SECTON REPORT YOUNG PHYSICIANS
Hero Priya J. Ghelani, DO FAAEM
I have heard this word in a variety
What is it about the word “hero” then that feels so unsettling?
of permutations over the past few months, whether on social media platforms, in the news, or when friends and family address me as the emergency medicine physician taking care of coronavirus patients. Caring citizens have sent care packages and kind notes letting me know they are thinking of me. My fellow colleagues say they have been going through some of the same, and it feels equally strange. While the appreciative gestures have been nice, the question remains. Do you feel like a hero? If there is a specialty in the house of medicine that is generally even-tempered, ready to resuscitate at the drop of a hat, and constantly humbled by the pathology we too often diagnose and see, it is the field of emergency medicine. There is a certain personality that is associated with the willingness to be able to function with maximum unpredictability with often minimal recognition, while facing an indefinite number of stressors at any given time. Taking care of exceptionally sick, often unconscious, and sometimes dying patients on a regular basis, some of the most vulnerable in our society, requires a certain resiliency and hardening of the human spirit. It is with great pride that we refer to our specialty as the one in which the lights are always on. What is it about the word “hero” then that feels so unsettling? Why have we as emergency medicine physicians been labeled as heroes, almost overnight? My fellow EM colleagues consistently come early, stay late, and work hard each shift as we took an oath to do long ago — that hasn’t changed. Is it because now our own lives are in jeopardy, and we are subsequently putting our families’ lives at risk? Is it because we are some of the few who are qualified to be on the frontline, and therefore some of the most likely to be sacrificed? Is it because during this pandemic, our ERs have turned into war zones, with patients dying in droves, and there is now a greater sense of empathy for those who witness death at such a scale? We as physicians strive to deliver the best care for our patients. So do many of our coworkers on the frontlines – paramedics, nurses, custodial staff, respiratory therapists, patient care assistants, security staff, and countless others. We are undeniably only one piece of the puzzle, lost without the rest. While we were frustrated by the lack of protective equipment, our medics routinely brought in the masses wearing only a mask. For those of us at county hospitals, resources on a good day are stretched thin. Our ICUs and medical floors frequently have no beds available, leading to lengthy boarding times, sometimes days at a time. The areas with the lowest socioeconomic populations in New York City transformed overnight into petri dishes of coronavirus infections and our ED, as it often does, became overwhelmed as the volume of critical patients skyrocketed. Our underprivileged communities became an abysmal example of health disparities. However, our staff, despite a sense of palpable fear, took this in stride, and got to work. I do not feel like a hero. When we first encountered coronavirus patients, we relied on minimal data we had from across the world. A lack of tests, we repetitively explained to patients, was the reason as to why they could not be diagnosed appropriately. Each radiograph looked nearly the same, a disastrous chaos of white-out multilobar pneumonia, as did their clinical presentation, varying degrees of hypoxemia. In the beginning, we intubated early, trialed high levels of alveolar pressure, and calculated each patient’s P:F ratios. Hospital administrators were fearful of utilizing non-invasive ventilation strategies, and our pendulum of management swung accordingly. We kept
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COMMON SENSE NOVEMBER/DECEMBER 2020
We are undeniably only one piece of the puzzle, lost without the rest.
