"Have you been fit tested?" I was puzzled by the question, which seemed to come out of nowhere. Fit tested? I realized that the attending was talking about a respirator:
"Fit testing" refers to the training and evaluation process that prepares health professionals to wear a particle mask. The one above is affectionately known as the "duckbill" (for obvious reasons) and is a subtype of filter known as N95, meaning that it is capable of filtering almost everything.
Especially flu viruses.
I swallowed hard. "Uh, yeah... I had to do it at the beginning of the year." I fumbled around my wallet and pulled out a worn card indicating the size and type of respirator that "fit" me; it hadn't been touched for almost a year. The last time I used it was for precautionary measures for a patient with suspected TB, but even that one had been a false alarm.
The attending examined the card and gave it back. "Oh good," she said. "You might need it."
Our clinic is located in a smallish city with a significant Hispanic population that I have come to have a certain affection for. Of the many patients we see at our large hospital, they tend to be the most grateful, cooperative, and appreciative of our services. Most of them are first generation immigrants from all over Central & South America: Argentina, Peru, the Dominican Republic, Cuba, Puerto Rico...
And, of course, Mexico.
In case you haven't heard yet, the latest and greatest outbreak of the feared influenza viruses is the Swine Flu that has recently struck Mexico with particular speed and ferocity. Influenza is a worrisome public health concern because of its ability to spread rapidly and with otherwise innocuous symptoms, enabling it to attain crisis levels similar to natural disaster/horror movies (think "Outbreak"). While SARS stands out the most in recent memory, the worst epidemic in modern history is the
Great Influenza Pandemic of 1918, during which 20-100 million people died worldwide in the span of 2 years. The other frightening thing about it was that the highest mortality rates were among young, otherwise healthy people.
Like me.
I was fascinated by infectious diseases as a child, inspired by books like "The Hot Zone" by Richard Preston about disease hunters & detectives. (I suppose the contemporary analogy would be the House fetish most people seem to have today.) I loved how science, brilliant intuition, and a bit of "luck" helped people detect and conquer something invisible to the human eye. It was cool and sexy, largely because I could rest comfortably behind the book pages and a protective screen of vaccinations.
But now? Just a thin, synthetic mask stands between the uninfected and an unknown force of nature. I make things sound dramatic because that is exactly what fear plays upon: the tension of the unknown. Never mind that health professionals have been planning and stockpiling for a possible flu epidemic or that the chances of infection are currently slim. Never mind that the vast majority of people with symptoms are likely suffering from a cold. The fear is still palpably there.
So far, I've seen at least a dozen patients or parents of patients who are (literally) worried sick. The screening questions roll off my tongue now: Have you or anyone in close contact traveled to Mexico, Texas, or California in the past week? Was he or she sick? Do you have a fever, cough, cold, body aches, and/or runny nose? So far, not a single patient has made me raise an eyebrow. The initial fear I had has worn off and is rapidly being replaced by indifference and annoyance. Emboldened by my benign experiences and a growing realization of how unlikely it is for me to get Swine Flu, I am tempted to simply ignore the threat or it's impact in my community. I pass by dozens of patients in the ER who wear surgical masks "just in case" and almost laugh to myself. "They have no idea," I think. "Only a respirator, an N95 will do them any good."
And then I remember that they really don't have any idea. I remember that I'm just a medical student wandering through the halls, a prepubescent professional. I'm not a worried parent with a coughing child or a homeless man on the streets with chills and body aches or an undocumented citizen just learning to say, "Hello," "How are you," and "No, I haven't touched any pigs recently." I'm not someone who has already tested positive for TB exposure. All I am is someone with a warm bed, good food, and an orange piece of cloth.
I'm learning to wash my hands in the clinic but not in the world.
I'm learning to be fearless of others but afraid for them.
I'm learning to absorb pain but intercede for mercy and comfort.
I'm learning to be like Christ.
P.S.
Did I make you paranoid?
This is what you need to know, as per the CDC.
Post a Comment