BCMS Medical Record Fall 2020 - 50

Reflections of the War - THEN AND NOW
continued from page 49

Thank you for your Service
During the Viet Nam era, there was extreme division of
public opinion between those opposed to the war and those who
supported it. After a public revelation of a military massacre of
innocent civilians at My Lai, many in the public came to see the
military draftees, many of whom were forced to participate in the
war against their will, as "baby killers." The resulting disrespect for
returning Viet Nam veterans, plus the failure to put a US stamp
of victory on the war, led most veterans to feel resentful at this
lack of public appreciation for their fulfilling of their patriotic
duty. Fortunately, the tide of public opinion has corrected with
the passage of time, so that the country for the most part now
appreciates more what the Viet Nam veterans endured.

Civil Disobedience
During the late 1960s public opinion about the validity of the
war effort became divided, to some degree, along generational lines,
pitting the "Baby Boomers," who were against the war, against
their parents, "the Greatest Generation," who had fought and won
World War II and tended toward unquestioning patriotism. Civil
disobedience for the first time became common in ways never seen
previously, such as burning of the flag and of draft cards, and by
the riots in the streets during the Chicago Democratic Convention
in 1968. The Viet Nam war became the focal point in time where
Americans began to distrust their government, and to push back to
express their disagreement with unjust public policy.
I will be very interested to hear how Kristen compares or
contrasts these takeaway issues from the Viet Nam war to the
current struggles in the treatment of the Corona Virus, or if she
identifies any additional areas of similarity.
Ray Truex, MD, FACS, FAANS

NOW
Thank you Dr. Truex for your service and for being one of
the best physicians and individuals that I have ever known. Your
candor is invaluable, and much appreciated, as we can only learn
from experiences such as yours while encountering situations such
as this pandemic. As I reflect on the past few months during the
Covid-19 pandemic, there have been numerous articles written
about the virus itself, epidemiology, treatment protocols, and
breaking medical research. What has been lacking in some of these
assessments is how this novel virus has affected the way we see each
other in health care as well as some of the lessons learned about our
patients and community.
In speaking with Emergency health care workers across the
spectrum (nurses, medics, patient care assistants, advanced practice

50

|

www.berkscms.org

providers, physicians, etc.), we agree that we have become a more
cohesive unit as a whole. The amount of empathy and compassion
that we now show each other is more than we have ever seen in our
careers. In the past, while we appreciated everyone's role on the
team, we did not always express our respect for each other. We also
noticed a sizable improvement in our communication amongst the
team. Whether it is triaging a patient with the paramedics in the
ambulance bay to assess for virus risk or working to resuscitate a
patient, we have been more cognizant of our verbal and non-verbal
communication, ensuring that the patient and each member of the
team remain safe.

Need to Triage
The days of the traditional triage that I was accustomed to
over the past 20 years in Emergency Medicine are over. During
the pandemic, we had to first triage if the patient (whether in the
Emergency Department entrance or the ambulance bay) was at risk
for the Covid-19 virus, and then triage the acuity of the illness. As
one legend in Emergency Medicine has said, there is no emergency
in a pandemic. Each member of the team needs to ensure they are
protected before assisting others. As the pandemic endured, many
staff members decided to wear their protected gear for every patient
encounter. As Dr. Truex mentioned...this is an invisible enemy and
even those we think of at low risk could be and are infected.

Dangerous Working Conditions
We learn early as Emergency Medicine residents to be prepared
for the worst. At times, there is very little notice of dangerous
situations that arise in the Emergency Department. Our medical
schools and residencies try to prepare us for these types of
situations, but until you are immersed in this environment, it is
very difficult to understand or simulate. The wonderful thing about
Emergency Medicine is that the staff in the department is very
adaptive, nimble, and can change protocols and processes quickly,
sometimes daily or hourly. This trait ensures that both patients
and staff are as safe as possible at all times. One of the challenging
things with this virus is that we are learning more about it each day,
meaning our medical treatment changes day to day. Fortunately,
we are all trained for this and we are able to adapt quickly.

The Invisible Enemy
As I mentioned previously, we know we have invisible enemies.
We deal with them on a daily basis. This novel virus is very difficult
to detect and to predict. What was known in February is not nearly
what we know today. We learned that at some point, we have to
assume that everyone has been exposed or infected and have to
prepare and protect ourselves and our other patients. Most of our
staff early on decided to wear masks, gloves, eye protection and
gowns for each patient, knowing that later in the encounter, we will
discover they actually were experiencing Covid-19 symptoms.
http://www.berkscms.org
BCMS Medical Record Fall 2020

Table of Contents for the Digital Edition of BCMS Medical Record Fall 2020
