I formulated my thoughts for this article while sitting on my favorite thinking rock. Everyone should have a thinking rock. A place where they can sit and relax while figuring things out or just enjoy the moment away from the stresses of life. My favorite thinking rock is next to water. A long glide of calm with the water entering from my left through a section of rocks and white water, and exiting around a bend to my right on the way to Dworshak and then to the ocean. I sat on the rock with my bamboo fly rod, a few fish rising in front of me, and the sound of the water all around.

My thoughts were not on the river, but on what was happening back at the hospital and what was happening in our community. My thoughts drifted back to a conversation I had with a specialist at one of our referral hospitals. It was about one of their patients, who was sick, complicated, and needed to be transferred for specialty care. The hospital there was full, but he agreed that the patient needed to be there, not at a community hospital. He said he would call the hospital’s transfer center and work something out. But he called about ten minutes later to say there was no way, they couldn’t take care of him.

“Phil, we’re living in Covid hell up here. We can’t take care of everybody who needs care. We have no beds—we are putting patients in the halls and in the conference room. We don’t have enough staff, we don’t have enough oxygen.” Then, “Phil, I’m sorry.”

I thought about a patient in our hospital with Covid. On high flow oxygen struggling to breathe. The look on his face showed that he had recently realized that he might die from his illness. Had not taken a Covid vaccine. I can’t remember his reason. I think I have heard them all. “I’m just not going to do it.” “They haven’t studied it” (there were over 40,000 patients in the study that got the Pfizer vaccine approved for use.) “The vaccine has killed 8,000 people in the U.S.” (it hasn’t.) “It has a chip to track you” (really?) “Covid is a hoax” (it isn’t.) “You can get Covid after being vaccinated” (Yes, I have seen this as well, but it’s not the usual, and they don’t die.) “It’s just the flu” (its not.) “It’s my personal choice.”

It doesn’t really matter what this patient’s thought process was. It doesn’t matter why he was not vaccinated. Only that he was not. It was all the same to the virus. As I was in his negative pressure isolation room I couldn’t help but think that if he had received the vaccine, he would not be here. Period. And the extension of that thought is that if everyone was vaccinated, we would likely no longer be dealing with this pandemic.

There is my medical training, which leads me to examine him, listen to his lungs, look at how much work he is doing to breath, looking at his oxygenation and how much oxygen and respiratory support is currently needed to keep him alive, looking at his current therapies to see if there is anything else that might help him. Looking at his trends, is he getting better, staying stable, or getting worse.

Then there is the emotional side. While we are physicians and are guided by science and data, we are still human and all have a deeply emotional response to our patients not doing well. There is anger that this patient is here, when he would not be here if vaccinated. There is anger at entities actively undercutting efforts to keep people healthy. There is frustration that we don’t have better tools to treat someone who is ill with this. And resignation to the fact that there is a significant segment of the community who will not be vaccinated no matter what, and that there will be more of our fellow citizens who will become seriously ill or even die. But mostly there is empathy for the patient in front of us who is struggling to breathe and scared. And the desire to do all possible to help him recover.

I think about the posts I see on social media and blogs. Some are hateful and accusatory. Some are mocking. Some are innuendo without any facts. Some assert a fact which is not correct. Some have a fact with an incorrect interpretation. What is lacking in most is empathy for those who are ill. Perhaps a person who has not gowned up, gone into the negative pressure room and watched a person scared and struggling to breathe is unable to understand how evil this virus can be.

The fact is that the immunization is by far the most effective means of preventing death or serious illness from this virus. Period. This is one arena where clearly an ounce of prevention is worth way more than a pound of cure.

Back to my thinking rock. At some point, you have to shake it off, get up and make your cast. There is one fish that seems to be rising more often than the rest. The currents are tricky, and the presentation is difficult, but after a half dozen casts the fish takes the fly and after a few runs the fish is in my hand. A beautiful strong wild fish. That should push every negative thought right out of my mind. But it doesn’t. Any more, the stress of what is happening never goes away.