Dr. Nathan Box – an ear, nose and throat/allergy specialist for Freeman Health System – is between patients on a recent morning and looking back on his time as a student at Missouri Southern State University and the decision to go to medical school.
For his first two years of college, he worked for a local billboard company. The latter two, he worked in the former St. John’s Regional Medical Center’s cholesterol clinic.
“I was thinking about pursuing something in the medical arena, and several of the cardiologists I worked with encouraged me to take the leap and go to medical school,” says Box.
After obtaining his bachelor of science degree in biology from Missouri Southern in 2001, he applied to – and was accepted by – both medical schools in Kansas City, ultimately choosing to attend Kansas City University of Medicine and Biosciences. When it came to choosing between a course of study to become a medical doctor (MD) or doctor of osteopathic medicine (DO), he chose the latter, which takes a “whole person” approach rather than treating specific symptoms.
“I chose to be a DO over an MD because I like the DO approach to medicine,” he says.
As he nears his 10th year as an attending physician at Freeman, Box has seen his share of crisis – from a devastating tornado to the current COVID-19 pandemic. It has given him a chance to reflect on all that he has learned over the years, and what the current situation means for the future of medicine and how Americans view health issues.
A holistic approach
There’s an interesting parallel to the creation of osteopathic treatments and the current pandemic, says Box.
Dr. A.T. Still, the founder of osteopathic medicine, established the first osteopathic medical school in Kirksville, Mo., in 1892. The treatment methods he helped pioneer would be put to the test during the 1918 flu pandemic.
“It’s a hands-on treatment,” Box says. “I’ve always liked the holistic approach better.”
The approach catching on with medical professionals and the town’s proximity to Kansas City is one of the reasons the latter city became a hub for medical education, he says.
More than a century later, the Joplin doctor has watched the global spread of the coronavirus pandemic and witnessed how it has affected the medical field.
“We had to start postponing surgeries in mid-March through April,” says Box. “Our office was only seeing emergent patients in the office. Fortunately, we were able to get telemedicine up and running fairly quick.”
Just as the race to find a vaccine will represent at “giant leap” for the field of medicine, he believes the spread of telemedicine will also reshape the industry.
“I’m utilizing telemedicine visits for new allergy patients and more significantly when it comes to follow-up visits and appointments for lab results,” he says. “I can discuss CAT scan results with patients and be able to pull them up for them to review on their phone while we talk.
“It’s a huge thing we’re able to do to keep our patients and office staff safe. Telemedicine isn’t going away, even after we have a vaccine.”
What he finds troubling, however, is that many people are putting off necessary medical visits for fear of contracting the coronavirus.
“Nationally, there has been a 40-percent reduction of strokes in the last two months,” Box says. “Did 40 percent of strokes just magically disappear?
“No. People aren’t calling their doctor or going into the emergency room. At some point, the general public will have to realize this virus isn’t going anywhere. There are caveats – the elderly and at-risk need to take extra precautions. Otherwise we’re taking all the necessary precautions so that people can get back into the routine of getting medical care.”
Compare and contrast
The challenging period brings to mind another crisis – the May 2011 tornado that carved a deadly path through Joplin, killing 161 people.
“I rode my bicycle to 26th and Maiden Lane (after the storm),” says Box. “I found a Joplin policeman and I told him I was a physician. He dropped me off at Memorial Hall, where there was a makeshift MASH unit.”
He began the grim duties of treating the injured and pronouncing others dead.
“I know I treated a 6-year-old boy with injuries who went by helicopter to (another hospital), but I really don’t have much memory of that night,” says Box. “I really don’t. To compare and contrast the two situations, after the tornado you were needed and could do something. At the outset when this pandemic shutdown occurred, you felt useless because people weren’t coming in to get treatment.”
While he sees the initial coronavirus panic mode lessening, Box also says the fact that it’s the middle of allergy season is bound to cause concern for some.
“You don’t see high fevers and dry, non-productive coughs with seasonal allergies,” he says. “It’s also very rare to have muscle or body aches with allergies.”
As for the necessity of wearing masks, it’s ultimately up to individual choice, though Box isn’t happy to see the issue become controversial.
“People who are wearing masks, it’s like wearing a scarlet letter,” he says. “And it’s the same for those who are not wearing a mask. We can’t win. It’s very unfortunate.”