An emergency physician to President Trump

I am a practicing emergency medicine physician in Indianapolis, IN.  I work in a county hospital whose mission is to serve the underserved.  I, like you, was born into a life of privilege with white skin and parents with the means to provide all that was needed and more. My college education was paid for, and I lived a carefree life through college.

I graduated from pharmacy school and entered the workforce as a pharmaceutical sales representative.  I quickly discovered that sales was not for me and that physicians were not rocket scientists.  My older brother was correct; I could be a physician and should go to medical school.  I found my way to the emergency department.

The ER is where the rubber hits the road.  You meet people from all walks of life, some of them on the worst days of their lives.  Most, on a typical day, are just trying to do the best they can for their families and loved ones.  Most of the failures of America’s health care system manifest themselves in the ER.  Mental health care, substance abuse disorders, and manifestations of poorly controlled common medical conditions.  On a daily basis, I see the inequalities of our society.  Medically, socially and, in the eyes of our judicial system, we are not all equal as are constitution mandates.

I experienced 9/11 as a young adult and saw how the country pulled together.  It reminded me of the stories I heard from my mother about growing up during World War II and the sacrifices that were necessary and gladly endured.  The current pandemic is a situation that most of us could not have imagined a few short months ago.  We have heard of death on an unimaginable scale from across the ocean.  It has now come to our shores.

Over the last few weeks, our hospital has begun to prepare for the anticipated volume of sick patients.  We have been thankful that the residents of Indianapolis have heeded warnings about staying away from the hospital.  Suspected and confirmed cases of COVID-19 have steadily increased.  We are now expecting to enter the steep part of the epidemiological curves for cases and deaths.  The anxiety and fear among my coworkers and nursing colleagues have been palpable.  We linger a little longer after shifts and ask a few more questions about cases and PPE procedures.  We have all been scouring the web for information about COVID-19 and experiences our colleagues around the country and globe have lived.  Several graduates from our program work in Seattle, ground zero in the United States.  They have given us first-hand insight about what to expect and what missteps to avoid.  We have been inundated with emails regarding policies and procedures that change frequently.   Yesterday, for the first time, I received an email with projections of PPE supply by days (2 days for gowns,  20 to 30 days for N95 masks, and 27 days for surgical masks).  I go back to work tomorrow night, wondering, “Will there be gowns to wear?”

Regardless of whether or not there are gowns available, my colleagues, nurses, and ED staff I work with will be there.  We will be doing our jobs to the best of our abilities, caring for patients like we would like our family members to be cared for.  I have one request for you and your coworkers.  When you are making decisions and making policy, consider what kind of care someone by the name of “John/Jane Doe” might receive as a result of your decisions.  Is the kind of care you would want for yourself or your loved one?  If not, perhaps you need to speak with Dr. Fauci.

Matthew S. Kuchinski is an emergency physician. 

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