My husband, pediatric cardiologist Kirk Milhoan, MD, PhD, and I have recently been honored as Senior Fellows with the FLCCC Alliance International Senior Fellowship Program, one of their many initiatives in support of their commitment to Honest Medicine.
Such an honor necessitates retrospection. The Front Line COVID-19 Critical Care Alliance (FLCCC) was founded by a group of leading critical care specialists in March 2020 as they dedicated themselves to helping prevent and treat covid-19. I have written elsewhere about how Kirk and I came to be involved in this same dedication. In March 2020, we found ourselves bewildered by the abandonment of long-held principles of public health, and the censorship and maligning of those who proposed alternative perspectives.
I’ve used the Bible verses from Job 14:7-9 before to describe the feeling of finding other physicians and medical professionals willing to explore prevention and treatment of covid-19 infection at a time when most were advocating and employing unprecedented methods focused solely on containing the spread of infection:
For there is hope for a tree,
When it is cut down, that it will sprout again,
And its shoots will not fail.
Though its roots grow old in the ground,
And its stump dies in the dry soil,
At the scent of water it will flourish
And produce sprigs like a plant.
The ability to find other physicians and medical professionals with which to collaborate was that scent of water that provided hope for flourishing during a time of incredible confusion and isolation. Finding FLCCC in 2020 provided some of that hope. I even summarized and shared a lecture entitiled “COVID-19: A Clinicians Perspective” by FLCCC co-founder Dr. Paul Marik on my Facebook page in September 2020. Co-founder Dr. Pierre Kory joined Kirk, myself, Dr. Ryan Cole, Dr. Robert Malone, and Dr. Sabine Hazan in presenting a “Topics in Covid-19 Management” continuing medical education (CME) conference in Maui, Hawaii in January 2021 (link currently unavailable). I’ve referred countless people to FLCCC’s prevention and treatment protocols. It is truly an honor to join in collaboration with this organization.
As I perused the list of international fellows, my specialty as an anesthesiologist is unique (I’m board-certified in both anesthesiology and pediatric anesthesiology, and I’ve specialized in pediatric cardiac anesthesioloy for the bulk of my career). I may care for patients affected by covid-19 infection, or the therapeutics touted to prevent it, if they need to come to an operating room, but the role of my specialty does not especially lend itself to knowledge, experience, or expertise in the prevention or treatment of covid-19. I became particularly interested in this subject because Kirk, in addition to being a pediatric cardiologist, is also a pastor. In March 2020, we had to quickly figure out how to protect our church body and the volunteer staff of our church’s food pantry which remained open as an essential service. Kirk and I also have a federally recognized mobile free medical clinic through our non-profit For Hearts and Souls, so we needed to quickly adapt to provide appropriate prevention and treatment advice for our patients. We were subsequently invited to join a now-defunct local organization called the Pono Coalition, which involved public speaking events and subsequent podcast participation. We met Drs. Ryan Cole, Robert Malone, Peter McCullough, Robert Urso, and LiMeng Yan at an American Association of Physicians and Surgeons meeting, which lead to involvement and speaking engagements with Global Covid Summit. I started an e-mail group to communicate with interested individuals in April 2021, which I transitioned to this Substack “relevant to the covid crisis, often with a Biblical lens,” in April 2022.
As more and more physicians and medical specialists have been able to share their experience, perspectives, and research relevant to covid-19 through more and more media and organizations, I have felt less and less of a need to speak and communicate, leaving those roles to those with greater expertise. My husband, as a pediatric cardiologist for instance, can and should ably speak about myocarditis and pericarditis as a consequence of covid-19 infection or of the products touted to prevent it. FLCCC’s commitment to Honest Medicine, through various initiative’s such as the International Senior Fellowship Program, has renewed my personal interest and reflection.
As others have had more clinical expertise, much of my reflection, writing, and speaking has been focused on the discernment of truth. We’ve trusted those in positions of authority and that trust has been utterly shaken. Unfortunately, my observation is that leads to a lot of “all or none” thinking. For example, “there is no truth,” “no traditional (or allopathic) physicians can be trusted,” “all vaccines are bad,” or “all pharmaceuticals are bad.”
I’m a Bible teacher, so I love going to Bible verses. Psalm 11:3 says, “If the foundations are destroyed, What can the righteous do?” That question is asked in despair. The foundation is truth and it can be sought, observed, and found. I was taught early in medical school that my education would be built on a foundation of basic education in anatomy, biochemistry, physiology, pharmacology, and pathophysiology. Interestingly, my role as an anesthesiologist is dependent on a knowledge of these bedrock principles and processes. My care of each patient is a living laboratory where I observe cause and effect, expanding on and applying my knowledge of foundational principles. Now, patient care can be delivered algorithmically. However, outcomes of care can be compromised when a patient responds differently than the algorithmic rules predict and there is no foundational understanding to apply. I believe much of what has gone awry in medicine is one of two problems: 1) failure to understand and build on solid foundation; or, 2) building a faulty structure, or “house of cards,” on a perfectly good foundation. The “house of cards” that has fallen down involves, for instance, conflict of interest and compromise of scientific agencies, medical literature, and institutions and corporations. Principles of scientific research and observation are not compromised. The publication, dissemination, and understanding of information, however, is compromised.
Two questions I’m often asked in the current era are: 1) what happened to the doctors?; and 2) how do I know who to trust? In addressing these questions, I find my role as anesthesiologist helpful. Many disillusioned physicians and medical practitioners in the current era are finding ways to practice outside “the system.” They are establishing direct primary care or direct specialty care practices, thus not being employed by institutions nor taking insurance. While I wholeheartedly support these alternatives, my specialty is still dependent on “the system.” My specialty is needed when prevention or outpatient treatment or “natural” remedy has failed or is inadequate. My specialty is also dependent on pharmaceuticals.
Since, by the necessity of my specialty, I’m in “the system,” I get to observe those in it. In answer to the question “what happened to the doctors?”, I’ve hypothesized five categories:
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 with “the system” and the prevailing narrative, but lack courage to act;
5) Those who are convinced all is not right and have the courage to act.
As for my specialty’s dependence on pharmaceuticals, I can tell you none are completely effective nor are any completely safe. My employment of them is a balance between risk and benefit. I’m grateful that in the current era I’ve been exposed to a number of alternative treatments. I consider the continuum of choices from traditional to alternative like a buffet. I no longer care about the category, but I care about effectiveness and safety profile. I also care about not deceiving people, allowing people to make informed choices, and not wasting people’s money.
These principles have led to my recommendations about who to trust:
Beware of absolutes
Examples are promises of absolute safety and efficacy, or even cure.
Beware the resistance to any hypothesis
Characterized by, “I don’t know what’s wrong with you, but I know it can’t be this.” Hypotheses can be rejected, but we must be open to entertaining them.
Beware of wholesale rejection or acceptance
“All vaccines are bad” ignores those who have not been harmed or may have been helped by them, but “all vaccines are good” ignores those who have been harmed and/or may not have been helped.
Beware ad hominem attacks
Defined as attacks on character or motive, instead of the substance of an argument. May incude criticism by association: “We can’t accept his analysis because he’s a conservative, or a Christian, or a Trump supporter.”
Beware of conflict of interest.
People have to make a living, but be cautious when someone is selling what they recommend.
Seek informed consent and respect for your medical autonomy
Practitioners must be willing to patiently and thoroughly discuss risks, benefits, and alternatives to treatment plans.
Seek humility
The question, “is there anything you’ve changed your mind about regarding this topic?” would likely be incredibly illuminating.
A lot of my thoughts resonate with the principles of Honest Medicine espoused by FLCCC. It is an honor to collaborate with them in the pursuit of truth.
Agree wholeheartedly with all of this. Praying for clarity and discernment as I try to help my patients while minimizing harm. The current challenge is “weight loss meds.” In addition, many young parents have found my practice, as I tolerate so called “antivaxers.” The lack of trust is understandable, when I reflect on how colleagues have treated parents who have legitimate concerns about giving their infants 4-5 shots at once.
God bless you and your husband and all of the fellow physicians who have been so wise and brave and courageous and godly. Thank you so much for all you have done for your fellow countrymen , for the entire world. You truly love your neighbor as yourself. May God bless and protect you all.