We are practicing in a time of shortage. This is something we are used to in emergency medicine. We adapt. We don’t have furosemide? Fine, I’ll use bumetanide. We don’t have LET cream? Fine, I’ll use lidocaine solution. We find work arounds for equipment we don’t have and drugs we can’t get on a daily basis. It’s what we do. Why? Because we have to. Because people’s lives depend on us figuring it out.
Now we are faced with two critical shortages that frighten me. First is the shortage of personal protective equipment in the face of a COVID-19 pandemic that we do not fully understand. Whether this shortage is due to the sheer amount needed due to the widespread infection, or due to people who don’t need the equipment hoarding it for their own personal use, it doesn’t really matter. What does matter is that we don’t have enough of it and we may run out.
The second shortage is the helpers. I have always loved the quote from Mr. Fred Rodgers that says “When I was a boy, and would see scary things on the news, my mother would say to me: Look for the helpers. There are always people who are helping”. I have always tried to be a helper. I wanted to be a doctor from the age of 5. I love the feeling of knowing I made someone feel better.
Over the last few years I have suffered from burnout. Burnout is a trendy term right now which describes the loss of joy. It came on slowly. First I attributed it to having twins and just being constantly exhausted and overwhelmed. Then it was “maybe its just adjusting to the new job as an attending”. Lately I just feel numb. I feel everything ‘less’. I don’t get as happy or laugh like I used to. I don’t get as sad or cry like I used to. I have been shoving the violent emotions of this job down for so long that I don’t think I know how to feel like a normal person any more.
What scares me most is the disdain I feel towards most people on a regular basis. I have a hard time being empathetic, which is normally something that comes very easily to me. I once received an evaluation in residency that recommended I develop a ‘grisly exterior’ or I won’t survive emergency medicine.
I try desperately every day to see the good and the silver lining. Minutes later, I see a story about someone who works from home, bought all the surgical masks or hand sanitizer off online for himself. Then I see crowds of people waiting in line to get into the only open bar in their neighborhood. Next, I get an email from work about how we need to reuse our surgical masks as often as possible so we don’t run out. And don’t even try to talk about N95 masks. They are locked up with the nursing supervisor because people have been stealing them from the hospitals to sell on eBay.
Burnout is widespread in medicine but the most prevalent specialties are Emergency Medicine and Critical Care. These will be the two specialties tested most with this pandemic. Put another way, we are adding lighter fluid to the bonfire.
We are going into one of the scariest times in medicine with a severe shortage, both of physical equipment and emotional equipment. We go to work every day with the goal to make things better. There’s a chance we could be exposed. There’s a chance we could be quarantined. This means we are kept home. There is a finite number of health care workers. Who will work if we get sick? We are all running on low reserves.
Be kind to one another. Stay home. Pray for the helpers. It’s what we have always wanted to do, we just need the tools, both emotionally and physically to do it.