Battle Lines

The Coronavirus pandemic has been an unprecedented stress on health care delivery. There are more patients, sicker patients, requiring more resources than seems possible. The specter of health care workers becoming infected has introduced an element of fear that most practitioners have never even imagined. As a recently retired anesthesiologist, I have stayed in touch with my colleagues in the New York metropolitan area to get a gauge on their day to day existence.

I have heard accounts of many health care workers who are conflicted on whether they should enter the fray or whether to sit this one out for their own safety and for the safety of their families. I myself wonder what I would do if I were not retired, with multiple risk factors and luckily isolated in a relatively safe zone. I know of several people who are sitting this one out, but just as many who have had to step up their hours as well as the intensity of work to meet the challenge.

We see accounts of health care workers in urban hospitals who are overwhelmed physically and emotionally, who are realistically fearful of getting sick because there is inadequate personal protective equipment for all practitioners. I’m sure these accounts are true, and am hard-pressed to understand how these situations developed. My heart goes out to those people who are sent to war without weapons.

Fortunately, the health system which I was associated with has exceptional resources, and I have not heard horror stories from my colleagues. The gist of what I have heard is that my colleagues are treating this just like any other challenge they have encountered in their careers. This challenge is unquestionably unique as the sheer unrelenting volume and intensity of disease has never been experienced except during wartime. The challenge is met through established channels of cooperation and decision making. That is because health care is a team effort. It requires resourceful administration and emergency planning. It requires the cooperation of multiple hospital departments in order to deploy services where they are required as well as to develop novel solutions to problems on the fly. It requires the dedication of health care workers to work harder and longer than they ever have before. In the trenches, teamwork is the only thing that gets people through the day and the only thing that gives people strength to get up and do it again the next day.

Today I saw a Facebook video from my hospital of a patient who was being discharged from the hospital after 17 days in the ICU. The entire hospital staff was lining the walls wearing masks and applauding the patient. There was a shedding of tears, but no hugs, just an occasional gloved fist-bump.

Everyone has seen a video like this. The difference for me was that I know this guy. He has worked at my hospital for 30 years and every person in the hospital knows him. In a week where many patients were dying despite the heroic efforts of the entire staff, he survived. It was a moment of victory in a season of death. The loss of countless patients was put in perspective by one friend who was saved. Health care workers must find a sense of detachment in order to stay sane. For a moment, that detachment was overwhelmed by the fact that health care is very, very personal. That experience provided the motivation to keep on going.

David Berger MD

Key West

April 2020