Evolution of an emergency physician in the face of a pandemic.
I am emergency medicine. It lives in my blood, and it is what made and mold me into what I have become. I am a leader, resilient, innovative, dynamic, forward-thinking, unwavering in the midst of adversities and I possess what my late mentor Dr. Lasalle Leffall often refers to as: “equanimity under duress.”
Simply speaking, under stress, I remained calm, relaxed and unfazed. These are the absolute attributes of a true emergency medicine physician. These qualities gave Emergency Physicians the aura of invincibility, a kind of badass bravado that screams: “bring it on.”
Every shift or working day in the emergency department is dynamic, and no two days are the same. The adrenaline and the calmness you feel when you hear trauma code reds or a cardiac arrest en route to the ED, the joy you feel with a successful resuscitation or the thrill of delivering that baby in the ED.
The solemn and humility of the loss of the patient you did not expect to succumb to their acute illness, and the sadness and emotions that overwhelm you when you have to deliver the bad news to a parent whose only child was killed via drive-by shooting on Christmas Eve. These are the situations that shape and mold emergency physicians to develop the intestinal fortitude over time to withstand the rigors of the profession.
As an emergency medicine physician evolves in the career of being a frontline physician, that once young invincible, badass, unfazed physician is now involved in meaningful relationships, or married with children, involved in the community, little league baseball, basketball or soccer coach, and now responsible for others’ well being in an entirely different dimension unlike his emergency department patients.
Perspectives change, gravitating towards more leadership or administrative roles. Our operating mantra begins to mirror risk aversion, with waning excitements for the so-called adrenaline charging scenarios. The aura of invincibility starts to dissipate slowly.
The world today is strongly interconnected. This interconnectedness creates an environment that allows for easy transmission of communicable diseases over thousands of miles. The communicable diseases that have evolved over the past two decades are more virulent and often evolve into an epidemic or pandemic. The Severe Acute Respiratory Distress Syndrome (SARS) outbreak in 2003, the Middle Eastern Respiratory Distress Syndrome (MERS) in 2012, and Ebola in 2014 were all epidemic conditions.
Presently, COVID-19 is a pandemic of devastating proportions. As all these diseases evolve, emergency medicine physicians are thrust unto the frontline of caring for the infected population.
Emergency medicine physicians deal with clear and present dangers on a daily basis. However, dealing with clearly visible danger is one thing; dealing with dangers that are not quite discernible, but yet deadly is a different story entirely.
The current Covid-19 pandemic is an example of danger that cannot be visualized, sniffed, or perceived. If you are unfortunate to contract the virus as a frontline emergency medicine provider, the consequences could be devastating. Here lies the paradigm shift.
Throughout our career, the superb aura of equanimity under duress, the uncanny ability to make order out of chaos and the incessant ability to be solution-oriented has defined the emergency physician. But now we are dealing with a situation where we are rendered impotent because of the limitations of what we could really offer to those afflicted with the Covid-19 virus.
Presently the battle we are fighting in the frontline has unfortunately taken the lives of some of our friends and colleagues, stricken several others with long-lasting sequelae, while the remainder stand, continuing to selflessly care for the afflicted while quietly pondering the potential inevitability of contracting the virus.
That aura of invincibility has dissipated. For once as an emergency physician, I am scared and afraid. The anxieties of potentially contaminating myself is emotionally draining. I am invincible no more.