weakness, not strength, and fear, not bravery.
Even if doubt creeps in, you may feel guiltier over the doubt than
the beliefs you have clung to. You have constructed a magically safe
world in your mind, a world promised to you by those you believe
in, a world that has not changed from what you are used to. Wearing
a mask feels like a betrayal of everything you stand for.
How do we reach people with these beliefs? Apparently, having
a person die every 11 minutes in Florida this July is not enough
evidence that COVID-19 kills. Disease curves that go straight up
are not enough. Celebrity endorsements of mask-wearing seem to
make no impact, nor do governmental pleas or the gatherings of
people in scrubs, weeping in each other’s arms outside hospitals.
A recent poll estimated that one-third of Americans now know
someone who has had COVID-19: and yet, everywhere, I see Kentuckians
unmasked.
Since denial is so wrapped up with identity and self-defense –
with it, we protect ourselves from knowing painful truths which
would require changing what we do – it requires every medical one
of us to inquire and attempt, at every visit, to assess what drives the
rejection of masks. Sometimes a little bit of denial will melt if the
person feels heard and in a safe place. Sometimes it will just make
them angry and defensive. But we might have a better chance of
persuasion if they know us already, if we are not some stranger
“ordering them around.”
On a mass scale, I believe we must deny access to everything
without a mask and hire people to enforce this. No mask – no
entry – no service – universally, everywhere. We should have only
one entry to a business; make people wait in lines again. We need
to hire enforcers to man the doors. (We could even post cell phone
video of their refusals in a hall of infamy on news sites.) The state
should train and pay the enforcers; an army of part-time workers
would help the long-term unemployed and the students trying to
survive. It must become unthinkable not to wear a mask.
We have no other choice at this point.
DOCTORS' LOUNGE
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.
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AUGUST 2020 27