Back in early 2021, the Moderna vaccine was not yet widely available. Protocols mandated who could get the scarce shots, prioritizing health care workers, senior citizens, and those with severe diseases. Each vial contained enough for 10 doses, but the doses had to be given with six hours, before the vaccine spoiled. On Dec. 29 Dr. Hasan Gokal, a Pakistani immigrant, worked at the county’s first vaccination event, set up for health care workers. Near the end of the scheduled event a health care worker showed up and a nurse punctured a new vial to give the worker the shot.
Now, what to do with the remaining nine doses? He got on the phone and drove around seeking and finding several senior citizens who wanted the vaccine. Exhausted with a half-hour until the vaccine expired, he gave the final dose to his wife, who had pulmonary sarcoidosis, which was indicated in the protocols as a qualification for the vaccine.
Dr. Gokal’s supervisor and the director of human resources then fired Dr. Gokal:
The officials maintained that he had violated protocol and should have returned the remaining doses to the office or thrown them away, the doctor recalled. He also said that one of the officials startled him by questioning the lack of “equity” among those he had vaccinated.
“Are you suggesting that there were too many Indian names in that group?” Dr. Gokal said he asked.
Exactly, he said he was told. (Barry 2021, p. A5)
A couple of weeks later, the county district attorney charged Dr. Gokal with theft of doses of the vaccine.
Dr. Gokal acted as a medical entrepreneur. His job was to save lives by administering the vaccine. He nimbly pivoted in a difficult situation. For that he was punished–fired and charged with a crime.
The growing promulgation and enforcement of protocols limit physicians from acting as mission-oriented entrepreneurs. They are limited in their use of judgement based on their own experiences, they are limited in innovating, and sometimes they are even limited in using all of a scarce vaccine. These limits may be part of the reason that so many physicians today experience frustration and burn-out.
[As of the time of the writing of the NYT article cited below, Dr. Gokal remained fired from his job, and still was in legal jeopardy.]
My source for the facts of Dr. Gokal’s case, is the NYT article:
(Note: the online version of the NYT article was updated June 23, 2023 [sic], and has the title “The Vaccine Had to Be Used. He Used It. He Was Fired.”)