Categories:Clinical medicine

You wouldn’t have had to watch too many episodes of my old TV show, House, MD, to hear mention of “sexually transmitted disease.” And you wouldn’t have to sit through too many medical school lectures before you heard about a “mosquito-transmitted disease,” like malaria, or a “tick-transmitted disease,” like Lyme disease.

Nowhere, however, would you ever hear about a “compassion-transmitted disease.” Yet, that’s exactly what Ebola virus disease is in humans.

With few exceptions, a person catches Ebola only through an act of compassion toward another person who has the virus.

For example, Thomas Eric Duncan, the man who died from Ebola in Dallas, picked up the virus when he helped a sick, infected woman get to a clinic in Liberia. The doctors and nurses who have contracted Ebola got it while delivering medical care to Ebola patients. Of course, lab technicians and a cleaning crew are part of the medical enterprise, too. And most of the thousands of people in west Africa who have gotten the disease were helping care for a loved one at home, or were performing post-mortem rituals as a token of benevolent love for the deceased.

Sure, there are exceptions to the compassion rule. The first patient to get the disease in any Ebola epidemic acquires it, most likely, from an animal. And perhaps there are a few cases where someone is exposed to infected body fluids while not coming to the aid of a fellow human. But, children excepted, there is no indication that disease is occurring in the current outbreak after only a coldly inadvertent exposure to body fluids.

There are two tragic ironies to the centrality of compassion.

First, for adults, callousness is effectively an excellent vaccine against Ebola virus disease. <sarcasm>So if you’re being a callous jerk, then congratulations, you’re protected from the disease.</sarcasm> It’s fortunate that Ebola is rare in human history, otherwise evolution might have removed compassion from the population.

Second, the entire epidemic could be ended very quickly if everyone in the affected regions immediately and completely discarded their compassion. In that compassionless scenario, any person who had a symptom or sign of Ebola virus disease would be instantly dumped into a well. Human-to-human transmission of the virus would immediately stop, and the epidemic would be over in a month… easy as pie.

The barbarity and utter impossibility of that scenario is an indication of how deeply compassion runs in humans. And maybe that is the inextinguishable good news in this bleak epidemic.

Multi-system effects of cobalt-containing hip prostheses

Rejected by the New England Journal of Medicine in 2014.
Co-authored with Stephen S. Tower, MD

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