I got the inevitable phone call at 1 AM. The patient is at the nurses’ station saying he thinks he has the flu. The nurse tells me his temperature is mildly elevated and he complains of a dry cough and stuffy nose. Surprise, surprise, he wants something for it. Looking at the chart, I see that he received throat lozenges from the previous hospitalist. Judging by their note, he complained at nearly every shift of respiratory symptoms.

It’s obvious there’s some desire on his part that we instantly prescribe a “cure” for all of this. As much as I would love to be able to do this, a cure is very unlikely to happen. If I could make the sniffles go away, I certainly would have a lot more in my bank account than I do now. So, after looking through the record and examining the patient, I discovered his condition is pretty much unchanged. I realize that this patient is tired of feeling this way. Nursie poo isn’t any better when he’s sick, and yes, it is typical of any male when sick (and female for that matter. Let’s be honest, neither sex holds the high ground in behavior while ill). After finally sitting down and discussing it with the patient, finally the real desire comes out; “can’t you give me antibiotics that would clear this right up?” Insert the Price is Right sound here, and we have managed to go to the question every patient asks when they’re sick, and now I get to explain why antibiotics aren’t the solution to everything.

The short answer is that antibiotics do not kill viruses, however, as soon as anyone gets sick, that’s the first request made by every patient. It would actually be better to drink a glass of water than to take an antibiotic for a virus. Why are people so stuck on getting an antibiotic? The simple answer is that when penicillin arrived on the scene in the 1940s to treat infections, we did not have the robust knowledge about viral infections as we do now. Yet, we are a society of habits, and our grandparents and our parents went to the doctor when they were sick, and they got a pill for everything (Think Vitameatavegamin from I Love Lucy). They assume their children should get pills when they are sick and welcomed that learned behavior. So, say this with me, “I don’t always need a pill when I am sick.” (Lies…I want all the pills when I’m sick…)

I know that many are told this on a regular basis and will parrot this mantra until they’re sick. I get it, people want the magic pill and to be well. Well go ahead and invent this because whoever does it will be a billionaire overnight.

Some might be curious as to what I prescribed for this patient. Well, the short answer is nothing. Because of increasing temperature, I did an influenza swab as I didn’t want to take a chance of him infecting an entire ward. I encouraged him to increase his fluids and offered him ibuprofen every 6 hours to assist with his stuffiness. He already had a throat lozenge for his cough, but I recommended and ordered as needed saltwater gargles if he developed a sore throat related to coughing. The truth is that none of this will make the duration of the virus any shorter. The only thing that works with a viral infection is time, and we don’t want to accept that. We’ve become the Internet generation of Amazon Prime users who can click on something, and it’s delivered as near to instantly as possible and still getting faster. But, at this point (although I hear the Star Trek transporter is coming soon along with replicators), we want the same with healthcare, except our body doesn’t do that, nor does conventional medicine have the ability to make this happen, yet.

What can a provider do for someone who’s sick? Well, if it’s a virus, there isn’t a lot we can do other than recommend things that will help mitigate the symptoms. Although the treatments might relieve some of the symptoms, they don’t reduce the duration of the illness for a viral infection. Bottom line is rest, fluids, and plenty of snacks, oh and watching the Price is Right while lying on the couch (I mean come on, who didn’t spend sick days when they were a kid watching Bob Barker or Drew?). The other thing that I should point out is that when I say rest, it doesn’t mean going to work sick. Yes, I know people don’t have sick days, and they would rather use them for something better than being flat on their asses with a virus, but it doesn’t do any service to anyone, except maybe giving it to Karen, so she takes it home to her children and infects them, so she has to stay home for weeks at a time.

As a world, we are in an antibiotics crisis. When penicillin arrived on the scene, bacteria didn’t know what to do, and penicillin was very quick at killing them. Bacteria, unlike a lot of people, learns quickly how to keep itself from being killed. While penicillin still works with some infections, it doesn’t work on nearly as much as it once did. So, we develop more antibiotics, and they get overused, and the bacteria learn, and they become useless. We’re pretty much at the point that bacteria should get seats in Harvard Medical school because they’ll soon be smarter than the average devil spawn coming from Karen’s loins…though they’re just resistant to almost every antibiotic, and soon we won’t have anything effective left to use on them. Don’t worry, we’re not there yet, but we are close.

Before I’m done with this, I do want to make an important point that there are physical conditions that do require antibiotics. When women have urinary symptoms, there is a good chance that it is a urinary tract infection. This should not be ignored or treated with things to relieve the symptoms before seeing a provider. While it is not a long course of antibiotics, it is necessary to kill the infection. So, oils and crystals are not going to make this go away. They won’t mitigate the symptoms either. I’ve treated women with urinary tract infections who have ignored them only to find the symptoms get much, much worse. While I have this moment, I have a message to all the ladies out there please, please, for the love of any deity, wipe front to back.

Still too many burn restrictions on this drafty castle. Thankfully, my faithful hounds are close. The bats, however, are another story…