Published on Friday, March 27, 2020
Normally I would answer your questions on this last Friday of the month. But because of everyone’s continued preoccupation with the novel coronavirus, I will stay on that topic.
I appreciated the sign that some thoughtful person placed on the front lawn of University Hospital this week:
Heroes Work Here!
That made me smile. It made me proud. Because it’s true. I am witnessing heroic work every day.
But we also have to acknowledge that even heroes have fears and uncertainties. Even heroes have frustrations that can make them upset and angry. Even heroes can become sad at times and need to call on others for help.
If all of that were not true, then being a hero wouldn’t be such a big deal, would it? If you are “bulletproof,” then what does it matter that you’re willing to take a bullet for a cause that’s bigger than yourself?
Being a hero is a big deal for the very reason that heroes are human. They have fears and frailties. They get tired. They suffer, often in silence. But when everything is on the line, they respond. As I said last week, when others step back, we step up.
A couple of things I read this week brought this home to me. These excerpts were written by three members of our Medical Center family, one a resident and the other two veteran faculty members.
In a social media post, Dr. John Caleb Grenn, a third-year med-peds resident, wrote about the fears he and his health care worker colleagues face as they confront this unfolding pandemic. The oft-used expression, “this is what you signed up for” because you chose a career as a physician, did not strike him as completely satisfying in the current moment, especially given the national shortage of personal protective equipment health care workers need to be safe. Still, he wrote:
“(Even) knowing that, go to work. Do your best to take care of the patients under your care. Not because it’s your job or your obligation or because you signed up for it, but because it’s a privilege to stand between medical science and a sick person and be the bridge.”
I love that Dr. Grenn chose to elevate what can sometimes be thought of as almost a contractual obligation to an opportunity to do something profoundly good.
Two of our longtime radiation oncologists, Dr. Srinivasan Vijayakumar and Dr. Satyaseelan Packianathan, asked me to review an opinion piece before they submitted it for publication. It’s about the modern version of the Hippocratic Oath and what it says to us as physicians (and other health professionals) as we face a 21st century disease about which we knew almost nothing two months ago.
“Although our knowledge of the sciences is now far advanced from even that time of the physicians of the 1950s, the fact is when anything new arises, our uncertainties and lack of information are the most evident of ‘evidence’ in the beginning,” they wrote. “Yet we must persevere using whatever knowledge and skills we have as new data are gathered step by step.”
The good doctors then shared something that can’t be overstated:
“The oath reminds us too that in the midst of this stress we should also take the time to care for ourselves and our families. Caring for the critically ill and dying is emotionally, mentally, culturally and physically challenging; indeed, we would not be human if it were not so. To remain the best we can be and maintain a clarity of purpose, for our patients and our colleagues, we all should seek times of quietness and activities that relieve our stress, sadness and feelings of inadequacy, even if they are as momentary as stepping aside and taking a deep breath or spending a few minutes covering for a colleague so they may call home and check on their family.”
In the context of these ideas, I want to share a few thoughts:
- Because taking care of ourselves and each other is so important during this stressful time, I want to bring your attention to the Stress and Coping Hotline established by the Division of Psychology. Please don’t feel any qualms about making use of this resource. Also, if you have a fever, headache or any symptoms consistent with the novel coronavirus infection, please stay home and/or seek screening through the employee/student hotline. I appreciate that you want to show up for work because your peers and patients are depending on you, but that’s the wrong response in this crisis.
- We are working every angle imaginable to maintain adequate supplies of personal protective equipment, including through state and federal pathways. Our community is responding overwhelmingly to this need and we have a number of promising leads from corporate suppliers. We will do whatever it takes to get what we need.
- We are asking people to literally work miracles under intense pressure. Yesterday a multidisciplinary team of basic and clinical scientists deployed our own test for COVID-19 infection, augmenting the state’s testing capabilities. The development of the test, which would normally have taken four months, was compressed into two weeks.
- Nasal swabs and viral media that make up testing kits are also in short supply. No problem: We are making our own. Teams of students have volunteered to work an assembly line in our micro labs and are producing 100 kits in an hour. We have even begun supplying our testing kits to the Mississippi State Department of Health.
Good things, amazing things are happening in the midst of this crisis. And yet, just before I wrote this, I took a walk through the University Hospital. I stopped on 2 South, which is the next unit we’ve reserved for COVID-19 patients – suspected and confirmed – who currently number 35 in our hospitals. This normally bustling unit was completely empty and eerily quiet – an unsettling portent of things to come.
Yes, we have lots of heroes working here and at our hospitals and clinics in Grenada, Lexington and elsewhere. And they are not just at UMMC but at our sister health care institutions around the world.
But with superhuman performance expectations come stress, fatigue and frustration. With an impending flood of infected patients come anxiety, fear and doubt.
I cannot tell you that every one of us will be OK. But I can tell you that we are as ready as we can possibly be under the circumstances. And I will tell you what I know in my heart to be true: We will be the bridge between our patients and the best care modern science can offer. And yes, it’s our privilege to do so.
Follow me on Twitter @LAWoodwardMD