“F—- you! I won’t do what you tell me!” the lyrics blare into my teenage ears, as I lip-synch to the rock band Rage Against the Machine’s song Killing In the Name. It’s 1992, and my Walkman is attached to the waistband of my Seattle Blues. It would take at least a decade to fully understand the meaning of those lyrics. Nearly thirty years later, this line rattles through my head on a near-daily basis as I move through our hospital’s COVID ward. Only it’s a line that’s been reappropriated for a different cause, an anti-vaccination one. When a patient or a staff member let me know that the government can’t make them get vaccinated, the chorus plays in my head. An equivalent to a slap across my face.
As a semi-professional hugger, I was relegated to time out when COVID hit. My patients asked not to be examined, trainees could no longer fist bump, and embracing friends was not an option because we no longer socialized. Without any special training, we had to figure out how to meet the needs of our family, community, and patients. We had to adapt. As physicians, there were hours of planning, learning the new guidelines and protocols, schedules with backups drafted and redrafted, as we waited for the floor to fall out. Our work lives became consumed by COVID-19, and for many of us, this bled into our personal lives. Early on in the pandemic, we wondered if we were carrying the virus home in our hair, if we should microwave the mail and wash our bananas.
I used to bribe myself with a “treat” for keeping it together. “Go a whole week without completely losing it and you can buy a grocery store orchid,” I cooed. I never made it a full week, yet it didn’t stop me from rebelliously buying orchids. My house began to resemble a funeral parlor in Hawaii or a nursing home. We pressed on at work as we planned our COVID-19 units and created a policy for how to triage ventilators when we ran out. Nothing was straightforward. We were living in a gray zone as we lost patients, colleagues, family, and neighbors to the virus. I lost sleep and became annoyingly anxious and isolated. I hated it. As my tolerance for Zoom meetings waned, my drinking habits spiraled alongside my anxiety. I was lonely. I ate hors d’oeuvres for dinner and watched ridiculous amounts of TV geared toward interior design. I gained weight and lost my ability to concentrate. I needed to dissociate, yet the reality was I had to be ready for a surge, to provide coverage when staff got sick or we got busier.
By December, my anxiety had turned into full-fledged depression when something amazing happened. Emails from leadership announcing a vaccination rollout. It was good news. Great news, like winning something or having people clap for you. As a medical doctor, I was going to be offered the vaccine first. As the months rolled by so would my family and neighbors. It was what our psyche desperately needed, reprieve. My depression was abating. We were part of history. I posted my first shot, me flexing a deltoid on Instagram. I was ecstatic and it was short-lived.
I was naive to think the rest of the country or even my own family would agree with me about how remarkable this opportunity was. My family and other anti-vaccination folks didn’t need scientific data or evidence to shun the vaccine, they had a belief. It was mind-boggling, yet we health care workers slogged onwards, and watched ourselves go from hero to villain for promoting vaccines, or being “anti-ecomony” for wearing a mask to the grocery store. I have experienced terrorizing fear, gut-wrenching heartbreak, dark depression, and anger as I argued my stance that “real patriots” get vaccinated.
All the while Rage Against the Machine played in my head. I hear the refrain every time I have a conversation with a staff member or a patient who “is waiting to get vaccinated” or just doesn’t “believe” in COVID. I hear those lyrics when I open up the news and a politician is suggesting vaccine volunteers should be shot, or extremist conspiracy theories are played as a loop on prime time.
I feel beaten down, but I am no longer angry. I don’t have any fight left. Logic left months ago and no one from the anti-vaccination camp can hear me anyway. When it comes to anti-vaccination arguments, I’ve set up home with apathy. I no longer engage in motivational interviewing to understand. I don’t pitch to their civility, sell to their humanity, or pique empathy in my arguments for vaccination. I care for unvaccinated patients with COVID-19 pneumonia who want other people to start taking this virus seriously. I shake my head. It’s up to them to spread the message, I can’t carry all the luggage. When they ask for a vaccine I have to tell them it’s too late to prevent this bout of pneumonia.
How we repair and heal will be up to all of us. Can we suspend our politics and our beliefs? Can we align our values to truly care for and respect each other? Rage Against the Machine valued accountability and demanded this from the police and government. By aligning their values they stood up fiercely for their community. This song doesn’t belong to the people who refuse to listen to science. Thirty years later I’m taking it back, and I’m “justified.” This song is mine, and it’s how I heal.
Amy Cowan is an internal medicine physician.
Image credit: Shutterstock.com
