03/31/2020
FYI :
This article was shared with me by a close friend, a dedicated Doctor 👨⚕️ on & near the Covid-19 front lines each day ‼️
I believe all of us should look and comprehend situations by trying to look at how they would affect us & how we would see things if we walked in the shoes 👞 of that person ‼️
Held Hostage by the Hippocratic Oath . . . ! or ?
Steven Tsoraides MD/ March 31, 2020/ Doctors, Early Practice, Medical Students, Residents/
Pandemic challenging doctor perceptions of profession
A partner in our surgical group posted this phrase to one of the many ongoing discussions regarding the current pandemic we are all facing. I’m sure pretty much every group or social circle of doctors has a similar ongoing support system unofficially established to help manage fears and anxieties. What is not clear from circle to circle is whether this statement is an assertion of disappointment or a question in fear.
Across the world doctors and nurses on the front lines dove head and heart first into the line of fire to do what they took an oath and pledge to do . . . help others. The first wave can be considered loyal. The second who started to see the consequences were both brave and loyal. The following waves may be considered obedient too. But as wave after wave of health care workers break against the rocky and dangerous shores of this pandemic, at what point are the doctors and nurses foolish to risk their lives fulfilling their oaths?
Never in modern times has this dilemma arose outside of the battlefield for most doctors practicing in peaceful nations. No common doctor was prepared for the day they would question everything they believed as the ideal of a physician they were trying to emulate. Prior generations trained us to have a stiff lip and strong shoulders in plowing through challenges. But now, doctors are being thrown into life threatening situations where one of the lives threatened is their own. Is it wrong to say no?
It is not contentious at all to state that America was not prepared for a pandemic and the result of this unpreparedness is that doctors, nurses, and first responders are literally risking their lives to respond to the crisis. The opportunity to stockpile and prepare resources was wasted. Any dramatic efforts now will fall short to protect those who spent all of their young lives training and preparing to be ready for this call.
I am certain the hearts of all of those on the front lines are in the right place. I don’t think you could find a doctor or nurse who doesn’t genuinely want to help at this time. I am also certain a shocking and overwhelming majority of these same people, the best of our society, have great fear and anxiety about being forced into what may often be a futile and dangerous situation. Dangerous and futile not because of the virus, but because of the lack of preparation our country has left us with.
Anyone who has flown on a commercial flight is well aware of the recommendation to first place one’s own oxygen mask on before helping others in the case of emergency. A very good lesson in not being able to help others unless you first look after yourself. Where are our ‘oxygen masks?’
In any other medical crisis doctors have actually been forced by their hospitals to don protective gear where doctors were actually resistant. Anyone in a trauma bay wearing leggings and lead knows what I mean. Now that we are hungry for protective gear, we are being told, even by the CDC, that we can relax on the type of gear we wear. Some places are actually scolding doctors for wearing masks due to the potential fear this invokes in others.
So at what point is our oath a binding burden that we should question? In a just society where health and life are valued over economy and ‘progress,’ resources would have been reserved and prepared for such a scenario. Wise leaders who prioritize people over policy would have heeded the warnings of experts. Anyone who knows anything about healthcare in America could have told you that our public health system is a mockery. There is no coordination or collaboration in actual care delivery beyond financial ties. No doctors are surprised, despite being disappointed and angry. America was not prepared. Public health officials who know better are not empowered to take action or influence lawmakers. There is no money to be made in prevention and preparedness. This is why our healthcare system is so much more expensive than any other in the world. Although I am a strong supporter of the benefits of our system that do indeed lead to innovation through competition and incentive, we have gone too far in ignoring basic public health measures that are well vetted and studied to ensure the health and protection of our society.
Money can be printed. Especially at a time in history when the gold standard no longer exists, money is truly an arbitrary measure of value created by human beings to transfer goods and services. Life cannot be printed. Of course this is an understatement and I am not wiser than the fool to state it, but how often we forget it.
Regardless of how we got here, doctors and nurses are now on the line. We have spent years watching the medical profession be seized by policymakers, lobbyists, administrators, lawyers and insurance companies. The result is an expensive system that no longer serves patients, doctors, or nurses as intended. Billions of dollars in profit have been shaved off by people that have no MD, DO, or RN degree to their credit. All the while patients are in more debt and health care workers have had to work double with increased risk and less income. We were already pi**ed off.
Now comes along a pandemic. After years of beating, doctors and nurses are at heightened risk of death because all of the vultures who r***d the system failed to prepare back up measures for crisis scenarios, from federal, state and local levels. Without calling anyone out, claims that “no one could have predicted this” are absolute bu****it. Anyone involved in infectious disease and public health could have told you that a pandemic was inevitable. Now we stand face-to-face with it armed with makeshift face masks and inadequate access to testing and resources.
Preparation would have been far cheaper than a 2 trillion dollar bail out package. But the cost of failure to prepare will be paid by innocent citizens and health care workers. Nonetheless, doctors and nurses are being asked, and in some cases forced to risk everything to honor their oaths. Are we being taken advantage of?
There is no cure for Covid-19. Current measures by doctors and nurses will not cure this infection. They will only expend a tremendous amount of passion and effort in the hopes that the body will pull through and survive. Futile in many cases. Current policy serves only to preserve what few resources actually exist. Evidence is lacking. Protection of doctors and nurses is not a priority in making recommendations because the situation is so dire. Are doctors and nurses to blindly follow the orders of vultures in futility?
No doubt many people in leadership, administration, and government have an earnest desire to do right. But their failings are having disproportionate consequence on doctors and nurses. I am in a community where the wave has not hit., and it may not. There is great anxiety and stress in this uncertainty, but no doubt lesser than that of those in large cities overloaded with the sick. So as doctors and nurses are subject to death, illness, stress, fear and confusion, when do we question the oath that we took to do no harm and care for the sick?
Fortunately for Americans, I assure you that the majority of doctors and nurses will not back down. They will not pass on these consequences of failure to the innocent citizens they stand in front of. They will stand strong and do what they can. We will honor our oaths not fully knowing the cost. The time to reconcile the consequences with the cause will come. Those who have failed Americans will need to be held accountable. The time for democracy to prove its worth will come. Doctors will honor their oaths. I plead them to advocate for change when the time comes.
Secure First
