CMDA's The Point

If Possible, So Far As It Depends on You

September 24, 2021
Martha, Martha September 4, 2018

by Amy Givler, MD

Last week, a friend asked me, as a family physician knowledgeable about COVID-19, to speak to a group she belongs to of community leaders, here in northeast Louisiana. I spoke about the current status of COVID infections in our area and the need for vaccination. The vaccination rate is low in our area—currently only 37 percent are fully vaccinated in our parish.

I left lots of time for questions, but I hadn’t expected the level of antagonism present in my audience.

The first question wasn’t really a question. She read a long, written statement about how doctors are not trusting people’s immune systems (meaning, “the vaccine is unnecessary”), and doctors are not acknowledging the importance of immunity after natural infection, and doctors are not using effective medications that would save people’s lives if they would just open their eyes and use them, and…

I confess I interrupted her at this point. There were other people with their hands up. I briefly countered her various points, I hope gently, and pointed to the next woman. She wanted to know why all doctors don’t know about the monoclonal antibody infusion, since it was so helpful. I agreed with her that it’s helpful, reminded her that I had emphasized its importance in my remarks and said that all doctors everywhere don’t instantly know everything found to be medically helpful. It takes time for information to become common knowledge.

The fact that I stayed calm in the face of anger-tinged doctor-bashing questions is a testimony to the grace of God poured into me at that moment. Let’s just say I like people to like me. But God kept me cool.

Until the last man’s question, that is. He asked, “Isn’t this whole COVID thing overblown? I mean, isn’t the death rate from this virus only about 1 percent? This is nothing like the 1918 flu. People were dropping dead in the streets back then. Nobody is dropping dead in the streets from COVID. Is all this reaction worth it for just 1 percent of people?”

I think my mouth was open and I was pausing a bit too long, because another audience member spoke up, answering him, “The reason you don’t see people dropping dead in the streets is that our medical system is better than back then. Now people get to the hospital before they drop dead.”

Finally, I got my voice back. “The U.S. has lost more than 680,000 souls due to COVID. Most people know someone who has died. And it’s not just death—after the infection many, perhaps most, people have lingering symptoms. ‘Long COVID’ is so debilitating. But do you realize that allowing the virus to kill 1 percent of the population would be five times as many people who have already died? Three and a half million people?”

He made some reply, but thankfully the host said there was no more time for questions and I stepped away from the lectern. I kept trying to think of a word to express what I thought of that questioner’s attitude. Harsh? Insensitive? Not until I got to my car did I think of it: Callous. Yes, that’s the word. “Being hardened and lacking sympathy for others.”

How has it come to this, that a community leader would freely express his opinion, in front of his peers, that snuffing out 1 percent of the population is a fine price to pay for maintaining normalcy?

And as my husband pointed out later, letting the virus run unchecked in an unvaccinated population would not just lead to 1 percent of people dying. With the hospitals overrun and medical care unavailable, people would succumb to many other illnesses and injuries than just Covid. There would indeed be people dropping dead in the street.

Obviously, his perspective is that 1 percent is a small number. I guess it seems small until you realize how many human beings it represents. Maybe he doesn’t know anybody who has died with COVID. If so, he is in the minority. A recent Pew Research Center poll showed 72 percent of Americans know someone who has died.

And even the mortality of the 1918 flu pandemic (which killed 675,000 Americans) was 0.64 percent of the population at that time—so not 1 percent. That number is probably an underestimate of the true fatality rate, however. COVID’s U.S. mortality has surpassed, numerically, the 1918 flu pandemic’s, but it is 0.21 percent of the population at this point. I am quite ready for deaths due to COVID to end completely.

Would you take a plane flight that had a 1 percent chance of crashing? What about attending a party knowing that one of the 100 partygoers would be shot? I wouldn’t take that flight, and I don’t want to attend that party.

This is not to say that I’m concerned the death rate from COVID will reach 1 percent of the U.S. population. Thanks to safe and effective vaccines, that is unlikely. What distressed me, though, is that my questioner thought a loss of that magnitude would be acceptable.

At this stage of the pandemic, I have a memory full of experiences that could affect how I treat my patients in the future. Patients who refuse to wear masks—and who then caught COVID. Patients who refused to get vaccinated—and who then caught COVID. Acquaintances who argued with me on social media about whether vaccines are safe, or even necessary. And now this man asserting that 1 percent of the population is expendable.

Today I learned a pregnant friend has COVID. A few months ago, I strongly urged her to get vaccinated. Her husband and kids also have it. For nine months I have answered hundreds of friends’ questions about the vaccines, though my words haven’t convinced every person to get vaccinated. That weighs heavily on my heart. What else could I have said? Tomorrow is the funeral of a friend who died of COVID. She wasn’t vaccinated, even though she was at very high risk of serious disease.

What do I do with all this sorrow?

I don’t want the last 18 months, as discouraging as they have been, to change me for the worse. I don’t want to treat my patients any less compassionately if they choose to not get vaccinated than if they do.

Lysa Terkeurst speaks to this concept in her new book, Forgiving What You Can’t Forget, when she unpacks Romans 12:18, “If possible, so far as it depends on you, live peaceably with all” (ESV).

“The Greeks thought of peace as the absence of hostility. But Paul is teaching that peace is the atmosphere we can bring into hostility. This peace is a wholeness we have because of our relationship with God. The Hebrew word for peace is shalom. … I need to make the decision to bring an atmosphere of peace, shalom, into every situation I’m placed in.”

Paul’s exhortation is both clear and inclusive. To live peaceably with others means all others: family and friends, church members, co-workers, patients, those with whom I agree and those with whom I disagree. I’m not off the hook with any relationship.

Two years from now, when I am caring for a patient with long COVID, I don’t want her vaccination status to determine whether I treat her with skill and kindness. There will be people in the future, as there are today, who think the response to this pandemic was overblown and vaccines were unnecessary. There will be patients who continue to believe conspiracy theories. I can’t control any of that, yet I can control my response.

As a follower of Christ, I want to truly follow Him, to walk in His steps. If possible, so far as it depends on me, I want to live peaceably with all.

About Amy Givler, MD

Amy Givler is a family physician in Monroe, Louisiana. She and her husband Don met in 1980 at a CMDA student event her first year of medical school, and they have both been active members of CMDA ever since. Amy graduated from Wellesley College and Georgetown University School of Medicine, and she then completed her family medicine residency at the same indigent-care hospital where she now works part time. She also works at an urgent-care clinic and is the medical director for a Shots for Tots clinic. Amy loves to write and has written many articles and one book, Hope in the Face of Cancer: A Survival Guide for the Journey You Did Not Choose. She and Don have a heart for missions, and hope to do more short-term trips now that their three children have launched from the nest.

2 Comments

  1. Pam Howorth on September 29, 2021 at 1:42 am

    Amy as always your writing is inspiring and helpfu, this really spoke into our situation. Thank you xx

  2. Henry Williams MD on October 5, 2021 at 5:23 am

    The questioner said death rate. I believe this would mean percent of those with Covid, not percent of the population. Correct me if wrong.

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