A COVID-19 Retrospective

The journey of Drs. Kirk and Kim Milhoan

I wrote this in May 2022 in response to a request for a chapter for a proposed book chronicling the stories of physicians engaged in the battle for truth regarding the covid-19 pandemic. Since it has yet to be published and though I haven’t updated the story since then, I thought it timely to share it here, on the eve of my husband’s anticipated congressional testimony, with Drs. Peter McCullough and Ryan Cole, on covid-19 vaccine injury.

Truth Claims

Pontius Pilate, when he was examining Jesus before His crucifixion, famously asked, “What is truth?” (John 8:38).

Samuel Webster, in his 1828 dictionary, defined truth as “conformity to fact or reality; exact accordance with that which is, or has been, or shall be.” We all believe and assert truth claims. Even the assertion that “there is no truth” is a truth claim. If the claim is true, however, it is actually false. There must be truth and we must be able to observe it.

My foundational truth claim is there is a God. I’ve never doubted there is a God, but find it helpful to hear the testimonies of those who have. It was the purposefulness of thought that led author C.S. Lewis from atheism to theism, for instance:

Supposing there was no intelligence behind the universe, no creative mind. In that case, nobody designed my brain for the purpose of thinking. It is merely that when the atoms inside my skull happen, for physical or chemical reasons, to arrange themselves in a certain way, this gives me, as a by-product, the sensation I call thought. But, if so, how can I trust my own thinking to be true? It’s like upsetting a milk jug and hoping that the way it splashes itself will give you a map of London. But if I can’t trust my own thinking, of course I can’t trust the arguments leading to Atheism, and therefore have no reason to be an Atheist, or anything else. Unless I believe in God, I cannot believe in thought: so, I can never use thought to disbelieve in God.

My next truth claim is that this God is revealed in the Bible. The Bible is likely the most disputed, criticized book that most people have never read. Reading it in my late twenties irrevocably changed me from someone who gave intellectual assent to the existence of God to someone who follows Him.

My final truth claim, based on my study of the Bible, is that God is good and loving and sovereign, and we are accountable to Him.

I share these truth claims because they informed my reactions to and conclusions about the COVID-19 crisis. The mysteries worth analyzing to me are: 1) why did others who claim to share these truth claims arrive at different conclusions, and 2) why did others who deny these truth claims arrive at similar conclusions?

Early Panic, Censorship, and Polarization of Views

I am an anesthesiologist who specializes in pediatric cardiac anesthesiology, so most of my career has been spent taking care of children with congenital heart disease, both domestically and internationally. My pediatric cardiologist husband, Kirk, and I have a Christian non-profit dedicated to international congenital cardiac care. His speaking in a church on our work led to his being called, in 2014, to be the full-time senior pastor of a church in Maui, where we have a food pantry and federally recognized free medical clinic, through which we became involved in the outpatient treatment of COVID-19. Since adding the vocation of pastor’s wife and women’s Bible study leader, I’ve worked as a general anesthesiologist on Maui. Kirk and I both still travel regularly to serve in our specialties in mainland children’s and international hospitals.

I was working in Little Rock, Arkansas, when the first case of COVID-19 was reported in that state, on March 12, 2020. The World Health Organization (WHO) declared a global pandemic that same day. Observing the rising panic and concerned about the possibility of a travel ban, I flew home to Maui the next day.

I distinctly remember a long phone conversation with my husband, on a layover en route, discussing what we were going to do about the church. By then, only two travel-related cases of COVID-19 had been diagnosed in Hawaii, on the neighboring island of Oahu.

Kirk started speaking consistently from the pulpit about COVID-19 on March 1, 2020. Recalling the timeline, the first person in the U.S. was diagnosed, in Washington state after travel to Wuhan, China, and the Centers for Disease Control (CDC) activated its Emergency Operations Center on January 21. The WHO declared the outbreak a Public Health Emergency of International Concern on January 30. On January 31, the U.S. Department of Health and Human Services (HHS) declared a public health emergency, President Trump limited travelers from mainland China to U.S. citizens and lawful permanent residents and their families, and the CDC published a health advisory for clinicians and public health practitioners.

Initial public health guidance for this novel coronavirus (SARS-CoV-2) was based on established management and prevention principles for known respiratory illnesses such as influenza, Severe Acute Respiratory Syndrome (SARS), and Middle East Respiratory Syndrome (MERS): hand washing, covering coughs and sneezes, and staying home when ill. The elderly, those with co-morbid conditions, and those with compromised immune systems seemed most vulnerable.

By the last week in February, there were widespread media reports of increasing cases and deaths in South Korea, Italy, and Iran. On February 28, a case of COVID-19 was identified in a resident of a long-term care skilled nursing facility in King County, Washington. By March 9, 81 of the residents of the facility, 34 staff members, and 14 visitors had tested positive for the virus. Twenty-three persons ultimately died, including the initial patient.

After the first U.S. death was reported, Seattle-area schools were closed, out of an “abundance of caution,” and the governor of Washington encouraged the avoidance of mass gatherings. Also on March 9, due to increasing hospitalizations and deaths, Italy declared a limited travel ban that they extended to the whole nation the following day. School closings and cancellations of mass gatherings of all types then started to occur across the United States.

Making sure we were not ignoring appropriate warnings, Kirk and I found a March 4 analysis of the Diamond Princess cruise ship cluster of infections that was reassuring. A cruise ship is a perfect laboratory for infection because it is a closed population where likely everyone is exposed and everyone is tested. Thoughtful analysis from this closed population estimated the case fatality rate for COVID-19 to be between 0.05 and 1%, much more reassuring than the WHO’s 3.4% estimate, and confirmed elderly adults were at risk for severe disease or death.

Kirk and I agreed, in our March 13 conversation as I traveled home, that our advice to our congregation would continue to be hand and respiratory hygiene and staying home if ill, part of or living with someone in a high-risk category, or simply concerned.  

The first case on Maui was not diagnosed until March 15. By March 21, there were only five cases of COVID-19 on Maui and none in the hospital, but the Hawaiian medical community had drafted a petition to state and local government demanding an immediate mandatory 14-day lockdown of the entire state of Hawaii, recommending the closure of all non-essential businesses and that citizens only be allowed to leave their homes for access to food, gas stations, banks, pharmacies, and healthcare.

In social media conversations soliciting providers’ signatures to this petition, I shared an article entitled “Evidence over Hysteria—COVID-19” by data analyst Aaron Ginn that had appeared on the website medium.com. The article had quickly gone viral and was just as quickly taken down. Fellow physicians commented that the analysis was “excellent,” “thorough,” “thoughtful,” and even “reassuring,” but they were concerned it would cause complacency and slow down preparation for the worst-case scenario.

After I shared the same article in a group text, one physician quickly commented on the author’s political affiliation, as well as negative social media comments on the article, before even having time to read it. After he did read it, he criticized the article for not being peer-reviewed and for the author not being a physician or epidemiologist. Another commented that my subsequent defense of the data analysis was “logical,” but that he would sign the petition, even if it seemed overzealous, because he’d rather be safe than sorry.

Trying to honor my colleagues’ desire for opinions from public health and medical professionals, I sought, found, and ultimately did not share a March 17 article by Stanford physician and epidemiologist, Dr. John Ioannidis, warning against prepare-for-the-worst measures of extreme social distancing and lockdowns in the absence of good data regarding disease prevalence and the adequacy of such measures. His article referenced a comprehensive review of the research on community mitigation strategies and included another encouraging analysis of the Diamond Princess. Like Ginn’s article, I found this one well-reasoned, compelling, and supported by data. This time, however, I read all the criticisms of it online and realized for the first time the polarization of views, even in the medical community, regarding COVID-19.

I declined to sign the petition, but I also withdrew from any further argument with my colleagues regarding the public health approach to COVID-19. In hindsight, I realize how quickly local and national physician Facebook discussion groups became polarized. Discussion was very open and useful until late March, and not thereafter.

Essential Services

A planned three-week medical mission trip, as well as another week of mainland work, were cancelled due to restrictions, so I spent four weeks, in late March and early April 2020, not on the medical front lines, but able to concentrate on our church community.

We were one of the last churches on Maui to have an official service, on March 22, the day after my debate with my medical colleagues. We cleaned all potentially contaminated surfaces, made hand sanitizer available at the door, did not serve our usual donuts and coffee, had congregants pick up their own single-service communion cups, and did not have our usual greeting time.

The mayor of Maui did announce a stay-at-home order that day, effective March 25. A 14-day quarantine of travelers arriving in Hawaii started on March 26. We knew these two orders would effectively shutter Maui’s tourism-dependent economy. Anticipating great need, we immediately elected to extend our church food pantry hours from three to seven days per week, receiving clarification from the mayor’s office that our services were deemed “essential” and being transparent we would conduct regular meetings of our volunteers. When we found out that Alcoholics Anonymous meetings were not considered “essential,” our federally recognized mobile medical clinic allowed Kirk to medically supervise a daily 6 a.m. meeting that was possibly the only one available on our island.

Biblical Mandate

That telephone conversation with my husband as I traveled was a fateful fork in the road. We all remember the early pressure not to be the asymptomatic carrier of disease who infected and killed someone else. I think many of us operated not out of fear for ourselves but fear of public opinion. The pressure on churches to close was immense. Kirk and I sought clinical data to reassure ourselves that abandonment of long-held principles of public health was not necessary. We staked our reputations and the reputation of the church on this conviction.

When doubts crept in, the call of the Christian life strengthened our resolve. The Bible teaches us to fear only God, not the opinions of men (Matthew 10:28). It reassures that God has given us the ability for sound judgment (2 Timothy 1:7). It teaches that all of God’s commands to His people are summarized in the commands to love God and love others (Matthew 22:36-40). It teaches that we show no greater love than in sacrificing our lives for another (John 15:13). It also tells us that, as Christians, we are supposed to gather in fellowship (Hebrews 10:25).

We had to decide whether our church was going to keep gathering and serving. Others had to decide their level of compliance with stay-at-home orders, social distancing, and mask wearing. The truth claims I established at the outset did not generally predict this resolve. People who claim to believe, study, and follow the Bible did, and still profoundly do, disagree with our conviction and actions, while many who do not claim a Christian faith were supportive.

Frustrated Journalism

As churches like ours were convicted to gather and serve their populations, I expected criticism from outside the Christian community, but was surprised at the level of criticism from within it.

I took a journalism course in 2014 and have only been intermittently successful in engaging this avocation. In mid-April 2020, when I read a scathing critique from the editor of my favorite Christian journalistic magazine (from whom I’d taken the journalism course) about the actions of other Christians, I hoped to put my perspective as a physician and skillset as a writer to use. Thus started a long dialog and lots of submitted articles over 14 months, when I finally gave up, that only resulted in one early and quick description of our food pantry work being published.

It's instructive to consider this editor’s justification for the criticism leveled at Christians who initially failed to stay home. Its foundation was the assumption that the asymptomatic could spread the infection for up to two to three weeks. The specter of asymptomatic spread has been a controversy inspiring much fear and supposedly justifying much action, but this initial time estimate was incredibly long.

Given this assumption, the editor declared, “The sixth commandment, you shall not murder, takes into account acting in foolhardy ways that jeopardize other people or ourselves.” My response: “God’s Law gives provision for those who do not ‘lie in wait’ or ‘act presumptuously’ (Exodus 21:12-15), offering refuge for those who kill ‘unintentionally’ (Numbers 35:11). There is enough fear surrounding this virus. It chills me to label with murder those who spread it unintentionally. As a medical professional who lives with the daily burden of ‘doing no harm,’ I can tell you the implication of murder for a mistake is too great a burden to lay on anyone.”  

His further justification for critique was, “The Bible also has very strict laws about isolating those with infectious diseases.” My response: “True. Notice, however, that God’s Law calls for isolating the infected, not everyone else.”

The bottom-line criticism labeled at Christians who failed to stay home: “We should love our neighbors as ourselves…if we harm our neighbors by ignoring medical advice, we place millstones around the necks of those who might otherwise see Christian love.” This persistent critique has applied to stay-at-home orders, social distancing, mask wearing, and vaccination. It has divided churches, families, and friendships.

I think some of the division has resulted from taking seriously, but misunderstanding, the Biblical admonition to glorify God by our actions. “Glorify” means to honor or hold in honor. We glorify God when we hold Him in our honor by obeying Him as individuals. The object of the glorification is God, not ourselves. If people don’t like what we do, if people fail to honor God themselves, that does not mean we, as individuals, have not glorified Him.

The critique that we are not loving our neighbors by failing to follow public health guidelines assumes these measures are effective. Let’s assume, for the sake of argument, they are. There are actions and expectations clearly enumerated in the Bible. These public health measures are not. For actions and expectations not clearly enumerated, the Bible asks, “Who are you to judge the servant of another? To his own master he stands or falls; and he will stand, for the Lord is able to make him stand” (Romans 14:4). “Therefore do not go on passing judgment before the time, but wait until the Lord comes who will both bring to light the things hidden in the darkness and disclose the motives of men’s hearts; and then each man’s praise will come to him from God” (1 Corinthians 4:5).

My husband wrote candidly about his decision, as pastor, to keep our church open:

My elders and I sought God through prayer and study of the Word. My personal motivation was to serve the risen Christ, my Good Shepherd, avoiding the temptation to serve either an idol of safety or an idol of liberty. We meditated on verses about gathering together and verses about authority. We reflected on the actions of historic and contemporary persecuted church throughout the world. The Lord impressed upon me the recurring ideas of sanctuary and keeping our doors open, as well as true fellowship for the body of Christ and not being ashamed of Jesus. Even though I did feel our rights under the constitution were being violated, I did not feel specifically called to address that right.

I had no desire to test the Lord, as Jesus had proscribed when Satan had tempted Him in the desert. I also made no faith claim that, if we believed or prayed hard enough, the Lord would keep us free from disease. I believed the medical science supported that, with appropriate precautions, we could decrease the risk to any participant at our church. I also had no particular reassurance from the Lord that our body would remain free of infection or even death. In fact, I wondered if those outcomes, and my subsequent public humiliation as a pastor and physician, would be part of my sanctification. Unsure of the outcome, I was confident that the Good Shepherd was leading.

Case Study

From the beginning of the COVID-19 crisis, my personal commitment was to stay abreast of the medical literature, which continued to offer poor support for many public health restrictions and give a clearer picture of populations at risk, as well as prophylaxis and treatment protocols. Outside of tilting at windmills with journalists and on Twitter, I shared my findings with our church community and with those who sought my opinion.

We made it clear as soon as March 1 that there was no pressure to be involved at church in any way and if we could serve those at home through prayer, shopping, delivery of food, or any other service, we would. We educated our members on our understanding of their risk and many, including those of retirement age, chose to be involved.

Over that initial two-month period, starting in March 2020, we had over 100 people from our church body regularly participate in our food pantry ministry and we served over 2,150 clients. As guidelines changed, we changed with them. We cleaned our facility daily. Volunteers wore masks and gloves when interacting with the public. Visitors were greeted at the door with hand sanitizer and a touchless thermometer. We moved the chairs in the sanctuary so family groups could sit in compliance with social distancing guidelines. If any volunteer had any concerning symptoms, they were required to stay home.

Transparent with the mayor’s office, we had bi-weekly pantry meetings for all our volunteers. We would start with an update on the pantry and COVID-19 science, and then we would sing, pray, celebrate communion, and hear a teaching. Our volunteers did share a meal together every day. We took off our masks when we were around each other and didn’t sit socially distanced. We hugged each other. We even hugged food pantry patrons when they specifically requested it. That moved many to tears.

As a way of assessing our effectiveness at limiting the spread of infection, we conducted serum antibody tests on over 100 regular volunteers and their family members in May 2020. Seven people tested positive, demonstrating previous infection with SARS-CoV-2. All infections were mild. No one was hospitalized. None of their household members, including spouses, tested positive.

Reassured, we resumed worship services on the day of Pentecost, at the end of May 2020. Other church gatherings, such as our women’s and men’s Bible studies, and the young adults’ group that met in our home, resumed at that time as well. Because they were in the lowest risk category, I confess that our youth actually never stopped gathering.

A Year of Living as Freely as Possible

My sincere hope during the first year of the COVID-19 crisis was to reassure people, through review of the medical evidence and the reality of our lived experience, that they too could safely live more freely.

I was one of the individuals who was antibody-positive to SARS-CoV-2 in May 2020. In hindsight, I believe I was infected during my mainland travels in March 2020. I felt slightly “off” as I traveled home and didn’t know if I could attribute it to jet lag or illness.

My 80-year-old mother and her same age friend had been with me on the mainland. I had counseled them on respiratory and hand hygiene and had practiced these principles diligently myself while I was with them, on my way home, and when I returned home to my husband, son, and 80-year-old mother-in-law. Everyone who was exposed to me at that time tested antibody-negative.

Since my husband was on site at the church daily, interacting with the public through the food pantry and free medical clinic, he was on a hydroxychloroquine prophylaxis regimen, until he finally succumbed to the delta variant in 2021. I’ve shared how freely we lived with our church community. As soon as restrictions allowed, we lived as freely as we possibly could in other ways as well. We returned to regular mainland medical practice, as well as international travel.

Some six of our mission trips were cancelled in 2020, but Kirk and I were able to travel to Tanzania in November to assess starting a pediatric cardiac program in the capital of Dodoma. We found a country living without COVID-19 restrictions at that time, largely without consequence. I tried to submit articles for publication based on my firsthand experience, but was literally told AP and other reporters, who were reporting from outside the country, were more trustworthy.

Death Comes

During that first year, following the success of numerous outpatient physicians across the country, we recommended to everyone we knew and loved who were concerned or at risk for COVID-19 infection to be on a minimum prophylaxis protocol of several over-the-counter medicines. If they became ill, we made sure they had access to a combination of prescription medications. No one we treated was hospitalized or died. Then, in February 2021, my friend’s brother on the East Coast died.

He had just received a vaccination against COVID-19 when he tested positive. When he began to be sick at home, he did use some over-the-counter supplements, but he didn’t receive a prescription home treatment protocol. He didn’t know us, since we are friends of his sister, and I imagine didn’t want to inconvenience strangers. Since he had heard about treatment protocols, as his symptoms worsened, he went to the hospital. I presume he thought that would be the best way to escalate treatment to prescription medicines. I don't know whether he anticipated getting admitted. For two weeks, as he steadily got worse, I had a play-by-play of how he was being treated and I was frankly horrified. His very educated family, on their own initiative, advocated for him, eventually hiring a lawyer before a different treatment regimen was tried. By then it was too late and he ultimately died.

Then, in March 2021, my friend died. She was a busy physician herself, working internationally. She believed she caught COVID from a symptomatic reporter who was covering her work. Numerous people were infected, got sick, and recovered. Except her. She must have been sick for a while when another physician friend in a different city spoke with her by phone and could assess her level of illness by her inability to finish sentences. We sent treatment protocols as well as evidence supporting them. We arranged for medicines to be sent to her. She didn’t take them. Three friends drove hours to get to her, to find her on death’s door in her apartment. She still refused some of the medicine, believing it would be harmful instead of helpful. She fought with us for days on this, refusing to take them. I saw the CT scan of her lungs when she got to the hospital. I’m not sure, at that point, if anything outside of the miracle we prayed for would have helped.

New Alliances

Because I obsessively stayed abreast of the medical literature and other physicians’ efforts to use data to reassure the public, in March 2021, I became aware of a letter submitted to the Journal of the American Medical Association (JAMA), written by Drs. Peter McCullough, Harvey Risch, and Joseph Ladapo, highlighting flaws in its recently published study of ivermectin to treat COVID-19, that JAMA refused to publish. As a result of my signing a petition in support of its publishing, I was invited to join an e-mail group of physicians and scientists, led by Dr. McCullough, dedicated to the discussion of COVID-19.

Cardiologist and epidemiologist Dr. Peter McCullough has now become famous for taking the lead on addressing early outpatient treatment for COVID-19. He explains four pillars of public health: 1) containment of the spread of infection; 2) treatment; 3) hospitalization; and 4) vaccination.

Early emphasis in the U.S. was obviously focused on the reduction of the spread of the virus that causes COVID-19, in an attempt to reduce hospitalizations and death. As his own patients became ill, Dr. McCullough wanted to offer them treatment options in the approximately two weeks that most patients are symptomatic before they need to be hospitalized. In May 2020, he gathered over 20 U.S. and international physician and scientists who, based on the available scientific literature and early clinical experience, developed a pathophysiologic rationale for early outpatient treatment.

Their approach, sequential multi-drug therapy (SMDT), first published in August 2020, addresses three known pathophysiologic processes in SARS-CoV-2 infection and COVID-19 illness: 1) viral replication; 2) cytokine storm; and 3) thrombosis. McCullough expanded his panel of physicians and scientists to 57 to get a broader international perspective and published those results in December 2020, adding a potential fifth pillar: prophylaxis. An observational study applying these principles in a series of patients in McKinney, TX, published in March 2021, demonstrated an over 75% reduction in hospitalizations and deaths.

Because Kirk and I had been willing to be a resource on COVID-19 to patients, friends, family, our church community, and all they referred to us, a community member introduced us to Maui District Health Officer Dr. Lorrin Pang in June 2021. He had implemented Maui’s COVID-19 vaccination program, but was nonetheless concerned about principles of informed consent and greatly alarmed by evidence of censorship of information.

The week we met, he had been given a summary link to Dr. Robert Malone’s now infamous appearance on the DarkHorse podcast. It interested him enough to listen to the entirety of the podcast, but while he attempted to do so it was taken down. Inspired by this and the concerns of community members, he helped found a now defunct organization on Maui called the Pono Coalition for Informed Consent. Dr. Malone agreed to serve as an advisor, as did Kirk and I.

We subsequently filmed a short webinar, with Drs. Malone and Pang, on informed consent for the vaccinations against COVID-19. The filmed product was short, but our discussion occurred before a public audience over a six-hour period that allowed for questions and answers. I was struck by people’s hunger for information and their gratitude that members of the public health and medical community would agree to talk with them.  

Delta

The delta variant of SARS-CoV-2 arrived in Maui in July 2021. Kirk, who had been traveling on the mainland, was the first to succumb. Self-enforced post-travel quarantine kept him from infecting anyone else and his case was mild. I did not get re-infected. My immunity and his early infection were blessings allowing us to care for others as they became ill during this wave. Ultimately, through our free medical clinic, we were involved in early outpatient treatment for hundreds of patients.

Our experience with the alpha, or legacy, variant of COVID-19 illness was that it was relatively easy to treat, especially if caught early. We quickly and humbly learned that the delta variant was not. We became even stronger advocates for early treatment, as that made a huge difference in people’s course and outcomes. Also, while the alpha variant was harder to transmit, even among household members, delta was incredibly easy to transmit. Once one household member got it, we told the rest of the household to presume they would and act accordingly.

Given the fast and different presentation he was seeing, Kirk shut down the church and food pantry for a week. He also called friend and Maui District Health Officer Dr. Lorrin Pang, alerting him to his concerns, which Dr. Pang shared. They decided to film another webinar, addressing early treatment and, once again, informed consent for the COVID-19 vaccines. This webinar resulted in negative media attention in the press for Kirk and Lorrin, and in both of their physician licenses being placed under investigation. The complaints against both have since been dismissed.

Subsequent to this media maelstrom, we conducted a two-hour interview with Dr. McCullough about our experience and early treatment for COVID-19. We met Dr. Peter Breggin and his wife Ginger, authors of Covid-19 and the Global Predators: We are the Prey, through Dr. McCullough’s C19 e-mail group. Dr. Breggin interviewed both Kirk and me on his radio show around this time, allowing us to tell our story.  

AAPS and Global Covid Summit

Kirk and I attended the Association of American Physicians and Surgeons (AAPS) meeting in Pittsburgh, Pennsylvania, in late September 2021. There we met Drs. McCullough and Malone in person, as well as Drs. Richard Urso, Ryan Cole, and Li-Meng Yan. Dr. Yan is the Chinese whistle blower who revealed the laboratory origin of the original Wuhan virus, and the most courageous person I have ever met.

Dr. Urso had recently convened a panel of physicians in Puerto Rico. They drafted a physicians and scientists declaration, since signed by over 17,000, that neither the naturally immune nor children need to be vaccinated against COVID-19 and that doctors should be free to be doctors. Dr. Malone had just read this declaration at an international meeting in Rome.

At the AAPS meeting, Drs. Urso and Cole challenged physicians to speak in public forums throughout the country on these issues. Dr. Malone had already accepted an invitation from the Pono Coalition for Informed Consent to speak in Maui in October 2021. We invited Drs. Urso, Cole, and Yan to join them. Out of this event, we formed the organization Global Covid Summit Maui (GCSM), a chapter of Global Covid Summit founded by Dr. Urso, with me as its executive director.

Since October 2021, either Kirk or I have spoken at subsequent events in Los Angeles, Tallahassee, Washington DC, Little Rock, Maui, Phoenix, Boise, Houston, and Louisville. GCSM held a physician and medical professionals’ continuing medical education event in Maui in January 2022 with Kirk, me, Dr. Ryan Cole, Dr. Sabine Hazan, Dr. Pierre Kory, Dr. Robert Malone, and Dr. Richard Urso (in absentia, via Dr. Cole) all presenting.

It is an incredible fellowship of physicians we have joined who are all committed to truth, science, transparency, and saving lives.

What is truth?

I started with the foundational truths that determine my worldview. Based on my review of the evidence, my education, training, and experience as a physician, especially during this crisis, and the personal experiences of myself and hundreds I know, were I called to the witness stand to give expert testimony, these are the truths I would claim about our COVID-19 response, so help me God (I’ll use McCullough’s five pillars of public health):

1)   Containment of spread of infection: Masks, social distancing, and lockdowns are not helpful and, in many ways, harmful;

2)   Treatment: early, sequential, multi-drug therapy is available and effective;

3)   Hospitalization: hospital protocols have actually increased mortality;

4)   Vaccination: the current vaccines using mRNA and adenoviral vector DNA technology are not “safe and effective”;

5)   Prophylaxis: there are many ways to protect oneself against infection and/or improve one’s outcome if infected.

I have hypothesized there are five categories of people in this crisis:

1)   Those who are truly nefarious (the evil “they”);

2)   Those who are compromised in some way, bribed, or bought off;

3)   Those who have acted in good faith, believing “the system” works;

4)   Those who are suspicious or even know all is not right but lack courage to act;

5)   Those who are convinced all is not right and have the courage to act.

The physicians, scientists, and other professionals Kirk and I have aligned ourselves with are in category 5, and our collective goal is to move as many people as we can to category 5. I believe most doctors, most Americans, and most people in the world are in category 3.

Category 3 is the most comfortable category. It does not have to look at the problem of evil, or the ways in which humans are so compromised they justify being complicit with evil. Those in category 3 do not have to admit they have been lied to. Moving out of category 3, to 4 or 5, is inherently painful.

Many in category 3 so reject my truth claims about COVID-19, they would place me, and others who believe like me, in category 1 or 2. They believe we are acting with selfish or evil intent. As such, many are willing to break relationship, publicly shame, or even try to destroy reputations or careers.

Traditional criteria for determining one’s trustworthiness have been dispensed with in this crisis. It does not matter that I am Stanford educated. It does not matter that I was among the top of my medical class, being inducted into the prestigious Alpha Omega Alpha honor society. It does not matter that I excelled in my anesthesia residency, passing my written boards in the first year and ultimately serving as chief resident. It does not matter that I’m doubly board-certified, in anesthesia and pediatric anesthesia. It doesn’t matter that I’ve been an assistant professor, clinical professor, or department chair. It doesn’t matter that I’ve been honored as a Fellow of the American Society of Anesthesia. It doesn’t matter that I’m a Christian, a pastor’s wife, a Bible teacher, a medical missionary. It doesn’t matter if someone has known me and my intellect and my character for years, or even most or all of my life.

None of these criteria matter in determining whether I am trustworthy on this subject. Someone in category 3 can easily counter with another highly educated, highly credentialed physician or another respected Christian who believes the exact opposite. The judgment of others in our society is now largely based on whether individuals believe or act “rightly” or “wrongly,” but who gets to decide that criteria for judgment?

At some point every truth claim must satisfactorily explain reality.

Socrates famously stated, “the unexamined life is not worth living.” Every truth claim can withstand the heat of examination. Most of us had parents who taught us a view of the world: there is no God, or there is a God and we follow Him in this particular faith tradition. Most of us also came to a point in our lives where we had to accept or reject these claims. We have either done so with ambivalence or conviction. Ambivalence comes from not seeing the conclusion as consequential. Conviction comes from seeing the conclusion as very consequential.

I was taught and believed there was a God and we followed Him in a particular Christian denomination. I never rejected this belief, but in my young adult life I did not see it as consequential to act upon. I gave assent but I lived my life as I wanted to live my life, until it became consequential, until the life I was leading became unsatisfying to my very soul. I was ultimately convicted to read the Bible, the book that was supposed to explain my beliefs but that I had never bothered to read in its entirety. This experience so changed me that I lost friends who no longer recognized who I was.

I believe this experience of thinking I knew but finding out I didn’t know primed me. I realized I believed a lot of things that I had been told or taught without really exploring them.

People like to assert that humans are inherently good. The Bible teaches that humans are inherently sinful. If we fairly examine ourselves, we each know there is at least some character sin that we struggle with, whether it be pride or envy or anger or dishonesty. That being said, we know there are humans who can largely be trusted to act with integrity, and those who can’t. How do we live with appropriate skepticism without collapsing under the weight of the belief that nothing or no one is trustworthy?

Be Bereans

I think we must be willing to examine what I’ll call “first source,” as well as multiple sources. If some claims of truth are consequential enough to determine life or death, or even eternal union or separation from God, they are worth examining in depth and from as many angles as possible. Many sources will begin to resonate in agreement.

“First source” for my examination of Christianity was the Bible. It really doesn’t matter what any person says or analyzes about the Bible. I could not rightly claim to have an opinion on it until I had read it. Having read and studied it for well over 20 years now, I can assent to CS Lewis’ claim that, “I believe in Christianity as I believe that the sun has risen: not only because I see it, but because by it I see everything else.” Examined Christianity is historically, archeologically, scientifically, and literarily satisfying.

The Bible itself gives us precedent for the examination of “first source.” The apostle Paul, when he was chased out of Thessalonica by those who did not want him to teach about Jesus Christ, escaped to Berea, where he promptly began teaching in the synagogue. Acts 17:11 states the Bereans “were more noble-minded than those in Thessalonica, for they received the word with great eagerness, examining the Scriptures daily to see whether these things were so.” Acts 18:28 states that Paul demonstrated “by the Scriptures that Jesus was the Christ.” The Bereans did not simply take Paul’s word for it. They examined the Scriptures themselves.

My favorite example of “first source” in medicine, as chronicled in Sam Quinones’ 2015 book Dreamland, about the opioid crisis in the U.S., is the 1980 one-paragraph letter to the editor of the New England Journal of Medicine referred to as “Porter and Jick,” after the names of its authors. Though it was a retrospective observation of hospitalized patients and not a peer-reviewed scientific study, it was first cited in a 1986 paper in the journal Pain and eventually summarized as a “landmark study” establishing the unqualified truth that opiate addiction was rare in patients treated with narcotic pain medicines. The supposed conclusions of “Porter and Jick" were passed on as dogma affecting medical training and practice, as well as public health policy, when few, if any, had read it. We now know the results were deadly.

Prior to reading Dreamland, I would have defended “the system”: the National Institutes of Health (NIH), the CDC, the Food and Drug Administration (FDA), peer-reviewed medical literature, the pharmaceutical industry, all of it. I was in category 3, but the book exposed those in categories 1 and 2 in America’s opioid crisis. It also initiated my membership in category 5 at the outset of the COVID-19 crisis.

My eyes had been opened to the “Porter and Jick” phenomena, akin to the game of “telephone.” Telling and retelling transformed a one-paragraph observation into an incorrect conclusion repeated as dogma, affecting medical education and practice. How often are we guilty of the same, quoting something we’ve heard as true, when we’ve never examined the source of that “truth”?

Ronald Reagan famously said, “trust but verify.” Whoever took the time to finally read the oft-quoted “Porter and Jick” probably realized with much alarm that too much of great consequence had been made of very little.

The truth claim of “Porter and Jick” was finally questioned because it did not conform to reality. Hospital patients treated with opiates did, in fact, get addicted to them. Dogma had to be dispensed with and medical practice and education has changed as a result.

The parallels between these two crises in America are apparent. “Truth” has been repeated as dogma, without evaluation of “first” or multiple sources, and even with suppression of such sources and cancellation of those who bring attention to them, and people have died as a result.

The answer to the mystery

Back to Samuel Webster’s 1828 definition (I purposefully used an old definition because we’ve become more and more sloppy with language), truth is “conformity to fact or reality; exact accordance with that which is, or has been, or shall be.” Note the importance of past, present, and future.

At the beginning of the crisis, proposals were being made that did not align with past precedent. Long-established principles of public health, supported by the medical literature, were abandoned, justified by very consequential claims of life and death and the premise that this virus was “novel.”

In March 2020, in order to evaluate whether the present situation justified abandoning past principles, we had the very perfect infectious disease laboratory of the Diamond Princess cruise ship. Assaults on character or beliefs or politics or education or credentials were effective means of silencing voices dissenting from the rising hysteria. Censorship was an effective means of prevention of examination of alternate sources.

I believe the answer to the mystery I posed at the outset in terms of the difference in responses is: those of us in category 5 from the outset made our decisions on evidence from the past and present, waiting on the future when our decisions would either be justified or condemned.

Our actions were consistent with the scientific method. One makes predictions based on past and present information. If future reality does not conform to those predictions, they must be rejected.

Living Case versus Control Study

Just as the Diamond Princess cruise ship was a laboratory at the outset of the crisis, Kirk and my church community was a laboratory throughout the whole crisis. Many chose, at great consequence, to trust our leadership. This was not blind faith. We had been in leadership for six years at that point. They knew our credentials and our character. We also shared our reasoning and our sources of that reasoning. Participation was volitional, not compelled.

Our community was the non-intervention, or control group, living in contrast to the intervention, or case, group around us. We lived as freely as possible. We masked only when we had to. We did not isolate or social distance. We traveled. We availed ourselves of prophylaxis and treatment protocols. Most of has did not get vaccinated. The majority eventually got infected, but that does not distinguish us from others who lived differently. What distinguishes us is that we survived and thrived, in faith and fun and fellowship.

What I claim to be true about our response to COVID-19 has been informed by historic and evolving medical literature, both “first” and multiple sources, and, eventually, the experiences of hundreds of people I know personally. If you want to deny what I claim is true about our COVID-19 response, you must be able to explain this reality.