Notes from a Healer

Coup d' Flu

Brian T. Maurer

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A recent article in the New York Times caught my eye: Swine Flu Wave May Have Peaked in U.S. Thank God, I thought, heaving a sigh of relief as I scanned the text. According to the Centers for Disease Control, influenza activity is declining across the country. New cases of the flu dropped significantly during the week ending November 13th.

Anyone working in primary care medicine can tell you that the past two months have been a nightmare. Offices and clinics have been bombarded with phone calls and patients scrambling to secure a dose of the H1N1 vaccine for themselves and their children. Initially, no one wanted the vaccine because it was so new. When it became apparent that supplies were severely limited, everyone clamored for a dose.

Supply shipments have been spotty at best. The press did a bang up job selling the idea that everyone should get a flu shot to protect themselves against the H1N1 virus, creating widespread panic among a citizenry whose government has been unable to insure the production and distribution of adequate amounts of the vaccine.

Anyone who developed a cough, sore throat, congestion and fever wanted to get checked for swine flu. I saw more than a few patients who swore they had all of the symptoms, but none of them exhibited any signs of illness on physical exam—not even documented fever. The operative epidemiologic term is mass sociogenic illness: when widespread panic sets in and everyone is convinced they’ve got the disease.

This past week I was actually able to put my feet up on my office desk for several short breaks during the day. The tide had turned; the onslaught had diminished. I was sure that we would continue to see patients with complaints of flu-like symptoms, but not nearly so many as before.

One of the last patients of my day was a 6-year-old girl. Her mother brought her in for an infrequent dry cough. Despite an overwhelming lack of clinical signs, this mother was terrified that her daughter had developed H1N1 influenza.

I listened to the mother’s rant, examined the child, and then offered my final proclamation. “Your daughter does not have the H1N1 flu—or seasonal flu either, for that matter.”

“Well, that’s a relief,” she sighed. “But then what has she got?”

I thought for a moment. “She’s got a case of the Amish flu,” I said.

“Amish flu—why, I’ve never heard of it. Is it serious?”

“Not at all.” I explained. “The Amish flu is when you get a little hoarse, and it drives ya buggy.”

In times of marked concern, even feeble attempts at levity remain largely unappreciated.

About the Author

Brian T. Maurer has practiced pediatric medicine as a Physician Assistant for the past three decades.  As a clinician, he has always gravitated toward the humane aspect in patient care—what he calls the soul of medicine.  Over the past decade, Mr. Maurer has explored the illness narrative as a tool to enhance the education of medical students and cultivate an appreciation for the delivery of humane medical care.  His first book, Patients Are a Virtue, recently reviewed in The Yale Journal for Humanities in Medicine, is a collection of patient vignettes illustrating what Sir William Osler called “the poetry of the commonplace” in clinical medical practice. Interested readers can read more of the author's writings at his website and blog.

Published: November 29, 2009