Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes
“Just a few seconds after the needle penetrated my arm, I felt a mild soreness, kind of like a flu shot. But as I sat for the required 15 minutes of observation time, a wave of something engulfed my body. It was such a strange, unfamiliar sensation that I didn’t realize what was happening. I looked around the room at the other medical personnel getting their shots, and no one seemed to pay me any attention. I wasn’t changing color, short of breath, or breaking out into a sweat. I did harbor reservations about the safety of this new vaccine that seemed rushed to market. Was I about to become a statistic in the next FDA safety bulletin?
It seemed like forever, but finally, I divined what was happening to me. I felt different inside. A fundamental change had occurred deep within my body. I sensed that others in the room experienced a similar feeling. I struggled to recall the name of the emotion. It had been so long.
It was happiness.”
Andrew N. Wilner is a neurologist.
He shares his story and discusses his KevinMD article, “An unexpected COVID-19 vaccine side effect.”
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 Andrew Wilner. He is a neurologist, and he wrote the KevinMD article “An unexpected COVID-19 vaccine side effect.” Andrew, welcome to the show.
Andrew N. Wilner: Kevin, thanks very much. It’s an honor.
Kevin Pho: We’ll get into your article in a little bit, but first off, can you share your story and your journey to where you are today?
Andrew N. Wilner: All right. Well, I’ll start with where I am. I’m an associate professor of neurology at the University of Tennessee Health Science Center in Memphis, Tennessee, and I work as a staff neurologist in the clinic and on the inpatient service. I teach the residents. As part of how I got here, I’m also board-certified in internal medicine. I started out as, “I’m going to be an internist,” because they were the thought leaders back in those days. In a stint I had as a locum tenens doc in the ER, I discovered that neurology was super cool. So, long story short, I ended up as a neurologist.
And also locum tenens: I did quite a bit of that. I’ve written a book on it, and I have a series of videos on that on YouTube, and it’s kind of a special topic of mine. I think it’s a way for doctors to sort of beat the burnout, with locum tenens, but that’s kind of a sidelight. So I keep pretty busy now. Writing has always been a big part of what I do. I’ve written four books, including the locum tenens books, and I like to write essays. And if somebody’s going to be willing to listen to my opinion, I’m very happy to provide it. I had something to say, and that’s why I wrote to KevinMD.
Kevin Pho: So through your lens as a neurologist, paint a picture of what you’ve been seeing during the pandemic.
Andrew N. Wilner: I think, as everybody knows, although not everybody really seems to digest it, the pandemic is a disaster. It’s a catastrophe. People are dying, and the people I see are usually in a coma in the hospital on a ventilator, and they don’t talk too much. That’s why they were asked to see them: They have encephalopathy. I saw one poor woman, and they said her mental status changed. So I asked the nurse, “What does that mean?” She said, “Well, before, she was in a coma, but when we stuck the tube down to suction her, she gagged, and yesterday she didn’t gag.” So on a scale of 100, we went from a 2 to a 1, or a 1 to a 0. So we did a CT scan, which is part of our evaluation frequently, and she had an enormous hemorrhage in her brain. This was a result, we’re not too sure, but in part of the treatment that she had for COVID, which was anticoagulation, because a lot of people get blood clots. Or it just may have been spontaneous or unrelated. But this is a daily event when I make rounds, and this was part of the impetus for what I wrote.
I think no one should underestimate how severely this virus can damage the body. Often, as a consequence, we think the virus does not affect the brain directly. The rabies virus goes right to the brain, or a polio virus goes to neurons, but it’s the indirect effects. If it affects the lungs, right, it’s a respiratory virus, then you can’t breathe, and if you can’t breathe, you don’t get oxygen in the brain, and then you get brain damage. And we have people who survive COVID talking about how they can’t think clearly anymore. So what’s that all about? Were they deprived of oxygen during their acute illness, or was there some sort of fibrosis that occurred, or microhemorrhages? But it’s all bad. It’s nothing that you want to even get close to.
And we take precautions in the hospital. I wash my hands, I don’t know, 100 times a day, maybe more. I have sanitizer in every pocket; it’s on the wall. I wear a mask, very uncomfortable. I wear a face shield; it fogs up when I cross the street. I think one of the side effects of COVID is I’m probably going to get run over by a truck, because I can’t see when it’s cold out; everything fogs up. So there are a lot of indirect effects, and it makes people anxious and irritable and kind of hard to get along with and stressed. So what we’re seeing is something we really want to get rid of.
Kevin Pho: Well, hopefully there is light at the end of the proverbial tunnel, and you wrote an article attesting to that. It’s titled “An unexpected COVID-19 vaccine side effect.” Now, for those who didn’t read that article, can you just walk my audience through it and share the story of why you decided to write it?
Andrew N. Wilner: Right. So you’ve heard kind of the why. It’s like, well, whatever we can do to get rid of this virus from our daily lives, we’ve got to do it. And then all of a sudden we start reading about vaccines. It’s like, “Oh, Pfizer’s got a vaccine, and Moderna has got a vaccine, but they made it super fast.” And McDonald’s is good at making hamburgers super fast, but it’s not all that complicated. I think all of us kind of appreciate that making a vaccine that’s going to actually work and be safe is probably not something you can do in your basement overnight, right? So I certainly had some trepidation that it was being rushed to market, like beta software, right? Nobody installs beta software. It’s like, “Well, give it some time. I don’t want to be the first one to get this vaccine.” And I’m a scientist. I’m a believer in science.
Yet when it finally became available at my hospital, I was on the list. First of all, I have direct patient contact, so I’m eligible for the vaccine. Secondly, believe it or not, I’m in the 65-plus age group, so that also puts me in a priority, not because I want to be, but because it makes me much more likely to die if I get infected. So I didn’t really like being in that group. So when the vaccine became available, with kind of that back story, I was in the front of the line. It’s like, “OK, when are you going to give it? I’ll be there.” So sure enough, I was in the front of the line. I was the first one to get it.
When my turn came, I really wasn’t all that happy about it. I mean, I got a flu shot and it hurt for three months. I’m not a big, I try and wiggle out of it if I can, the sort of optional vaccines, but to me this was not optional. Anyway, I survived the first shot. I was OK. But it was the second shot. I went back, and one of the things they make you do when you get the vaccine is you have to hang out for about 15 minutes, 30 minutes, so they make sure you don’t drop dead right afterwards or have an allergic reaction while you’re walking down the stairs.
So it was an interesting phenomenon that happened. The room was full of, I’m at the University of Tennessee, so they had University of Tennessee pharmacists giving the injection, and a lot of the faculty like myself were there getting their shots. And then they were kind of stuck. Usually everybody’s got someplace to run, but you couldn’t leave, so it kind of turned into a little cocktail party: “Hey, how are you? I haven’t seen you in a while,” because everybody had to kill those 15 minutes before rushing off. And I sensed that I felt different. There was levity in the air. It was like a celebration, but nobody articulated it, and it was kind of mysterious to me. As the day wore on, I kind of figured out what happened: I felt great. I mean, I felt euphoric, unconsciously, now that I had my two shots, the chances of me dying.
And also, one of my main concerns: I’ve been on the front lines. I see patients in the hospital who are sick. I try not to spend too much time with them face to face, but I wear my mask, I wear my shield, and I do what I have to do. But I’ve been terrified of bringing it home to my wife, and I have a toddler at home, and I don’t want him to get sick. I mean, that would be the worst thing in the world. And I’ve made sure, by the way, he’s gotten all of his vaccinations, and I hope all of his peers get their vaccinations. I don’t want them getting measles and chickenpox and rubella and all the things I had as a kid. I survived them, but they were kind of nasty, and he doesn’t have to have that. So I didn’t want to bring COVID home to them. But what can I do? I have to go to work, come home, dump the clothes in the washing machine, jump in the shower, try not to breathe on them for a while. Kind of helpless.
All of a sudden, I wasn’t helpless anymore. I thought this was fantastic, and I really felt compelled to write about it because it was so unexpected. A lot of things I write about, I kind of think about for days, weeks, months, and structure in my brain and kind of sort it all out. But this was like an epiphany. It just sort of happened, completely unexpected. I was concerned about the side effect of, “I’m going to be the one in a million that has an allergic reaction.” But when that didn’t happen, I suddenly felt good. And so all of a sudden, I became a vaccination advocate.
I mean, what I see every day, to me, this is like a fairy tale, right? There’s this plague, and now 500,000 Americans have died, right? I remember during the Vietnam War, we watched the stats on TV. You may be too young to remember that, but every night on the six o’clock news: how many Americans have died. And eventually the number got up to about 50,000 young men. We’re talking 10 times that number. So here’s the fairy tale: There’s this incredible plague that wipes out half a million people, and through the hard work of scientists, the cooperation of pharmaceutical companies, and the largesse of the government, willing to pay for it, I didn’t have to pay for this vaccine, they’ve come up with something that doesn’t cure it, but it’s going to prevent it. I mean, this is a miracle. People should be dancing in the streets. This is incredible. I mean, suppose there was no vaccine: “Oh, I guess we’re just going to keep dying. Bad luck. Don’t go anywhere. Stay home.” And now we have, of course, it’s not perfect, but it’s about as close to perfect as you can get in the real world. It’s really amazing.
Kevin Pho: You said at first you had a little bit of trepidation when it came to taking a vaccine, maybe it was developed too quickly and whatnot, but then you were at the front of the line. So was there a tipping point that convinced you to overcome some of the reservations that you initially had about the vaccine?
Andrew N. Wilner: I mean, I guess in medicine we always talk about risk-benefit, right? “I’m going to give you penicillin for your infection. You could have an allergic reaction, but that infection is going to turn into gangrene, and then we’re going to have to amputate your toe. What do you think?” It’s like, “Oh, OK, I like my toe. I’ll take the penicillin.” Sure. So it really was a risk-benefit. It’s like, well, I don’t want to bring it home. I don’t want to get sick. The idea of being intubated on a ventilator, often for weeks and weeks and weeks, is very unpleasant, after which you often die. So it’s kind of a slow, agonizing way to go. Some people do survive it, of course. That’s why we do it, hopefully to tide them over until they can breathe on their own.
But the downside, really, and I read about it, I mean, I researched this: What are the side effects? I’ve kept up with all the neurologic complications that have been reported from all over the world, and most of them are complications of just being sick. Being sick, all kinds of bad things happen to you. When you’re in the ICU just lying there, it doesn’t matter what’s wrong with you: Your muscles are going to waste away, your nerves start wasting away, there are some blood clots. Nothing good happens to you when you’re lying in the, you don’t get, you’re malnourished. It’s not good.
So I think it wasn’t one; the other thing was, as I researched this, the University of Tennessee has a pretty good website, and every day they put up the numbers: how many people were diagnosed, how many people died, in the U.S. and worldwide. And I consulted that frequently, because I was writing some articles, scientific kind of articles, this is COVID, preparing grand rounds. And I remember I started preparing grand rounds in March, April, when this first came, a brand-new thing. What’s COVID? What are the neurologic complications? That’s my thing. Then I realized my slides got outdated really fast. We’re talking about 30,000 people dead, then it’s 90,000, then it’s 190,000. It’s like, “Wow, this is a train that is gaining momentum. It’s not just fading away all by itself. We’ve got to do something.”
So I think the logic of the situation really drove me to the shot, but it was kind of the emotional aspect of it afterwards that really, really struck me. And it was very interesting: After I wrote it, I started reading more and more, and I saw that other people had had the same kind of revelation. I saw comics of, “Now I have a superpower,” where people were dressed up like superheroes. I wasn’t the only one. When I wrote my article, I thought it was just me, which is one of the reasons I wrote it. I was like, “Wow, I hadn’t read this or seen it anywhere, that other people had had this kind of euphoria.” But it turns out it’s actually pretty widespread that when people get their shot, it’s like, “Whoa.” It’s just this huge cloud that goes away. Of course, it’s not perfect.
But in all that, and I’m going to sort of give a public service message here, people have such a poor understanding about risk. Yes, there is a risk to the vaccine, but it’s a whole lot less than the risk of getting in your car. It’s a whole lot less than just walking across the street. I mean, the risk of getting struck by lightning is greater than the risk of something bad happening to you from the vaccine. So that means you should never go outside. So anybody I see who leaves their house has already made that risk-benefit decision that, yes, it’s safer to leave my house even though there’s lightning. Well, the vaccine is dwarfed, in terms of its risks, by these other major risks that we deal with every day. So I really, rationally, have a hard time sort of understanding vaccine hesitancy from a logical, rational point of view. I think it’s irrational.
There are people who believe the world is flat. I read this big article in the New York Times about people who believe the world is flat, and they’re just convinced that it’s flat, that it’s a hoax, that whoever figured out that it’s round, they were just wrong. And these people say it’s hard to make friends when people find out that you’re one of those people who believes the world is flat. You lose a lot of your friends. But there’s some society of flat-worlders, I think they are. Well, to me, the vaccine hesitancy people share the stage with them. I mean, this is a no-brainer, if you will, from a neurologist. You want to get that vaccine.
And which one? I’ll mention, you see behind me, “The Art of Medicine.” This is a podcast where I interview people who I think are really interesting and have something to do with medicine. I interviewed Ken Tyler a couple of weeks ago, who is a neuro-infectious disease specialist. Like myself, he’s board-certified in internal medicine, board-certified in neurology, and has made his career understanding neurologic infections. So needless to say, he’s become an expert on COVID. We talked about this, and we both agreed: Whichever vaccine is available to you, that’s the one you want to get. Might there be one that’s a little better? But what do they call that? Gilding the lily. I mean, we really don’t know which one is better for any specific person, so the one that somebody’s willing to give you is the better one. And down the line, we may all have to take booster shots every year. Who knows? So two versus one, just get that vaccine and don’t die, and don’t spread it to your neighbor, right? I mean, we all care about our neighbors, right? We have a social contract with the people we live with. We respect them. We even like some of them, right? So you don’t want to spread that disease. So if not for yourself, do it for your neighbor.
Kevin Pho: We’re talking to Andrew Wilner. He’s a neurologist, and he wrote the KevinMD article “An unexpected COVID-19 vaccine side effect.” Andrew, you mentioned vaccine hesitancy, and even within the health care field, there are still some people who are hesitant to receive the COVID-19 vaccine. Can you share any messaging tips to help convince them, or perhaps share some of the euphoria that you so eloquently described previously?
Andrew N. Wilner: Oh, well, read the article. I’ve talked to other physicians who have gotten the vaccine, and I think a lot of this vaccine hesitancy comes from sort of this spirit of distrust. We don’t trust our organizations; we don’t trust authority. I don’t know really where that. There are some historical roots for that, particularly minorities, not very trusting: “Oh, they’re experimenting on me.” But I think that there is kind of a movement now, and this has happened at the hospitals, as more and more people, some of the hesitant ones, have seen others go before them and get the vaccine and are euphoric. So I think by sort of setting an example, the reality may set in.
And also, the science of vaccines is such that if you don’t, because I was concerned, boy, they’re messing with my RNA, all of that, but it turns out, as I researched it, that if you don’t have an immediate complication, the likelihood of a late complication, six months from now, six years from now, is very remote. It doesn’t really work that way. Medicines we take: I’ve been involved in clinical research with epilepsy drugs, and I’ve seen a couple of them taken off the market six months or a year later, because we saw cumulative side effects. Because, of course, those are medicines you take every day. There have been some things that have happened that we didn’t see in the trials, where we tested 3,000 people, but after 100,000 people took it, we started seeing things that occur one in 100,000. If you’ve only tried it in 3,000, you’re not going to see what happens one in 100,000, unless you’re lucky.
But now we’ve given the vaccine to millions of people. Like I read in the New York Times today, I think 2 million people a day are getting a vaccine. So good job. I mean, 2 million people a day, that’s nice. So look around you: If 2 million people a day are doing it, maybe it’s the right thing to do. So yeah, protect yourself, protect your family, protect your community, and let’s move on. I think there’s so much to be excited about, that the world is going to open up and we can maybe travel again and do other projects again and have parties again. My social life has been very curtailed. It’s not very big even on a good day, but it’s really pretty small. I mean, I can count on one hand the number of times I’ve been to a restaurant in the last year, because of social distancing. It’s important, a contagious disease that you don’t want to get, you don’t want to spread.
Kevin Pho: And my final question: What’s your take-home message for the KevinMD audience?
Andrew N. Wilner: I’m going to go so far as to say, read KevinMD. I read the blogs on KevinMD, and I find it’s very, very interesting, because we live in a diverse community, a diverse world, a diverse group of physicians, and people come at questions from different angles. It’s very interesting to read perspectives, because KevinMD is an opinion piece. These aren’t scientific articles. It’s like, “Well, this is what happened to me.” And some of them are very surprising, and some are really heart-wrenching, where people have decided to leave medicine because of bad things that have happened to them, or disappointments. There are kind of stories that you wouldn’t otherwise hear, and I find it kind of broadens my own perspective, because we all tend to collaborate with like-minded people, and it makes us feel good: “You agree with me, I agree with you, we’re both really smart. It’s terrific.” But I think it’s interesting to be exposed to people with completely different backgrounds and experience and points of view.
And there’s also the opportunity to comment, because sometimes they’re completely off base, so that’s important also. But I think there are big movements in the professional world, in medicine certainly, to accommodate diversity, right? To be inclusive. And I think that’s great, and I think it’s nice to sort of have, it’s sort of a smattering, KevinMD. There’s no particular theme, like, “We need you to write about this.” It’s like, I guess, whatever you think is worth publishing is what happens. My last article, which didn’t get nearly as many shares but was really important to me, I wrote “Life hacks from a nine-month-old,” and that’s what I learned from my little baby: the way he approached the world, in certainly an innocent but very confident way. And I was like, “Boy, if only I could be like my nine-month-old, I think my life would be better.” So I decided to share that. So I think there’s a lot to really gain from sort of scanning the blogs that show up on KevinMD.
Kevin Pho: Well, thank you so much for being on the show, and thanks again for sharing your time and insight.
Andrew N. Wilner: Thank you very much, Kevin. It was great.
Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes
