Every Christmas my Mother gave each of her daughters a “Choice Gleanings” devotional calendar. I still buy myself one every year, now that she’s in heaven with Jesus.

From January 27: “And I will give you the treasures of darkness, and hidden riches of secret places.” Isaiah 45:3 and “For you will light my candle: the LORD my God will enlighten my darkness.” Psalm 18:28 the note added, “… so do not fear dark places child of God, His presence will lighten your darkness and give you strength to go on.” another verse I have meditated on over the years , “When I sit in darkness, the LORD will be a light to me.” Micah 7:8.

Those words resonate with me after knee replacement surgery twelve weeks ago.

My knee is healing quite nicely. Duane and i have been biking with our red recumbent tandem since week four post surgery. I’m walking well although can’t do more than a mile. I’m back at yoga classes.

But after the surgery, what I thought was a mild anxiety disorder ballooned, with help from worry about pain, about not doing enough to heal properly and having some drug reactions that caused me to lose my appetite and ten pounds.

I’d wake up at 5 in the morning, sweating, jittery and crying to Duane for help.

Thankfully, I had a supportive doctor who I was able to get in to see. She did tests and said my health looked fine. I also called my therapist who I had seen in the past for direction and help with travel anxiety. She’s a Christian, and knows I’m a Christian, so when I told her, in tears, that I was worried I was going to hell, she could see I needed medical help.

“Jill, I’ve never seen you like this before,” she said. “I want you to see a psychiatrist to get your medications sorted out.”

The psychiatrist told me that one of the medications I had been taking for years for restless legs, and anxiety, had outlived its’ usefulness, and was the source of much of my problem, when it had combined with other knee medicines. It was time to wean off it.

Easier said than done.

One question my therapist asked, amid all the anxiety, was: “Do I feel safe?”

It’s a good question. I believe what I don’t feel safe about right now is my body. My knee is healing nicely, very well, and yet I still am limited in how much I walk and what I can do. I still remember the pressure the physical therapists put on me to “do everything right or you will not have a good outcome…”

Cutting back on the restless leg medicine solved the morning hysterics. Then as I cut back more, I began having hot flashes and jitteriness during the day or night, every day. It felt like my body was working against me with those general uncomfortable symptoms that some days had me laid out on the sofa. The psychiatrist gave me medicine to take the edge off, but the awareness of being on the cusp of an episode day after day is exhausting.

I was used to having a healthy body, but since December 10, when I had the surgery, I was fighting different body battles each week.

I grew up in a family where physical weakness was “poo poo-ed.”

“You’re healthy stock,” my father would say. He played tennis every day until he was 82. My mother walked daily with a friend. Neither was rarely sick. My mother developed Parkinson’s disease mildly at 65 which didn’t affect her daily life until her late 70’s.

Only in the last 2 years of his life did my father suffer with congestive heart failure, which caused him to lose so much weight he looked like a survivor of a concentration camp. That was when he and my mother had moved here to Clearwater, where my two sisters lived.

Some days we’d walk into their apartment at Regency Oaks and Dad would be sitting up at their small kitchen table eating his cereal, feeling fine. One day I walked in and he was sitting in his recliner, not feeling well at all. He often asked, “When do you think I’m going to go to the doctor and start feeling better?” He was a Dale Carnegie positive thinker. My unspoken response was, sadly, “Dad, you’re not going to be getting better.”

The day that hurt me the most was the day he said, “Just take me out and shoot me.” So unlike my Dad; he rarely complained but I knew the CHF was miserable.

Then the next time I visited, he was sitting in his recliner watching tennis on TV and he turned and said, “We’ll remember these days as the good times.” In my heart my response was, “Oh Dad, you have to be kidding, this is awful seeing you declining and suffering.” Now I laugh to myself that actually he was right: we enjoyed many good times with them in those last years, in spite of his health.

I’m thinking about my dad’s health because I think I’m too thin right now, like him. My appetite is coming back, but with drug withdrawal symptoms I’m not always hungry to eat, but know I should. Then I worry that the stress of being too thin and anxiety is hard on my heart. Duane checked that and it’s fine.

In my frustration and impatience with healing from surgery and overcoming medicine issues, my therapist suggested that maybe God has this time for me to slow down, wait, and work on relaxing.

“You need to adjust your expectations,” she said. “Give yourself six months to heal.” She suggested the “Calm” app when I was feeling anxious. Also, I began setting the iPad beside my bed so I could listen to hymns when I woke in the morning. Duane and I continue to take a walk after supper to listen to a Psalm and pray.

“Get a massage,” was another idea of the therapist, which was a new activity for me.

And Duane has been gently keeping me doing/going while also saying, “I understand.” I love him so much.

My morning devotional thought from March 5 was, “…He gives more of Himself to one person than to all the governments, politics, programs and opinions of this world. So dear believer, take courage and trust your loving Savior to get you through whatever you are facing today. You are a much loved child. Believe it.”

The blind hymn writer Fanny Crosby penned the lyric that followed, “…. Safe in the arms of Jesus, safe on His gentle breast. There by His love o’ershaded, sweetly my soul doth rest.”

Dad served on H. M. S. Glory, a British aircraft carrier, during World War II.

He traveled to Deal, England, to enlist in the Royal Marines in October 1943.  This is that ‘last day’ photo before leaving his mother, father,  little sister Ruth, and the family dog Carlos, at 20 Valley Drive, Gateshead.  He was 18 years old.

H. M. S.  Glory sailed from Belfast to ports around the world: Alexandria, Egypt to Australia and the Japanese surrender in the Pacific in 1945.   I can see in the pictures that Dad lost weight.  Dad told us his mother sent him a chicken in a tin can, she was so worried about how thin he was getting.  I can hear Dad laughing:

“When I opened the tin, the chicken had to be thrown overboard immediately.”

Dad earned the nickname “Posty” with his ‘pals’ (his word) because his job on the ship was delivering the mail.  I can’t figure who took these pictures or who owned a camera and where they developed the film, during a war.  Dad learned a cheerful attitude from his commanding officer.

“We started each day by looking in the mirror and saying, ‘In every way, throughout the day, this is going to be the best day of my life.”

The men entertained each other with shipboard shows.

Dad also told stories of the planes that missed the ship’s runway and disappeared into the sea.  Or the horrors of transporting the British P. O. W.’s from the Japanese camps after the surrender.

“They were in terrible shape.  Many didn’t make it home.”

Dad told us he held the pen at the signing of the Japanese surrender, which wasn’t true.  But the Japanese did surrender to Britain on  his ship the H. M. S. Glory on September 6, 1945, at Rabaul, off the coast of New Britain, now New Guinea.

Dad’s hero throughout and after the war was Prime Minister Winston Churchill.

“We shall never surrender, and even if, which I do not for a second believe, this island, or part of it, is subjugated and starving, then our Empire across the seas, armed and guarded by the British fleet, will carry on the struggle, until, in God’s good time, the New World, in all its strength and might sets forth to the rescue and liberation of the Old.”

I close my eyes or don’t watch movies with scenes of torture, or when a child dies or a pet is hurt.

So it’s been tough watching my grandkids, 4th and 7th grade, sitting, sitting, staring in front of a computer monitor for electronic ‘supposed’ learning, off and on the last months. 

I ventured out to Palm Harbor Nursery yesterday to buy red geraniums.  

“Don’t go out!” I hear the CDC voice, but I go out anyway.  The sun is shining in the great state of Florida.

During the purchase, the owner shared her horror about the kids in New York City who have been banished to E Learning.  I agreed with her.  The Academy of Pediatrics has stated that the safest place for children during The Virus is in brick and mortar schools.

Last Sunday, friends shared their experience visiting their elderly mother in a senior living facility.  

“They wouldn’t let us hug her goodbye, after the fifteen minutes, and she was crying.”

After nine months, these are not isolated cruelties, but repeated over and over and over, 

“Be safe,” everybody says to everybody now.

We’re sick of hearing it because it has created, not a safer world, but an unhealthy way of existing in our homes, churches, schools and businesses that used to bring life and joy.

The news media continues to peddle fear and misunderstanding so that we continue to tune in tomorrow. They’re desperate for ratings.  They have become expert in making us feel.  They should be helping us to understand.

The biggest turning point of 2020 is upon us.  Covid vaccines are ready for approval and distribution. We’ll be able to put this season of misery and death behind us.  However, in the misguided ideal of reporting both sides of the issue, the news continues to give air time to vaccine naysayers.

Many politicians, and the medical politicians at our CDC only make the problem worse.

We’re advised to not:  not go out, not get together with family for the holiday or any time, not travel, not touch.  That is cruel.  I can’t remember one week for the last nine months when the word ‘Surge’ wasn’t a headline in the newspaper, but the present week is always, according to The Experts, the beginning of The Worst.  That’s emotional torture.

In actor Alec Guinness’ autobiography “Blessings in Disguise” he describes his search for God during World War II.  He describes how he, along with many soldiers, turned to God, reading the New Testament on their Navy ship, in the days before battle and possible death.  

God is still our help, and we acknowledge Him as the source of providing treatments and vaccines for Covid.  He is our healer.

In Agatha Christie’s “An Autobiography,” she describes what life was like in London during the years of World War II:

“So time went on, now not so much like a nightmare as something that had been always going on, had always been there.  It had become, in fact, natural to expect that you yourself might be killed soon, that the people you loved best might be killed, that you would hear of the death of friends…”

Later, she reflects on the virtue that made those cruel days livable:

“…we can hope… we do not appreciate that second virtue in the trilogy ‘faith, hope, love.’ … how often do we forget that there is hope as well, and that we seldom think about hope?  We are ready to despair too soon…”  – Agatha Christie

The simplest shopping trip, over the last few months, could be a cause for despair.  I’d overhear a customer snap at another customer, “Stand back six feet from me!” Or encounter empty shelves.  But yesterday, I had a different, delightful experience. I stopped in at “The Painted Pear,” one of the few specialty shops of handmade and unique gifts that has not gone out of business because of the pandemic.  After picking out Christmas tree ornaments, I spotted, on the top shelf of one of the display cases, a wooden, handmade sign:

“Courage,   Dear Heart”

               -C.S. Lewis

I’m a Wheaton grad and devoted fan of Lewis.  He has a way of getting to the important point in a most clear and beautiful way.

I wanted to buy the sign, because it was the message I wanted to keep in front of me now.

I asked, but it wasn’t for sale. 

I’ll have to make one.

Encouraging truths which hide like secrets in the newspaper, regarding The Virus:

  1.  Safe and highly effective vaccines are almost ready to distribute.
  2. The Infection Mortality Rate, in spite of the constant drone of ‘case counts,’ remains extremely low, especially for the young and increasingly, because of advances in treatments, those of advancing age.

-picture taken at the College of Anesthesiologists in London, England.

 

 

 

 

 

 

 

 

 

 

an overdue guest editorial by pediatrician Dr. Duane Rommel:

“In a lecture at Cornell University in 1964, physicist Richard Feynman defined the scientific method:  First, you GUESS.  Then you determine the consequences of your guess.  Then you compare those consequences with outcome of experiments.  If your guess disagrees with the experiment, it is WRONG.   This is science.” 

    from the book, “How Innovation Works: And Why It Flourishes in Freedom”

For the past 9 months, we’ve been making a lot of guesses about Covid 19.  Some of the guesses have been wrong.  Some have been right.  Some vilified, some verified.  Some, we await the verdict.

I hear leaders claim that they are following “science.”  What that really means is that they are listening to certain scientists who happen to agree with their political bias.  The science of Covid 19 is incomplete and complex.  Therefore,  public health policy leaders need to be open to reassess their guesses and policies.

Anthony Fauci was christened by the press to be our ultimate “scientist.” Policy makers had to heed his guesses or be labeled “anti-scientific,” “uneducated,” or a “conspiracy theorist.”   However, our present reality illustrates that scientific policymakers need to re-examine their theory and be open to new ones.  That is how science works.  

Today’s newspaper trumpets “New Virus Cases Surge Across U.S. and America.”  The scientific policies followed by most Western countries are failing.   Many states and European countries hit by the pandemic imposed strict lockdowns this spring.  They launched testing and contact tracing programs to stop the spread of the virus throughout the summer and fall. These policies have failed as these countries and states have tried to ease their lockdowns.   They prove that the virus can’t be controlled that way. Their scientific theories aren’t working.

In October, another group of highly respected scientists gathered to propose a new plan for dealing with the pandemic.  

I strongly recommend everyone read “The Barrington Declaration,” and watch their video titled, “Dissenting Scientists Issue Herd Immunity Declaration” on their website: gbdeclaration.org.  Their Declaration challenges the current guesses about how to defeat the pandemic.

They explain why our current policies are 1.) Poor public health policy 2) Unscientific in their conclusions, and 3) Immoral as general policy.

They present the concept of herd immunity as a scientific fact which applies to the covid pandemic.  We reach herd immunity with every highly contagious illness that exists.   Herd immunity is the resistance to the spread of a contagious disease within a population that results when a sufficiently high proportion of individuals are immune to the disease. Herd immunity is not policy or opinion, but the way infectious diseases are controlled.  It will happen. The only question is how we will get to herd immunity with the least harm to the public.

Their proposal rests on the unchanging scientific fact of Covid: the Infection Mortality Rate.  This undeniable scientific data should be driving public health policy.  The Infection Mortality Rate for Covid 19 is ‘age specific;’ or radically different for different ages.  These scientists insist that leaders in public health must, in their words, ‘exploit this weakness’ of the virus to defeat it and reach herd immunity.  

I’m seeing patients frightened by Covid in my pediatric office.  These young people and their parents equate getting Covid 19 with a death sentence.  In fact, according to the CDC, the chance of dying from Covid, for a person under age 19, is 3 per 100,000.  www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html.   According to the CDC the chance of dying from the influenza last year for that same age person is 1.6 per 100,000.    For those 20 to 49 years old,  the chance of dying from Covid is 2 per 10,000.   The chance of dying from the flu is 2 per 100,000.   It’s not until age 70+ that the mortality rate of Covid 19 increases dramatically to 5 per 100.

This fact, the extremely low mortality rate in young people, which is accepted by all scientists, needs to be driving our policies. Scientific reality states that we will reach herd immunity at some point with Covid.  To clarify: the infection will largely come under control when enough people are immune to it.   Immunity will either be achieved through getting the illness or through a vaccine for the illness.  There is no other way.

The public health question that policy makers, assisted by the scientific data, need to discuss is: “How to achieve herd immunity with the least harm to the public’s health?”   

The Barrington Group recommends: “The most compassionate approach that balances the risks and benefits of reaching herd immunity, is to allow those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk. We call this Focused Protection.”

I strongly agree with their recommendations.  The second video illustrates their reasoning as to why this is better health policy, better moral policy and more compassionate than our current policy.  

We must stop being overly focused on Covid 19 alone.  That distorts our overall health policies to the point of harming the people we want to protect. 

6105 Abbott Avenue had only, one and three quarter bathrooms.  A family of six, we four girls shared the ‘main’ bath.  The infamous ‘pink shirt’ picture of the Mitchell girls:

When we moved to 6105, Wendy and I were in high school,  Jennifer was in junior high and Pam attended elementary school.  I never remember our bathroom door ever being closed.

Mother scrubbed its’ tan tile floor every Friday, and washed the rug.  Two lightbulbs, hidden behind a frosted glass cover, hung above the mirrored medicine cabinet.  Maybe that was all the light a room only 5 x 7 feet needed.   The white porcelain sink wasn’t even a pedestal sink but a bowl attached to the wall, with no storage or shelving underneath.  A bar of gold Dial soap sat in a silver metal dish screwed into the wall above the sink. The white bathtub might have had tile surrounding it at one time, or it had been replaced with a plastic insert.

The space would be ripe for an HGTV makeover today.  Yet we were content with it.  Even with four girls, I can’t remember the small medicine cabinet overflowing with bottles of beauty ointments, or any of the stereotypical fights with girls banging on the door, “It’s my turn!  Get out!”

The one extra feature it had was a mysterious small oak door in the wall beside the toilet.  Guests would always ask, “What’s that?”  A clever builder designed the door for convenience.  It was a laundry chute that led to a large wicker basket in the basement below, near the washer and dryer.  All Mother’s grandchildren at one time or another used the chute as a toy.  It was fun to open the door and make matchbox cars disappear.

That bathroom taught me, before I was married,  a lesson about the rigors of married life.  While on a family vacation in Ocean City, New Jersey, Dad had to fly back to Edina to work for a couple of weeks.  He offered to wallpaper the bathroom for my mother.  Unfortunately, he also picked out the wallpaper: a very 60’s looking turquoise and brown daisy pattern.  When my mother got home and saw it, she was horrified.  But, she never repapered that bathroom.

I learned another lesson there: take every opportunity to enrich your life.  Mother wasn’t a professional musician, but she played the piano.  Her baby grand sat in the living room.

 

She appreciated the beautiful things in life, and as a born teacher, found ways to instill a love for beauty in her children.  When we lived at 6105, Mother loved taking us to the Edina library, a separate city library in those days.  Besides books, they loaned out framed art prints for free, on a monthly basis.  So Mother joyfully hung her choice for the month in that bathroom, over the laundry chute door.

I can’t remember any of those masterpieces now,  but on occasion I’ll see a painting that I recognize from that bathroom classroom.  Having no photo, memory has to paint the picture of that special place, down the hall, second door on the right.

 

 

A combined movie review (by Jill) and Covid 19 update (by Dr. Duane Rommel)!

Jill:  Once again, Tom Hanks, the famous actor with the average face of Everyman, occupies center stage in heroic glory, as the Captain of an Allied ship in WW II.  Their mission: to defend desperately needed supplies as they travel through the Atlantic.  They face a formidable enemy,  German u-boats.

The most surprising moments in the film are brief scenes where Hanks prays over his breakfast, or fixes his tie as he gazes into a mirror edged with the verse, “Jesus, the same yesterday, today and forever, Hebrews 13:8.”  Or worries about the souls of the Germans he just killed.

Captain Krause is a man of faith.  The story unfolds as the intense 36 hour fight to protect the convoy.   Tom Hanks exudes believability Krause,  directing the ship through icy winter seas and torpedo attacks.   When the Germans send threatening messages in the dark night that play over the ship’s radio to the crew, “We are Grey Wolf and we are going to destroy you,” I felt the fear.  But Krause skillfully leads his team to work together to destroy a few of the German U boats who are trying to kill them.  Some of their own men die (war is hell) but Krause ultimately triumphs, bringing his ship into safe harbor.

In stark contrast, yesterday The Tampa Bay Times featured a front page picture of a teacher holding up a sign, “I can’t teach from a coffin.”  I was shocked.  In a time of war on Covid, our country and world need heroes.   The  teaching profession is usually made up of our leaders who instruct and inspire our next generation.   The message of magic marker on the sign was worse than a lie, it was a half-truth, something more powerfully destructive than a complete falsehood.  Yes, the truth is, a small percentage of those who get Covid will die.  But someone dedicated to teaching truth should know that the data supports the fact that most people will not.

Dr. Duane:  The fear and hysteria surrounding Covid 19 continues in a significant percentage of the population in the U.S.  Because of these overblown fears, many are now advocating a delay in the opening of school.  In my office, my patients ask me:

“Should kids return to school next month?”

My answer is an unqualified “YES”.

I am in agreement with the American Academy of Pediatrics, who wrote in their guidance statement: ” Schools are fundamental to child and adolescent development and well-being.  They provide our children with academic instruction, social and emotional skills,  safety, reliable nutrition, physical/speech and mental health therapy, and opportunities for physical activity, among other benefits.”  Statistics continue to show that the risks for kids under the age of 19 are minimal for dying from Covid.  Of the total number of deaths from the virus in the U.S., .0004 are in people under the age of 19.  And that does not even account for the underlying conditions in those children who died.  That is the total number.

So, school leaders need to ask themselves:  When is the treatment worse that the illness?  It’s obvious that the risks associated with the virus for our children are much less than the problems we will create in not opening the schools.  This does not address the personal concerns of  individual teachers.  If a teacher has an identified health risk from Covid 19 according to their physician, they should not teach this year.  But that does not mean we should close the schools because a small minority of teachers cannot be in the classroom.  To clarify: teachers, along with the general public, need to be reassured that statistical data shows the risk of dying from Covid, for teachers under the age of 65  is very low.  (see  http://jillrommel.com/2020/06/01/covid-19-statistics-for-dummies/).  The fear of some should not control a school districts’ decision about what is the right thing to do for our kids.

 

Winston Churchill said, “When you’re going through hell, keep going.”  We must move forward with life.  Schools must open.  As a physician, concerned with the whole well being of my patient families, I see how unwise policies produce more fear, which are pushing too many into unemployment, isolation and depression.

Jill and Dr. Duane:  The media is not helping.  Putting an image of a frightened teacher on the front page tears down the truth.  Rather than instructing the public, they pander to their fears to sell papers.  They play the part of “Greywolf” in the movie, the enemy, taunting the sailors with lies.  “We are coming after you and will destroy you.”  Instead, the media should be highlighting the lawn signs we’ve seen as we’ve biked our neighborhoods, “Thank you to our heroes: our health care workers and grocery store workers.”  Our heroes show up to work.  They are.  Teachers need to be heroes, too, and show up for school.

Seeing a hero, like the one Tom Hanks portrayed in “Greyhound,” reminds us that right actions are based in our faith in the truth.  And the truth is, getting Covid is not an automatic death sentence.  Scientific data continues to support this.    One would hope that schools, some with specific ‘STEM’ labels, would be places where their leaders would grasp these ideas.  I know quite a few teachers who do, and are ready to start back to school.

Some British made WW II movies are based on the idea of ‘the enemy within.’  This theme used to surprise me, as I assumed that all the Allies were on the same team:  ‘We’re all in this together.’  The facts reveal stories like that of Charles Lindbergh, American aviation hero, who was supporting the Nazis.  Royal Edward and his wife Wallis Simpson sympathized with the Nazis … or the traitor can be turn out to be the neighbor next door.  Unfortunately, there may be those among us that are trying to tear us down; who are on the Fear Team.

Facing the realities of life, like this Covid illness, forces each of us to choose what kind of person we’re going to be.  Interesting that in “Greyhound,” Captain Krause found his strength in God.  Duane and I have found ourselves to be in need of help these days.  Not that we’re afraid of the virus, but it’s sobering and saddens to see how the fear of the virus has destroyed so much.

‘Greyhound’ ends with a prayer.  Before falling into bed, exhausted after 36 hours straight of fighting the enemy, Captain Krause kneels beside his bed and says,  “I thank you, my heavenly Father, that you have graciously kept me this day.  Into your hands I commit my body and soul.”

 

 

Another guest posting by Pediatrician Dr. Duane Rommel.

I often get a call in the middle of the night from an anxious parent because their child has a fever of 104.  

“What other symptoms does he have?”  I ask.  “How is he acting?”

The mere fact that a two-year-old has an elevated fever is not a cause for alarm if the child is acting fairly normal, or if other family members have had the same illness.  Fever is only a symptom.  The important information for me is what is causing the fever. 

Similar reasoning applies to the most recent increase in Covid 19 cases in Florida.  The number of reported Covid 19 cases has increased significantly in Florida in the last week.  Forecasters are predicting their usual doom and gloom. 

“There will be catastrophic consequences,” according to the ‘model’ of Dr. Marrazzo of U of Alabama Birmingham Infectious Diseases. 

The big issue I have with the word “models” is that it suggests some kind of legitimate scientific basis for predicting the future.  However, every model which has been quoted in the news since the pandemic started has been drastically wrong. 

Governor Andrew Cuomo recently stated the same thing when asked about reopening New York, “All the national experts … were all wrong.”  There is not much difference between ‘models’ predicting the future for Covid 19 and tea leaves predicting the future.  These are guesses. There is a little bit of science and a lot of guessing.  So let’s start ignoring these guesses and concentrate on what is important.  

From the beginning, I have stated that many people will get infected with Covid 19.  The state of Florida has dramatically increased its testing availability and more cases are being diagnosed  which were missed several weeks ago.  

Also,  the state has relaxed the lockdown guidelines for most of Florida. Many more people are returning to normal activities with social distancing.  It is to be expected that more people will get the virus.   This also is not a cause for concern.

The infection mortality rate is the most important statistic, which the media continues to ignore.  The infection mortality rate is the risk of dying from Covid 19 if a person gets infected with it. The infection mortality rate in people under age 65 is about .1% in the latest U.S. studies.  This is a more encouraging and lower mortality rate than previously feared.  It is not necessary or wise,  in light of this data, to make any changes to present health guidelines regarding the virus in Florida.  

As Democratic Governor Gavin Newsom stated this week,”We have to recognize that you can’t be in a permanent state where people are locked away to see lives and livelihoods completely destroyed, without considering the health impact of those decisions as well.”

Efforts and resources need to be focused in protecting those who are most at risk of dying from this infection:  people in nursing homes and those with well defined risk factors. 

The most important statistics are not the daily case counts.   Other statistics to monitor are the ages of the individuals who are becoming infected, the daily hospitalization rates and  daily death counts.  These statistics will be better guides for our policy making decisions than the number of cases per day. 

A child with a fever can cause anxiety for a loving parent.  Reassurance and education  about how the fever is the body’s normal way of fighting an infection are often the only treatment needed.  The prospect of an uncontrolled virus at large has caused the same anxiety; however, the most important facts, like the infection mortality rate, should be trumpeted by the media to calm our country.

As a medical professional, I implore the media to cease broadcasting the so-called ‘scientific models’.  It’s harming my patients, and the general public as much as the screaming of ‘Fire!’ in a crowded theatre.

Disclaimer: My views may not reflect the views of Children’s Medical Center.  Please consult your own doctor for specific advice in your situation.

 

We biked into the church parking lot this Sunday morning.  I was so happy to be back at church that my eyes filled with tears.

I’ve been having flashbacks of Duane’s medical residency, forty years ago, during these last months of lockdown.  We had moved to Rochester, Minnesota, where we knew no one.  Duane was on call at the hospital every third night, leaving me alone at home.  That July, I realized the normal routines of life would be gone for three years.  The natural rhythm of workweek/weekend disappeared.  Friday night movie dates, over.  We used to go to church together on Sunday mornings.  Now I went alone.

I was pregnant, too, so technically not alone.  I found a job at the County Clerk’s office processing passports and marriage licenses.  A  kind couple at  the church I attended started a Bible study for new mothers soon after Mike was born.  Even though I was new to the church, the ladies held a baby shower for me.  I went home with a car full of presents, from other young mothers who hardly knew me.

For Duane and I, being part of a healthy church has been a top priority.  We’ve moved a lot in our forty three years of marriage.  Wherever we settled, we searched for a good church.  A place where people who follow Jesus gather.

I remember the couple who taught our Sunday School class when Duane was in residency, Herb and Fran Reigler.  They tried anonymously, to pay for our car repair bill when the motor froze.  Where ever we’ve moved, we’ve met more people like them:  the friends who visited the juvenile jail with us to share their lives with incarcerated kids.  Jeanne always remembered each child’s birthday with a card. Our Sunday morning team who planned and led a worship program for kids.  The high school kids who babysat the kids of young parents so they could get together.  The friends who have listened to our family emergencies and prayed for us, and asked us, “How’s it going?”  These are people who care about others.

Over the last weeks, unable to go to church on Sunday mornings, I miss my Christian friends.  We’re different ages, in different ‘life seasons’ with different callings and backgrounds.  But my Christian friends share two characteristics that attract me: gentleness and grace.  Over the years, we’ve shared the good, bad and ugly of life.

When something comes up on a Monday morning, or whenever life crashes into my plans, I  think, “I’ll be able to share this with my friends at church.”  It comforts me to know they’re praying for me. I’ve seen circumstances change in ways I couldn’t make happen myself.  These aren’t just nice people, they’re people who’ve made the choice to believe God exists and that he cares about us.  And so, we  care about each other.

On the old  British show “All Creatures Great and Small”, two veterinarians were discussing the hard lives of their patients, the farmers of northern England.

“They have sheer stubborn pride and refuse to quit, in spite of the frightening day to day realities they face.  They’re a breed apart.  They possess that exceptional quality of the unbreakable human spirit.”

In the next scene, James, one of the vets, is sitting at the kitchen table of the farm family whose cows needed his healing.  The farmer’s wife kindly asks James if he would like a cup of tea and a piece of pie.  Her son, hardly twelve, breezes through the room.

“I’m off to check on the cows for Dad,”  he announces as he goes out the door.

“Where’s your husband?”  James asks.

“He’s in hospital,”  the wife answers.

“Is it serious?”  James looks shocked, as he had just seen him a week ago, and farmers can’t afford to go to hospital.

“Well… it’s not looking hopeful,”  she says quietly.  Set in 1937, before present day medical treatments, death was not uncommon for illnesses we shrug off today.

I’ve been meditating on that ‘unbreakable human spirit,’ pictured so poignantly in that farm family.

When ‘the going gets tough, the tough get going,’ goes the old motto, and in these present days my ‘unbreakable human spirit,’ can feel fragile.  I used to turn on the news each morning, to catch the local weather.  Not anymore;  I’d have to endure hearing the newscasters spouting the latest Covid stats.  So I make other choices, which take time to consider.  The constant ‘considering how to spend the time’ and being forced out of life’s habits and routines, is, in itself, exhausting.

I try to surround myself with inspiration.  Winston Churchill’s speeches can do that. The epitome of moral courage, he determined to survive against Hitler.  In response to the idea of surrender to Hitler, Churchill stated, ““If this long island story of ours is to end at last, let it end only when each of us lies choking in his own blood upon the ground.”    

I try to copy his resolve.  Lately, I also  remember that Churchill spent much of the war taking hot baths and drinking heavily.

The greatest hardship of quarantine for me has been the loss of the Sunday morning church experience.  Zoom and internet services can’t fill the void.  My mainstay, beyond faith in God, is  being able to get together with people who love God.   I go to church on Sundays with expectancy.  A  serendipitous Energy pervades those gatherings, that begin out in the parking lot when we arrive, because we often meet there first.   Surprising encounters happen in hallways and the lobby.  The carefully planned services restore my spirit’s perspective.  Through music, prayers and spoken truth I’m changed and strengthened.  Something I didn’t expect but came looking for is found.

It’s the one morning out of seven where the focus is God’s community, not me.   I’m reminded of important things I knew but forgot.  Being with other Christians, God’s kingdom comes alive. The ideas I hear may propel me to a new choice or a new habit.  Or something to eliminate from my life.  This morning I learned about a summer Bible study to join.

If the human spirit is ‘unbreakable’ or we’re stronger than we feel at times, it’s only because God is the one who supplies the love and strength that we need to make it.  He designed us to live in relationship with him through our relationships with others.

I was thrilled and thankful to be with my church family this Sunday.  We met at 8 a.m. outside, in our shady parking lot.  Being the middle of June, no one  expected the cool Florida breeze that floated around us, scattering the Pastors music and sermon notes.   We sat on lawn chairs or blankets we brought, with our children at our feet.   We joined in Communion with each other.

In the last weeks, as our county has begun a careful Reopening,  some of the New Normals have been a disappointment.  Store shelves still have empty spaces..  Libraries and restaurants aren’t their usual selves.

But this Sunday morning’s gathering, thoughtfully planned with wisdom, began my week with the same life-giving joy as every other Sunday.  As always, God’s glory shines in his people.

 

“I will proclaim your name to my brothers and sisters. I will praise you among your assembled people.”       -Psalm 22:22.

“The world is a perfectly safe place to be as long as you are in the Kingdom of God.”  – Dallas Willard

Another in what has turned out to be a series of medical posts by Dr. Duane Rommel:

I read the headline in the National Review, “Why does the CDC think the Covid 19 fatality rate is so low and why won’t it tell anyone?”  (https://www.nationalreview.com/corner/why-does-the-cdc-think-the-covid-19-fatality-rate-is-so-low-and-why-wont-it-tell-anyone/)

I’ve been asking myself the same question.

In April, early data was beginning to show the Covid virus that locked us  in our homes was not as fearsome as first thought.  The health experts that supported that view were lambasted.  As the weeks pass, more data has arrived, supporting their claims.  The latest news comes from the CDC, our government’s scientists; yet some don’t want to believe it.  Or, worse, report it clearly to the public.

This report from the CDC, our nation’s health protection agency (https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html) was dated May 20.  Their best understanding of Covid 19 shows  that for those age 0-49 the Case Fatality Rate for people who have symptoms is .05%.  

Please take time to learn this important statistic.  This is one statistic that has meaning, in a never ending sea of confusing numbers broadcast in the media.  The case fatality rate means the number of deaths from Covid 19 divided by the number of people who had symptoms of Covid 19 and tested positive.

The case fatality rate for age 50-64 year olds with symptoms is .2%. The case fatality rate for age 65+ year olds  with symptoms is 1.3%. The CDC currently estimates that 35% of Covid 19 cases are without symptoms.  

Even more important than the Case Fatality Rate is the Infection Fatality Rate.  The Infection Fatality Rate is the number of deaths from Covid 19 divided by all the cases; symptomatic plus asymptomatic.  The Infection Fatality Rate, according to the CDC’s research at this time, is: 

Age 0 to 49:  .032%

Age 50 to 64:  .13%

Age 65 + :   .85%

Earlier rates were being used by the government to set policies leading to the shutdown of our country.   These numbers are a significant change from those used in March, which were estimated to be 3-5%.  The case fatality rates clearly have been a major factor in government officials’ decision making.  The higher the fatality rate, the more aggressive we needed to be to minimize the transfer of the virus from person to person.  The less the fatality rate, the more we can resume activities which allow contact between people.   

The current understanding of the Infection Fatality Rate by the CDC on May 20, is one tenth the original estimate.  A typical infection fatality rate for the ‘seasonal flu’ is .1%.  So Covid 19 is three times more deadly than the seasonal flu, not thirty times, as originally predicted.

This great news should be leading media headlines.  Instead, each night news anchors mindlessly read the number of cases and deaths.  Death counts have no meaning out of context.  If a patient deciding on surgery with anesthesia asks, “How many people died from anesthesia last year?”  The factual answer is “310.”  This is not helpful; what they need to know is the death rate, not the number.  The death rate is .001%, a reasonable risk to take.

Why did the CDC, a reliable group of physicians and scientists, change their estimates?

Scientist Brian Nosek, Ph.D., of the University of Virginia, comments: 

 “The pandemic has exposed the messiness of science.  That’s how science always is, but we don’t usually see that truth exposed so vividly.  We all want answers today, and science is not going to give them.  Science is uncertainty.  And the pace of uncertainty reduction in science is way slower that the pace of a pandemic.”

 From the beginning of the pandemic, scientists have been clamoring for reliable data.  New data and findings continue to pour in. The truth about Covid 19 is complex.  These fatality numbers are the CDC’s new best estimates.

It’s better to understand science  as a process.  As the new knowledge about Covid-19 emerges, the recommendations by experts need to reflect this change.  We cannot stay stuck in the March policies when we have a better understanding of reality.  This means we should not be fearing the numbers of cases in most people under age 65.  We should be treating this situation as we deal with our yearly flu epidemics. Open schools.  Open camps.  Open stores.  Stop wiping all surfaces.  Finally, figure out how to protect the elderly.  

The greatest challenge for our government and health leaders will be to communicate, after months of fear, that this is a virus we can manage and survive.  The CDC’s latest projections can’t be ignored.

The tornado that whisks Dorothy out of Kansas in the Wizard of Oz,  and drops her house on the Wicked Witch of the East, terrifies the folk of Munchkin Land.  The Munchkins are hiding in their homes. Glinda, the good witch, arrives and sings, “Come out, come out, wherever you are, and meet the young lady who fell from a star.” 

We can come out now.

 

Guest editorial by Pediatrician Duane Rommel, M.D.

In my first year of Pediatric Residency at the Mayo Clinic, I learned a major lesson.  We had to research a topic and present it at Grand Rounds.  The topic I chose was ‘The Placebo Effect in Medicine.’  Placebos are a harmless pill or procedure given for a psychological benefit to the patient.  The Placebo Effect, well documented in medicine, also explains why, when we do medical studies, we always take it into account.

I learned to use the power of placebo.  For example, studies have shown that patients begin to feel better when walking in the door to a doctor’s office.  My words and involvement in the patient’s life within the healing context of my office can influence both the actual illness and the perception of the illness in the patient.  This has a major impact on the outcome of the patient’s problem.

This applies to Covid 19. With Covid 19, as with many medical decisions  we face as doctors, there are unknowns.  We don’t really know the true fatality rate of this virus because the statistics are incomplete at this time.  We don’t know why it impacts the older population far more that the younger population.  We don’t know the likelihood of spreading the infection from surfaces which have been contaminated by someone with the infection.  We don’t know how the mental and physical health of people will be affected after months of ‘stay at home’ isolation.   

But as physicians, we are forced to make medical decisions within current knowledge, even though sometimes key facts aren’t clear.  We make educated choices on the science we have, along with past experience. 

Epidemiologists, another type of medical professional, make predictions about our health future. The scientific name for these guesses is “modeling.”   Modeling tries to put numbers on some of the theories which will predict our medical future. 

I’ve lived in Florida for 25 years. Floridians know modeling.  About ten times a year, scientists make models for hurricanes. They attempt to predict how strong they will be and where they will go.  Floridians spend hours, days, even weeks, glued to our televisions, watching the ‘spaghetti’ hurricane models.  Almost every one one of them is wrong in specific outcomes, especially when the storm is farther out in the Atlantic. 

The same thing is happening for Covid 19 modeling.  Two months ago, the models were predicting that there would be 460,000 cases of Covid 19 in Florida and that the ICU beds would be totally full by April 15.  As of today, May 4, there are 36,000 cases of the virus and about a 40% vacancy rate in the ICU’s.  

Our nation’s epidemiologists and newspapers have used models and statistics over the last months to scare us into behaving how they believe we need to live.  We’ve been told that if you get Covid 19 either you will die or, even worse:   “I’m not worried for myself, but I have a family member  who’s high risk, and I don’t want to cause their death.”

There’s a bit of truth there, but also, like an iceberg that is only partially visible, lots of hidden fiction.  The truth is that my life does impact others.  Because it does, I will take reasonable precautions, like six foot distancing and washing my hands and coughing into my elbow or possibly even wearing a mask.  But the insidious lie is:  ” I am the one responsible for a family member getting sick because I choose not to “stay at home” anymore.”

If we believe this lie, we wouldn’t drive our car with a loved one in it.  I would force my brother to get a flu vaccine even though he doesn’t want one.  I wouldn’t allow my children to go to school because they might get meningitis.   The truth is, every person is responsible for their own health. We can never fully protect our loved ones no matter how hard we try. I cannot take on the impossible burden of protecting everyone else’s health to the detriment of my own well being.

To be fair, medical epidemiologists will never give a message of comfort; their livelihood is statistics and graphs.  Scientists make the hurricane models. It’s the task of local weatherpeople, like our favorite Denis Phillips on abc TV,  to use their experience to interpret them, to advise and calm, during the storm.  Likewise, medical practitioners, the ones dealing with direct patient care, need to use their expertise to reassure the public.

“This is a serious infection, but very likely you will get over the illness, so take proper precautions and you will get through this.”  

Instead of hearing that reasonable and calming message, while the infection rate drops, the public’s fear rate now runs rampant.  

Today, in Florida, we’re allowed to go to the beach and pool. However, the Florida Department of Health has a two page list of disinfecting rules, so technical and at the same time vague, that citizens are afraid of liability or continuing to spread the virus.  There are warning signs at the beach.  FDOH is still spreading fear of the sickness that prevents people from enjoying these activities, even though the chances of transferring illness through them is likely extremely small.

Stores and restaurants began opening this week.  Jill went to three stores yesterday that were open but empty of customers.  Pandemic panic is still incapacitating us from getting back to life enhancing activities.  Many stores have chosen to remain closed.  The Placebo Effect is working in a negative way at this time.  We are being told the country is sick.  We aren’t being told we’re getting better. 

No one knows the final outcome of the Covid 19 story.  But as a physician, I choose to look for the positive outcome.  My goal is to remove fear from my patients.  In medicine the outcome is always better when patients have hope, rather than when they are anxious. 

 The biggest problem we’re facing now is fear.  Fear for myself.  Fear of me getting someone else sick. Fear is our enemy.  

In the film “The Farewell,”  a beloved grandmother in China is diagnosed with lung cancer.  She’s coughing up blood.  However, the medical community in China doesn’t believe in predicting the patient’s life expectancy.  The films’ true story plays out through the eyes of her granddaughter, a college student in America.  She’s horrified her grandmother is not being told the prognosis: death in six months.  Along with her parents and extended family, they travel to see the grandmother, ‘for the last farewell.’  The gathering of a family wedding conceals the real motive for the trip to China.  At the end of the movie we see a clip of the grandmother practicing Tai Chi, six years later. 

“It’s the fear of death that actually kills you,”  the grandmother’s Chinese sister explains to the granddaughter.

Modeling and statistics can be interpreted either to bring life, or cause suffering and death. 

As a physician, I choose hope and life.

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