An ER Doctor in Arkansas Told Us What Its Like to Work in Unvaccinated America

·11-min read
Photo credit: Misha Friedman - Getty Images
Photo credit: Misha Friedman - Getty Images

(Permanent Musical Accompaniment To The Last Post Of The Week From The Blog’s Favourite Living Canadian.)

We are going to hand over a big chunk of the weekender here at the shebeen to Friend of the Blog Dr. Ken Starnes. Ken works in emergency medicine down in Winters Bone country on the border between Missouri and Arkansas, and we have checked in with him from time to time for reports on how the pandemic is hitting the people in that particularly tough part of the country. The answer, often, was “very hard.” But now, with the Delta Variant on the loose, the answer for both Arkansas and Missouri now would be “like a freight-train pulling a bulldozer chained to a steamroller.”

According to the CDC, Arkansas’s rate of new cases is up by 35 percent from last week, and 34.8 percent of the state’s population is fully vaccinated. Missouri’s new cases also are up 35 percent from last week and nearly 40 percent are fully vaccinated. If there is an epicenter of this latest outbreak, and if it’s not in this part of the country, it’s close. I’ve been texting back and forth with Dr. Starnes over the last couple of weeks as the new wave of the pandemic builds, and I think I’m going to let him tell you himself what it’s like on the ground there.

The last day I worked wasn’t too bad. Had several people come in with symptoms or just to be tested. Mostly younger than 40. Of course zero vaccinations, and when I asked why, I don’t get the “cause the internet, cause screw the libs, I think it’s dangerous” excuses. I don’t get any excuses at all. They just shrug their shoulders and say they didn’t need it. It’s just part of their psyche now. Sun rises in the east, Jesus will return to judge the quick and the dead, you just don’t get vaccinated.

The ones that were negative, when I ask them if they are going to get vaccinated they look at me like I have three heads.

The positive ones sometimes have some regrets, one in particular started crying after we talked about intubation, CPR, and ECMO. The ones I send home often get mad when I tell them there’s not anything I can do for them.

I’ve resisted the temptation to put on their discharge instructions: “You didn’t listen to me about how not to get this, why would you listen now. Ask the internet when to return to the ED.”

When I was in college I did telemarketing for a while. In those jobs they give you a sheet of things to say to overcome objections when people don’t want to buy from you. But how do you overcome an objection when they don’t give you one? They just look at you [and] shrug [their] shoulders. I tried giving them the science. I tried mild anger and looking at everybody over my glasses like their disappointed father. They are just not gonna do it and nothing I say is going to change that so it makes me wonder whether I even need to keep trying.

I’ve gotten updates from lots of people in Missouri and Arkansas. Things are absolutely at their capacity. They’re talking about field hospitals again in Springfield and we are very close to running out of capacity for ECMO in Arkansas and Missouri. Last week a paramedic posted a whiteboard showing that every ICU in Arkansas was on divert. That means they are not accepting any transfers and critically ill patients will stay in the emergency department for the foreseeable future. None of which is safe for anybody.

Photo credit: Mario Tama - Getty Images
Photo credit: Mario Tama - Getty Images

Arkansas in particular is seeing as many cases as they were in February. Missouri is about at that level in the south, and the St. Louis and Kansas City areas are starting to get there as well. So we’re back to the same situation that we were in back in the winter, where there’s no excess capacity.

I guess the biggest thing that I’ve noticed is when this first started there was a sense of going into battle. We were training and we were equipping ourselves. It felt like it must’ve felt for soldiers in World War II, training for the day, but there was a battle up ahead and as long as we did the right thing and stuck together then it was something that we would win and get past. Now it almost feels like it must’ve felt like on the other side at the end of World War II. That the enemy is coming and we’re almost certainly going to lose. And even worse than that, everybody on the outside seems to be willfully ignorant of what’s going on. We will never go back to masks or shutdowns or anything like that. Everything is opening up so there’s no sense that things are going to get any better at anytime, sooner or later.

I guess the biggest thing for me personally is being out of that area for a week in another part of the country that started to feel like home to me is the idea that I’ve lived in Missouri and Arkansas almost my entire life and it’s time for me to leave. As soon as I possibly can. Those are my people. My family has been in Arkansas longer than there has been an Arkansas but I don’t recognize the people there anymore. The prion disease as you put it has fully taken control, and it seems like there’s no concern for what’s happening. So maybe it’s time to go somewhere people are at least a little more sane. I also don’t think that I can work in the emergency department too much longer if I have to continually see this, and as far as I’m concerned, I will continually see this.

One other thing that might be useful. This is a Facebook post from one of the faculty where I was a resident. [Dr. Christi Crymes] is a family practice doctor who is obviously in the middle of things. She was also diagnosed with Covid about a month ago, even though she was fully vaccinated. Very, very nice woman, a great doctor. She gave me permission to send this to you for you to use if you want it.

Photo credit: screenshot
Photo credit: screenshot

Goddammit, none of this had to happen. And it certainly doesn’t have to continue to happen. If you’re making a buck out there off telling people tales about the perils of the vaccines, or if you’re an idiot meat puppet from Fox News bothering the White House with stupid questions, just shut up and sit all your asses down. Get used to the fact that you’re going to hell, every damn one of you.

God bless Dr. Starnes and Dr. Crymes, and all the people doing the good work. You didn’t deserve this.

Weekly WWOZ Pick To Click: “Ghost Train” (Spencer Bohren): Yeah, I still pretty much love New Orleans.

Weekly Visit To The Pathe Archives: Here, from 1962, are a whole lot of dead fish in a harbor in Denmark. An oil spill did them in. As you can see, it claimed some waterfowl as well. History is so cool, especially as a prelude to some of the rest of the week’s news.

For example, this week, we had the discovery of football-sized goldfish in a lake in Minnesota. From CNN:

They caught 10 goldfish last week and another 18 this week -- each was more than a foot long, with the largest being 15 inches long and weighing about four pounds. Burnsville natural resouces specialist Caleb Ashling told CNN that the city partnered with neighboring Apple Valley and the company Carp Solutions to find out how many goldfish are in the lake. "We had some reports from residents of some increasingly large groups of goldfish out on the lake," Ashling said. "Folks were seeing them from shore or if they were out kayaking, they would catch a glimpse of them when they were out in their boat."

Presumably, it was the residents who were out kayaking and not the giant goldfish, but who can say nowadays? Especially when this story is taken in tandem with the discovery of…speed-freak trout. From National Geographic:

Recent laboratory experiments found that brown trout, a common fish in Eastern European rivers, exposed to methamphetamine at concentrations like those seen just downstream of wastewater treatment plants showed signs of addiction—such as being less active—and withdrawal. In the wild, meth-addicted fish could have difficulties reproducing and finding food. “I was surprised that methamphetamine users can unknowingly cause fish meth addiction in the ecosystems around us,” Pavel Horký, a behavioral ecologist from the Czech University of Life Sciences in Prague, said by email…

…The researchers also gave the trout from both groups a choice to enter one of two streams of water: one with methamphetamine and one without. The meth-exposed trout preferred to swim in the meth-laced water, particularly in the four days after their drug supply stopped. Over time, the study trout’s preference for methamphetamine declined to match those of the control fish—a clear sign of addiction withdrawal, Horký says.

And, if you click through the links, you find that antidepressants have made crayfish dangerously heedless of their own well-being. Again, from NatGeo:

In a paper published today in the journal Ecosphere, researchers found that crayfish exposed to moderate levels of the antidepressant citalopram, commonly sold as Celexa, spent significantly more time foraging for food and less time in hiding. The behavior could make the crayfish more vulnerable to predators, and their altered behavior could, over time, have other effects on stream ecosystems.

In a semi-related development, the extreme heat in the Pacific Northwest is driving baby hawks to fling themselves out of their nests. From KVAL 13:

Baby birds, specifically hawks, are being found all over, from either being pushed or bailing out of their nests, according to Blue Mountain Wildlife. Experts believe it's due to the current heatwave in the Pacific Northwest that has major cities such as Portland, Ore., and Seattle see record temperatures. Baby hawks are struggling in this intense heat, some jumping out of the nest. Many people are spotting them near large sycamore trees.

Of course, given what’s happening elsewhere in that region, these just could be elaborate fire drills.

Photo credit: Mel Melcon - Getty Images
Photo credit: Mel Melcon - Getty Images

Is it a good day for dinosaur news, BBC? It’s always a good day for dinosaur news!

Our results show that the number of species was in steep decline from 10 million years before the asteroid strike until the dinosaurs were wiped out. This decline is particularly interesting because it is worldwide, and affects both carnivorous groups such as Tyrannosaurs, and herbivorous groups such as Triceratops. What could have caused this strong decline?

One theory is climate change: at that time, the Earth underwent a period of global cooling of 7-8C. We know that dinosaurs need a warm climate for their metabolism to function properly. As we often hear, they were not ectothermic (cold-blooded) animals like crocodiles or lizards, nor endothermic (warm-blooded), like mammals or birds. They were mesotherms, a metabolic system between reptiles and mammals, and needed a warm climate to maintain their temperature and thus perform basic biological functions. This temperature decrease must have had a very strong impact on them.

I’ll bet there were some Dinos who just didn’t believe the science. After all, Fox had to evolve from somewhere.

One big question remains: what would have happened if the asteroid had not crashed? Would dinosaurs have gone extinct anyway, due to the decline that had already begun, or could they have rebounded? It's very difficult to say. Many palaeontologists believe that if the dinosaurs had survived, primates and therefore humans would never have appeared on Earth.

Well, not for long, anyway. And we certainly wouldn’t have been around today to enjoy how dinosaurs lived then to make us happy now.

I’ll be back on Monday as we come down to the wire on getting anything done in that great inert mass known as the United States Senate. Be well and play nice, ya bastids. Stay above the snake-line, wear the damn mask if you want, but for the love of the living god, get the damn shots.

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