Tag Archive | Eric Topol

The Journey

“When I got a review back for a paper in Science, one of the reviewers wrote “it’s at the 6th grade level.” I sent that review on to Alan [Alda] and he wrote back that it was the nicest compliment I’ve ever received. For my presentations, I give the same talk and show the same slides whether it’s a lay public audience or a science/medicine group of attendees.” ~ Eric Topol, Ground Truths, March 13, 2023

When I read this, I experienced a flash into an alternate universe, where instead of spending my nest egg on 35 acres of relatively wild forest, I used it to attend the science writing grad program at UCSC where I had been accepted. That was 31 years ago. 

In this flash vision, I had graduated from that program with the credentials to follow one of my passions, understanding and communicating developments in science to the general public. In that universe, I had an exciting career that took me from the panda nurseries in China to the Australian outback and Great Barrier Reef, from the shrinking glaciers of Greenland to the drying Great Salt Lake in Utah. I had interviewed some of my idols including Anthony Fauci, and when the pandemic struck I had become a meaningful voice in translating its rapid public health implications for lay consumption, just like Eric Topol. 

Oh well. The flash was over in an instant, washed away by a wave of reassuring recognition that I’ve lived a good life, and come to a place of contentment with internal balance, loving friendships, and meaningful work. Things could have been different, but they weren’t. My choices, along with conditions I had nothing to do with, led me to this place, and I’m grateful for the journey of discovery, continuing to pursue the question I’ve been asking since I settled on this beautiful wild land: Who am I, and how did I come to be here?

Scientists

I’m grateful for all the doctors and other scientists who continue to research the many facets of Covid-19. This diagram is from Eric Topol’s newsletter a week ago, delineating the number of new variants as of November 3 that have multiple convergent mutations. Note that at least ten of these variant families are resistant to prophylactic Evusheld, and/or monoclonal antibodies currently used to treat Covid. Some days Topol, who is among other things a professor of Molecular Medicine at The Scripps Research Institute, offers good news in his daily Covid update, and some days not so good news. In one report this week he cites research suggesting that Paxlovid treatment for acute Covid significantly reduces the incidence of subsequent Long Covid. On the flip side, he cites another study indicating that “a 2nd or 3rd infection is associated with worse acute and post-acute (Long Covid) outcomes than not having a reinfection.” I don’t pretend to understand the statistics, charts, and graphs he cites, but I do understand the plain English of his interpretations.

I’m grateful that the top scientists in the world continue to take seriously the threats to public health from this virus. Most authorities on the subject concur that this pandemic is far from over. I’m saddened to see so many in my community sickened with Covid right now, and disillusioned to see almost everyone I know dropping precautions right and left. When I share my concerns with friends in explaining my ongoing vigilance, they offer polite but insubstantial sympathy. I’ve been crystal clear since March 2020 that I have no intention of getting Covid and absolutely do not want to be exposed to it. I’ve shared with my close friends that I already suffer chronic pain (most likely from a previous infection of an unknown virus thirty years ago); that another virus laid me low for nearly two years after an acute attack of vertigo that prevented normal functioning for six months; that I already have enough trouble breathing (even before the COPD diagnosis and being on night oxygen). My life is already hard enough. I don’t bitch about it here, or much anywhere. Instead I celebrate the good and the beautiful that helps me enjoy this one life, one precious day at a time. But I’m laying it on the line tonight.

For almost three years, I’ve asked people to respect my precautions and accept my protective isolation, and for the most part they’ve been willing and supportive. Some have been kind enough to do my grocery shopping regularly this whole time. I had a heartwarming conversation with a friend on Tuesday morning in which she assured me that people would be happy to honor any guidelines I might lay out before connecting with me. I pointed out that a) I’ve already been clear about my guidelines, and b) I don’t have any right to ask people to change their behaviors just to come near me. But I do have the right to protect myself by limiting my potential exposure with ‘informed consent.’ It’s like avoiding an STD: just let me know where you’ve been and with whom, and then I can decide how close I want to get to you. Ironically, at the time of that conversation, I had no idea that I’d been potentially exposed the day before.

I sense my friends are getting tired of me–I’m an extremist, an outlier. I sense my community, like much of the world, has decided they’re over Covid even if it’s not through with them–we’re in a hyper-local mini-surge here these days: everyone I talk to knows someone who has Covid right now–as one by one they drop their previous precautions like masking in the grocery store, or refraining from large gatherings, or traveling, or so many more. Perhaps they’ve surrendered to the inevitability of catching it, or the presumption of immunity. Or they’ve had it and “it wasn’t that bad.” Or they assume that because people they know who’ve gotten Covid have said “It’s like the flu,” that they’ll be sick for a few days and then be fine. But not everybody is fine: Covid still kills nearly 400 Americans everyday and they’re not all old and riddled with co-morbidities. And the parallel pandemic of Long Covid is revealing horrifying neurological and other systemic breakdowns occurring in millions of people, including an appalling rate of suicides by people whose brains just quit working. Check out this video featuring Yale Immunobiology Professor Akiko Iwasaki.

Or read this article in Time about neurological symptoms in Long Covid sufferers. While I’ve been super cautious, I’ve chosen to take a few risks during these pandemic years, largely to get healthcare for me or my pets. I can’t control everything: I need surgery for skin cancer next month. I’ll be in a closed building with plenty of other people with no mask requirements for hours under the knife. In this case the risk of cancer spreading outweighs the risk of the virus. Tough choices. I’ve figured (another naive assumption) that if I survived acute Covid, and ended up with Long Covid, at least I’d have the skills to handle prolonged fatigue, chronic pain, brain fog, and the other symptoms I’d read about–I’ve had plenty of experience with those already, plus now I’ve got mindfulness. Then I learned of a particular suicide that raised the question of the limits of the practice, and opened the door to deeper understanding of the dire realities of Long Covid. My budding complacency was shattered. Any temptation to lower my risk threshold evaporated. I’m grateful I enjoy being a hermit.