Family Medicine and Pandemic

 According to the literary critic Ryota Fukushima's essay "The Inner Enemy and Negative Festivals: Between the Earthquake and the Coronavirus," the peculiarities of SARS-COV-2 are twofold. The first is that SARS-COV-2 infection has a wide spectrum of symptoms, ranging from asymptomatic to cold-like symptoms to acute pneumonia to multiple organ failure, but the symptoms of SARS-COV-2 infection are generally generalized to the respiratory system and are not as dramatic as those seen in Small Pox, Ebola, and Plague, such as rapid death or flashy skin rashes and bleeding. This is what Fukushima calls the "mediocrity" of self-expression. Another characteristic of the disease is that the number of asymptomatic patients is so high that it is difficult to know who is infected and where. SARS-COV-2 has a tendency to quietly conceal himself, which Fukushima calls "self-concealment". This mediocre and self-concealing characteristic has a similarity with the characteristics of radioactive materials that have been a concern since the Great East Japan Earthquake. Fukushima adds his thoughts on the pandemic from the perspective of disaster and recovery, and this essay is deeply encouraging to us.

 I would also like to draw your attention to the urgently published collection of essays by a young Italian novelist in one of the countries most devastated by the pandemic, Paolo Giordano's "We in the Age of Corona" . The book contains a dense description of the pandemic in relation to climate change and environmental issues, as well as issues surrounding individual lives and ethics, with excellent science communication skills that only a literary scholar with a background in physics and mathematics could provide. The message, "At this time of year, each of us should write down the things we think we should not forget in the future," is compelling.
After reading these two essays, it is important again to pay attention not only to the knowledge of the sciences (natural sciences) but also to the knowledge of the humanities. I think that's more necessary than anything else in the field.


 SARS-COV-2 is transmitted through droplet and contact infection. Therefore, SARS-COV2 propagates along with human communication such as talking, listening, expressing joy and sorrow, and physically touching each other. So, as a family physician, I have been forced to retain the basic values that I have been emphasizing, such as communication, physical examination, visiting the patient's home, and approaching the patient rather than the disease, which has created a situation in which I have been forced to treat my patients with a simple thought pattern, such as diagnosing SARS-COV-2 or other diseases. However, even under these circumstances, when people in the community who have been using me as a family physician as a health resource come to the outpatient fever clinic, the family structure and lifestyle recorded in the past medical records are very helpful, and it is very relaxing to consult with people I know. They often understand that their current practice is unavoidably changing from their usual practice. They keep the physical distance, but they keep the psychosocial connection.

 This pandemic has called into question the very raison d'être of primary care.