Dear well-heeled travellers, affluent wanderlusters, and others of that ilk and those postal codes: I think you may be afflicted with Thermophilia

You’ve come under a great deal of scorn and venom in the last few months for your holiday romps, I know. I come to you as an ICU physician, someone with an understanding of and compassion for pain and suffering, but also as a scientist, someone with a great interest in the rare and misunderstood. It is in embodying these characteristics that I began to wonder if a grave injustice was being carried out against you. I am of the belief that the lay public may need to be made aware that there is a possibility your actions could be due to a little known, insidious medical condition. You may not even be aware of the symptoms and be suffering in silence (unless you were by the Pacific Ocean. Those waves can be noisy.)

It seems to me that your recent apparent flouting of the strongly worded directives imploring us all to stay home and restrict all types of travel, may be attributed to a rare yet consequential affliction that seems to develop specifically among those who have access to, among other things, beachside vacation destinations. I think you may be afflicted with Thermophilia.

A thermophile is an organism that exists and thrives at temperatures between 41 and 122-degrees Celsius (the range quoted by the most reliable of medical resources, Wikipedia). They must live in warm to scorching climates to stay alive. Thermophilia, then, would be the pathologic condition of having to seek out warmer temperatures (which coincidentally happen to be found wherever there are expensive resort accommodations) for survival. How could anyone be faulted for that? 

Facultative thermophiles do best at temperatures above 50-degrees but can still manage at temperatures below that, different from obligate thermophiles who must always be in a hot zone to live. I would venture that you, our Betters, all fit into the facultative category given your brave and stoic tolerance of the rather chillier climes of our fair country for much of year. So, you can survive in Canada for the most part, but surviving isn’t the same as thriving, is it?  What may appear to be brazenness at disregarding the strict rules much of Canadian society is stoically attempting to adhere to by vacationing in Mexico or Bermuda could very well be a pathologically driven imperative to boost your body temperature periodically in order to achieve homeostasis and restore your normal metabolic rate, medically speaking of course. I totally get it.

Well, if Thermophilia is the diagnosis, then my job is to provide the best management. Given our deeply strained healthcare system, the best medicine must also be the most fiscally responsible medicine. And I think I’ve done it. It struck me a few weeks ago, while I was working in one of our many ICUs, the one specifically designated for cases of COVID-19. I fortuitously came upon the most cost-effective, readily accessible and surely effective therapy for your troublesome Thermophilia: You should spend one hour with a nurse looking after a critically ill COVID patient. 

I have never seen a nurse emerge from the isolation rooms without a mist of condensation on the plastic face shield obscuring direct vision, or wiping a swath of perspiration away from the forehead or the ability to do anything else before fanning her- or himself for a good 15 minutes while ingesting large volumes of cold water. Having to don the punishing layers of claustrophobia-inducing PPE while endlessly circling around the bed to complete the hourly clinical assessment, the obsessively checking and double-checking of pumps, monitors, ventilators, dialysis machines, deciphering the cacophony of multiple alarms.  All of it generating a fever of concern and worry. Every single hour. I guarantee you if we took any nurse’s body temperature inside one of those rooms, we would be gathering readings nearing 40-degrees within the first few minutes. 

So there it is: a simple, cost-effective therapy for you, our helpless and helplessly beached Thermophiles! The next time the illness takes over and you desperately find yourself on the Expedia or Travelocity webpages about to hit “confirm”, hop on over to your nearest ICU, or Emergency Department or COVID ward and start donning that PPE. My prescription, however, would only be for 5 minutes inside the isolation rooms; I suspect that would be more than enough time for folks like you to start to feel the heat. 

Be well.

Shelly Dev, MD