We have been here before of course: methicillin-resistant Staphylococcus aureus (MRSA) played through the hospitals and the headlines (and even the National Football League) last decade, alarming the public and spurring new regulations to contain it as well as the application of money, sort of, to develop new weapons.
Perhaps because of all the hubbub, MRSA now seems almost quaint and surely not a headline-screaming scourge: mostly contained, a nuisance, a problem, but being dealt with at the right place by the right people. In other words, it has assumed its proper proportion in the world of threats and dangers.
The same likely will happen with CRE. More cases will occur, hospitals will make the necessary adjustments suggested by the CDC, specialists will learn their way around the diseases, and eventually the threat and the excitement around it will flatten out. And then the next red-hot development on some other front will emerge rendering the acronym to oblivion.
The problem though is this: the mix of steady CDC concern about a real issue that requires attention, a world with infinite capacity for both news and “news,” and a perverse public enjoyment of being frightened has succeeded in little other than scaring the crap out of people who might need medical care.
Indeed, hospitals seem to occupy the same imagined place as the Overlook Hotel, the cavernous inn Jack Nicholson prowled in The Shining—the last place on earth a sane person would go. Health care in general and hospitals specifically are viewed these days by just about everyone as a veritable killing field, the place where the two inevitabilities—death and taxes—meet daily as people are fleeced then killed.
Such is not the case. Honest. Yes, I know I am tainted goods because of my conflict of interest: I work in a hospital and I believe in medical care. But please remember that people in ICUs, where CRE and so many other deadly infections lurk, are not denizens of executive suites. They are already quite ill, usually with multiorgan failure from the heart attack or stroke or high-speed automobile crash that brought them to emergency medical care. They then are exposed to the high-tech ballet of life-sustaining futuristic machines, venous and urinary catheters, potent and often toxic medications, and all the rest.
They also are exposed to the bacteria in their own intestines, mouth, and skin, as well those in the environment, much less the imperfectly cleaned hands of hospital staff. Horrible, heartbreaking, and fully preventable things happen in ICUs, but so too are many lives saved.
The demonization of health care has occurred simultaneously with our deepening fascination of the promise of tomorrow, an almost religious belief that medicine is just inches away from conquering just about everything.
These two fantastic extremes pervert reality with equal force and fully obscure the truth about medical care in 2013: we are neither in a hell of ineptitude and willful neglect nor just inches from the next great golden age of health. And though hospitals are complicated, difficult places to spend time, the view that, to preserve health, it is safer to avoid care than to seek it is a dangerous and troubling delusion.