• Russell Hill

Healthcare Heroes in A Holding Pattern

I wanted to be an ER doc from my first day at medical school. Not because of the schedule, or the shift work grind, or the paperwork. But those things go with the territory so I guess I signed up for them, too. But what I really signed up for is the chance to take on unexpected challenges every day.  I’m a problem-solver, I think out-of-the box and I like making things better. Even if I can’t always improve a situation, I can always try. 

Ingenuity is the hallmark of all the staff in emergency departments. We are doers.  Just last week I read about an emergency medicine physician in New York who assembled homemade materials to create a needed “negative pressure room'' to treat COVID-19 patinets.  It was ingenious and highly functional. But days later it was disassembled by hospital administrators concerned about liability issues. Red tape triumphing over practicality. In another emergency department, a physician “jury-rigged” ventilator tubing so that a ventilator which ordinarily supplies oxygen to only one pateint could now support four patients instead-- theoretically solving the potential ventilator shortage at her hospital. 

 Surprises are less than a breath away in the ER. During nine hours of uninterrupted emergencies in my shift last night, I was just starting to unwrap a sandwich I had brought from home when a concerned technician found me. She hurriedly placed an EKG over my paper bag showing a heart attack in progress.  Lunch will have to wait. 

I enjoy facing patients' complicated complaints and solving their specific problems. It is why I went into medicine in the first place. I have patiently calmed the fears of worried parents about their child's fever and then raced out of the room when alerted to attend to a cardiac arrest of a child found lifeless in a pool. I have been punched in the face by a man brought in by police for “psychiatric clearance” and then calming walked into the next room to see a very irate businessman upset because he waited in the lobby for an hour for what turned out to be a simply treated injury. Real people with real problems, some big, some small. All seen as an emergency to them. 

I’m no different than thousands of other emergency medicine professionals in hundreds of other hospitals. This is what we do every day. We take one problem at a time. We look for solutions unique to each person. We block out distractions. We learn to compartmentalize. 

Like others affected by COVID-19, health care workers have also been displaced. Operations postponed. Care deferred. Across the country, non-emergency medical personnel have been furloughed. A healthcare system and economy straining to meet an exploding pandemic now hampered by healthcare workers sent home leaving them without salaries or health care themselves. Ironic, really, that those who have dedicated their lives to take care of others--and who surely will do so again when this present crisis passes-- are now dependent on the “social network” taking care of them. 

The pandemic can make strangers of us all and casualties out of some of those who raise concerns. Last month Dr Ming Lin, from Bellingham Washington, apparently was fired for sharing his concerns online about his hospital administration's failure to provide the nurses, doctors, staff, and patients with appropriate protective gear.  One group of emergency physicians in Leominster, Massachusetts had their contract with the hospital terminated when physicians used Facebook to express concerns about the lack of PPE for front line providers.

Healthcare workers at Banner Health based in Phoenix faced threats of firing two weeks ago for wearing masks at all times because the hospital system deemed it incitied more fear. However, a  week later the CDC recommends that all healthcare workers wear masks at all times while treating patients. Now, of course, many state and national leaders are urging even the general public to wear masks when outside their own homes.    

These staggering contradictions belie an uncommon distrust. Every stranger now seems to pose a threat so we keep our social distance. Every pronouncement by government officials seemingly provokes panic so we hoard everything from peanut butter to toilet paper. Every infection rate projection prompts a skittish stock market to take another nose dive. Every healthcare worker with a concern seemingly becomes a renegade. 

The societal antidote may be somewhat unclear, but it is becoming its own pandemic. It, too, needs to be understood, analyzed, addressed. It, too, needs its own set of projections, its own remedies. The social fabric that holds us together is coming apart at the seams. Can we take a deep breath and take a step back to see this part of the picture more clearly, with fewer knee jerk reactions and more studied recommendations?  

We will likely need all of the healthcare workers that we can get in the coming weeks and months. The nonemergency personnel and their counterparts, the furloughed and the overworked, the frequent social media users and the uninitiated, the fearless and the fearful. Have we praised them too much or furloughed them too quickly? Have we ignored them too easily and failed to muster the masks and equipment they need too often? Have we failed to listen to them and to ourselves too often so that now we can’t really hear anyone above the din of our own anxiety?  

Ninety years ago, in the midst of the Great Depression, President Franklin Delano Rosevelt reminded us that the only thing we have to fear is fear itself. Today, we do have a very real fear. The coronavirus can be lethal. But thousands of specialists around the globe are testing dozens of potential treatments and vaccines. Eventually, a vaccine or a remedy will be found for COVID-19. The pandemic may be severe, but its fate is sealed. It will eventually be conquered. 

But will a solution also be found for the growing social isolation, for the distrust, for the self-absorption caused by the pandemics paranoia? Let’s hope as much time and attention is paid to treating all the collateral damage as we are spending to stop the spread of the virus itself. 

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