Louisville Medicine Volume 68, Issue 8 | Page 27

AUTHOR John David Kolter , MD
more likely to die .”
We have lost COVID-19 doctors to the virus , and to suicide . Worldwide , we have lost at least 1,500 nurses . More nurses have died from COVID-19 than were lost in World War I . Still , that is a huge underestimate , according to the International Council of Nurses , because fewer than 25 % of countries have even reported data . The poorest countries are hardly able to keep track . The Council estimates a worldwide 10 % fatality rate of caregivers : that would be upwards of 145,000 nursing deaths . As for Russian data : who knows ? When you have highways named the Road of Bones , you cannot expect us to accept all your reporting .
Grief is tiring . It brings you low . It shreds your ability to concentrate and assaults you without warning in an ordinary moment . Losing patient after patient to COVID-19 , like losing patient after patient to AIDS , to acute leukemias when we had few weapons , becomes numbing . There is so much grief and anger that we have no place and no time to process it . Those working daily overtime in the ICUs and emergency rooms have all the regular trauma , all the normal catastrophes to deal with . All direct caregivers for COVID-19 patients must daily manage the fear , then guilt , of bringing it home to their loved ones . Our grief lurks below the surface , a constant dull ache .
The anger is too impatient to wait . It comes out in snappishness ,

On Nov . 25 , Justice Neil Gorsuch

made a small splash in the relatively stormy sea that is the 2020 news cycle with his concurring opinion in the case of Roman Catholic Archdiocese of Brooklyn versus Cuomo . The Court , as was well-reported , granted the Archdiocese , and by extension Agudath Israel of America , et al . in a similar case , the application for injunctive relief from executive order of the governor of New York . That order limited in person occupancy of religious services in local “ red zones ,” pending disposition of appeal to the US Court of Appeals in the Second Circuit . The splashy news was not so much the grant of injunctive relief but more the sarcastic and moralistic locution lurking in several sentences in his opinion . I haven ’ t the legal chops to argue the opinion granting injunctive relief , at least in such a public forum , but I will resist the approach of Justice Gorsuch as inconsistent with his charge of applying the law in an unbiased and impartial fashion . Further , this dictum serves as a reminder to us all to approach those under
DOCTORS ' LOUNGE a sharper intolerance of others . I try to run that fury up and down stairs , muttering all the way . It ’ s not like a disagreement with your friend - that , you can discuss . It ’ s a huge mass of hatred for everything bad that ’ s happened this year . We look for antidotes , laughing and tenderness with those we love , losing ourselves in some pleasant pursuit . Victories help . Dogs help . Playing helps . Rain and sun and wind and birds in trees help . Yet we can ’ t go and hug people and snug up together at dinner ; our distractions are virtually flawed .
But I have faith that the doctors and EMTs and nurses of this world will bear up . They have so far , because it ’ s their duty . A strong sense of duty is built on caring for others , no matter what . It ’ s built on esprit d ’ corps and self-respect . It comes from training and habit and discipline , from emulating your mentors , from yearning to be the best at what you do .
Medical training must instill this sense of duty , above all . Your patients come first : go to them . You need help : get it . Your buddy needs help : fix all you can for him . Duty will light your path and guide you . I am wishing , for the peace of December , that you will not run out of PPE on the way .
Dr . Barry is an internist and Associate Professor of Medicine ( Gratis Faculty ) at the University of Louisville School of Medicine , currently taking a six-month sabbatical .

A DECISION SPLIT ALONG A MERIDIAN AND TRENDING TO DISTAL POINTS

AUTHOR John David Kolter , MD
our medical purview without judgment , especially judgment laced with our own moral bias .
Three paragraphs in to Justice Gorsuch ’ s opinion , he writes , “ The Governor has chosen to impose no capacity restrictions on certain businesses he considers “ essential .” And it turns out the businesses the Governor considers essential include hardware stores , acupuncturists and liquor stores . One can see where this is going , particularly if you compare the businesses Justices Breyer , Sotomayor and Kagan highlight as “ essential businesses ” in their dissenting opinion , “ grocery stores and banks .” Regardless , leaving little of his point of view to question , Justice Gorsuch concludes the paragraph noting , “ So , at least according to the Governor , it may be unsafe to go to church , but it is always fine to pick up another bottle of wine , shop for a new bike or spend the afternoon exploring your distal points and meridians . Who knew public health would so perfectly align with secular convenience ?” All too eager to sarcastically dismiss those who would dare flout Judeo-Christian western wisdom to visit an acupuncturist , or briefly walk into a liquor store to purchase a bottle of wine , Justice Gorsuch provides a window into what he
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