BCMS Medical Record Fall 2020 - 51

Lack of Supplies
As you may have seen in the news, it is well known that there
has been a lack of Personal Protective Equipment (PPE) in the
medical community. That being said, I cannot say enough about
the community efforts to ensure we have adequate PPE if we
have a shortage in our institutions. Clearly, it is very difficult for
any healthcare facility to purchase and store enough PPE to be
utilized not to mention last for their staff through a pandemic.
The community has really rallied and donated supplies, whether it
was masks and gloves, or 3D printed items. The amount of love
and support from these companies and individuals was greatly
appreciated and will forever be remembered.

Disruption of Personal Life
As you may have read in other articles, healthcare workers'
personal lives have been greatly disrupted. Many have self-isolated
for weeks and months as to not spread the virus to their families,
friends, or community members. This action has left many feeling
isolated and lonely. Fortunately, we have had a wonderful group of
coworkers and friends to rely on to be our rocks during this time
of need. For me personally, I have relied on virtual meetings with
friends from high school, college, medical school and residency to
help keep me grounded and mentally well. An unexpected positive
from this pandemic is that I was able to connect with friends I have
not heard from in years due to our busy lives and they have been
angels in my world.

Our Emergency Department Patients
We have also learned a great deal about our patient population.
The Emergency Department treats many older adults who have
hearing disabilities and rely heavily on reading our lips. Only when
we donned masks at all times did we realize the extent of this issue
within a large segment of our patient population. We also were
more mindful of our dementia patients who now have a team of
professionals in full personal protective equipment (PPE) caring for
them, but do not understand why we are wearing these items. The
Emergency Department may have seemed like a scarier and less
friendly environment to these patients if we did not communicate
extensively with them and make them feel safe and secure.
We learned that there were fewer "medical emergencies" with
more patients calling the Emergency Department to assess if their
symptoms warranted a visit, rather than dialing an ambulance or
immediately coming by car. Patients did not want to be exposed
or expose others to this debilitating virus and many sought care
in alternate environments with telemedicine visits or in Urgent
Care settings. Patients who did seek care in our department were
extremely kind, many thanking us for everything that we do on a
daily basis.

Thank you for your Service
We learned that the community really appreciated our efforts
as frontline providers and were very generous in their support.
Whether it was car parades, candlelights, cards with words of

encouragement and thanks, or the tremendous amount of food that
was provided, the community rallied around the hospitals, giving us
hope and support when we needed it the most.

Civil Disobedience
Fortunately, we have not seen the violent civil disobedience
that Dr. Truex and the rest of America experienced during the war.
We have seen protests, mostly peaceful, regarding the stay at home
orders as well as the closing of many businesses trying to flatten the
curve. The economic hardship that many citizens are going through
was a very steep price to pay to try to keep the public healthy and
safe.
The pandemic has forever changed the landscape of healthcare,
but there are many positives that will be taken away from this time.
Although we do not know what will be written medically about this
pandemic in the years to come, we did learn to better appreciate
each other, each patient, and our community as a whole.
Kristen Sandel, MD
AUTHOR'S COMMENT
Some of the observations we have made are obvious and
timeless. Working with invisible infectious agents has
presented danger to the physician from the time of the
Bubonic Plague in the 14th Century, for example. We may
be able to decode the DNA sequence now, but the risk to
the physician remains. Other of the observations represent
a sea change in the way Americans see things and react to
what they see, an example of this being the willingness
of our fellow citizens to criticize public policy and push
back with civil disobedience against what they perceive as
injustice. This type of behavior would have been anathema
to my parents' generation and is a direct consequence
of the Vietnam War. Some of the changes are overdue.
The recognition of the sacrifices of frontline health care
workers has evolved from the public recognition that
injustice was done to the returning Vietnam veterans,
who returned from combat only to be vilified. Finally,
the current pandemic, like the Vietnam war, may bring
permanent changes in the way we think and in the way we
act. The "new normal" may be telemedicine, or it may be in
the way we stockpile masks and ventilators, and prepare
for future pandemics.
It has been a very interesting exercise for Kristen and me
to develop our thoughts about the issues confronting
medicine on the front lines over time, and we hope that
you find our observations to be interesting and thought
provoking. Or perhaps you disagree, or have other
thoughts about what the future may bring. In any case, we
hope to hear from you.
Ray Truex, MD
Kristen Sandel, MD

FALL 2020

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BCMS Medical Record Fall 2020

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