Editorial

A Colleague Has Fallen

There are lessons to be learned

Q IEditorial

Among many stories, on February 8, 2021, one story in particular set the medical community abuzz. That day our colleague Dr. John Barton Williams, 36-yearold Orthopedic surgeon, died of COVID-19.

He has a brilliant resume, the first Covington High School graduate to attend Harvard College; a high honors graduate of the College of Medicine at the University of Tennessee Health Sciences Center; an Orthopedic residency at University of Utah; fellowship in Hand Surgery in Miami.

His Great Grandfather, Bozo Williams, founded the famous BBQ restaurant Bozo’s in Mason, Tennessee. In 2017, he returned to Memphis to join his long term mentor Dr. Timothy Henry Krahn at OrthoSouth.

There’s more than the usual sadness in his story. His career, after all that effort, study, training, was only beginning. He had just married, was married all of 45 days. His mentor, Dr. Tim Krahn died unexpectedly on Christmas Eve. And, he had just received his COVID-19 vaccination.

Despite all that could be done, including ECMO, Extracorporeal Membrane Oxygenation, he didn’t make it. It’s not just the virus. It’s the inflammatory response, in his case MIS, Multi-system Inflammatory Syndrome, not the severe inflammatory response first affecting lungs and pulmonary system often seen early in COVID-19. Dr. Mike Threlkeld made the diagnosis.

Another of our colleagues, cardiologist Nancy Chase, M.D., herself having very likely contracted COVID-19 twice, now recovered and vaccinated, is familiar with MIS. She sees two versions, in older children and adults, one, MIS-C, the other MIS-A, C for child, A for adult. There was early confusion with Kawasaki’s Disease, a small vessel disease described in 1967, seen in babies and toddlers, high fever, inflamed palms and feet, peeling skin, coronary artery disease. COVID-19 children with the inflammatory process MIS-C have myocarditis, clean coronary arteries, much like adults with MIS-A most of whom test negative at admission, but who have been found to have positive antibodies. It was a case in an 8-year-old with MIS-C, mistakenly taken for Kawasaki’s, a different disease, that may well have exposed Dr. Chase to COVID-19 for a second time.

Dr. Stephen Threlkeld, head of Infectious Disease at Baptist, has become the frequent media spokesperson for COVID-19 issues. He explained that on October 9, the Morbidity and Mortality Report from the CDC, reported 27 cases of MIS-A in Covid patients.

Unlike Dr. Williams, none had been vaccinated. He is the first such patient.

The question is obvious. Was his fatal immune response caused by the vaccine or the natural virus?

Dr. Williams had nucleocapsid antibodies, confirming his immune response was to the virus, not to the vaccine. Dr. Threlkeld reiterates there is no evidence that it was a result of the vaccination, though the CDC is carefully investigating the issue, communicating almost daily with Dr. Threlkeld.

So COVID-19 continues to perplex.

Dr. Williams’ family, his wife Peria, grief stricken, have pledged cooperation in any way to help in the investigation.

Surely Dr. Williams would have concurred.

Anything to help others so stricken.

Thomas C. Gettelfinger, M.D.