As the medical director of a Midwest community emergency department that has yet to see the New York City-levels of devastation, I am begging hospital administrators across the country to begin leading their front line health care workers in preparation to meet the enemy head-on. It has become painfully clear in our hospital daily incident command briefings and discussions with our hospital leadership that no one is making decisions. The decisions ...

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Growing evidence suggests that the novel COVID-19 virus can be aerosolized.  To adequately protect employees, providers require not just “droplet,” but “airborne” precautions and the appropriate healthcare worker personal protective equipment (PPE). Appropriate PPE mandates an N95 mask. News reports for weeks have described hospitals working without the necessary protection for health care providers. This is the case in Boston-area hospitals, which are running short on these masks. One of the city’s ...

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On Doctors' Day, my hospital celebrated our work by giving us each a pair of cheap headphones, and also announced the death of an attending. Though the personal risk to each of us was highlighted by the recent death, the administration did not give hazard pay, or PPE comparable to other countries', or even a guaranteed supply of isolation gowns. Just headphones a different color than the ones they gave ...

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“You are a hero! “ “Thank you for all you are doing!” It is overwhelming and tremendous; it is touching and heartwarming; it is genuine and sincere.  The outpouring of support and love for health care workers and first responders has been a bright light in the dark days of the coronavirus.  But I have been forced to wonder: What has really changed?  OK, before you get outraged by that statement, hear ...

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It is a dark time to be a physician.  Yes, because of the global pandemic- watching our colleagues in other countries die, staring down the barrel of not enough ventilators, reading the New England Journal of Medicine’s paper on how to choose who gets care and who we allow to die. But we are trained for this.  We are up to the task, to take care of the ill.  What is ...

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Physicians are leaders.  As leaders, we are focused on how to ensure safety for our coworkers while also acknowledging a need for stewardship of scarce supply of resources, namely, personal protective equipment (PPE). I have a particular interest in this topic since I am an emergency physician with a high-risk newborn at home (who spent time in the neonatal ICU just a ...

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The image of patients dying in the intensive care unit is changing. Over the phone, family members cry on the other end as I tell them that we are not allowing visitors due to “the coronavirus” at this time. They tell me, “but I help make his decisions for him.” These decisions now have to be made over the phone. This is just what we have to do to keep society ...

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We represent the front lines in this ongoing crisis, and we are disheartened by not only the lack of support but overwhelming greed from just about all of you. We have kept our mouths shut and practiced medicine, providing excellent patient care, while many of you became incredibly wealthy on the backs of our hard work. Many of you have not touched or cared for a patient in years; some of ...

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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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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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As an anesthesiologist, the odds are I might get to work thirty minutes or an hour before you to prepare for the case or cases which you will perform that day. No matter what the procedure is, I am prepared for the worst possible scenario. This includes emergency drugs and an intubation plan, even if the procedure would not typically require intubation. As each patient is different and reacts differently ...

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There’s an intruder in our relationship, and her name is COVID.  Every night I come home, and she’s lurking around the corner on an Amazon box, in the crevice of my couch perhaps, or her scent is lingering on my husband’s scrubs.  A physician-physician marriage is hard enough, but when put under the microscope of a life-threatening pandemic, well, it is disjointed to say the least. My husband is an orthopedic ...

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I hope we eventually study the COVID-19 event after a sober period of analysis and reflection as an example of a societal panic attack. This is not Ebola, with a mortality rate of over 50%, or even SARS, with a 10% death rate.  We’ve seen this movie before, figuratively and literally. A new viral disease appears (like the swine flu in 2009), people die, the fear and misinformation spread like wildfire.   ...

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The Joint Commission of Hospital Accreditation requires hospitals to ask the patient for their level of pain, just subjectively. They require we use a 10-point scale, from 0 for no pain to 10 being the worst pain ever. I knew instinctively that this was a bad thing and would lead to more narcotic addiction, as it did eventually. But in our patients, the pain scores went down as we detoxified patients ...

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Physician burnout. Physician suicide awareness. Buzzwords. Words that get tossed around. People in leadership seem to be concerned about. Institutions say they care. “Solutions” get created.  Solutions that look great on paper. Sometimes under the guise of the employee assistance program. The brochure says we care about your mental and emotional health. We get that life is hard. So we’re here to help. We’ll set you up ...

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As I hug my younger daughter's little head at school drop-off, the calming aroma of her hair fills me with peace. She scurries across the schoolyard toward her 2nd-grade classroom, her big backpack bouncing up and down, seemingly with its own agenda and dwarfing her tiny frame. As soon as I leave the school, my focus switches. I'm at the edge of my patient's hospital bed, reviewing the day's treatment goals. ...

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I am a middle-aged gastroenterologist almost 15 years out of training. I have a chronic medical disease and had a bout with lymphoma two years ago, both of which require me to stay indefinitely on immunosuppressive drugs. I am certainly not the only health care worker who is scared. Most winters that I will contract the flu or another illness from patients who want their screening colonoscopies performed while sick, from ...

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The elevator area on the ground floor of our hospital is split. As you enter, the common elevators are on the left, and to the right is a set of double doors, with a sign posted reading, “AUTHORIZED PERSONNEL ONLY.” And behind those doors are the employee elevators, elevators for hospital beds, and large elevators where we can run a code while traveling up or down. The employee elevators are private, ...

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"I'm not impressed with his pain." "I only give Norco if I see a bone sticking out." "She says her pain is a 10/10 but ..."

On any given shift in the emergency room, I hear some version of these said by residents or fellow attendings. And whenever I hear these phrases, I think to myself, "When did we stop treating pain?"

I'm not talking about chronic pain. I feel terribly for ...

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This nurse notified his hospital unit director testing availability for novel coronavirus on January 26, 2020.  This nurse asked his hospital unit director if signs could be posted discouraging visitation unless necessary on March 10, 2020. The response was, “People need to take care of themselves.” She said this standing next to the signs that restrict children under the age of 12 from coming into the hospital for RSV season.  This nurse ...

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