportioning sympathy and resources accordingly? I may not wish death on those responsible for killing our loved ones, but when the champagne of their ignorance (benefits they were enjoying such as cheap air travel and wedding venues) turns to piss, I'm not going to rush to suck it out of their mouths.

          I agree with you very much in advocating for a society that mitigates my own stupidity. No, these people don't deserve to die, but I understand the anger of those who suffer after doing everything right.

          17 votes
          1. [2]
            archevel
            Link Parent
            Not from a societal point of view. On a personal level of course if I got to choose I'd be picking based on my subjective preferences (it would be impossible not to). But as a society I think it...

            Surely you would agree that if anyone has to suffer the consequences of COVID, it would be preferable for it not to be the careful, the considerate, and the rational rather than the reckless, the selfish, and the stupid.

            Not from a societal point of view. On a personal level of course if I got to choose I'd be picking based on my subjective preferences (it would be impossible not to). But as a society I think it would be hard/impossible to agree on an objective measure for those criteria. Eg. who is being reckless vs who is being just stupid?

            2 votes
            1. vord
              Link Parent
              In this case there is a very clear objective criteria: If one is capable of getting the vaccinne, they get it. If they aren't for any reason other than "My immune system is comprimised," they are...

              In this case there is a very clear objective criteria:

              If one is capable of getting the vaccinne, they get it. If they aren't for any reason other than "My immune system is comprimised," they are ignorant, and their ignorance is making the vaccinne less effective and actively killing people.

              I have 0 sympathy for issues that are so fundementally basic. I don't wish ill will on them per se, but they also get pushed to the back of the line for sympathy.

              3 votes
      2. [3]
        Kuromantis
        Link Parent
        I said something like that once and I soon regretted it a lot. You might want to read through that thread and comment. (Maybe the comment first.) It won't make you more sympathetic to anti-vaxxers...

        They deserve to reap what they sow.

        I said something like that once and I soon regretted it a lot. You might want to read through that thread and comment. (Maybe the comment first.) It won't make you more sympathetic to anti-vaxxers but it did make me genuinely regret saying right wingers disproportionately dying from COVID is technically a positive.

        7 votes
        1. Loire
          Link Parent
          It's hard to think that way when you have, typically very normal, moderately intelligent family members who refuses to get the vaccine. No I don't want my dad and sisters to die of COVID despite...

          It's hard to think that way when you have, typically very normal, moderately intelligent family members who refuses to get the vaccine. No I don't want my dad and sisters to die of COVID despite the fact that they have clearly succumbed to misinformation. No they don't deserve to die because their human brains are humanly susceptible to this kind of stuff.

          10 votes
        2. HotPants
          Link Parent
          I completely missed this I switch names every year, and last year I thought it would be funny to pick the most absurd name I could think of, to see if people treated me less seriously. Well done....

          I completely missed this

          From /MonkeyPants: Usually, we learn by being fucked up.

          I switch names every year, and last year I thought it would be funny to pick the most absurd name I could think of, to see if people treated me less seriously. Well done.

          BTW, I think the exact quote might have been that we only learn by fucking up. E.g. poking a finger in the fire.

          Being fucked up has a different connotation. E.g. physical or emotional scars.

          2 votes
      3. knocklessmonster
        Link Parent
        This is the equivalent to saying "git gud, scrub." Critical thinking isn't a skill to teach or learn, it is a practice that must be properly developed. The problem, as I see it, is many people...

        If you are an adult, some of the basic tools to navigate daily life is the ability to think critically, to separate facts from opinions, and to weigh how much to trust a research source. If you've failed to get those skills, then you are in danger, and you should get them now.

        This is the equivalent to saying "git gud, scrub."

        Critical thinking isn't a skill to teach or learn, it is a practice that must be properly developed. The problem, as I see it, is many people come to many bad, and outright wrong conclusions through generally logical processes. The rest of us can't track the logic because we're missing a crucial element, but the issue is their methodology is flawed. I'd also go further and suggest a fair amount of it may be to do with the fact that about 10% of the population might suffer with oppositional defiant disorder.

        I guess my point here is, you haven't said anything that demonstrates people deserve to die for thinking differently. I would say they deserve help in correcting their thinking.

        7 votes