An Open Message to My Healthcare and First Responder Colleagues....

Some of you have practiced long enough to have faced situations where you and only you were force to make the terrible decision of what patient got a limited treatment resource (helicopter, surgery, ventilator, etc.) and who did not. You applied your best professional, ethical and empathetic self to the decision and then worked ten times harder to save both lives.

In many cases you beat the odds and save both patients. In some, the patient who did not get the resource unavoidably died. In a few cases, both died. Those who faced this decision have carried the faces and cases of those lives and deaths with them to this day.

As #Covid-19 enters its logarithmic spread phase, we are already seeing the early signs of limited healthcare resources. With #SocialDistancing to #FlattenTheCurve some hospitals not exceed their #SurgeCapacity and some of you (I pray all of you) may avoid being forced to choose which patient receives the last bed or the last vent.

As resources become limited and care 'gracefully declines' to rationing most on social media and in the news media will continue to praise your efforts and acknowledge you as the heros that you are. There will be memes and videos of thanks... for a time.

At first there will be a very few who will attack you for "Playing God" and "enjoying the power to choose life or death" and even "killing patients so you can take a longer break." As the disease wanes and the recovery begins, the number of negative and hurtful posts will grow. No matter how much you try to brush these attacks aside, they will trigger you.

KNOW THAT YOU ARE SAVING LIVES AND DEATH, NO MATTER HOW TRAGIC, NO MATTER HOW AVOIDABLE UNDER BUSINESS AS USUAL, IS UNAVOIDABLE DURING THIS PANDEMIC.

You are not God and you are not playing God. You will relive every rationing decision not because you were wrong but because you care and you strive to improve every day.

The weight of those death will follow you as they all do. You are not alone. You have colleagues, friend, family who KNOW YOU. They know your heart and they know your dedication to saving lives. Talk to them. Look after your teammates and colleagues. Pain, regret and flashbacks are all temporary. DO NOT CHOOSE A PERMANENT SOLUTION FOR A TEMPORARY PROBLEM.

The healthcare community will lose a percentage of providers to #Covid19. This is the occupational hazard we chose. Showing up despite the risk is what makes you heroes and professionals. Do NOT let the weight of rationing decisions claim your life or the life of anyone you know.

THE POST COVID-19 WORLD NEEDS YOU.

Be Safe.

Remember that

• love is not cancelled
• life is not cancelled
• family is not cancelled
• friendship is not cancelled
• laughter is not cancelled
• compassion is not cancelled
• empathy is not cancelled
• communication is not cancelled

SYOTOS

Maurice A. Ramirez, DO, PhD

Recipient of the Lifetime Achievement Award in Disaster Medicine