I wrote recently of intubating my first suspected COVID patient.
It made me feel like a huge liability to my family.
We know that persons infected with COVID can remain asymptomatic for days after exposure, and that they can transmit disease during this period.
One of the few characteristics I am grateful for is that so far children do not appear to become critically ill from the disease. I'll accept comfort however it arrives.
I could still pass it onto my wife, on the other hand. I don't know how I would forgive myself if I got her sick, even though she is also a doc and understands the occupational hazard completely.
There is the as yet unexplored medical malpractice liability. I was speaking to a colleague about the possibility of informing patients that there are no remaining ventilators available for their use, or more difficult still, that they do not meet criteria to receive those few ventilators that remain based on a rationally created institutional policy.
Imagine for a moment that you are the patient, or their family member. Imagine that you come to the hospital and get this information. It will be a time of crisis. There will be no quiet, comfortable room upstairs for you to be whisked away into.
More likely, it will be pandemonium, and the floor upstairs will insist that they cannot accept the patient because they have their own fires to stamp out. The staff in the ED will be overwhelmed. No one will bring the blanket you asked for or the food tray that was requested because people are busy dying. It will be a horrible experience for the patient and the family.
As for the doc, nurse and tech - we will all go home and fall apart having been unable to deliver on what we entered our respective fields to do.
We will risk our health and the health of our families, and then we will get sued, because that is how human beings express displeasure and vent righteous indignation in America.
We will understand and share their indignation. I work at an incredible facility with top notch colleagues who make me better at what I do. How could this happen? How did we fall asleep at the guard tower?
Those who eliminated the offices tasked with pandemic surveillance will not be held liable in the way the front-line medical personnel will be held liable.
In addition to risking our physical and emotional well-being, we will perceive risk to our financial security.
It doesn't much matter that the perceived risk is overblown, and that we will likely prevail in the lawsuit. The process of being sued is inherently destructive to your ability to continue practicing medicine.
I'm feeling pretty disheartened about the practice of medicine these days, even as I know I'm most needed to be present for it.
I'm far from alone.
Chin up, get through the next shift, help my friends come together so we can do the impossible for one more day.