I have been writing columns for physicians for twenty years. And year after year, I have had physicians say this: “I’m glad you said what you did. If I said it, I’d be fired.” There are variations on the theme, but they’re much the same. Twenty years, and far more than 20 years, during which the alleged health care leaders in America have been routinely muzzled because they aren’t supposed to speak the truth. Open discussions shut down because they might embarrass someone or upset an administrator. Because it might, heaven forbid, shine a light on a genuine problem.
Some years ago, as the mental health crisis was gathering steam across the emergency departments of the land, I was contacted by a news show in France. The producers wanted to come to South Carolina and follow me on some shifts in my ED. They wanted to see how mental health was working out here. “We have socialized care, but mental health is also a huge problem in our country,” the producer said.
I dutifully, and appropriately, went to administration. “No, we can’t do that,” I was informed. I was given this explanation when everyone knew the mental health system was at the breaking point: “What if they uncover a problem?” Here was a chance for publicity, for potential grant money or to demonstrate that a political solution was in order. How dare we let in fresh air? How dare we suggest that things were not perfect?
The same thing is happening in the midst of the pandemic. Physicians, nurses, and other assorted health care professionals are being threatened for wearing masks. Administrators say, “They make the patients nervous.” Also likely, administrators have realized they don’t have adequate equipment. Facilities and systems with enormous budgets caught unprepared in a pandemic.
I see the stories of these professionals as I follow online forums. Physicians, nurses, and others, threatened with firing because they dared to speak out on the issue of PPE (personal protective equipment).
Like police officers without ballistic vests, these physicians don’t want to go into the rooms of COVID-19 patients without the masks and respirators, gloves, gowns, and face shields that will keep them safe. The equipment that will allow them to return home to their loved ones and prevent them from infecting their families. This isn’t a good look. A hospital that refuses to acknowledge the concerns and safety of its professionals is a hospital that ultimately doesn’t deserve them.
The same veil of silence pervades dialogue on the treatment of coronavirus. When I follow discussions, I see a lot of shaming. “There just isn’t enough evidence to try hydroxychloroquine, Zithromax, convalescent plasma, an untried vaccine, HIV drugs, etc.” Those who suggest we might try are considered reckless or ignorant. As the battle rages and lives are lost, innovation and risk are viewed with disdain. And our medical establishment is locked into the paradigm of double-blinded, placebo-controlled studies involving tens of thousands of people and lasting years. Here’s a view of the same from the U.K. Unfortunately, to suggest that we may need to react faster is only met with ridicule, and often tied to political views instead of expediency. Worse, it ignores the deep, fundamental need to offer hope, any hope, to hundreds of millions of professionals and citizens who are living in fear.
There is a tragic irony here; a painful coincidence. Physicians silenced. Let’s see. Where did we see that sort of thing resulting in a worldwide pandemic? Does China come to mind? The Chinese Communist Party threatened (and who knows what else) physicians who dared to speak out about coronavirus, even when they knew its danger. Even when they knew how easily and widely it spread.
They continued to soft-peddle numbers about total cases and case fatality. The party continued to allow travel to and from China long after the problem was known. They even suggested that Italians have a “hug a Chinese person” campaign to combat alleged racism; a charge delightfully accepted and repeated by gullible Western journalists in pursuit of a narrative.
Truth dies in silence. Sadly, so do people. And certainly when we tell dedicated health care professionals to keep their mouths shut when they have identified problems, offered solutions and simply asked for help. Whether it’s a private business, a totalitarian government, or anything in between, we should insist that the truth be spoken; freely and without fear of punishment.
Because, for the foreseeable future, lives will depend on it.
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