ER Physicians Share the Profound Impacts of the COVID-19 Pandemic

In January 2020, it was inconceivable to think a viral pandemic would soon up-end our daily routines for the immediate future.

The summer of 2020 will bring many uncertainties. The valid questions we ask now will likely remain unanswered in the coming weeks.

• We hope social distancing efforts to mitigate the spread of the virus are successful.
• We hope that treatment modalities will be identified and offered to those battling COVID-19.
• We hope that the seemingly distant past marked by everyday commutes to work and school will re-started again.

However, the reality that many have come to identify is that these questions are impossible to definitively answer. The myriad of financial, social, and forthcoming unknowns spark concern for all of us.

In light of the pandemic physically and emotionally impacting millions of us, I felt it would be a disservice to not go beyond highlighting the profound empathy and humanity we are seeing from emergency medicine physicians. On top of this, I would like to take this opportunity to share authentic voices from front line doctors.

From resident physicians to veteran attendings, these perspectives are from ER physicians leading the care of emergency rooms in this unprecedented time.

Emergency room doctors were asked to share their experiences on shift during the COVID-19 crisis:

I worked in a New York City metropolitan ER today. I write this covered in sweat. I'm exhausted. Critical patient followed by critical patient marks a typical shift in the height of COVID's spread.

I have never seen anything like what I’ve encountered here. One day I cry, the next day I'm angry, the next day I'm fine.

Medicine...our lives...the world...will never be the same.

It breaks my heart for the families who can't be with family members during this vulnerable time. I don't even have masks for myself.

Seeing tragically long rows of intubated, proned patients in a makeshift ICU. This sight- in the year 2020- is one I will never forget as an ER doc.

This is what we signed up for. At the same time, it kills me to not be able to come home to see my family (after shifts). In my 20+ years this really does mark a different time. This is our darkest hour.

This will change my life, my kids' lives, and your life. The damage we are seeing will flip medicine as we know it on its head. I hope, for the better.

I am at roughly a year since graduating from residency... (I had) 12 years+ of training... in almost 12 days of shifts since this started I have been inundated with the most hectic and troubling stretches of my career. How can I lead my trainees with confidence when we are on a suicide mission.... to treat patients without rudimentary safety equipment is a concern from 1920 not 2020.

Do no harm. How can we balance this knowing that colleagues are being terminated for speaking up. I am at one of the most "cutting edge" and prestigious hospitals in the country. Yet, coming to the ER for just an afternoon looks far too similar to a combat zone with depleting PPE.

We are facing the ultimate test. One-by-one, our nurses, medics, and fellow physicians are falling ill. The fault lines (in the healthcare system) are only making this worse.

My plea as a retired ER doctor is to continue to social distancing practices. You have the power to save a life by staying home.

These brief narratives are, by no means, attempting to dilute the significant sacrifice we have seen from thousands of others during this time. Nor should it be viewed as a critique of the operations or administrative facets of our healthcare system. The conversations surrounding these topics have garnered a great deal of media attention over the past several weeks. However, the war against this virus is still very much underway. By lifting up the humbling actions of emergency medicine providers during this time, we can allow one another to support our physicians in the current battle that is being fought.

Shifting the dialogue to encourage more narratives from front-line providers is a vital transformation I urge us to embrace. Through this outlet of hearing emergency medicine physicians share authentic experiences, we can communally embrace these heroes while disbanding the ever-present fear that they face from speaking out at the moment.

To close, I would like to share a note from an emergency medicine resident in one of the hardest-hit urban areas in the country. He details what it is like to train as a physician in one of our country's most tragic realities.

An Emergency Medicine Resident's Thoughts on the COVID-19 Epidemic:

"This is not something I ever expected to encounter during my residency...

During my 2 years of training so far, I’ve been able to experience and see a lot, but this is different. Being in the ER, I have the luxury of seeing the gamut of health - healthy people coming in for stitches from a cut all the way to the sick and dying, the latter possibly needing chest compressions, intubation, and the like. As ER doctors, the basis of our training is to quickly recognize the sick and not sick. COVID-19 has made this extremely difficult - we are not dealing with simple viral pneumonia. 

Never have I been so humbled about a disease process, comfortable discharging someone who in my opinion, would do well and easily fight off this virus, only to come back to the hospital the next day requiring a breathing tube. Never did I have to be so conscious of exposure - not only of the virus to myself, but me possibly spreading it to colleagues, family, and friends, unknowingly. Never have I been so unsure of the outcome if I do get the virus - sure, numbers are numbers and the chance that I succumb to COVID-19 is extremely low. However, 3 other medical residents in America - young, healthy, adults - have passed to COVID-19, which is possibly the most sobering part of this. 

This being said, being a medical resident during a time of a pandemic will only strengthen the training I get from these years and prepare me for anything in the future. During a pandemic, you must be able to adapt. Adapt to changing protocols, medical recommendations, and to a varied patient population that one might not otherwise experience. It reminds me daily of the amount of respect and trust I have for everyone on our team - other doctors, nurses, techs, EMS, janitorial staff, etc. We all rely on each other to do our respective jobs to the best of our ability to bring the best care to patients while also protecting ourselves and each other. Despite all these concerns, never have I been so sure of my career choice. As daunting as this virus seems, all those thoughts go by the wayside when you encounter a sick person in front of you needing help. You know what you must do at that moment, and you just do it."