Go Retire Psychiatrist

I got this fascinating comment on one of my posts, (Do We See Each Other”), I wrote last year about one of Ray Bradbury’s short stories, entitled “I See You Never.” Judy’s remark was right on target, “Sometimes fiction mirrors life too painfully.”

I don’t know whether Bradbury’s short story she called “The Lighthouse” is the same one as “The Fog Horn” or not. A lighthouse is featured in “The Fog Horn”, though. The fog horn attracts a prehistoric sea monster kind of like the Loch Ness Monster to the lighthouse because they both make the same call.

The monster is alone and isolated. It’s probably the last surviving creature of its kind. And because the fog horn is just a noise after all and not a potential mate or friend, the monster levels the lighthouse. The is just one of several examples of Bradbury’s tendency to examine isolation in his stories.

The theme of isolation reminds me of something current in the news lately, and that’s the Ebola outbreak in Africa. The CDC and other public health experts tell us that there’s very low risk of Americans getting infected. This is reassuring to some extent, but I remember the last time the threat of Ebola made a target of Iowa. That was in 2014, while I was still working as a psychiatric consultant in the almost 800 bed hospital.

The leadership of The University of Iowa Health Care convened a meeting about how our institution might become involved as an accepting hospital and what our plan would be for managing any patients in the event that Nebraska Medical Center would need to send overflow patients to us if their Biocontainment Unit were full.

Leaders from Hospital Epidemiology delivered a detailed and well-organized presentation of how our institution would handle the issue. I remember wondering how and whether medical and psychiatric consultants would be involved.

The good news was that we had national infection prevention experts on staff, and that Ebola infection rates were low compared to measles and HIV. The bad news, of course, is the high mortality rate of Ebolavirus disease and (at that time) there were no vaccines or approved treatments. There is one vaccine, but only for one particular Ebola virus species.

Further, information at the time about transmission was that it occurred by contact with bodily fluids. However, new scientific data in just the last year by University Iowa researchers revealed some evidence supporting a possible role of skin-to-skin transmission.

What’s reassuring is that The University of Iowa houses the state’s CDC-verified Ebola/Special Pathogen treatment center. The presentation also included a great deal of information about diagnostic clinical findings, infection control procedures, as well as coordination with local, state, and national public health officials and emergency medical systems providers.

Patients would be cared for only by experienced critical care providers. No consultants, trainees (no medical, nursing, or allied health students, residents, or fellows), or family members would be permitted in ICU patient care rooms. Although not explicitly mentioned, clergy and pastoral services would presumably also not be permitted into the patient’s room. There was the stipulation that it would be necessary to provide consultation and support to help staff members in the patient’s room. Patients would not leave the unit.

Obviously, the patients would be in isolation for their entire stay, in some instances until they died. As a psychiatric consultant, while I could provide support to staff members, the patient would be alone.

This description of isolation in reality is in no way as moving or as lyrical as Ray Bradbury might have made it. Maybe it would be a good idea to have a close relationship with God.