COVID Slop

Make no mistake, the “I did my own research” crowd were annoying long before COVID.

Becoming a doctor is not an easy or swift process. While many Western European schools will accept students into a medical education program right out of the equivalent of high school, those programs of education tend to be five or more years in length. In Canada and the United States (US), most schools require an applicant to have completed at least an undergraduate degree, though many applicants, not successful in finding admission on the first opportunity, end up with a masters or other designation of continued successful study. After managing to get accepted, most Canadian and US schools require three to four years training for an MD. However, to actually take care of patients independently, graduates of an MD program must complete additional training in the area they intend to practice, anywhere from two to five (or more) years. There are tests and exams along the way; many, many tests and exams, of knowledge and practice.

Medical training is an applied education. Experience is required. While most programs are didactically oriented in the first year or two, the majority of medical education is accomplished by doing the job, taking care of patients in a variety of settings, under supervision that gets progressively less as the training advances (as the candidate shows that they are proficient). So, “reading the book” is only the first step in medical training; applying the reading to real world situations is where the learning really happens. Judith Martin is quoted, “If written directions alone would suffice, libraries wouldn't need to have the rest of the universities attached.” In medical education, if reading was all that were required, medical school would only be two years long.

So, at least four years undergrad (to get the first degree), four years undergrad medical education, a minimum of two years post-MD-grad training means the minimum time it takes to go from being a high school graduate to being a practicing physician (brand spanking new), in Canada and the US, is ten years of time, energy and academic rigour at the highest standards.

Even before COVID, family doctors in particular were regularly insulted by patients whose questionable abilities to use Google on their phone led the patients to believe they could instruct the physician about all manner of things. It was not unusual for a patient, after having started the office encounter by complaining that they were made to wait for their appointment, to proclaim that they had already “done their own research,” knew what was wrong with them and to inform the Family Doctor what they needed. So, if the physician could just hurry up and give them what they had determined that they need – they were “made to wait” after all and they have better things to be doing than hanging around here – they would be on their way.

We live in a time where the public would rather hear what they want than what they should or even have to hear, even if it could cost them their health or their lives. Artificial Intelligence (AI) chatbots are presently quite popular with many patients who would rather interact with them (particularly over mental health issues) for precisely that reason; the chatbot is more like to agree with and encourage the patient in what they are doing even if those actions are to the detriment of the person (court cases are being heard). Psychiatric patients are being told they did the right thing by stopping their meds or cutting off ties with their family. They don’t want – a sentiment frequently confused with need – to have some fussy doctor tell them what they should be doing, when, with a little ingenuity and selective searching in echo chambers of their choosing, they can be told by someone somewhere on the internet that this thing that they want is really what they need.

What was it about COVID that made this all so much worse for practitioners? Governmental endorsement of quackery and vilification of experts layered with political interference in medical decisions. A toxic soup of vaccine deniers and mask opponents, ivermectin proponents and “It’s going to disappear. It is disappearing.” Virologists and infectious disease specialists, just trying to do their job, finding they needed personally security because politicians in power were disparaging them to constituents who threatened them and/or their families.

Politicians fell into two groups (which were not mutually exclusive); those that enabled lesser angels and those that were more concerned over their own popularity than public health. People didn’t like masks and isolation and vaccination and discomfort in their lives. The politicians empowered the public to deny the advise of the scientists who were desperately trying to help them because it suited their political purposes. The public metaphorically yelled epithets at people of science, people who had invested much of their lives learning what to do in times like COVID, because the answers that science had for them were not the ones they wanted to hear. They were enabled and emboldened by some politicians whose only identifiable skill was winning popularity contests called elections.

Imagine doctors working that hard, under those conditions, some putting their own lives on the line, all the while being defamed (and targeted for personal harm) by a politician that can’t tell the difference between Iceland and Greenland. For many, giving that much for people who, some felt, really wanted not to wear a mask so that it would be easier to spit in their face, was simply too much. Too much on top of too much.

The deprecation of the medical profession during COVID by those in political power is a stain that, if it ever does, will take years to cleanse. While most of the bile was directed at infectious disease specialists, the rest of us got the message and the public definitely got it. It was ok, fashionable even, to tell your doctor how much more you knew about the subject at hand and wag a finger when they tried to correct you. After all, if someone with little demonstrable intelligence can tell a scientist who was the director of the National Institute of Allergy and Infectious Diseases for almost forty years that he is wrong on national TV, anyone can correct their doctor because they “did my own research.”

We got the message. Did you?