Paging Dr. Dunning, Dr. Kruger

We are quickly approaching the two year anniversary of when everything changed.

The medical community had been reading about Covid/coronavirus/SARS for a while. Speculation was rampant. The stories coming out of China were terrifying. Italy was in terrible shape as well. Laypeople were openly disparaging Asian Americans. People were coming to the hospital because they had been near someone who looked Chinese. Early on, hospital administrators discouraged staff from wearing masks, as they didn’t want us to scare the public. We soon realized it wouldn’t matter much, because there weren’t enough masks (of any kind) to go around. We got our first cases while the rest of the “non-essential” country was shut away in their homes, and those cases were truly awful. The initial recommendation was to intubate patients early, as it seemed that anyone who was still hypoxic despite maximal supplemental oxygen would not improve, and we were instructed not to use less invasive techniques such as CPAP and BiPAP, for fear of aerosolizing the virus into the rest of the treatment area. We constructed intubation tents out of PVC pipe and plastic drop cloths. We wore face shields made by neighbors who bought 3D printers specifically for that purpose. Families were wearing homemade cloth masks. Doctors and nurses were sleeping in their garages to avoid contaminating their loved ones.

Meanwhile, government recommendations seemed to change every day.

People who had no other real contact with the medical world were now being exposed to information overload. The general (non-medical) public had to drink from the firehose of information. They had to learn about things that the medial world took for granted. Sensitivity. Specificity. R0. Intubation. Ventilator. ICU. Bed capacity. Diversion. Surveillance. Infection prevention. Contact tracing. Masks. Masks. Masks.

Naturally, the public was frightened about the threat of Covid, but also incensed at having to give up some “freedoms” in order to hopefully protect others. Politicians told us that some of us were “non-essential.” Those that were least able to accommodate having to work from home and take care of kids going to school at home were no longer able to go to work to feed their families.

Fear led to Anger. Anger led to Hate. Hate led to Suffering.

And so for the last two years, the people who actually work with Covid patients have been trying desperately to spread the truth about what is really going on inside our hospitals and ICUs, but we’ve been drowned out by politicians, bureaucrats, grifters, overnight “experts,” soothsayers, snake oil salesmen, and Social Media Like Farmers. It did not help that we medical people weren’t able to predict the future, and made some mistakes along the way. Because hospitals got some emergency government funding to cover the cost of caring for Covid patients, suddenly doctors were accused of fudging the numbers in order to “get $30,000 per patient.” It’s no surprise then that when vaccines finally became available, they simply became another issue for everyone to fight over.

Now everyone had to learn quickly about mRNA, population statistics, effectiveness rates, incidence, prevalence, variants, variants, variants.

When turmoil seemed to be reaching its highest level, I started posting on FB messages like “If you have honest questions, please ask.” There were a few trolls here and there that most definitely did not ask honest questions, but for the most part, I had really good and thoughtful conversations with friends and strangers who were concerned that they may have been given misleading information. If there was something I couldn’t answer right away, I tried to find relevant and reliable sources that could hopefully provide some insight.

I don’t know how long it will be before we have a clear picture of the true story of Covid. Right now, as they say, it’s too soon. We could have another variant spring up at any moment. I’m not prepared even to knock on wood and say that we’re approaching the end. Certainly it seems hopeful right now. My greatest hope is that the next time something like Covid comes up again, we as a People decide that our Responsibilities are as important as our Rights, and listen to the folks who are closest to the issue before jumping to conclusions.

So what in the world does this have to do with me running for PSC?

Well, you don’t become a doctor overnight. You have to do well in high school to get into a good college, where you have to take the appropriate pre-requisites and do well on the MCAT and apply to highly competitive med schools where everyone else is as smart or smarter than you. By the time you finally get in, you think you’re hot (stuff). One of the docs I worked for in college told me “Oh yeah, today you say ‘look at me I got into med school,’ next year you’ll say ‘don’t ask me I’m just a med student!’” It really is overwhelming, trying to learn things that you’ve never encountered before in a language you’ve never spoken before. Anatomy. Physiology. Pharmacology. Histology. Embryology. Pathology. Human Biochemistry. Then there’s the actual business: History, Family and Social History, Past Medical History, Past Surgical History, Review of Systems, Physical Exam, CBC, H&H, BMP, CMP, INR, Lactate, Blood cultures, CRP, ESR, Type and Screen, Mag, Phos, Intern, Resident, Fellow, Attending, Dispo, Admit, Discharge, and on and on and on. You finally get then hang of it and apply to a residency. You go through the Match. You get your first or second choice and you’re hot (stuff) once again.

Then there’s residency. Those who came before me thought my class had it easy because we were limited to an 80 hour work week. Going on a rotation that only had q4 Call felt like a vacation after months of q3 Call (Call starts at 6am on day 1, continues until 6am on day 2, you get to go home after 6 additional hours of rounding during post-call, go home and have a delirious evening with your significant other, and have a non-call day 3 working 6am to 6pm. Wash. Rinse. Repeat.) All the nice empathetic long-form history-taking you learned in med school goes out the window, because you’ve got to get on to the next patient ASAP but don’t you dare present your patient to your attending without knowing the answers to the “what am I thinking?” game. Oh and by the way you must also order exactly the right amount of testing (not too little, not too much) and also know why you’re ordering it and what you’re going to do about it when you get the results and, and, and….

So you do that for three (or four or seven) years and then you interview for a Big Boy Job and you get it and woohoo you’re hot (stuff) again. I was blessed to have found a job with a small democratic group that is collaborative and accommodating and helpful and forgiving. But for most new docs it’s “Welcome to Generic Staffing Company. Here’s your log in. Here’s your locker. Here’s the coffee machine. Here’s your first chart.” You now know everything. You can do everything. Your judgment is infallible. You make the perfect decision every time and quickly. You order just enough tests to make the dispo but not too many that waste resources or time. Your charts are perfect and you bill the maximum RVUs and you leave on time and don’t sign anything out. You go home and have healthy relationships and keep up with the housework and don’t let anything get you down.

Except you don’t. You can’t.

I’ve been a fully fledged doctor at the same hospital with the same group for 12 1/2 years. I ought to be Practically Perfect in Every Way. But I’m still learning both technical Things and human interaction Things. At this point most of what I do is pattern recognition and I can usually predict fairly well what’s going to happen with a patient during their stay but I am surprised by something at least once a shift. My attitude toward patients, families, and Healthcare is not the same today as it was when I started. It will continue to evolve as I grow and experience more.

So I’ve been trying to learn everything I can about the Energy world for the last six weeks or so. I’m well outside my wheelhouse and I feel like I’m drinking from the firehose again. Coal. Ash. Sulfur. Gas. CO. CO2. Methane. Hydro. Gravity Hydro. Wind. Offshore. Onshore. Solar. PV. Thermal. Geothermal. Nuclear. Hydrogen. FERC. MEAG. EMC. RFPs. IRPs. RTOs. TOU. Net Metering. EVs. Hybrids. Level 1s. Vogtle. Vogtle. Vogtle. The Energy world touches EVERYTHING. (In America) We (almost) all have some way to turn on the lights and heat and cool our homes. We have to be able to get from place to place, usually in a vehicle of some sort. There are millions of variables that cause millions of individual decisions that influence the market every day. And the market is immensely complex. There are Rate payers. Tax payers. Providers. Transmitters. Subsidiaries. Conglomerates. Local regulators. State regulators. Federal regulators. International groups and treaties. Every one of these players has its own agenda and puts out information to support that agenda.

The Energy world, just like the world of Medicine, suffers from politicians, bureaucrats, grifters, overnight “experts,” soothsayers, snake oil salesmen, and Social Media Like Farmers. Just like the laypeople who had to learn overnight who to trust regarding Covid, and made mistakes along the way, I am certain I have fallen victim to some of these bad actors. I have not been doing this long enough to spot bad or misleading information automatically, but I had a sneaking suspicion that [radio guy] may have been promoting some “alternative facts” in order to support [his] opinion this afternoon.

Just. Like. Covid.

So, if you live and work in the Energy world, and see me using bad information sources to make bad assumptions or draw bad conclusions, please let me know. I am new to your world and will not presume to know better than you. Please understand that I’m trying to assimilate as much information as I can as quickly as I can. Please be patient if I ask questions that seem elementary to you. I welcome honest criticism and guidance. I want to be the best candidate possible. I honestly want to know the best way to serve Georgians, the best ways to increase choices and freedom, the best ways to encourage cooperation and remove coercion, and the best ways to generate and use energy while not harming our neighbors or descendants.

Thank you for your time.

Stay tuned for a non-energy non-medical non-autobiographical post.