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For This Rural Missouri Doctor, Treating COVID-19 Patients Can Get Personal


The week that just ended was among the darkest we've seen in the pandemic yet. Daily infections hovered at around 200,000, with thousands dying each day and, due to Thanksgiving travel, an increase in indoor gatherings and, as we're about to hear, pandemic fatigue. Next week might not be any better. Scotland County Hospital is in rural northeast Missouri. It's small - just 25 beds - and they've been filling up fast as the number of COVID-19 cases there surges. Shane Wilson grew up nearby and works at the hospital now.

Doctor Wilson, good morning.

SHANE WILSON: Good morning.

ELLIOTT: So what are you seeing right now in terms of community spread there?

WILSON: Last I knew, our positivity rate was right around 30%, meaning basically that around 1 out of every 3 people that we test locally are positive. We're the only hospital around for about basically four counties, and then we're adjacent to Iowa. And there are also a couple of southern Iowa communities that we see people from and help them out, too. But everyone that I've treated thus far that's been hospitalized or required to be hospitalized has been someone I know. I had my father actually in the hospital here three or four weeks ago...


WILSON: ...That was COVID positive. And so fortunately, he was one of the ones that was able to recover and doing well. So...

ELLIOTT: Good. How do you cope when it's not just a random patient but your own family and people you grew up with who you're taking care of?

WILSON: Well, once it becomes a family member, it obviously has deeper impact. The most odd emotion I had was anger and frustration 'cause, you know, Dad's Superman - always has been. And he's not supposed to be that sick. And not that I don't have that same feeling and compassion towards other patients, but when it's your own flesh and blood, then - and boy, this virus took its toll. So...

ELLIOTT: So you sound like it's taking a bit of a toll on you. You must be exhausted.

WILSON: (Laughter) Yeah, that's pretty easy to say. You know, the virus itself and the pandemic that we're dealing with is - it's its own beast. But to be honest with you, the most exhausting part of it is I can't get the patients who are very sick and critically ill that are not COVID-positive - people that I normally would not be keeping at our small critical access hospital and I would be moving on to a tertiary center - we have to keep them here because we don't have an option.

ELLIOTT: You would normally be transferring them to a larger hospital in a nearby city.

WILSON: Right. And the difficult part of that is that they're tapped, too. You know, this isn't just a rural America issue. It's an urban issue, like everybody knows. But - and if we have a huge surge, which I'm fearful, the question is, where are we going to put these people?

ELLIOTT: You know, I saw that Missouri could receive vaccine doses by the middle of December. How likely do you think Scotland County is going to get any of those doses? And is there a plan there for trying to start getting them to the most vulnerable people?

WILSON: I think there's going to be limited doses that hit the states, and it'll probably be spring before we're actually seeing widespread vaccinations. To answer your question directly - when do I think Scotland County will get it? Well, if it's like any other thing, we'll probably be towards back of the line.

ELLIOTT: What is it like there in Scotland County in terms of - are people taking this pandemic seriously? Are people trying to prevent the spread, do you feel?

WILSON: I'm in a unique situation because I see it at work. And then we walk away from work, and we hear, you know, friends and family and neighbors who don't understand the reality of what we're seeing at the hospital. They don't see how sick people are. They don't see these patients that are struggling literally to take their next breath.

And when they do see it or they do hear about it, they feel like, well, you know, 90-some percent of whoever gets this virus is going to survive without a problem. That's not true. I've had a lot of people who were not hospitalized with this virus and fell ill with it who said this is one of the worst illnesses that they can ever remember, that they felt like hell.

So people in the community don't see that. They don't necessarily understand it. And it's not their own fault. But I would say they're fatigued. They are tired of hearing, wear your mask; wash your hands; social distance. It's not the fact that they're not getting the message. It's the fact that they're tired of hearing it. And I get it. You know, there's nobody more than me that wants a normal - some sense of normalcy.

ELLIOTT: That must be just so hard to deal with day in and day out. How do you take a break when you go home? What do you do to give yourself some rest and some peace?

WILSON: Well, fortunately, last month was deer season, and I'm just an old hillbilly from rural America. And so my...

ELLIOTT: Get out in the woods, right?

WILSON: My salvation was to climb up a deer stand with my bow and not think about anything. That's what I do. My salvation is to get away and try to forget.

ELLIOTT: Doctor Shane Wilson works at Scotland County Hospital in northeastern Missouri.

Thank you so much for taking time to explain the situation there for us. Please stay safe.

WILSON: Hey, you bet. We'll do what we can. You stay safe, too, OK? Transcript provided by NPR, Copyright NPR.

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