Recommended by Ricochet Members Created with Sketch. The Physician in a Time of Plague

 
This is probably not a picture of Dr. Alpert.

So I’m reading the American Journal of Medicine, and on page 651 there is an editorial by Joseph S. Alpert, MD. He starts by discussing the book, “The Plague” by Albert Camus, a historical novel set in the Middle Ages. It’s about an heroic physician named Dr. Rieux who elects not to flee, but to stay in his hometown of Oran during the Black Death and treat his patients as best he can. Dr. Alpert then writes (I swear I am not making this up), “At this time (the end of March 2020), we are experiencing events in the United States and throughout the world similar to those described in “The Plague.” Not feeling sufficiently heroic yet, Dr. Alpert writes in the penultimate paragraph, “Thus, the arrival of the coronavirus in the United States presented me with the same decision that Dr. Rieux and his colleagues had to make. They chose to fight the plague as did I … I followed in the footsteps of Dr. Rieux.” Again, I swear that these are direct quotes from Dr. Alpert’s editorial. He even entitled his essay, “Life Imitates Art: The Physician in a Time of Plague.” Go look it up yourself if you like.

The Black Death killed an estimated 30% – 60% of Europe’s population. It reduced the world’s population by about 25%. It had fatality rates of nearly 90% in some places. Anyone who looks at our coronavirus data and sees the Black Death has lost all sense of reality. Perhaps Dr. Alpert really wants to be a hero. Or perhaps he knows nothing about history. Or, perhaps, nothing about current events. Or, perhaps, well, I just don’t know. And remember, he is a medical school professor writing in a medical journal. This is not MSNBC, The Huffington Post, or The New York Times. What the heck is going on? How could he write this? I just don’t understand. And neither, apparently, does Dr. Alpert.

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  1. Stina Member

    People don’t handle easy lives well.

    • #1
    • July 21, 2020, at 7:47 AM PDT
    • 23 likes
  2. Gossamer Cat Coolidge

    I give credit to all the frontline workers-doctors, nurses, grocery clerks, deliverymen, paramedics-all of them, particularly in those early days when no one quite knew what we were dealing with. They did their jobs. COVID is a nasty disease-and accounts from NY during the height of it were truly scary. So I suppose if he wants to see himself as a hero, he can. 

    But COVID is not the plague. Not even the Spanish Flu. And it took mass media to make it seem like it was.

    • #2
    • July 21, 2020, at 8:13 AM PDT
    • 18 likes
  3. Full Size Tabby Member

    My recurring rant (which has appeared here on Ricochet in a few forms) is that the media and government officials keep conveying the idea that any contact with the Wuhan virus leads to certain death, and that the few who escape death have long excruciating illnesses. The communications from government officials and in the media seem carefully designed to stoke as much fear as possible. 

    As a result, people seem to have a greatly exaggerated perception of the risks to themselves from the Wuhan virus. 

    • #3
    • July 21, 2020, at 8:17 AM PDT
    • 9 likes
  4. John H. Member
    John H. Joined in the first year of Ricochet Ricochet Charter Member

    (I swear I am not making this up)

    I wonder what Dave Barry has to say about current events.

    • #4
    • July 21, 2020, at 8:18 AM PDT
    • 9 likes
  5. Percival Thatcher
    Percival Joined in the first year of Ricochet Ricochet Charter Member

    Back in March, it wasn’t yet clear who Neil Ferguson was, or that he was a doink with a squirrelly 14-year-old model.

    • #5
    • July 21, 2020, at 8:19 AM PDT
    • 3 likes
  6. MarciN Member

    Half of the world, it seems, formed a first impression of what this virus would do once it got inside the world population, and it scared them the way a horror movie would. That first impression so traumatized them that they have been unable to shake it even in the face of a reality in which it turned out to be not nearly as devastating as it first looked.

    The press has created an alternate reality of sorts. I’m serious. Half of the world is living in a continuation of the crazy events in Wuhan last December, and the other half is in the actual reality where the virus ended up moving among relatively healthy people and was weakened in so doing.

    • #6
    • July 21, 2020, at 8:21 AM PDT
    • 13 likes
    • This comment has been edited.
  7. 9thDistrictNeighbor Member

    Dr. Bastiat: This is probably not a picture of Dr. Alpert.

    Yabbut he has a stethoscope and a white coat. And apparently there is a feeling of great power that comes from sowing panic. First, do no harm.

    • #7
    • July 21, 2020, at 8:31 AM PDT
    • 12 likes
  8. MarciN Member

    The other thing that I’m seeing in the world of medicine right now is this belief that it was their actions alone that kept it from being The Plague.

    Perhaps it was. It’s very possible. The thing about upper-respiratory viruses and bacteria is that there are thousands of them and they tend to tag team each other. So if the first one doesn’t get you, it will make you weak so the next one will come in for the kill.

    That’s the public-health idea behind stopping the flu each year with vaccines. They know it’s usually a secondary pneumonia infection that actually kills the flu patient, not the flu itself. But if they can keep the flu at bay, that will save a lot of people from dying of pneumonia who would not have succumbed to that pneumonia if they hadn’t gotten the flu.

    I’m not sure that the heroic efforts of the world’s doctors did not prevent a much worse pandemic event. I know they see it that way.

    • #8
    • July 21, 2020, at 8:32 AM PDT
    • 10 likes
    • This comment has been edited.
  9. Jim McConnell Member
    Jim McConnell Joined in the first year of Ricochet Ricochet Charter Member

    Full Size Tabby (View Comment):

    My recurring rant (which has appeared here on Ricochet in a few forms) is that the media and government officials keep conveying the idea that any contact with the Wuhan virus leads to certain death, and that the few who escape death have long excruciating illnesses. The communications from government officials and in the media seem carefully designed to stoke as much fear as possible.

    As a result, people seem to have a greatly exaggerated perception of the risks to themselves from the Wuhan virus.

    Exactly. Much as I dislike to say it, our Democratic government in Oregon has been doing a great job by providing us with daily reports listing the running total of Virus cases and presumed* cases in the state, new cases, fatalities, individual decedent’s age, date of diagnosis and death, place of death, and concomitant conditions if any. By tracking this information, one is able to form an educated opinion of the progress of the virus. Needless to say, the facts often differ markedly from what can be gleaned from media reports.

    • #9
    • July 21, 2020, at 9:32 AM PDT
    • 5 likes
  10. Sisyphus Coolidge
    Sisyphus Joined in the first year of Ricochet Ricochet Charter Member

    There were a slew of medical personnel lost to the CCP virus in New York City, and in Northern Italy. One of the standard measures taken when medical personnel are overloaded is to bring in retired personnel to help fill the gap, which may have made it worse. It was shocking and terrifying for everyone involved, and measures have been taken to avoid it happening again. 

    • #10
    • July 21, 2020, at 9:45 AM PDT
    • 10 likes
  11. PHCheese Member

    My next door neighbor is a retired doctor from the Cleveland Clinic . He is about to receive a Master’s in History from the Citadel here in Charleston. His first love was medicine but he loved history but couldn’t study both. Now that he is retired he is learning things that the narrow study of medicine didn’t include. I’ve noticed he has become less liberal and more conservative in his thinking. History can teach us a lot about the present and future.

    • #11
    • July 21, 2020, at 10:07 AM PDT
    • 18 likes
  12. Roderic Coolidge

    Hospitals, where doctors work, are places where sick people are taken for care. As the pandemic escalates in Texas some medical providers are exposed to large numbers of infected patients as a matter of course. Over 90 COVID victims are currently patients in one hospital. I don’t know details about the other hospitals in the area, but the aggregate number of beds occupied with COVID patients for the Houston area is 2638, up 1000 from last month, according to the Texas Health Department. The number of available beds is down 70% from April. We have about 1500 beds left in Houston of which 88 are ICU beds.

    A few nurses I know of have died from COVID they got at work here. I don’t know of any physicians who have died, but I know of a couple of older doctors who got infected at work and almost died.

    In Northern Italy it was reported that 60 physicians died from COVID because of the extreme crowding of the hospitals with COVID patients and other problems. Heaven forbid, but it looks like we are in the process of working our way up to that now.

    • #12
    • July 21, 2020, at 10:27 AM PDT
    • 4 likes
  13. MarciN Member

    Roderic (View Comment):

    Hospitals, where doctors work, are places where sick people are taken for care. As the pandemic escalates in Texas some medical providers are exposed to large numbers of infected patients as a matter of course. Over 90 COVID victims are currently patients in one hospital. I don’t know details about the other hospitals in the area, but the aggregate number of beds occupied with COVID patients for the Houston area is 2638, up 1000 from last month, according to the Texas Health Department. The number of available beds is down 70% from April. We have about 1500 beds left in Houston of which 88 are ICU beds.

    A few nurses I know of have died from COVID they got at work here. I don’t know of any physicians who have died, but I know of a couple of older doctors who got infected at work and almost died.

    In Northern Italy it was reported that 60 physicians died from COVID because of the extreme crowding of the hospitals with COVID patients and other problems. Heaven forbid, but it looks like we are in the process of working our way up to that now.

    Before the CCP kicked them out, the WSJ reported that 22 doctors had died in Wuhan. A hundred NHS healthcare workers have died from covid-19 infections. By some counts, about 300 people in the healthcare field in the United States have lost their lives due to covid-19 infections.

    It’s the viral load issue for medical staff. The greater the viral load exposure, the sicker the patient becomes.

    • #13
    • July 21, 2020, at 11:17 AM PDT
    • 5 likes
    • This comment has been edited.
  14. Percival Thatcher
    Percival Joined in the first year of Ricochet Ricochet Charter Member

    9thDistrictNeighbor (View Comment):

    Dr. Bastiat: This is probably not a picture of Dr. Alpert.

    Yabbut he has a stethoscope and a white coat. And apparently there is a feeling of great power that comes from sowing panic. First, do no harm.

    Give him a clipboard and he’s a department chief.

    • #14
    • July 21, 2020, at 11:22 AM PDT
    • 1 like
  15. JosePluma Thatcher

    Roderic (View Comment):

    Hospitals, where doctors work, are places where sick people are taken for care. As the pandemic escalates in Texas some medical providers are exposed to large numbers of infected patients as a matter of course. Over 90 COVID victims are currently patients in one hospital. I don’t know details about the other hospitals in the area, but the aggregate number of beds occupied with COVID patients for the Houston area is 2638, up 1000 from last month, according to the Texas Health Department. The number of available beds is down 70% from April. We have about 1500 beds left in Houston of which 88 are ICU beds.

    A few nurses I know of have died from COVID they got at work here. I don’t know of any physicians who have died, but I know of a couple of older doctors who got infected at work and almost died.

    In Northern Italy it was reported that 60 physicians died from COVID because of the extreme crowding of the hospitals with COVID patients and other problems. Heaven forbid, but it looks like we are in the process of working our way up to that now.

    No, not even close. Texas peaked last week and is on the way down. Our overall death rate is below normal. Several of my colleagues have been positive for the virus, but none have died. One of the young women who used to swim with my daughter is now an ICU nurse at another hospital in our system. In spite of taking care of Wuhan Virus patients from the beginning, and without adequate PPE for a short period, not one staff member on her unit has caught the virus.

    • #15
    • July 21, 2020, at 11:48 AM PDT
    • 7 likes
  16. JosePluma Thatcher

    I wonder how many public school teachers who have taught The Plague are now refusing to do the work they are paid for. I do know how many see the irony in this: Zero.

    • #16
    • July 21, 2020, at 11:51 AM PDT
    • 8 likes
  17. 9thDistrictNeighbor Member

    JosePluma (View Comment):

    I wonder how many public school teachers who have taught The Plague are now refusing to do the work they are paid for. I do know how many see the irony in this: Zero.

    Camus is beyond the reading and comprehension level of common core educated high school students. 

    • #17
    • July 21, 2020, at 3:43 PM PDT
    • 7 likes
  18. Caryn Thatcher
    Caryn Joined in the first year of Ricochet Ricochet Charter Member

    Dr. Alpert also may not have read the book. It is not an historical novel set in the middle ages, but rather takes place in the late 1930s-early ’40s. It has been suggested that the plague of the book was meant allegorically to represent the murderous antisemitism of the Nazis, with Dr. Rieux representing the French Resistance. I generally read books without looking for hidden meanings (they tend to be lost on me), but did find the suggestion pretty compelling. The final paragraph of the book where it warns of the plague remaining below the surface, ever ready to return should vigilance wane, seems to support this interpretation. So, too, Camus’ own actions as a member of the Resistance. The real one.

    • #18
    • July 21, 2020, at 5:08 PM PDT
    • 10 likes
  19. Hang On Member
    Hang On Joined in the first year of Ricochet Ricochet Charter Member

    The Plague is not set in medieval Oran but late 1940s or early 1950s Oran. They drive around in cars and have ambulances. 

     

    • #19
    • July 21, 2020, at 5:26 PM PDT
    • 4 likes
  20. Caryn Thatcher
    Caryn Joined in the first year of Ricochet Ricochet Charter Member

    In fairness….I tracked down the article. He had the book right, at least the straightforward reading of it. Yes, he over-dramatizes and seems to see himself as a heroic figure, along the lines of Dr. Rieux. But, in fairness to him, but shamefully to the medical establishment, there were many health care workers early on questioning whether they could refuse to treat Covid patients. So, with that in the background…

    Not today, it seems, the calling to health care as a vocation. Not today, the nuns and nurses caring in the TB sanatoria with no treatment available but good food and fresh air. It wasn’t a question then of if they’d get at least latent infection (if not fulminant), but when. And it wasn’t all that long ago. I was Teaching Assistant in grad school to a man who got his MD in 1941 and went to work in a TB sanatorium. It was from him that I got that sentence about if/when. (The first treatment for TB came out in 1944, but the full spectrum of drugs needed to treat it weren’t available until 1969.) So, too, the priests, nuns, physicians, and nurses who cared for patients during the various cholera epidemics, the influenza pandemic of 1918, in leper colonies, and treating all of the various contagious diseases prior to effective vaccination or treatment.

    BTW, the hospital system where I work said that, No, care workers could not refuse to treat Covid patients. Still, the fact that the question was asked and had to be answered was shameful. So, perhaps with that in the background, Dr. Alpert felt particularly brave. Small competition, sad to say.

    • #20
    • July 21, 2020, at 5:41 PM PDT
    • 14 likes
  21. Skyler Coolidge

    Albert Camus’ “The Plague” did not take place in medieval Europe, it was in Oran in the 1940’s and as I recall was based on a real outbreak. (I read the book in 1981 as a college freshman, and I just pulled my copy to check. I was right, 1940’s, he even writes it as 194-.) It wasn’t quite the same level of death as the 14th century, but the book was dreary with death as only a French author could make it.

    I’ve been equally struck by the hubris of doctors and others in the medical community. Only they can understand things, it seems. It’s like they’ve waited their whole lives and now is their day in the sun. The corona virus will usher in universal health care. A friend of mine from college is now a research doctor at Stanford, and he wants the nation to have a military model of “reservist” doctors who can do medical research. How odd. He also thinks that he and those like him have the exclusive authority to tell the rest of us what to do.

    I think the whole clapping nonsense for the medical people got their egos going. They really began to think of themselves as war heroes of a sort, you know the kind that go home to nice warm beds and wake up to starbucks coffee and their family.

    My view of the medical community is jaded, to say the least.

    • #21
    • July 21, 2020, at 7:40 PM PDT
    • 5 likes
  22. MISTER BITCOIN Member

    Caryn (View Comment):

    In fairness….I tracked down the article. He had the book right, at least the straightforward reading of it. Yes, he over-dramatizes and seems to see himself as a heroic figure, along the lines of Dr. Rieux. But, in fairness to him, but shamefully to the medical establishment, there were many health care workers early on questioning whether they could refuse to treat Covid patients. So, with that in the background…

    Not today, it seems, the calling to health care as a vocation. Not today, the nuns and nurses caring in the TB sanatoria with no treatment available but good food and fresh air. It wasn’t a question then of if they’d get at least latent infection (if not fulminant), but when. And it wasn’t all that long ago. I was Teaching Assistant in grad school to a man who got his MD in 1941 and went to work in a TB sanatorium. It was from him that I got that sentence about if/when. (The first treatment for TB came out in 1944, but the full spectrum of drugs needed to treat it weren’t available until 1969.) So, too, the priests, nuns, physicians, and nurses who cared for patients during the various cholera epidemics, the influenza pandemic of 1918, in leper colonies, and treating all of the various contagious diseases prior to effective vaccination or treatment.

    BTW, the hospital system where I work said that, No, care workers could not refuse to treat Covid patients. Still, the fact that the question was asked and had to be answered was shameful. So, perhaps with that in the background, Dr. Alpert felt particularly brave. Small competition, sad to say.

    I bet good fresh air is good for preventing or reducing the viral load of coronavirus/covid?

    Woke politics has now contaminated the medical profession.

    Dr. Alpert wants to be a left wing celebrity.

    Covid has not changed life expectancy in America. I believe it is 78 or 79?

     

    • #22
    • July 21, 2020, at 7:40 PM PDT
    • 4 likes
  23. Jason Obermeyer Member

    Stina (View Comment):

    People don’t handle easy lives well.

    In The Matrix, Agent Smith explains that the original program failed because it created a world too perfect for the human mind to deal with. 

    It seems that a lot of frivolous, upper -middle class people – many of whom can work from home or are otherwise still being paid – are deriving their meaning from participating in the hysteria. They lack genuine religion or even a comprehensive philosophy, so it’s all they have. 

    • #23
    • July 21, 2020, at 7:54 PM PDT
    • 8 likes
  24. Skyler Coolidge

    Full Size Tabby (View Comment):

    My recurring rant (which has appeared here on Ricochet in a few forms) is that the media and government officials keep conveying the idea that any contact with the Wuhan virus leads to certain death, and that the few who escape death have long excruciating illnesses. The communications from government officials and in the media seem carefully designed to stoke as much fear as possible.

    As a result, people seem to have a greatly exaggerated perception of the risks to themselves from the Wuhan virus.

    If the corona virus came out when Obama was still president, the press would be describing it as a variation of the common cold virus that has just become more lethal than normal, no worries. Neither description is accurate, of course.

    • #24
    • July 21, 2020, at 7:59 PM PDT
    • 7 likes
  25. Roderic Coolidge

    JosePluma (View Comment):
    Texas peaked last week and is on the way down.

    I hope that’s right, but it’s not clear that we’ve seen the peak yet.

    We thought it had peaked in mid May, but instead it started climbing again.

    • #25
    • July 21, 2020, at 8:15 PM PDT
    • 4 likes
  26. Bishop Wash Member

    Skyler (View Comment):

    Albert Camus’ “The Plague” did not take place in medieval Europe, it was in Oran in the 1940’s and as I recall was based on a real outbreak. (I read the book in 1981 as a college freshman, and I just pulled my copy to check. I was right, 1940’s, he even writes it as 194-.) It wasn’t quite the same level of death as the 14th century, but the book was dreary with death as only a French author could make it.

    I’ve been equally struck by the hubris of doctors and others in the medical community. Only they can understand things, it seems. It’s like they’ve waited their whole lives and now is their day in the sun. The corona virus will usher in universal health care. A friend of mine from college is now a research doctor at Stanford, and he wants the nation to have a military model of “reservist” doctors who can do medical research. How odd. He also thinks that he and those like him have the exclusive authority to tell the rest of us what to do.

    I think the whole clapping nonsense for the medical people got their egos going. They really began to think of themselves as war heroes of a sort, you know the kind that go home to nice warm beds and wake up to starbucks coffee and their family.

    Ah, POGs or REMFs. My deployment location had the nickname Camp Cupcake, with Green Bean Coffee available. 

    • #26
    • July 21, 2020, at 8:15 PM PDT
    • 1 like
  27. JosePluma Thatcher

    Roderic (View Comment):

    JosePluma (View Comment):
    Texas peaked last week and is on the way down.

    I hope that’s right, but it’s not clear that we’ve seen the peak yet.

    We thought it had peaked in mid May, but instead it started climbing again.

    No, we flattened the curve in May. The “peaks” in May were just normal variations.

    • #27
    • July 21, 2020, at 8:43 PM PDT
    • 5 likes
  28. JosePluma Thatcher

    Caryn (View Comment):
    BTW, the hospital system where I work said that, No, care workers could not refuse to treat Covid patients. Still, the fact that the question was asked and had to be answered was shameful. So, perhaps with that in the background, Dr. Alpert felt particularly brave. Small competition, sad to say.

    Of course, you could always resign. None of my colleagues did that, and none complained about having to treat Wuhan Virus patients. One of the nurses, who was about to go on maternity leave, was concerned about both herself and her child. But she was also hearing a lot of nonsense: “I heard someone say that this is going to be worse than the Spanish Flu.”

    What we have complained about is being sent to adult hospitals, but again, no one has refused an assignment. 

    • #28
    • July 21, 2020, at 8:52 PM PDT
    • 6 likes
  29. She Reagan
    She Joined in the first year of Ricochet Ricochet Charter Member

    Yes, the timeframe of the original novel, as given in the OP is wrong. we’re talking about plague in the 1940’s, not the 1440s. But it think the larger problem, as demonstrated in Dr. Alpert’s article in the AMJ, is that he’s completely missed the point of the novel, which is more accurately and interestingly, and perhaps less self-involvedly, described here: https://lithub.com/what-we-can-learn-and-should-unlearn-from-albert-camuss-the-plague/.

    At the end of the novel, the “plague,” which is a metaphor Camus uses to describe any sort of disruptive pestilence, not necessarily even of the medical sort, goes “slinking back to the obscure lair from which it had stealthily emerged.”

    Dr. Rieux did not “triumph” over the plague, as Dr. Alpert so breezily suggests. (Camus really didn’t believe in human “triumph.”) I don’t expect we’ll “triumph” over coronavirus either. We’ll just have to learn to live with it and deal with it as best we can. (As most of the diseases we thought we’d “triumphed” over during the last fifty years have recently shown us, they’re still there, lurking, waiting to come back as soon as we drop our guard or assume self-destruction mode and invite them back into our lives.)

    As for Dr. Alpert’s contention that he’s in the same situation as Dr. Rieux, and that coronavirus is similar in nature and deadliness to the plague, clearly that’s preposterous; equally clearly, as the OP suggests, he’d like to be regarded as a rather heroic for his dedication and fearlessness. But here’s what the actual passage Dr. Alpert references with regard to Dr. Rieux’s motivations had to say:

    “‘However, there’s one thing I must tell you: there’s no question of heroism in all this. It’s a matter of common decency. That’s an idea that may make some people smile, but the only means of righting a plague is common decency.’

    “‘What do you mean by ‘common decency?’ Rambert’s tone was grave.

    “‘I don’t know what it means for other people. But in my case I know that it consists in doing my job.’”

    The book doesn’t end with a triumphant bang. It ends with a resigned whimper. All we can do is our jobs. We can’t understand everything that happens in life. So many things are beyond our control. The universe is irrational. We don’t know what’s going to happen next.

    All we can do is try to be decent to each other, and do our jobs.

    As depressing and spiritless as I find Camus, and most of the Existentialists, it’s not a bad message. Certainly not an heroic one, but not a bad one.

    • #29
    • July 22, 2020, at 4:44 AM PDT
    • 6 likes
    • This comment has been edited.
  30. Dr. Bastiat Member
    Dr. Bastiat

    Absolutely brilliant comment, She. Thanks so much for putting that together. I’ve never read Camus. I had no idea.

    • #30
    • July 22, 2020, at 4:56 AM PDT
    • 6 likes