PREVIOUSLY RECORDED.

>>> THE UPCOMING PROGRAM WAS PREVIOUSLY RECORDED.

THE VIEWS EXPRESSED ON THIS PROGRAM ARE NOT NECESSARILY THOSE OF WTJX, IT´S BOARD, STAFF OR UNDERWRITERS.

♫♫ ♫♫ >>> GOOD DAY, AND WELCOME TO "ABLE TO RAISE."

I´M YOUR HOST, AMELIA HEADLY LAMONT ON BEHALF OF THE DISABILITY RIGHTS CENTER OF THE VIRGIN ISLANDS.

TODAY I´M SO PLEASED TO WELCOME A MEDICAL DOCTOR, A FAMILY PRACTITIONER FROM THE ISLAND OF IS JUST, DR. JOSEPH DEJAMES.

DOCTOR, WELCOME.

THANK YOU FOR JOINING US.

>> GOOD AFTERNOON.

THANK YOU FOR HAVING ME.

>> OKAY.

AS A START, BECAUSE ONE OF THE THINGS WE´LL TOUCH UPON IS YOU´VE BEEN VERY, I´D SAY, OPEN TO PROVIDING INFORMATION TO THE COMMUNITY THROUGH YOUR LETTERS TO THE EDITOR IN THE DAILY NEWS AND THE SOURCE.

TELL US ABOUT YOURSELF.

>> I´M A FAMILY PHYSICIAN BY TRAINING.

BEEN IN THE VIRGIN ISLANDS, SPECIFICALLY ST. JOHN FOR 21 YEARS, GREW UP ON THE ISLAND OF PUERTO RICO AND ENDED UP GOING TO UNDERGRADUATE UP TO BOSTON, FINISHING MY MEDICAL EDUCATION UP IN BUFFALO, NEW YORK.

THAT´S WHERE MY FATHER´S SIDE OF THE FAMILY IS FROM.

AND THEN BACK IN NOVEMBER 2000, CAME DOWN TO ST. JOHN.

BECAUSE I HAD TO GET BACK TO CIVILIZATION SOMEHOW AFTER GETTING AWAY FROM THE NORTHEAST.

>> SO THAT´S WHAT BROUGHT YOU TO THE VIRGIN ISLANDS, YOU KNOW, CIVILIZATION, AS YOU WILL?

>> YEP.

THE JOB OPPORTUNITY, SO I HAVEN´T LOOKED BACK SINCE.

SO HAPPY TO BE HERE STILL.

>> RIGHT.

THAT´S A GOOD THING.

WELL, TELL US WHAT´S IT LIKE TO PRACTICE IN A CLINIC ON ST. JOHN, WHICH HAS SOME, I WOULD IMAGINE, SOME CHALLENGES BECAUSE THERE´S NO PER SE HOSPITAL ON ST. JOHN.

HOW DOES THAT WORK?

CAN YOU EXPLAIN A LITTLE BIT ABOUT THAT?

>> WELL, WE ARE A BRANCH AFFILIATE OF THE SCHNEIDER REGIONAL MEDICAL CENTER IN ST. THOMAS.

THEY´RE OUR PARENT ORGANIZATION.

WITH THAT, A LOT OF THE CARE AND THE EMERGENCY CARE, SO TO SPEAK, IS COORDINATED WITH THE HOSPITAL AND WITH THE VIRGIN ISLANDS, EMS EMERGENCY MEDICAL SERVICES SYSTEM FOR TRANSPORT.

FROM ST. JOHN TO ST. THOMAS.

THAT´S USUALLY BY AMBULANCE BOAT, A DEDICATED AMBULANCE BOAT WHERE IF THERE NEEDS TO BE TESTING OR SPECIALTY CARE, WE ARRANGE TRANSPORTATION TO SCHNEIDER REGIONAL THAT WAY.

YOU KNOW, SO SOMETIMES THE CHALLENGES COULD BE WEATHER, COULD BE LIMITED RESOURCES LIKE IF THERE´S AN EMERGENCY GOING ON.

WE ONLY HAVE ONE AMBULANCE CREW ON THE ISLAND, SO WE BECOME PRETTY CREATIVE AND, YOU KNOW, ENLIST NATIONAL PARK, FIRE, POLICE, ST. JOHN RESCUE TO TRY TO HELP THINGS MOVE ALONG.

ONE OF THE GOOD THINGS, HOWEVER, IS THAT THE SMITH COMMUNITY HEALTH CENTER WHERE I WORK IS OPEN 24/7, AND WE´VE EVOLVED TO CREATE AN INTEGRATED HEALTH CARE DELIVERY MODEL.

SO DR. ELIZABETH BARRETT, WHO´S BEEN THERE ABOUT 35 YEARS, AND MYSELF HAVE BEEN THERE CLOSE TO 21, AND WE HAVE PHYSICIAN ASSISTANT JASON SNOW, WHO´S BEEN THERE FOR ABOUT 15 YEARS.

WE´RE THE THREE DOCTORS PROVIDERS THERE, SO YOU RECEIVE YOUR PRIMARY URGENT EMERGENCY CARE FROM THE SAME GROUP OF PROVIDERS.

THAT ALLOWS THINGS TO BE A LITTLE BIT MORE EASILY COORDINATED, SO YOU´RE NEVER GOING TO RUN OUT OF YOUR MEDICATIONS, YOUR DOCTOR´S OFFICES ARE NEVER GOING TO BE CLOSED.

AND IT DOES PROVIDE A LOT OF PREVENTATIVE AND PRIMARY CARE SO PEOPLE DO NOT END UP HAVING TO GO TO THE HOSPITAL AS MUCH OR UTILIZE THE EMERGENCY ROOM FOR NONEMERGENCY THINGS.

I THINK IT´S A VERY EFFECTIVE HEALTH CARE DELIVERY MODEL, ESPECIALLY IN A SMALL, RURAL, ISOLATED AREA LIKE ST. JOHN.

>> RIGHT.

IT SOUNDS VERY GOOD BECAUSE I WOULD IMAGINE OVER THOSE PERIOD OF YEARS PEOPLE GET TO KNOW YOU, YOU GET TO KNOW THEM, SO THERE IS THAT FAMILIARITY AND ARGUABLY PERHAPS CONFIDENCE.

HERE´S SOMEBODY I´VE KNOWN NOW FOR X AMOUNT OF YEARS WHO IS FAMILIAR WITH MY HEALTH RECORDS, SO THAT MAKES THINGS, I WOULD IMAGINE, A LITTLE BIT MORE, AS YOU SUGGESTED, SEAMLESS.

AM I WRONG?

>> YES, ASIDE FROM A HEALTH CARE DELIVERY MODEL, FOR EXAMPLE, IF I´M WORKING IN THE UNITED STATES IN AN EMERGENCY ROOM AND SOMEBODY´S DIAGNOSED WITH DIABETES THEY DIDN´T KNOW THEY HAD BEFORE, I HAVE TO FIND A PRIMARY DOCTOR.

IN ST. JOHN, YOU BECOME ONE OF OUR PATIENTS, SHOULD YOU CHOOSE TO RIGHT ON THE SPOT, SO THERE´S NO DELAY IN CARE.

AND IN TERMS OF IN COORDINATION WITH ANY SPECIALISTS NEED TO BE UNDERTAKEN, IT´S DONE RIGHT THEN AND THERE.

>> WHAT KINDS OF -- UH-HUH.

GO AHEAD, I´M SORRY.

>> IF YOU BROKE YOUR ANKLE THAT SAME DAY, YOU WOULD BE CONNECTED WITH AN ORTHOPEDIST OR CONTACT WILL BE SCHEDULED FOR YOUR FOLLOW-UP APPOINTMENT, X-RAYS, OTHER STUDIES ARE DONE, SO IT´S NOT LIKE, OKAY, YOU BROKE YOUR ANKLE, LET ME GIVE YOU SOME NUMBERS TO CALL TO CARE -- TO GET CARE WHERE IT´S ALL HAPPENING IN REAL TIME.

>> ARE THERE ANY KINDS OF SITUATIONS THAT MAY PRESENT, YOU KNOW, TO YOUR CLINIC MORE SO THAN OTHERS?

ACCIDENTS OR, YOU KNOW, WHAT KINDS OF ISSUES DOES ST. JOHN FACE PERHAPS IN A NOTABLE WAY?

>> I MEAN, IT´S PRETTY STANDARD.

IT´S USUALLY CHRONIC MEDICAL CONDITIONS, DIABETES, HYPERTENSION, HIGH CHOLESTEROL, KIDNEY DISEASE, OBESITY.

SINCE WE ARE THE URGENT/EMERGENCY ROOM FOR THE ISLAND, YOU KNOW, WHETHER IT´S SWIMMING ACCIDENT, SCUBA DIVING ACCIDENTS, AUTOMOBILE ACCIDENTS, ANY SORT OF TRAUMA, CONSTRUCTION SITE INJURIES, FALLS, HEAD INJURIES TEND TO BE, YOU KNOW, THINGS WHERE WE REALLY NEED TO MOVE QUICKLY BECAUSE ON ST. JOHN, UNFORTUNATELY, WE DO NOT HAVE A LOT OF THE DIAGNOSTICS TO EVALUATE TRAUMA, THINGS LIKE CAT SCANS PRETTY MUCH, SOMETHING THAT NEEDS TO BE DONE.

BUT WE´RE KIND OF LIMITED AND WE DO NOT HAVE A CT MACHINE ON THE ISLAND.

>> RIGHT.

SO IF A PATIENT PRESENTS WITH A HEAD INJURY, WHAT WOULD BE YOUR FIRST COURSE OF TREATMENT?

>> WELL, THE FIRST COURSE IS KIND OF EVALUATING.

THERE ARE DOZENS OF HEAD INJURY GUIDELINES DEPENDING ON HOW OLD THE PATIENT IS, HOW FAR DID THEY FALL, DO THEY HAVE ANY OTHER MEDICAL CONDITIONS, ARE THEY ON BLOOD THINNERS, FOR EXAMPLE.

WAS THERE LOSS OF CONSCIOUSNESS?

WAS THE MECHANISM OF INJURY SIGNIFICANT?

THOSE ARE ALL TAKEN INTO CONSIDERATION BECAUSE, ON THE OTHER HAND, WE´RE NOT IN A PRACTICE OF SENDING PEOPLE FOR HEAD SCANS JUST BECAUSE THEY BUMPED THEIR HEAD.

>> RIGHT.

>> BUT THINGS OF A PRETTY SERIOUS TRAUMATIC, UNRESTRAINED CAR ACCIDENTS, ESPECIALLY IF SOMEBODY LOST CONSCIOUSNESS OR HAS OTHER INJURIES, YOU KNOW, YOU HAVE TO TAKE THAT INTO CONSIDERATION.

IN THOSE CASES, YOU KNOW, SPEED IS OF THE ESSENCE TO GET THE PATIENT TO ST. THOMAS BECAUSE IF IT WAS SOMETHING SERIOUS LIKE A BLEED INSIDE YOUR BRAIN, SOMETIMES THAT HAS TO BE FLOWN OFF ISLAND AS WELL.

>> RIGHT.

>> KIND OF A TWO-STEP TO GET DEFINITIVE CARE.

THOSE ARE THE TIMES THAT IT MAKES IT A LITTLE BIT SCARY, IF YOU WILL.

I´LL BE HONEST.

MANY TIMES MAYBE IT´S BECAUSE IT´S A TOURIST DESTINATION, A LOT OF THESE HEAD INJURIES HAVE ALCOHOL AS A COMPONENT.

>> RIGHT.

>> NOW YOU HAVE A PATIENT WHO REALLY MAY NOT BE ABLE TO MAKE DECISIONS FOR THEMSELVES BECAUSE THEY´RE INTOXICATED BUT REFUSE TREATMENT OR TRANSPORT.

SO IT KIND OF MAKES IT PRETTY INTERESTING, NEGOTIATING WITH PATIENTS OR HAVING THE POLICE DEPARTMENT PUT THEM UNDER PROTECTIVE CUSTODY TO BE ESCORTED TO ST. THOMAS.

BUT LUCKILY MOST HEAD INJURIES TEND TO BE MILD.

FROM A CLINICAL STANDPOINT, USING ESTABLISHED GUIDELINES, YOU FEEL SAFE ENOUGH YOU´RE NOT SENDING SOMEBODY HOME WHO HAS SERIOUS INJURY.

YOU KNOW, IT´S ALWAYS STILL A LITTLE BIT TRICKY BECAUSE STATESIDE PRETTY MUCH EVERYBODY GETS A CAT SCAN IF THEY COME TO AN EMERGENCY ROOM.

>> RIGHT.

>> THEY´RE SEEING TEN HEAD INJURIES A DAY, THEY CAN´T REALLY SOMETIMES SIT AND THINK IF IT´S SOMETHING SERIOUS OR THAT HAS TO, YOU KNOW.

SO YOU PRACTICE EXTRA CAUTION.

>> RIGHT.

SO IS THERE -- AND THEN I HAVE A LOT MORE QUESTIONS FOR YOU.

BUT ARE THERE ANY OUTWARD APPEARANCES THAT MIGHT SUGGEST TO YOU, OKAY, THIS IS SOMEBODY THAT NEEDS TO BE REFERRED TO THE SCHNEIDER HOSPITAL FOR A CAT SCAN?

ANY OUTWARD BEHAVIORS THAT MIGHT SUGGEST THAT?

YOU TALKED ABOUT POSSIBLE SEVERITY OF THE INJURY ITSELF, BUT ARE THERE ANY BEHAVIORS THAT THE PATIENT WOULD EXHIBIT THAT MAY SUGGEST YOU PROBABLY NEED TO SEND THIS PERSON OFF ISLAND?

>> YES.

THE PHYSICAL EXAM, NOT TO SOUND TOO BASIC, THE LAST BIG, HUGE BUMP ON YOUR HEAD OR A BIG CUT AND YOU FELL, YOU KNOW, TEN FEET OFF A ROOF.

YOU KNOW, THAT´S GOING TO KIND OF GET YOU A NEED FOR MORE EVALUATION.

ADDITIONALLY, IF SOMEBODY HAS ALTERED MENTAL STATUS, THEY´RE ASKING THE SAME QUESTIONS, THEY HAD A SEIZURE, THEY DON´T SEEM TO KNOW WHERE THEY ARE, THEY´RE NOT ANSWERING APPROPRIATELY, THEY´RE NOT NORMAL IN RESPONDING OR SPEAKING OR ACTING RIGHT, THAT ALSO IS A BIG CONCERN.

>> OKAY.

WELL, LET´S GET BACK TO YOUR PASSION, WHICH IS OBVIOUSLY WRITING.

I´M CURIOUS.

WHAT BROUGHT YOU TO WRITING LETTERS TO THE EDITOR?

HOW DID THAT COME ABOUT?

>> CAN´T REALLY REMEMBER.

IN PREVIOUS LIVES I THINK BEFORE GETTING INTO MEDICINE I HAD THOUGHT I WAS GOING TO BE A COLLEGE PROFESSOR.

I WAS ACTUALLY MORE INVOLVED IN THE HUMANITIES ALONGSIDE WITH THE BASIC SCIENCES.

AND I GUESS I GOT OLD AND GOT KIND OF TIRED OF REPEATING MYSELF ALL THE TIME, SO I GUESS PUTTING IT IN A WRITTEN FORM MAY BE ABLE TO REACH MORE PEOPLE THAT WAY.

>> WHAT DO YOU MEAN BY REPEATING YOURSELF?

>> LET´S SEE WE´RE TALKING ABOUT A MEDICAL CONDITION, YOU MAY HAVE TO SAY THE SAME MESSAGE.

>> RIGHT.

>> YOU DO THAT IF IT´S IN A FACE-TO-FACE CLINICAL ENCOUNTER WITH A PATIENT.

BUT IF, YOU KNOW, YOU KIND OF WANT TO EXPRESS SOMETHING AS TO WHETHER IT BE HOW TO ACCESS THE HEALTH CENTER OR POETRY OR, YOU KNOW, COVID, IT MIGHT BE EASIER TO JUST PUT IT IN A FORUM OR A FORMAT WHERE MORE THAN ONE PERSON HEARS IT AT THE SAME TIME.

>> WELL, YOU RECENTLY -- YEAH.

THAT´S WELL SACHLTD RECENTLY YOU DID A LETTER TO THE EDITOR ABOUT THE PANDEMIC, THE COVID-19 PANDEMIC, PROVIDING INFORMATION.

HOW HAS THE PANDEMIC IMPACTED YOUR WORK AS A FAMILY PRACTITIONER?

>> YOU CAN MEET THE CHALLENGES AS THEY COME, WHETHER IT´S THE PANDEMIC, WHICH HAS BEEN LONG AND DRAWN OUT, AS YOU WERE MENTIONING, A FOUR-PERSON CAR ACCIDENT, YOU HAVE TO BE READY AND DEAL WITH THAT.

I THINK WHAT SEEMS A LITTLE BIT MORE CURIOUS FOR ME IS, YOU KNOW, IN A CAR ACCIDENT IT´S PRETTY OBJECTIVE.

YOU KNOW, OR ANY TYPE OF INJURY YOU KIND OF SEE WHAT´S GOING ON.

WITH THE PANDEMIC, THERE´S BEEN SO MUCH DIFFERENT OPINIONS, AGENDAS, DISINFORMATION, MISINFORMATION THAT IT KIND OF MAKES IT A LITTLE BIT TOUGH TO -- TO DELIVER THE SAME MESSAGE BECAUSE, YOU KNOW, IF YOU BROKE YOUR LEG, YOU BROKE YOUR LEG.

>> RIGHT.

>> YOU HAVE HIGH BLOOD PRESSURE, YOU HAVE HIGH BLOOD PRESSURE.

WHEN YOU´RE TRYING TO KIND OF ADDRESS PATIENTS´ COVID QUESTIONS OR CONCERNS, IT SEEMS TO HAVE GONE OFF IN MANY TANGENTS AND FOR PEOPLE TO HEAR A CONSTANT MESSAGE WHEN YOU JUST SIGN INTO THE INTERNET IN THE ONLINE WORLD AND KIND OF SAY WHATEVER IT IS YOU WANT TO HEAR.

>> WHAT KIND OF -- YEAH.

WHAT KIND OF APPREHENSIONS HAVE YOU BEEN HEARING FROM YOUR PATIENTS WITH RESPECT TO, YOU KNOW, BEING, YOU KNOW, PREVENTING AN OUTBREAK OF, YOU KNOW, OF COVID-19 IN THEIR FAMILY OR, YOU KNOW, WITH THEMSELVES?

>> WELL, MOSTLY IT SEEMS TO BE MOSTLY RELATED TO GETTING VACCINATED.

FOR SOME REASON, YOU KNOW, THIS PARTICULAR VACCINE HAS ELISTED A LOT OF FEAR.

THAT CONFIRMS YOUR OWN BIAS AND IT´S MORE DIFFICULT TO TALK TO SOMEBODY ABOUT IT.

ALL YOU NEED IS THREE OR FOUR PEOPLE WHO FEEL THE SAME WAY AND THE INTERNET PROVIDES THOUSANDS IF NOT MILLIONS.

AND NOW YOU KIND OF JUMPED DOWN AN AGENDA, SO TO SPEAK.

>> RIGHT.

>> WHAT´S CURIOUS, THOUGH, IS WHEN PEOPLE HAVE TROUBLE BREATHING OR THEY FEEL SOME KIND OF WAY, THEY COME TO HEALTH CARE.

>> RIGHT.

>> YOU KNOW, WHICH IS KIND OF INCONGRUOUS TO ME.

YOU KIND OF SORT OF THINK YOU TRUST YOUR HEALTH CARE PROVIDER?

HOPEFULLY WE´RE NOT SITTING THERE PLANNING YOUR DEMISE, BUT SOMEBODY´S BEEN TELLING YOU TO GET VACCINATED FOR A YEAR, YOU COME DOWN WITH COVID AND HAVE REAL TROUBLE BREATHING, THAT´S WHO YOU GO TO.

SO IT´S SORT OF A WEIRD DYNAMIC, IF YOU WILL.

>> RIGHT.

>> BECAUSE IF I FELT THAT STRONGLY, I WOULD JUST STAY HOME AND WHATEVER HAPPENS, HAPPENS.

BUT PEOPLE WILL FIND THEIR WAY TO THE EMERGENCY ROOM, TO DOCTOR OFFICES.

BUT WHAT´S EVEN MORE CURIOUS IS THEN PEOPLE SOMETIMES WANT TO PICK AND CHOOSE THE TREATMENT YOU WANT FOR THEM, YOU KNOW.

I MEAN, ONE THING IS OFFERING DIFFERENT BLOOD PRESSURE MEDICATION, DIFFERENT TYPES OF BLOOD PRESSURE MEDICATION DEPENDING ON SOMEBODY´S CONDITIONS.

BUT IF THE STANDARD OF CARE FOR TREATING COVID IS A, B, AND C, AND A LOT OF PEOPLE SAY I DON´T WANT A AND C, I JUST WANT B.

THE THREE LITTLE GUYS INSIDE MY HEAD ARE SCRATCHING THEIR HEADS FROWNING AT EACH OTHER, LIKE, OKAY, SO THIS PERSON ALL OF A SUDDEN BECAME A HEALTH CARE PROVIDER.

>> RIGHT.

>> DID SOME RESEARCH ONLINE AND THAT´S WHAT THEY FELT NEEDS TO BE DONE.

YOU KNOW, IT MAKES FOR A TRICKY SITUATION BECAUSE THEY´RE NOT FOLLOWING HEALTH CARE.

>> I WOULD IMAGINE THAT WOULD BE A VERY CHALLENGE PLACE TO BE BECAUSE, YOU KNOW, THE WAY WE´RE APPROACHING HEALTH CARE, IT´S SUPPOSED TO BE PATIENT CENTERED, RIGHT?

SO THE PATIENT IS SUPPOSED TO BE A PARTNER WITH THEIR HEALTH CARE PROVIDER.

GRANTED, WE DON´T HAVE A MEDICAL DEGREE.

AND SO I WOULD IMAGINE FOR YOU, IT WOULD INVOLVE SOME CONVERSATION, PERHAPS -- AS YOU WERE DOING TO YOUR LETTERS TO THE EDITOR.

I WOULD IMAGINE THAT´S WHEN YOU´RE DOING WHEN YOU´RE HAVING AN INDIVIDUAL CONSULTATION AS TO WHY PERHAPS B MIGHT NOT BE AS EFFECTIVE AS A OR C. BUT I´M ASSUMING THAT AT LEAST THERE´S A DIALOGUE BECAUSE, REGRETTABLY, ALL TOO OFTEN, PARTICULARLY IN THE PAST, YOU KNOW, PEOPLE TOOK THE WORDS OF THEIR DOCTOR AS GOSPEL, AND THAT´S NOT ALWAYS NECESSARILY THE CASE.

SO I COULD SEE WHAT YOU´RE SUGGESTING IS THAT, OKAY, WE NEED TO HAVE A CONVERSATION.

THIS IS THE SCIENCE, THIS IS WHAT HAS WORKED, NOTHING IS 100%.

BUT IF YOU WANT TO CONTINUE TO BREATHE, YOU MAY WANT TO CONSIDER A AND C, AND WE CAN HAVE A CONVERSATION.

BUT THIS IS WHERE YOU ARE, AND THIS WILL HELP YOU TO BREATHE.

YOU KNOW, I DON´T KNOW WHETHER PEOPLE RECOGNIZE THAT THEY DO HAVE A RIGHT TO THEIR OPINION, BUT IF YOU WANT TO CONTINUE TO LIVE AND, YOU KNOW, BE PRODUCTIVE, THEN THERE NEEDS TO BE SOME MEANINGFUL DIALOGUE, YOU KNOW, WITH A MEDICAL PROFESSIONAL.

I MEAN, YOU STRIKE ME AS A PERSON WHO LIKES TO ENGAGE IN CONVERSATIONS AND PROVIDE, YOU KNOW, THE PROS AND THE CONS.

SADLY, YOU KNOW, THERE ARE INDIVIDUALS, YOU KNOW, WHO HAVE A BACKGROUND WHO MIGHT BE AS OPEN TO, YOU KNOW, HEARING POINTS OF VIEW, OTHER POINTS OF VIEW, RIGHT?

>> YEAH.

AS I SAID, THE MOST OF ANYTHING WE DO IS KIND OF SHARED DECISION-MAKING.

AND IT´S, ONCE AGAIN, IT´S A LITTLE BIT FUNNY BECAUSE SAY YOU BROKE YOUR LEG, YOU MIGHT NEED A CAST OR SURGERY.

>> RIGHT.

>> AND THAT´S KIND OF PRETTY STRAIGHTFORWARD.

A LOT OF TIMES IF WE PRESCRIBE A MEDICATION FOR YOUR DIABETES OR AN ANTIBIOTIC, TALKING ABOUT COVID SPECIFICALLY, IT´S STANDARD OF CARE SORT OF THING.

>> RIGHT.

>> YOU KNOW, AND THINGS DO CHANGE A LITTLE BIT.

IT´S EVOLVING, BUT SOME OF THE BASIC STUFF DOESN´T CHANGE.

ESPECIALLY, YOU KNOW, IF IT´S, YOU KNOW, YOU´RE HEARING FROM EXPERTS WHO DO THIS FULL TIME >> RIGHT.

>> THIS IS MY OFF-RECORD SORT OF COMMENT ON THE EFFECT OF THE INTERNET AND STUFF.

HUMAN THOUGHT, WE´RE THE ONLY CREATURES THAT I THINK CREATED BELIEF SYSTEMS AS OPPOSED TO ANTS OR SEAGULLS OR TURTLES.

THOSE CREATURES TEND TO FOLLOW INSTINCT AND ROUTINE WHERE HUMANS HAVE CREATED BELIEF SYSTEMS OUT OF THINGS THAT ARE NOT EVIDENT TO THEM.

AND IT´S REALLY FOCUSED ON STUFF LIKE THIS WHERE YOU HAVE PEOPLE -- EXTREME CASES WHERE PEOPLE ARE DIAGNOSED WITH COVID, THEY´RE IN THE HOSPITAL AND TELL THEIR DOCTORS THEY DON´T HAVE IT.

>> WOW.

>> OR PRETTY MUCH IN THE VIRGIN ISLANDS RIGHT NOW, EVERYBODY IN THE HOSPITAL WITH COVID, SERIOUS ENOUGH TO NEED HOSPITALIZATION IS UNVACCINATED.

YOU KNOW, AND THE VACCINE HAS BEEN AROUND SINCE, YOU KNOW, ALL THIS YEAR PRETTY MUCH.

>> RIGHT.

>> AND IT´S IN THE NEWS 24/7, SO NO ONE CAN SAY THEY HAVEN´T HEARD OF COVID, LIKE WHAT´S THAT?

>> RIGHT.

>> SO YOU DO HAVE THE CONVERSATIONS, YOU DO TRY TO CONVINCE FOLK, BUT THERE SEEMS TO BE, YOU KNOW, CEMENTED BELIEF IN THIS IS WHAT I BELIEVE AND, YOU KNOW, PICKING AND CHOOSING THINGS TO KIND OF FURTHER THAT BELIEF.

YOU KNOW, IF I TELL YOU HUNDREDS OF TIMES -- PEOPLE SAY I´VE DONE MY RESEARCH.

OH, BOY.

YOU SHOULDN´T HAVE COME TO SEE ME.

OR GO TO, I DON´T KNOW, DO YOUR OWN TREATMENT IF YOU DID YOUR OWN RESEARCH.

>> RIGHT, RIGHT.

>> GO TO A CAR MECHANIC AND YOU NEED SOMETHING CHANGED BUT YOU´RE GOING TO TELL THE MECHANIC HOW TO CHANGE IT, WHERE TO CHANGE IT, EVEN THOUGH THEY MAY TRY TO EXPLAIN WHAT´S GOING ON, IT MAKES IT A LITTLE BIT MORE OF A TRICKY CONVERSATION.

>> ABSOLUTELY.

ABSOLUTELY.

HAVE YOU SEEN AN UPTICK IN THE USAGE OF BEDS AT THE SCHNEIDER MEDICAL?

I´M ASSUMING THERE´S NO INPATIENT CARE AT MEYER KEITHING CLINIC?

>> RIGHT NOW IN THE TERRITORY SINCE EVERYTHING BEGAN, LET´S SAY BEGINNING OF 2020, THIS IS THE WORST THAT IT´S BEEN.

THE HOSPITALS ARE KIND OF TEARING AT THE SEAMS HAVING TO BUILD MORE ROOMS, NEGATIVE PRESSURE ROOMS SO THAT ANY VIRUS HOPEFULLY DOESN´T SPREAD INTO THE HOSPITAL.

PROVIDERS ARE KIND OF, YOU KNOW, VERY STRESSED.

OUR NURSING STAFF IS STRESSED.

SO IT´S INTERESTING BECAUSE, REMEMBER WHEN THIS FIRST STARTED, EVERYTHING WENT INTO A SHUTDOWN.

>> RIGHT.

>> NOW IT´S HORRIBLY WORSE AND, YOU KNOW, WE KIND OF CARRY ON PRETTY MUCH, YOU KNOW, PRETTY MUCH KIND OF ALMOST BUSINESS AS USUAL.

YOU SEE OUR TRANSLATION WITH THE DELTA VARIANT AND THE OTHER SITUATION GOING ON.

>> RIGHT.

>> AS AN ASIDE, YOU KNOW, BECAUSE INITIALLY TOURISM CHANGED A LOT IN ST. JOHN.

DURING THE SLOW SEASON IT´S BEEN SUPER BUSY.

>> RIGHT IT HAS.

>> BUT NOBODY IN THE HOSPITAL IS A TOURIST.

>> RIGHT.

>> EVERYBODY IS PEOPLE FROM THE ISLANDS, SO IT´S KIND OF COMMUNITY SPREAD HERE MOSTLY.

>> WOW.

WELL, WHAT KINDS OF MESSAGE WOULD YOU GIVE TO THE PEOPLE OF THE VIRGIN ISLANDS AS A PHYSICIAN, AS SOMEBODY WHO´S ON THE FRONT LINES, AS AN ESSENTIAL SERVICE PROVIDER?

>> I MEAN, I WOULD JUST SAY THE SAME THING EVERYBODY´S BEEN SAYING FROM THE BEGINNING, SOCIAL DISTANCING, WEAR YOUR MASK, WASH YOUR HANDS, AND PLEASE, PLEASE, PLEASE GET VACCINATED.

DOCTORS, WE DON´T MAKE ANY MONEY WITH VACCINATING PEOPLE.

YOU KNOW, I´M NOT MAGNETIZED.

I FLY TWO OR THREE TIMES A MONTH AND I NEVER SET OFF THE METAL DETECTOR AT THE AIRPORT.

YOU KNOW, YOU HAVE TO KIND OF BECOME USED TO HOW TO LIVE IN A NEW REALITY.

WE NEED TO PROTECT HEALTH CARE WORKERS BUT ALSO HEALTH CARE WORKERS WHO CHOOSE NOT TO GET VACCINATED HELPS PROTECT PATIENTS IS THE VACCINE.

IS IT PERFECT?

AS YOU MENTIONED, NO.

DOES IT HELP?

DEFINITELY YES.

IN FACT, I THINK THEY´RE GOING TO BE COMING UP WITH A BOOSTER DOSE, LIKE A THIRD VACCINE DOSE, I BELIEVE, IN SEPTEMBER.

>> RIGHT SEPTEMBER 20th IF I´M NOT MISTAKEN.

LET ME ASK YOU WITH THE LITTLE TIME WE HAVE LEFT.

IF YOU HAVE A PFIZER V YOU SHOULD GET A PFIZER BOOSTER?

IF YOU HAVE A MODERNA VACCINE, DO YOU GET A MODERNA BOOSTER?

>> THE MAINSTREAM IS TO STAY WITH THE SAME VACCINE.

THERE ARE STUDIES COMING OUT BECAUSE OF SHORTAGES THAT IT SEEMS THAT YOU CAN MIX THEM.

BUT YOU DO NOT GET AS STRONG AN IMMUNE RESPONSE IF YOU DID BOTH OF THE SAME.

>> MAKES SENSE.

>> IN ADDITION, YOU ALSO HAVE TO CONSIDER THE FLU SHOT.

>> RIGHT.

>> THAT HASN´T GONE AWAY.

>> RIGHT.

>> SOME PLACES ARE RECOMMENDING AT LEAST 14 DAYS BETWEEN SHOTS.

BUT THAT´S AN EVOLVING THING THE CDC WILL GIVE US GUIDELINES ON.

>> DR. JAMES, YOU HAVE BEEN A FOUNTAIN OF INFORMATION.

I APPRECIATE YOU TAKING THE TIME TO ADDRESS US, TO EDUCATE US FOLKS.

THANKS FOR LISTENING TO "ABLE TO RAISE."

BE SAFE AND THANK YOU SO MUCH FOR WATCHING.

♫♫