Dr. Maura and Dr. Marks
THOUGHTS ON THE PAST FEW MONTHS
Madison Valley Medical Center (MVMC) had a couple COVID-19 cases early as the coronavirus hit Montana. A nurse tested positive within the first two weeks. The team at the hospital shifted gears immediately—changing how they moved people through the hospital, wearing masks as part of a daily practice and stopped seeing extra patients to limit exposure.
Dr. Maura Davenport and Dr. R.D. Marks are not fans of the masks. Dr. Marks said it brings out his ‘grouch factor.’
“I think since then we’re kind of just trying to get people back in the door and working on treating all the things that people didn’t come in for when COVID was kind of a big deal,” Dr. Davenport said.
It is a big deal, she recognized, but it ended up not being a big deal in Ennis. Initial cases created a sense of urgency that allowed the hospital to prepare. “I think we’re ready if it does come. We spent a lot of time getting ready. We did a really good job with that and so I think now we can easily transition back to being ready for when it does show up,” Dr. Davenport said.
Dr. Marks called society’s and the government’s jump onto the same train the Pied Piper effect, a jump prompted by a fear reaction, he reckoned.
“I think we jumped right into social isolation and we didn’t take into account what happens to people when they socially isolate. I’m seeing two or three patients a day right now for depression and anxiety related to not being around people, financial concerns,” Dr. Davenport said.
“We’ve had people not come to the hospital and get really sick or die at home. The nursing home, appropriately, is not letting anyone in the building and we’ve had an uptick in mental health there, too,” she continued. “We didn’t think about it when we did it, and I think we’re dealing with the consequences of that right now.”
The doctors saw the jump and the fear factor as characteristics that made this virus response different. Doctors know how to treat respiratory viruses, know how to work with personal protective equipment and know how to work with contagious diseases.
Fear made this different, they said, and from where did it stem?
“You want to point a finger…” Dr. Marks said, an index finger at the reporter in the room.
“When the only thing you can read in the news is this news about COVID it sort of takes your focus and always keeps your focus on this thing that is going on that may be part of your life, but probably won’t be. I think that keeps everybody’s fear going,” he said.
A patient at MVMC was sent to a bigger hospital for a pulmonology consult and sat on a COVID floor for three days before being seen by a pulmonologist. No one wanted to expose themselves or a patient to a potential COVID case. “She got terrible care because they were worried she had COVID and that just doesn’t make sense to me,” Dr. Davenport said.
As people digest fear, some end up rejecting it, Dr. Marks pointed out. He used crowded beaches and swimming pools as examples of this rejection, a response to being kept captive and the rejection of authority, leading to decisions that may not benefit community health.
The health of a community is more than the measure of one illness, however, as Dr. Davenport put it. Economy, mental health and personal interactions have value equal to physical health and as any one is affected, community members react.
Fear of and respect for the coronavirus are two different things, Dr. Marks said. It is important to respect that one may get the disease, but not let fear cripple the reaction to the possibility. It is going to show up in case counts when we start ‘mixing’ again, he said. “You cannot stop it. We have to learn to deal with it and mitigate it, but you can’t stop it.”
“Control what you can control, which is yourself,” Dr. Davenport offered as a suggestion moving forward.
Furthermore, keep judgement to a minimum. There are some who will wear a mask everywhere they go and some who know they will be six feet apart from others in a coffee shop and ditch the mask.
As medical professionals, the doctors treat everyone assuming they want to be protected and are serious about the virus. “We have to adjust what we do to where we’re at and the situation,” Dr. Marks said. Restrictions in New York do not parallel restrictions in Ennis, just as a phased reopening of Montana does not mirror New York’s.
“I think it’s really easy to look at people and say, well you’re not doing a good job or you’re not doing what I think you should be doing, but I think that’s what gets a community in trouble. That’s where a lot of the anger and fear comes from,” Dr. Davenport said.
Both doctors agreed COVID-19 did not really change their lives. “I’m just a grouchy old guy. To me, this is just like another day,” Dr. Marks said. He compared it to his decision to join the military—he understood it was his choice and was aware of the consequences, and viewed the decision to be in the medical field the same.
Both agreed the acceptance of the usefulness of telemedicine was a big win. As a hospital, colleagues are learning how to better work together and use each other’s strengths to their potential. “Every crisis is a learning opportunity, and we’ve learned a lot,” Dr. Marks said.
“I think it comes down to common sense and taking responsibility for yourself and making decisions. All you can do is control yourself and how you treat others, and how you decide to interact with others,” Dr. Davenport said.
“I think a lot of the fear that we’re seeing now, some of the riots and everything, that fear is a direct consequence of the isolation and the decisions we made, and we’re going to have to live with that,” she said.