Reflections on July 4, 2020

Since 1972, I have been working in hospitals in one form or another. If one were to culture my microbiome, it terrifies me to consider what multiply-resistant bacteria would be lurking there. I have been bled on by patients with Hepatitis C and coughed on by those with Streptococcus pneumoniae. I have done endoscopy on people suffering acutely with influenza-like illness and performed fecal microbiome transplant on patients with Clostridiodies. difficile. As a resident and fellow in the 1980’s, I cared for countless people with AIDS, when we thought it was blood-borne but no one was quite sure how it was transmitted; we were sure that contracting it was a death sentence - and a very ugly death at that. One took precautions, and one did what one had to do.

One should not care for the sick for accolades or sympathy or reward other than those rewards that are personal and intangible: altruism, compassion, empathy, professionalism. One should not enter the field if not prepared to expose himself to disease and suffering and people at their worst. One should expect bureaucrats and the public to generally demand more and do less to make the job of those at the bedside easier. That is the reality of the caring professions. And knowing that, I find the melodramatic lambastes of my medical and nursing colleagues scolding the public to hide under their beds, destitute and lonely in craven acquiescence to the ever-changing and histrionic dictates of public health bureaucrats to be distasteful at best. Dignity died in the twentieth century.

The attached article (1) documents our new reality, and the quicker we accept it and recover our lives in light of it, the happier we will be. SARS-CoV-2 is now endemic. It is part of the great cloud of pathogens surrounding us. It is not going back to China; we cannot effectively mitigate it, and attempts to do so will only slow - not stop - its propagation through the population. The promises of a vaccine in a few months are optimistic at best and pitiably naive at worst. As the epidemiologists at Stanford (the only ones that have been consistently right about anything in the COVID-19 epidemic so far) frequently remind their interviewers: There is no human coronavirus vaccine. There is no vaccine for most other single-stranded RNA viruses. SARS-CoV-2 will march through the population with periodic outbreaks killing about 0.1% of those it infects - just like influenza and other lower respiratory viruses.

Two hundred and forty-four years ago today, fifty-six men - white, aristocratic, mostly older, probably heterosexual, all cis-gendered, mostly racist, a few slave-owning, certainly all now dead - pledged their lives, fortunes, and sacred honor to create a revolutionary ideal, to envision and enact a worldview and a nation that enabled human flourishing on a scale hitherto unknown however incomplete or problematic the development of that ideal proved to be. They were flawed men - as are all human beings, but they rose above themselves to create something sublime. In today’s America, we stand on the shoulders of giants and castigate them as beneath us.

About them on that warm (2) summer’s day in Philadelphia, malaria, yellow fever, tuberculosis, typhus, cholera, even bubonic plague lurked. Death from infectious disease was ever-present, and therapeutic options were ineffective if not barbaric. Nevertheless, they persisted, and the natural rights of man were paramount to their persistence. Liberty - one’s prerogative to live as one sees fit, to pursue one’s dreams, to create wealth and dispose of it as one sees fit, to love and gather with whomever and however one chooses, to worship or ignore God as one chooses — these are the stuff of life and what emboldens the human spirit. Liberty for these dead, white, European men was of inestimable more worth than safety; they considered that if man is not free, he is not truly alive.

It is no longer fashionable to say such things. Rather, to claim such things is considered reprehensible by some: clear evidence of fragility and privilege at best and moral depravity at worst. Yet insofar as I am able, I claim the Spirit of 1776. Insofar as I can, I proclaim the genius of the American Declaration of Independence. I declare before God and Man that Liberty under God in a constitutional republic dedicated to the preservation of natural rights and the rule of law applied equally to each is the system of government most conducive to human flourishing. I declare that I will defend that heritage in whatever manner I can regardless of cost.

For the support of this Declaration, with a firm reliance on the support of Divine Providence, I pledge my Life, my Fortune, and my sacred Honor.