Defining the Path to Workforce Readiness, SEA Spring Conference May 8-10, 2020 – Rescheduled

by: Abiona V. Berkeley, MD, JD
Category: Newsletter
May
26

Thirty years ago HIV/AIDS still held thrall of the world.1 I wrote the following as I switched careers from law to medicine:

It was the call I received regarding the HIV positive man whose will I had executed one week earlier which made me reflect on the difference between the power of words and the fight for life.  The news of his death recalled the irritation I had felt at trying to get him to meet with me to devise ways to settle an estate of which the greatest asset was the eleven-year-old son he would leave behind alone.  The moment that I heard of his death, all of the work, all of the time, all of the trouble was absolutely meaningless...trite.

It was a time when doctors were afraid of their calling. Patients - people - were stigmatized. At the age of twenty-four I looked on while thinking “this is what you signed up for.” The police don’t get to say “there are bullets flying to the west so I’ll go east” and the firefighter doesn’t get to say “that building is burning, I’d better stay out here.”

It is almost thirty years later and I have kids that I want to be around to raise. I have residents who are similarly my progeny that I need to lead through this contagion, safe and strong and ingrained with the knowledge of what it is to be an anesthesiologist.  I now understand inherently, that the police officer is also afraid but she walks on towards danger.  The fireman moves forward hoping that the training, the back-up, the caution is enough.

Innovation, creativity and dedication reign in the tales being told today.2, 3, 4 Anesthesiology Chairs repurpose their departments to meet new health care demands as their faculty become internists and walk into rooms to examine COVID positive patients.5, 6 Residents at all levels work along-side faculty and CRNAs preforming highly stressful intubations in operating rooms that are now intensive care units.6 Medical students garbed in isolating personal protective equipment strive to attain the human touch and to bring back to patients their dignity.7,8 Nurses facilitate video conferencing for a family whose COVID negative mother/wife is now comfort care and otherwise passing on alone. As we turn a watchful eye to our colleagues in Ecuador, China, Martinique, Ghana, New York, Italy, New Zealand, we recognize that it is healthy to be afraid but we stand together economically and socially in growing camaraderie and international scientific fervor.8, 9, 10 At the end of the day, this is the way battle looks for us as health care workers.

The goodness of people at large is evident. Groups volunteer to make face masks for health care workers11, restaurants donate food to the homeless12, private checks are written to support numerous non-essential workers in their time of need.13, 14 We can be proud of humanity in this moment. My sentiments remain the same as they were thirty years ago, in a profession where a day is bad for all the right reasons:

If I won the lottery today, I would still want to be a doctor.

REFERENCES

  1. Merson, MH. Perspective.  The HIV-AIDS Pandemic at 25 – The Global Response.  N Engl J Med 2006; 354:2414-2417.
  2. Rosenthal, B, Pinkowski, J, Goldstein, J.  ‘The Other Option is Death’: New York Starts Sharing of Ventilators. (2020, March 26). The New York Times. https://www.nytimes.com/2020/03/26/health/coronavirus-ventilator-sharing.html
  3. Rome, B, Avorn, J.  Perspective.  Drug Evaluation during COVID-19 pandemic. N Engl J Med 2020; DOI: 10.1056/NEJMp2009457.
  4. Grein, J, Ohmagari, N, et al.  Compassionate Use of Remdesivir for Patients with Severe Covid-19. N Engl J Med  2020; DOI: 10.1056/NEJMoa2007016.
  5. Leonard, K. Pay cuts, furloughs, and layoffs for doctors, nurses, and other healthcare workers are mounting as the coronavirus pandemic hits hospitals (2020, April 9).Business Insider.
  6. Baldwin, A. Anesthesiologists hailed as special heroes in fight against coronavirus.  (2020, April8) ABC News.
  7. Heinzerling A, Stuckey MJ, Scheuer T, et al. Transmission of COVID-19 to Health Care Personnel During Exposures to a Hospitalized Patient — Solano County, California, February 2020. MMWR Morb Mortal Wkly Rep. ePub: 14 April 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6915e5external icon
  8. Gallagher, T, Schleyer, A.  “We signed up for This!” – Student and Trainee Responses to the Covid-19 Pandemic.  N Engl J Med 2020; DOI: 10.1056/NEJMp2005234.
  9. Craven, M, Mysore, M, Singhal, S, Wilson, M, et al. Executive Briefing. COVID-19: Implications for business.  (2020, April).  McKinsey & Company.  
  10. Peng, P, et al. Outbreak of a new coronavirus: what anaesthetists should know.  (Article in Press) DOI: https://doi.org/10.1016/j.bja.2020.02.008.
  11. Lipner, M. Volunteers work with hospitals to make emergency face masks for workers (2020, April, 3).  Today.
  12. Hartlaub, P. Bay Area restaurants pivot to feed the homeless during coronavirus pandemic. (2020, April 7).  San Francisco Chronicle.
  13. Carlsson-Szlezak, P, Reeves, M, Swartz, P. Understanding the Economic Shock of Coronavirus.  (2020, March 27). Harvard Business Review.  
  14. Collins, T. These are the workers the U.S. government deems ‘essential’ amid the coronavirus pandemic.  (2020, March 20). Fortune.
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