A pathologist’s urgent pandemic message to the public [PODCAST]

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes

“The events over the last couple of weeks have affected me deeply. Of course, I’m concerned about a novel virus that is infecting and killing people. But, I’m more distraught over the reaction of the people, the response of the state and federal governments, the blatant disregard of science/epidemiology, and the warnings of our physicians on the front lines.

Most of us will get this virus and be OK. But slowing it down is 100 percent vital. Why? Because our health care system has limited resources. We only have so many hospital beds in this country and, at last count, only 62,000 ventilators. If the forecasted numbers of infected Americans reach the projected peak in the millions, we will have no choice but to ration those resources. This means a physician will be tasked with choosing who gets a chance to live and who does not. This is the reality in other countries.”

Michelle C. Hure is a dermatopathologist.

She shares her story and discusses her KevinMD article, “A pathologist’s message to the public.”

This episode is brought to you by Saykara, the first voice-powered ambient virtual assistant.

Did you enjoy today’s episode?

Please click here to leave a review for The Podcast by KevinMD. Subscribe on your favorite podcast app to get notified when a new episode comes out!

Do you know someone who might enjoy this episode? Share this episode to anyone who wants to hear health care stories filled with information, insight, and inspiration.

Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Michelle Hure. She’s a dermatopathologist, and she wrote the KevinMD article “A pathologist’s message to the public.” It got 47,000 shares on KevinMD, so I’m interested in hearing more of the story behind that. But first off, Michelle, welcome to the show.

Michelle C. Hure: Thank you. Thank you so much for having me.

Kevin Pho: So before we get to your article, I was wondering if you could share your story and your journey to where you are today.

Michelle C. Hure: Sure. I’m basically considered to be very nontraditional; I have a nontraditional approach to where I am today. I took a very long route to get to medical school. I did many different things, whether it be research, grad school, or being a medic on the ambulance, a lot of different things, before I decided to go to medical school and realized it was right for me, as opposed to doing something else within the medical field. Having taken so long, I ended up having to go out of the country, so that’s another kind of different thing. I am considered a foreign medical graduate. I went to Ross University in the Caribbean and then came back and did a lot of rotations all over, from Yale to UC Davis, and realized what I wanted to do was pathology.

That’s not a very popular field to go into, but I really felt the most at home there. Even though I love clinical medicine and incorporate that into my career today, I wanted something beyond clinical medicine, so I wanted to have that pathology background.

Kevin Pho: Great. And we are filming this the first week of June, and you wrote your article back in March. So how has the pandemic affected you and your practice?

Michelle C. Hure: Yeah, so I’m a clinical dermatopathologist, having done clinical medicine as well as pathology, and specializing in skin pathology. Our practice is basically half pathology, so we could do that, no problem. I can look at slides and not have to worry about the pandemic. But for the clinical aspect, obviously, we shut the whole office down, as most people did, and in that time, everyone was shut down except for urgent issues.

I realized that I had a strong clinical background, with my really amazing critical care training at the hospital where I did my internship, and that I may need to draw upon that, even though it’s been a long time, over 10 years, since I had been there. I realized that this was my opportunity, my downtime, that I needed to prepare in case I was needed in the field, on the front line. In that time period when I wrote this article, I really was going through a lot. Obviously, we were all going through a lot of turmoil.

My husband is also a physician, in radiology, and he really couldn’t take that time to not go into the hospital. He still had to do that, even though he has underlying health issues and asthma. And I thought, “My God, this is going to come home to roost at some point. What if we’re really actually affected by this personally? What if something happens to him, and I’m also working in the ICU? What’s going to happen to our kids?” These are real-life questions that a lot of my colleagues who are in dual-physician households were asking: What happens if we die? What happens to our kids? So many people were having these conversations, writing up their wills and trusts, and figuring out what to do if something happened, since we were potentially on the front lines.

So I felt all of this turmoil and angst and fear, and I had to write it somehow so that people could see what we were going through and see how their actions were affecting the very people that were taking care of them. I felt a lot of anger too. I was sheltering at home. I was doing everything I could for my family, and obviously my patients and my community, to help protect them, but there were so many people that just seemed like they didn’t care.

That was the basis of my article: It’s not all about you; it’s about the people around you. How are you supporting the people around you? How are you supporting your health care workers, who you assume will take care of you when you get sick, but you’re not helping yourself to not get sick, right? Or you’re not protecting those health care workers so they are not getting sick and dying. I just had so much anger, and that’s where this came from.

Kevin Pho: I want to read you an excerpt from this article. So you write, “The events over the last couple of weeks have affected me deeply. Of course, I’m concerned about a novel virus that is infecting and killing people, but I’m more distraught over the reaction of the people, the response of the state and federal governments, the blatant disregard of science and epidemiology, and the warnings of our physicians on the front lines.” Now, you wrote that in March, and now we’re in the beginning of June, and I think those words are pretty prescient. So tell me, what’s changed from three months ago, when you wrote this article, to now?

Michelle C. Hure: Yeah, unfortunately, things have gotten a lot worse, I think, in the way that people are interpreting the data out there and how they’re acting. I’m in Orange County, Orange County, California, and we just had our public health officer, an MD PhD who advocated for universal masking in the county. She was harassed. She was called a Nazi. She had people camp out on her front lawn, and she had to eventually resign because she had three young children that were being harassed. And now the county doesn’t have mandatory masking because of these people.

I feel like whatever I wrote about in March has been completely amplified in Orange County, at least. We haven’t seen these crazy numbers that we were worried about, but we haven’t seen those numbers because of the measures that were taken. And all it means, now that we’re starting to reopen, is that we have hospital beds for you when you get sick. It doesn’t mean that everything is OK. And the attitude that we have here, and in a lot of the country, is that this is not a big deal, and people are getting hurt, shot, and harassed for trying to just impose a very simple masking order. I’m just wearing a mask.

That really does bring me back to all the tenets that made me write this article in the first place: You’re not thinking about others. As physicians, we think about others, and that’s why so many doctors and nurses were getting sick and dying, because they were putting patients’ needs above their own by not having proper PPE, or they were running into a room without having anything on, and they were getting sick and dying. This is unfortunate. This is not how it should be. We as doctors automatically think about others, but we can’t legislate that onto other people.

And unfortunately, this is how this virus is spreading. People are spreading it out in the community, and they’re not being considerate of other people, so it’s about themselves: “I don’t want to wear a mask. I shouldn’t have to wear a mask. I should be able to do whatever I want.” But in reality, it’s not all about you. And when people say that, people like me, people like Dr. Quick in Orange County, who resigned, are labeled as the bad guy. I don’t understand. I just don’t understand where this is coming from. This is real science. This is real epidemiology. This is being considerate. It’s not an infringement; I put that in the article as well. This is not an infringement upon your rights or your freedom. This is a pandemic. There is a difference, and we shouldn’t be made the bad guy.

Kevin Pho: So what are some solutions? I’m in primary care, internal medicine. If I were to see a patient who may not believe in universal masking, and approximately 50 percent of the country doesn’t believe in masking, it’s unfortunately been politicized. So what are some of your tips and suggestions for us to approach patients who may not believe in something as simple as masking?

Michelle C. Hure: So I think a lot of the time, the frustration that the public is having with physicians is that they feel like they’re being talked down to or they’re being dictated to. I mean, this is a systemic problem in medicine, which is why so many people don’t trust their doctor, and we can get into that; that’s a whole other thing. But what I try to tell my colleagues, and what I try to tell patients or people in the community who are super-duper anti-mask, is that I want to see their point of view. I see their point of view. I try to give them the actual data and the science, which is tough these days because there are a lot of conflicting articles out there and a lot of conflicting information for these people to look at.

But I am trying to give them the information instead of being sort of like this dictator: “You need to do this. You need to do that for your own good.” No one really responds well to that. They don’t want someone telling them what to do, right or wrong. So my suggestion is to try to come at it in a different way and to have them relate personally to the situation. It’s not just us versus them. This is for everybody. You have to think about everybody. These are the statistics out there. These are the measures we can take to try to mitigate and try to decrease the risk.

Inevitably, they will always come back to say that we’re going to get it regardless, or everyone; there’s not a big problem; it’s like the flu, and they’ll always come up with these different talking points. But you just have to give them the truth repetitively, which does change from time to time. That’s something, and again, it’s a problem, but this is medicine. Nothing is concrete. You can never say that something is 100 percent all the time. That is medicine. So things change. This is a new virus. Our information, our data, and our understanding change all the time. We shouldn’t be held accountable for that. That’s just the way science works; it’s not concrete. So today’s recommendations may not be the same as tomorrow’s, and that’s the way it works. That’s medicine. That is it.

So you cannot say, “Well, you’ve changed your mind, and therefore I’m not going to believe you anymore.” People have to understand the process. They have to understand where we’re coming from. Things change, but we’re doing it to help the greater good, and that is something that people are failing to understand. They want their lives back to the way they were. They want to have everything back to normal. Unfortunately, that is not going to happen. That world does not exist anymore, and I think that level of denial is hard to get past. Unfortunately, until we get more information and more understanding, and we can get that message out in a concise way so that people understand it, we’re always going to have these issues. We’re going to have these problems with people not wanting to play along.

Kevin Pho: Is there anything that’s surprised you during the course of the pandemic so far?

Michelle C. Hure: I am constantly surprised, almost every day. Every day I’m surprised at how much people are antagonistic toward medicine and science, and how much people are really bullying, almost to an extent. If you post something that is an actual scientific fact, for every post you can have 20 people saying that you’re wrong, and they have absolutely no background in medicine, epidemiology, or any real hard science to back it up. I have never seen so many armchair physicians and epidemiologists and experts out there. This is so surprising to me. I don’t know why. It shouldn’t be. But I have been constantly surprised every day by the sheer lack of respect for people in my station, or others that are even more qualified to have a medical opinion, that they’re just being discredited or attempted to be discredited. I guess I don’t really understand that very well. That’s something that has surprised me daily, and it’s just now the norm.

Kevin Pho: Well, my final question, Michelle, and thank you so much for sharing your insight: What’s your take-home message for the KevinMD audience?

Michelle C. Hure: So my take-home message is going to be: Try to do your best to relate to these people who are so adamant against public health policy, and try to see it from their point of view. I think that denial and anger are big, big things that we have to deal with, and I think that my psychology or my psychiatry colleagues are really on board with this. They try to rationalize with people and try to get them to just see their own issues around it.

But do what you can to just put the word out. Give your unbiased, nonpolitical expert opinion out there. Don’t engage in a way that is going to be harmful for you or cause any undue stress. Just put it out there and realize you cannot change everybody, but even if you change a couple of people, that’s huge, because that’s all we can do right now. And just try to be considerate of other people, or pass that on to those around you who are so against masking and all the safety protocols. Try to be considerate, try to be considerate of the state that they’re in, and then have them just see to be considerate to other people around them.

Honestly, that’s the biggest thing to me: There are so many people just not caring what others are saying, and if we just stop and listen and try to meet them on their level, this is what they want, and this would make a much better dialogue than just trying to ram some public policy down their throat. They have to see the why. Whether they do it or not, I don’t know, but we’ll see what happens when they go to the hospital, right? We’ll see what happens when all the ICU beds get filled up. I hope it doesn’t get to that point, though.

Kevin Pho: Well, thank you so much for sharing your insight. On the show, we have Michelle Hure. She is a dermatopathologist, and she wrote the KevinMD article “A pathologist’s message to the public.” Michelle, thank you so much for being on the show.

Michelle C. Hure: Thanks for having me, Kevin. Thank you so much.

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes