This thread is brought to you by the letter "P". Pandemics, pain, pancreatitis, planning, protection & patience. I'll bet you're wondering if sleep deprivation has finally got the best of me. But stick around & hear me out... 1/

The pancreas is one of the most fascinating organs in the body. Apart from making insulin which allows glucose to be used by our muscles & tissues, it also makes a bevy of enzymes that help digest our food. These are helpful but only up to a point 2/

If something insults the pancreas, say too much alcohol, or a gallstone that gets lodged in one of it's main ducts, the result is an overproduction of these enzymes that start to digest the pancreas itself not unlike an acid bath. It's painful! 3/

Treating this condition requires some basic measures:
1. Stop drinking alcohol or remove the gallstone
2. Fluids & pain meds
3. Give the pancreas a rest by avoiding a resumption of normal eating habits till things "cool off" a bit 4/

If my patient leaves hospital or starts eating "normally" too quickly, those caustic enzymes ramp up again. Back to square one. If it continues to worsen, the pancreas might start to die, disease spreads elsewhere & can be life-threatening in nature 5/

Eating a "normal" diet is essential to providing the health and nutritional support we need to function. It also gives us some basic pleasure & satisfaction which is good for our mental health, sense of well-being. But in this case, "normal" is harmful 6/

A pandemic like this challenges us to understand that what used to be normal, seemingly harmless, in fact, good for our health & well-being, can actually be harmful. Socializing, singing, indoor team sports, have become risky pursuits 7/

If we want to get this under control & avoid the pain of self-harm that will be more lasting to our community at all levels, we cannot insist on a strategy of cheating towards normal too soon. It's a predictable path to pernicious places 8/

Pragmatism, patience, protection of people is the plan. No vaccine exists in Taiwan, NZ, S Korea, Japan, even Uruguay. Yet all these places are not suffering dire economic or public health crises anymore. They did it right 9/

We need our businesses to survive, grow & thrive. We also need people to stay healthy & alive to make this happen. We need to stop politicizing policies & practicing principles of public health measures EVERYWHERE, private & commercial 10/

We CAN do this. Nobody wants people out of work, out of income or livelihoods. That's exactly why we need to do something that is not a band-aid but a prescription that allows sustainable healing and a proper recovery 11/

This thread has been brought to you by the letter "P".
P is for people, pride, passion, potential & positivity. One day that pancreas will fully heal. The road will be long & bumpy but success is very much ours to find. It's 100% POSSIBLE. End 12/