Like sports, the practice of medicine has seasons. For instance, summer is the season of injuries, bites and stings. People plunge from waterfalls, roll about in fire ant hills, wreck motorcycles while wearing bathing suits (it's as bad as it sounds), try to catch rattlesnakes and find themselves impaled on fishhooks.
Then, after the collective madness of Memorial Day, July 4th and Labor Day, a magical, mystical thing happens. The emergency rooms become quiet. There is often a week or two or even more when the insanity settles down and the waiting rooms are relatively empty. I love that time. I long for it during the sultry, alcohol-scented, sun-burnt, inappropriate swimsuit-laden shifts of mid-summer.
This year it happened as well. There was a kind of pause, a low tide, even noticeable in the midst of the rising ER volumes across the country. Except this year, it was like when you're at the beach and it isn't actually time for low tide, and it suddenly goes out and you think it looks strange and fascinating. And while you're picking up seashells and ogling the lifeguard, someone yells, "tidal wave!"
Because now, after the calm of autumn, hospitals, clinics, emergency departments and all the rest have felt the unrelenting devastation of the "flunami." That's right, folks. Influenza A, H3N2, is widespread, and it has crashed on our shores, and it looks like a vast, 10-foot wall of phlegm and tissues, carrying in its wake entire pharmacies of cough and cold drugs, Rock and Rye, Hot Toddies, Neti-pots, unnecessary antibiotic prescriptions and work excuses.
Life in medicine these days is an endless litany of "fever, cough, cold, headache, stuffy nose, body aches." Or, in some cases, "cough, sore throat, stuffy nose, fever, cold, body aches and headaches." And sometimes: "I'm hot and cold and hurt all over and I think I'm dying. Oh, and I have a stuffy nose, cough, fever and headache." You get the picture. In the end, the days and nights of patients, doctors, paramedics, clerks and nurses are all filled with human misery as people who haven't been sick for a very long time suddenly re-discover the inestimable wonders of the flu.
I'm not trying to minimize it. I know how badly it can make a person feel. While I don't ever actually recall having influenza (ER folks have the immunity of hyenas), I remember that sort of aching misery with other illnesses. I know that it disrupts holidays, travel, school, businesses and entire economies.
Sometimes patients need an inhaler, sometimes a little something for nausea. Occasionally, what seems like flu is pneumonia and requires an antibiotic or even hospitalization. And please understand, I'm not trying to suggest it isn't dangerous. Indeed, some people, every year, die from influenza. Just as they die from other infectious illnesses. The very young, very old and those already ill and weak are in danger from the virus.
However, for the overwhelming majority of humans, the current flunami is a shaking, aching, sniffling, hacking inconvenience that will run its course, no matter what we do with our shiny degrees and cutting-edge prescriptions. As such, a visit to the doctor is generally a waste of time and dollars.
Maybe I'm betraying my profession. But in truth, while we're glad to take your money, flu leaves us feeling a little inadequate, and your cough only shares the joy with the staff and everyone in the waiting room. And most of the time we'll say this: "I'm sorry, you have the flu. I can't do much for you." At this point I'm not even doing many flu swabs. (If it walks like a duck, you know.)
Adding to the general woes, this year's vaccine is less useful than predicted at fighting the current strain. (It happens; even the best science comes up short now and then.) To add insult to illness, the much-advertised, much-prescribed drugs Relenza and Tamiflu aren't much help either. While they may reduce transmission in some instances, they only make people feel better by a day or two sooner at best and by only 14 hours in one study. (They have been shown to increase corporate profits, however, so I guess that's a plus for some people!) You can see the most recent reviews for yourself at: http://www.medscape.com/viewarticle/823431.
Bottom line? Hang in there. Even the flunami can't last forever. It will eventually recede into the great green ocean of human grossness. News outlets will become bored and medical pundits will move on to summery topics like skin cancer and dehydration. And God speed the day! Before long we'll be attacked by insects and injured in softball games all over again. And honestly, it will be a pleasant change of pace for this slightly cynical but seasoned doctor.
Now go drink some orange juice and take a nap. You look terrible!