A patient was in today for the common cold.
She did not think of it like this, however. The 22 year old white girl said “I don’t know what it is!” when asked about her nasal congestion, body aches, and fatigue that she’s had since yesterday. She had no asthma or other treatable medical issues. Just the typical viral cold we see day after day after day, the useless cases that nevertheless keep the lights on and the bills paid around here. The typical viral cold that does not respond to prescribed antibiotics whatsoever, and should be treated by bedrest and OTC meds only.
But something told me my hands were going to be tied here. Sure enough, a glance at the chart shows this patient was here 2-3 times a year for the exact same symptoms, and I looked at her prescribed medications with increasing despair.
Omnicef… Biaxin… Zithromax… Omnicef… Biaxin.
Each and every time, different doctors or PAs gave her antibiotics for her cold. Nobody ever bothered to tell her she was wasting her time coming here. So at this point, she’s been conditioned. If she’s sick, she needs an antibiotic pill. Because, after all, antibiotics are magic.
This puts me in a tight position. Every other visit for the common cold, she’s gotten her antibiotics, after all. If I deny her, I can trigger an epic meltdown, garner 1-star Yelp reviews, and cause her to go to a different clinic or even the ER to receive her expected antibiotics.
This behavior is a big reason behind the increasing resistance problem to antibiotics. Because we keep pumping healthy people full of antibiotics like cattle, the germs learn how to resist these medicines for when the time comes that they’re actually needed. It’s also a factor in our sky-high medical costs in this country: both the doctor’s visit and the pills need to be paid for by somebody, and the cost tends to be socialized out to you and me.
But sometimes, it’s our fault. We have failed this patient by reinforcing her magical, erroneous thinking about the common cold and the role of antibiotics. We have failed to educate her about her own health and her own body. And at this point, the conditioning is set too deep.
I had a cold myself a few weeks ago. I felt achy, tired, miserable. I doped myself up on ridiculous amounts of Dayquil and Nyquil. One thing I did NOT do was give myself antibiotics. Sometimes I tell my patients this story. Sometimes they listen. Mostly, not.
But what did we expect? The medical establishment has much to blame for this monster we created. And when the next scarily resistant strain of E. Coli starts showing up, we have no right to complain.