But a series of worrying interactions last weekend triggered something powerful within Trunsky. Maybe it was the long hours. But most of all, he said, it was the endless scope of misinformation and conspiracy theories he felt about patients who had not been vaccinated, many of them in critical condition.
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So on Saturday, just after another 12-hour shift and still with his black scrubs, Dr. Trunsky grabbed a ham sandwich, headed to his backyard, and listened to the next one on a cell phone keypad, which he posted on Facebook:
In my last two days of work I have heard the following:
1) “You’re wrong doctor. I’m too healthy. I don’t have Covid. I’m fine.” (He actually fights for his life).
2) “I ask for ivermectin or you will know my lawyer.”
3) “Demand hydroxychloroquine”.
4) “I don’t care what you say. I’m going to leave. (Answer: “This is your prerogative, but you will be dead before you get in the car”).
5) “I’d rather die and then get the vaccine.” [You may get your wish.]
6) “I didn’t take it because my son told me he would kill me.” (Currently, the patient is fighting for his life, in fact it is the child’s advice that can kill him).
7. “I want a different doctor. I do not believe you. ”
8. Of a woman whose husband died of Covid, “I would never feel comfortable recommending the vaccine to family and friends.”
And at the click of a button, Trunsky, a specialist in pneumology, critical care and hospice and palliative care, joined the growing ranks of U.S. health workers who publicly make their exasperation with the non vaccinated, which make up the vast majority of patients with COVID. to hospital emergencies and to the ICU.
“They got fucked. They didn’t get vaccinated,” Trunsky told Bridge Michigan in an interview about his Facebook post. “And now they’re asking for attention.”
Part of that despair is taken away from the medical teams that treat them, Trunsky continues on Facebook:
Not to mention the anger people have towards the nursing doctors who are really doing our best and offering exceptionally excellent care. Of course, the answer was to have been vaccinated, but they were not and now they are angry with the medical community for their failure.
The numbers are rising. Get the vaccine.
In fact, Beaumont Health announced Wednesday that the ten emergencies in its system were approaching capacity, not just with COVID, but with patients suffering from other conditions that had delayed care during the pandemic.
Trunsky said he wants to be clear: doctors and hospital staff work to treat both unvaccinated and vaccinated patients.
“We took the oath, we take everyone who arrives,” he said. “And I think that in the end is the reason why most of us dedicated ourselves to medicine, to take care of patients. And it really doesn’t matter who they are and what decisions they make. ”
Doctors and nurses can ask a patient why they are not vaccinated, he said, but “you don’t want to come in with a chip on your shoulder, ready to say, ‘You’re stupid.'”
Fight fatigue out of compassion
Medical ethics and those who monitor the well-being of doctors said unvaccinated patients present a particular strain for hospital workers.
Dr. Jessica Gold, assistant professor of psychiatry at the University of Washington at St. Louis recently told a medical publication that it is not uncommon for doctors to encounter “compassion fatigue” in their work. People forget, he said, that even though doctors have to keep the Hippocratic oath they are also human.
“I think it’s permissible to be angry and still be a good doctor,” said Gold, whose clinical and research work includes doctors ’mental health. He is allowed to “be anxious and remain a good doctor. And it doesn’t mean that people don’t take care of their patients. ”
Dr. Kristin Jacob, who oversees the Grand Rapids-based wellness program at Spectrum Health, told Bridge that the strain can be acute among already stressed hospital workers who have spent more than a year working long hours. hours with limited staff while enduring their “exposure to trauma”.
We now have vaccines that can help end the pandemic, “and our community is not taking advantage of it. This causes a lot of moral distress to all of our caregivers, “Jacob said. There is a” natural inclination to feel defensive and continue to worsen fatigue out of compassion. This is difficult to talk about. Nobody wants to admit it. “
Trunsky told Bridge that he feels guilty for having these feelings, but added that they do not extend to all unvaccinated patients.
“Patients who regret it, to a certain extent, when they come in and say, ‘I never thought this could happen. I’m very sorry. I’ve already talked to my friends and family telling them to (get vaccinated) , “makes it easier to take care of them,” he said.
She also recalled a new mother who skipped the vaccine, saying she had persistent doubts about the government’s recommendations that lactating and pregnant women could be safely vaccinated against COVID. She was breastfeeding at the time and still didn’t feel comfortable, Trunsky said.
“It’s hard to be angry at a 29-year-old new mom who’s 10 at home,” she said. “You just can’t.”
But compassion didn’t always come as easily to patients as those Trunsky refers to on Facebook.
This included the man in the emergency room who was barely breathing, even as the machinery transmitted 15 liters of oxygen per minute to his lungs, but who nevertheless declared that he was leaving the hospital.
“He just won’t live if he goes home,” Trunsky said.
Or the wife of a COVID patient who threatened to call her lawyer if doctors did not immediately order ivermectin, a deworming drug that, in humans, is used to treat some parasitic worms, head lice and skin conditions. Although there are clinical trials evaluating the ability of ivermectin to prevent or treat COVID-19, the drug has not been approved by the Food and Drug Administration and there is as yet no evidence to show that it is effective.
Trunsky said several patients discussed with him about peer review research related to COVID, citing conspiracy theories they had read about on social media or formulated on their own.
Some attacked young nurses and overworked emergency personnel.
“They’re looking for someone to get angry about because they did, and that’s not fair,” Trunsky said.
“It’s not fair for doctors, nurses, respiratory therapists, nurses and practicing nurses who bear the brunt of people’s anger when we are the ones telling them what to do and not listening to them. ”
Across the country, doctors, nurses, respiratory therapists and other medical professionals are expressing similar frustrations, including an Alabama doctor who told patients that after Oct. 1, he will no longer see patients who are not vaccinated against the COVID.
“I cannot and will not force anyone to get the vaccine,” he said in a letter posted online, “but I also cannot continue to see how my patients suffer and die from an eminently preventable disease.”
In South Florida, another doctor announced last week that he will no longer treat unvaccinated patients in person.
A “moral injury”
Certainly, doctors are accustomed to treating emergency situations involving patients making risky decisions about their health or lifestyle: smoking, drug abuse, unprotected sex, too much salt, or fried foods. And choosing a career in medicine carries the risk of being exposed to a global range of infections.
But COVID has an unprecedented scale and doctors, nurses and others who have spoken out say the cause and effect of refusing to take an approved vaccine is too obvious to ignore. Last week, for example, the CDC released a new study based on a review of more than 600,000 cases of COVID. Unvaccinated people receiving COVID were found to be ten times more likely to be hospitalized and 11 times more likely to die.
“It’s highly preventable,” Trunsky said of the virus, “and it’s lethal.”
What Trunsky feels is a “moral injury,” said Sean Valles, director and associate professor at Michigan State University’s Center for Bioethics and Social Justice, about the doctor’s Facebook feelings.
“When we face situations in which we participate or have to see that they are so contrary to our moral code, it affects us,” Valles said.