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A doctor’s dilemma: to help or hold back from treating dangerous infections

If, like me, you’ve wondered why a doctor or nurse would decide to volunteer to help patients with often fatal infectious diseases like Ebola, The New York Times Magazine ran an essay today by Stanford physician and author Abraham Verghese, MD, MACP, in which he addresses, among other issues, the tension for clinicians between self-preservation and the impulse to help.

We doctors feel the pull. But each of us has reasons to stay back, reasons that get bigger as we age

He begins with his time treating patients in a hospital in India, detailing his encounters with tuberculosis, malaria, and filariasis among other diseases, but his description of his fear of and his reflections of his encounter with his first rabies patient is poignant:

I felt terribly sorry for this man who was old enough to be my father. Squatting by his mat, I was ashamed of my earlier fear and hesitation. I was glad to spend some time with him. By the next morning he was comatose and convulsing. By nightfall, he’d transcended the mortal world.

He  goes on to discuss his work with HIV patients in the 1980s, and the fear that surrounded the disease at the time. Many physicians donned full protective gear, even though researchers had determined, even in the early days of the epidemic, that the disease wasn’t spread via casual contact. Verghese connects these fears to current fears about Ebola, but doesn’t blame physicians who are cautious. He also documents his own impulses:

I have the urge to sign up, to head to Liberia or Sierra Leone; the call for doctors seems personally addressed to me. When I tell my mother, who is in her 90s, that I am thinking of volunteering in West Africa, she clutches my hand and says: “Oh, no, no, no. Don’t go!” I’m secretly pleased.

….

We doctors feel the pull. But each of us has reasons to stay back, reasons that get bigger as we age: children, partners, parents, grants.

Verghese captures the conundrum facing doctors and nurses who want to help, but who are - for a  variety of reasons - pulled away.

Previously: Ebola: This outbreak is differentStanford physician shares his story of treating Ebola patients in Liberia and Dr. Paul Farmer: We should be saving Ebola patients

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