Let Me Forget about Today until Tomorrow

By. Dr. Steve Elias

Remember when life was simple? There were so many things you had to do. Every day. Maybe that is what Henry David Thoreau was thinking when he hunkered down at Walden Pond in 1845. His own elective self-quarantine. His own shelter-in-place. He actually really enjoyed the experience, “I find it wholesome to be alone the greater part of the time. To be in company, even with the best, is soon wearisome and dissipating. I love to be alone. I never found a companion that was so companionable as solitude.” COVID-19 transformed most of the world into a “Walden Experience.”

Thoreau’s isolation was self-imposed and he could end it when he wanted to. Personally, I think the man was a little off, he self-exiled for two years. At the time of writing this, most of us were having issues with a few weeks of semi solitude. And he didn’t even have the Internet. He was a transcendental.

There is some solace that we can get from Thoreau. Maybe now is the time to think about what he famously wrote, “our life is frittered away by detail… simplify, simplify.” Remember when you thought life was simple, maybe a few months ago? Now we may think it is more complicated. Not really. Not much to do now. Very simple: physically interact with a minimal amount of human beings as possible and stay healthy and figure out how to reinvent your daily life as things pick up. Sounds simple to me. Doesn’t it sound much simpler than the five or six or more things you felt you needed to accomplish every day a few months ago before you had even heard the word “COVID-19”? It may sound like it is simple now, but it feels more complicated.

This issue of VEIN was conceptualized well before the world became one. One dealing with one big thing. One might be tempted to apologize for even intimating that what is in this issue is important. And it may not be that important now. But vein disease is not going away, the COVID-19 pandemic will, and we will all get back to our previous “simple life”.

There are many intertwined articles in VEIN this issue:

  1. Appropriate use, abuse and underuse – two articles
  2. Venous ulcer care – two articles
  3. The swollen leg – two articles
  4. The Big Interview – one article

VEIN has previously had articles addressing the idea of a coordinated registry network (CRN). Progress has been made with the bringing together of a core group of physicians, a steering committee, and the introduction of a name: COVER, which stands for Consortium of Venous Registries. Jens Jorgensen, Marlin Schul, and others bring us up to date as to COVER’s progress and the clinical questions COVER hopes to answer. This will be big data, finally.

Elna Masuda and I continue the discussion of appropriate use: what it is, how we categorize it, and how it helps our venous patients. Underuse is not something we often speak about in vein disease. Marlin Schul has been championing the concept of underuse of care for advanced venous disease. He spoke about it in his presidential address at AVLS and he writes about it now.

A companion piece by Michael Cioroiu et al. discusses wound care from the wound specialist’s point of view. If you put his article and Marlin’s together, you’ll better care for wound patients. Mike is the Director of Englewood Health Network Wound Center where I work. A great asset. If any reader knows how to pronounce his last name, let me know. I call him Mike. They call him Dr. C. Then there is edema and lipedema. We all see many patients with these issues. Both articles help us understand these vexing problems.

Finally, the “Big Interview” with Frank Veith of VEITHsymposium fame (his name and meeting name is pure coincidence according to Frank) was a pleasure for me to record. The man is open, honest, and opinionated in a good way. We touched on many topics: venous, arterial, historical, and philosophical. You get the idea.

Read it…a few times.

Frank Veith has seen a lot but nothing like COVID-19 and these times. Many of us may feel like Brian Wilson of the Beach Boys when he sings, “I just wasn’t made for these times.” How long will the COVID-19 Pandemic last? How long will we need to live a Thoreau-like life? How are some of us doing depending upon where we are on the “curve”? Thoreau lived alone for two years. Brian Wilson lived in his California home in psychological purgatory for 10 years. Let us pray we don’t come anywhere close to either one of them. Brian has been back to his “simple life” for many years now. We are with those most important to us now as we simplify our lives. Pay attention at this time and when you look around and feel nothing good is happening, remember Thoreau. Thoreau had the right idea, “It is not what you look at that matters, it’s what you see.” Stop looking and start seeing. See yourself, see your loved ones, and see a better time. This is what COVID-19 may have inadvertently taught us: to see things that we have not seen before. Hopefully, when you read this, most of us will be getting to the other side. Be healthy and be safe. And read VEIN.