Ever Wish You’d Taken those Epidemiology Classes More Seriously?
I confess, I am a bookaholic. My family members complain that on vacations,
my suitcase is filled with (paper) books and at least 2 Kindles, which they
consider excessive. So, choosing one
book from the current stack was hard – so I’ve chosen 6!!
Fiction(al)?
Lessons in
Chemistry by Bonnie Garmus? It’s a
wonderful read! The main character becomes the face of a cooking show through
which she educates her viewers in chemistry, self-worth and agency. And she
even includes a bit on outdoor rowing teams!!
Non -Fiction?
Song
of the Cell by Siddhartha Mukherjee? He is an articulate and a beautiful writer
(and a Pulitzer Prize-winning oncologist), who explains our evolving
understanding of the body’s smallest structural and functional unit — and its
implications for everything from immune therapy and in vitro fertilization to
Covid-19. I can’t speed through this
one, though the immunology research is fascinating.
Auto-Biographical? Orbiting
the Giant Hairball by Gordon MacKenzie (subtitled a corporate fool’s guide
to surviving with grace)? It’s an oldie
but SO relevant for living in organizations right now.
My Final Top 3? Making Sense of the Whiplash of
Recent Years
How about something that ties together present, past and
future for those of us working in health care and GME? For most of us the past few years have been
whiplash-inducing, and the future effect on our workplace finances and people
remains uncertain.
· The impact of the COVID pandemic (and
the specter of others ahead) has rocked our almost-nonexistent public health
infrastructure, shaken the medical/health care delivery system to its core,
triggered long-latent economic, social, and political upheaval.
· Disparities between communities
became starkly evident when access to ventilators, medications and vaccines
were publicly acknowledged.
· And we did not do well as a country: as one of the most highly technically
developed, economically advantaged countries in the world we lost more people
to illness than during the 1918 flu epidemic.
At the beginning of the pandemic, would we have guessed that we would
have over a million deaths (and many more chronically ill as a result?)
· Remember everyone staying at home,
sewing cloth masks? Remember our
confusion about transmissibility early on?
(I recall one of our infectious disease physicians yelling “droplets
people!!”) before we knew COVID was airborne.
Remember wiping everything from the grocery store with wipes?
More poignantly, how many of us know residents, faculty,
family members who died as a result of the disease?
And while we now know much more than we did, we still are
debating the source of the pandemic (Wuhan market? Raccoon dogs?
Pangolins? Laboratory leak?)! What will be the next global threat, and how
will we respond?
#1: How did we get here? For historical perspective
and depth of understanding, no one writes better than Laurie Garrett, in Betrayal of Trust: The Collapse of Global Public Health. This book was published in 2000, is half
footnotes, and is a must read, especially now.
Garrett was one of the first journalists to document the state of
infectious disease and the need for vaccine support, production, and
safety. (She documents an unguarded
laboratory with a stash of smallpox virus, which was declared eradicated in
1980). She accurately predicted that
future epidemics would not be resolved by simple local measures (like the
removal of the pump handle by John Snow in England’s cholera history). The impact of changing population, political
disintegration of public health governance, and increasing global travel on
disease transmission is starkly predictive of what occurred in COVID and what
can still occur in the next pandemic.
#2: What happens
when science and agility collide with the uninformed? A second fast read by a popular author,
Michael Lewis’s The
Premonition details the efforts of the state and local public health
officers across the US who formed an unofficial network (called the Wolverines).
Their purpose? To communicate about COVID containment, epidemiology, and
treatment in addition to, and sometimes avoiding the federal government messaging. The book is a speed read that unveils the
tenacity of the public health and physician health leaders who used their own
data and observations to serve their communities as well as they could. The wrenching stories of abuse from hate mail
to threats which were heaped on these leaders by both laypersons and their
colleagues, underscores the impact of our lack of scientific education that
also lives with us today.
#3: A painful and apologetic memoir by Deborah Birx MD?
Silent
Invasion details the inner workings of the political response by the US
government, the CDC, the White House, and HHS to the pandemic. Poignant in its viewpoint, as a woman leader
in a turbulent setting, Birx details her struggles to manage messages about
safety. She describes the efforts she
and her colleagues made to go from state to state, where resurgences were
predictable. They sought to work with these state governors, local public
health officials, and community leaders to message prevention, containment, and
treatments at each local level, while knowing that her role in the White House
was largely ineffective. She describes
the herculean efforts to get vaccines ready and distributed as rapidly as
possible, an amazing feat by industry and military partners alike.
Final Thoughts
While many of us were inside health care settings, overwhelmed
by staffing crises, lack of resources (gowns, gloves, masks, ventilators), illnesses
of colleagues, protecting trainees, and managing COVID emergency status for
GME, these public health systems and leaders (and authors) were doing
their jobs to keep us (all) safe from physical and economic harms.
As I have read these, I have become more committed to the
need to train all health care professionals in the basics of public health, the
principles of prevention, and support for our public health infrastructure and
communication systems to help us with the next (inevitable) global health
crisis.
And I wish I’d taken those Epidemiology classes more seriously many years ago.