Calling Dr. Crumbine — Kansas is sick and needs a prescription

Today we have a special guest. On the spirit phone is Samuel J. Crumbine, a Kansas doctor and public health pioneer. He campaigned against the common drinking cup, invented the flyswatter, and ordered bricks telling us not to spit on the sidewalk.

Dr. Crumbine, welcome to the column.

Thanks, glad to be here. (A bit mystified). Actually, I’m glad to be anywhere, since I died in 1954. Where am I, exactly?

A better question might be “when” are you. The year is 2020. You’re piped into my home office on Constitution Street in Emporia, Kansas.

How does that work?

I’m not sure, but don’t hit the red button on your end.

Yes, I see it. What’s it do?

Nobody knows, but the plans Thomas Edison left behind for the spirit phone explicitly say not to touch the red button. They didn’t call him the Wizard of Menlo Park for nothing. Now, doctor, you spent your early career practicing medicine in Dodge City when it was a rip-roaring cattle town.

Oh, those cowboys! Now, that will teach you something about how disease spreads.

In fact, you were the inspiration for Doc, the character played by Milburn Stone on the television series “Gunsmoke.”

Sorry, never saw it. But I didn’t like how the doctor was portrayed on the radio. Too dark. Always grubbing after autopsy fees.

Funny you should say that. Perhaps we’ll have you back to talk about Shawn Parcells. But doctor, the reason you’ve been summoned tonight is to discuss a more urgent matter. Kansas again finds itself in the grip of a killer virus, part of a global pandemic like the one you saw in 1918 when you were the chief of the Kansas State Board of Health. This one is a little different — it doesn’t target mostly young people, like last time — but the trajectory of the epidemic has been disturbingly similar to that of a century ago.

How can I help?

Give us some insight into how, as the state’s chief medical officer, you dealt with it.

(Whistles). How much time do you have?

A thousand words or so.

OK, I’ll keep it short. Well, in any public health crisis it’s critical that the public be educated on the best and most scientific ways to avoid disease. That’s why we campaigned so hard in my day to educate the public about proper hygiene and to avoid practices that spread infection, such as the use of the roller towel or common drinking cups in passenger trains, hotels and schools.

You were also instrumental in promoting municipal sewage treatment and making sure cities had safe sources of drinking water.

Yes! (Makes a shuddering sound). In the early 20th Century, Kansas City took its drinking water from the river downstream of many sources of human and industrial waste. We corrected that situation, eventually! It has always been a fight to make people understand that the public health is everybody’s business, that we live in an interconnected world where what we do in our personal lives and businesses might make somebody we’ve never met deathly ill. 

That fight is still going on, doctor.

No! How do they justify it?

Something called “personal responsibility,” which apparently is a kind of honor system in which you’re supposed to do the right thing. The right thing apparently means doing whatever the hell you want, as long as you keep pumping money into the local economy, and then being left on your own when you get sick because, after all, it was your fault.

Surely things have progressed since my time. In this current pandemic, has there been a shutdown? I urged Gov. Arthur Capper to close the state in October and November 1918, and he did. Public gatherings of any kind were banned. There’s no telling how many lives were saved.

Our governor, Laura Kelly, issued a statewide shutdown in the spring, but some in the Legislature opposed it. There was a compromise in June that let individual counties decide on things like mask mandates. In the name of privacy, it also allowed people who are infected to opt out of contact tracing. Health officials say it’s one of the things that have made fighting the pandemic here particularly tough. And, in spite of all we know about the disease, there are some who deny it even exists, or that it’s no worse than any other flu. Our current spike in cases, which looks like a hockey stick, began a couple of weeks after Halloween. We expect more after Thanksgiving, even though health experts have pleaded with people to stay home.

But surely public officials are setting a good example? Keeping distant and wearing masks?

I’m afraid not, doctor. The governor and your modern counterpart, Kansas Department of Health and Environment secretary Lee Norman, wear masks when they make public appearances, but many lawmakers do not. Masks have become politicized. A mask is the best tool we have against the virus, but a lot of Kansans — and many Republicans, the ruling party at the Statehouse — won’t wear masks because they believe the virus is a hoax, that the infection isn’t that bad, or that science somehow threatens their personal liberty. During a coronavirus recovery committee meeting last week at the Capitol, unemployed Kansans were demonized for taking state unemployment funds rather than accepting any job offered. Of the 12 lawmakers on the committee, only four were wearing masks.

But that would be crazy even in 1918! Wear masks! Stay home if you can!

The state is embarking on a $1.5 million publicity campaign to encourage Kansans to wear masks, but many fear it will accomplish little. The political divisions run too deep. There is a greater mistrust of science than at any time in the last hundred years. Crackpot theories and vicious hoaxes breed like plague rats on the internet while truth goes begging.

What’s the internet?

Telegraph and newspapers and radio and television all rolled into a kind of big telephone party line. You can view messages from anybody you want, and quite a few you don’t, and it makes you happy and sad all at the same time. Most Kansans have at least some kind of internet access.

What a tool for education!

You would think so, but it hasn’t made us smarter.

Then what do people use it for?

Oh, gosh. Entertainment, mostly. Movies and such, including a lot of obscene material. Fighting with family and unfriending people over politics. Buying stuff they don’t need. Reading newspapers online for free, so they have to stop the print editions. Posting anonymous comments that are hurtful and worse. And cats. Lots of pictures of cats.

Well, it must be useful for something.

Sure, you can check and see how many infections we have.

How many infections are there, then?

Um, let’s see. Give me a second. Ah, here it is. As of Nov. 27, more than 153,000, according to the Kansas Department of Health and Environment dashboard. That’s about one in 20 Kansans.

And deaths?

1,529.

(Sigh) There’s no vaccine?

Not yet. But even if one were available now, a considerable fraction of people —

— believe the vaccine is a hoax. Or poison.

Yes, exactly.

(Long sigh). Things have not changed.

Doctor, there’s a statue of you outside the Kansas Health Institute in Topeka, across the street from the Capitol. The institute is a nonprofit that provides health data to lawmakers. The statue is a fairly good likeness, and it shows you with hat in hand and arms outstretched, as if you are imploring the public to observe good health practices. On a brass plaque is a quote from you. Would you care to guess which quote?

(Clears throat) I began to realize, as I never had before, how much the health of each of us depend on the health of all of us.

Exactly.

But nobody listened. (A moan. Then, a soft curse.)

What’s wrong?

I put my head in my hands and my elbow … well, my right elbow depressed the red button.

How’s that again? You’re breaking up! I’m losing you.

Tell people to believe in science. Wear masks. Stay home! (Static)

Dr. Crumbine, can you hear me? Dr. Crumbine!

(More static) Hello?

Yes, I can hear you! Go ahead.

This is Dr. John Romulus Brinkley, broadcasting from Kansas First Kansas Best at Milford, Kansas! Welcome to the Medical Mailbag!

Do you see the red button, Dr. Brinkley?