I am a practicing infectious disease physician who holds a healthy respect for the microbes we share our world with. I blog because I want doctoring to be better.
What Is An Infectious Disease Physician?
We are commonly known as ID physicians, ID doctors, or ID specialists. We are master diagnosticians and medical detectives, not unlike House, except most of us do not perform procedures or beat people about with a cane. Other doctors refer their patients to us when they need help diagnosing an infection or determining the best treatment plan for one. In any one patient encounter, we are uniquely positioned to have our patients range from our colleagues (figuratively), the individual patient before us, that patient’s family and social or health-care contacts, and sometimes society at large. Our specialized skill-set is cognitive-based and sometimes our secret weapon is a tincture of time, in other words “let’s wait and see”.
What are microbes?
Microbes (microorganisms) are living things that we cannot see with the naked eye. They include bacteria, viruses, fungi, and protozoa. They precede our evolutionary ancestors on earth. Microbes have changed human history and culture in ways both small and large. The potato blight (Phytophthora infestatans) changed Ireland and the countries to which victims of the Irish famine fled to. The Black Death (Yersinia pestis) devastated Europe in the 14th century. Malaria (Plasmodium species) continues to threaten the lives of about half of the world’s population.
Battling Microbes (Germs)
Our narrative is “germs make us sick”. We are reminded daily how drastic environmental change and radical lifestyle choices affect our health. These days we hear of new and resurgent diseases such as Zika, Ebola, H1N1, HIV/AIDS that are caused by microbes. In the war against germs we have created antimicrobials particularly antibiotics like penicillin. We have saved millions of human lives as a result but we have also developed an unhealthy attitude towards microbes.
Some Microbes Keep us Healthy
While some microbes make us sick many in fact keep us healthy. Some are vital to our survival. We are inhabited by thousands of microbial species. They make their home on our skin and in our digestive system from mouth to anus. Others we get from the food we eat, the things we touch, and even the air we breathe. Truth is we ceased being sterile beings the minute we were born.
Antimicrobial Overuse
As an infectious disease physician I worry about modern society’s reliance on antimicrobials. I fear that too often we use antimicrobials as a crutch in the place of proper history-taking and diagnostic testing or to soothe our nerves. Antimicrobials may as well be called chemotherapy. They are far from benign. I realize that when I prescribe an antimicrobial there is potential for collateral damage either felt by the patient individually or by society. Thus each decision to prescribe an antimicrobial is an exercise in assessing need and in risk-benefit analysis.
Respect the microbiota
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