ICE is requesting bids for 45,000 N95 masks Why is ICE soliciting for masks when our frontline health care workers need them? There is no social distancing during detention and deportation, and what ICE is doing puts the public at risk. We should immediately suspend detention and deportation for the time being! Health care workers forcing to take PTO to self-quarantine When PPE (personal protective equipment, e.g., face masks and gowns) are in ...

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In the HBO miniseries Chernobyl, there’s a scene where one of the supervisors, Dyatlov, is told there has been a breach of the nuclear reactor. When he hears that their radiation detectors are maxing out at 3.6 Roetgen, he casually responds, “3.6 Roetgen ... not great ... not terrible.” He was obviously wrong. The United States is currently in a 3.6 Roetgen moment with the novel coronavirus (COVID-19) pandemic. We ...

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Upon walking through the revolving door that guards the hospital’s main entrance, I was ushered by security staff to join the queues of my peers, also seeking passage to their respective posts. “The new policy,” the officer explained, examining my hospital ID to confirm that I am, indeed, an employee. Visitors are no longer allowed. “Please sanitize your hands,” another instructed me, as he pointed to the neat rows of surgical masks ...

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These are tremendous times that we have never faced before. A novel virus, lack of preparation time, and a healthcare system that already runs at near capacity, we have a disaster of epic proportions on our hands.  What can we do? What should we do? How can I help even if I am not on the front lines? Many of you are waging war on the front lines: the hospitals, clinics, ...

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I am an anesthesiologist. I am trained to stay calm when everything surrounding me is going downhill. In the OR, I am the anchor. The steady hand, the ready plans. I work with skilled CRNAs who are an integral part of the team.  We do critical care medicine every day. We don’t run from the chaos. We are always ready to fight the good fight. We don’t scare easily, but ...

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Many moons ago, in the 1970’s era, when no imposition from physically brutal on-call schedules to laudable scut to demeaning attendings was outside the boundaries of the house staff training curriculum, our leaders informed us that we were being introduced to the worst-case medical environment.  That familiarity with setting aside our own creature comforts would enable us to save patient lives when the circumstances demanded our resilience. Not quite two years ...

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Physicians are, without a doubt, some of the most educated professionals around. You spend endless hours studying, taking tests, and jumping through academic hoops in the name of good grades and patient care. But is the education you are receiving truly preparing you for the practice of medicine today? Health care is now considered almost exclusively a business term. And yet there is a lack of business taught in medical school. ...

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We are health care workers. We are doctors, advanced care practitioners, nurses, pharmacists, social workers, and so much more. We are on the frontlines. We are our parents' children, and we are parents to our young children. For the first time, we are at an extremely high risk of being quarantined by the same beast we are trying to conquer. We are experiencing moral distress, guilt, and frustration, knowing our ...

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Prayer is a funny thing. I guess it’s like an N95 protective mask to guard you against COVID-19. You don’t realize how valuable and precious it is until you’re without it, and sadly we are all running low. For the past 25 years of my career as an emergency physician, I bet my partner Dr. Jaime Harper and I have passed by them on the droplet isolation precaution carts a ...

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Doctors used to be heroes. We used to be universally respected. Our opinions used to mean something. And now? Now the president of the United States goes on live TV and vilifies us. Pointing the finger, shifting the blame to us as the reason you can’t go to the bar and watch the game, or go to Disney World, or get drunk every day on spring break at the beach. ...

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I had my first full day of telemedicine today. Telemedicine is my happy place.  For the last two years, I have provided telepsychiatry for a rural facility in my home state. I had the privilege of talking to my patients in their homes today. I was beyond humbled that my patients embraced the change with me and invited me into their homes. As I saw them in their homes ...

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The number of COVID-19 cases now exceeds 378,000 worldwide. This new coronavirus, also known as SARS-CoV-2, is having unprecedented global effects. The number of deaths in Italy surpasses 6,000, and there is a lock-down in many countries. The number of worldwide cases of COVID-19 increases each day, and it is important we do everything we can to prevent the spread of disease. To achieve this, we need ...

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I decided to write this note because I am grieving. I am grieving for those infected and affected by the coronavirus pandemic, of course. But the deepest grief I feel right now is for my fellow healthcare workers who I know will be going through their toughest days in the next few months. I hate that so many of you will be forced to go through this experience, ...

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Doctors are begging the public for basic protective equipment.  Us. The United States of America. Supposedly the most advanced, most privileged nation in the world.

We are in a pandemic dumpster fire. There has been no centralized movement to tackle this escalating threat.  Every hospital, city, county, and state has been left to flounder on its own. I’m not the only one who’s noticed we’re completely floundering, right?  Doctors ...

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We are physicians. We are experts at triaging and prioritizing action. Our decisions mean the difference between life and death. We regularly balance competing interests in the setting of constrained resources. We fight hard for our patients. Our job has been likened to “walking through minefields in clown shoes.” It breeds humility. If we make a bad decision, the unthinkable happens. And we are frequently reminded of the fragility of ...

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It began last week in our neighborhood, between the locals, who, out for a breath of fresh air, and dutifully in line with the new social distancing rules, began to shout back and forth through the crisp March air. “Good morning! I hope you’re well!” “Good morning! We’re well! I hope you are, too!” Then goodwill took over the neighborhood email chain. Who needs a casserole? Just let us know! We’ll drop one off at ...

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In light of the COVID-19 pandemic, people across the country are grappling with the question, "What and who is essential?" Instructions to reduce non-essential activity hit differently in crisis compared to our normal mindset that our day-planners are scheduled with only crucial tasks. When suddenly gyms, churches, and restaurants close their doors, one must reflect on what is truly indispensable. This hits home in my field ...

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For thousands of years, medicine was an in-person enterprise. Patients with mysterious symptoms or requiring complex interventions traveled days to obtain an expert opinion. At times, Medicine appears to be nostalgic for these days now past; as society braces for the advent of 5G, many of us in medicine communicate via pager and landline telephones. The potential of telemedicine - the use of technology to remotely deliver patient care - ...

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The conversations we’ve had with physicians this week confirmed that the primal fight-or-flight response has kicked in as physicians across the nation recognize the COVID-19 pandemic as an imminent threat to the survival of their practices. Some are reacting from a place of fear, while others are proactively evaluating options and making strategic moves. In surgery, there exists a time-honored adage: all bleeding stops eventually. When a patient has unexpected severe ...

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In November each year, I usually attend an all-day conference in Louisville on the subject of depression. Some of it can become a little grim, but there is an especially tasty free box-lunch that I appreciate. Suicide is a big subject at depression conferences. One might expect this to be true. The focus is on suicide prevention, which is as it should be. The discussion is usually led by university professors, and ...

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