I am a general surgeon who practices breast cancer healthcare. I haven’t entered into an ICU in 15 years. I love that I get to care for patients at a glacial pace where I have an industrial amount of upfront information and make challenging decisions as a group, in part with direction from the patient and in part with my colleagues. We get to consider choices for days, weighing out options until we drill down on a plan.
I practice this way for a reason. I have made them, but I don’t like unilateral snap decisions like those required by trauma and critical care. I am so grateful that there are those of us out there who are human calculators and get all excited about vent settings, ABG results and which type of metabolic acidosis goes with what. That’s not me. While I was just fine with it when I needed to be, I’ve chosen another path and left all of my ICU hats behind.
Many health care workers have been asked to help with the expected surge in patients who need advanced care the coming weeks. I appreciate that there may be a knee-jerk reaction to say “I’m not a critical care practitioner, therefore I wouldn’t be useful”.
Even if it’s been years or even decades since we’ve had to use these skills, we should not be afraid to dust them off. All of us will be tackling new tasks and learning on the go. We will make mistakes, as will our colleagues. There will be new specific practices to care for this patient population that we may never need again. Still – there’s no excuse to not get back on that bicycle, even if it may feel a little wobbly.
I think it is important to help to our communities in this time of need. So, I’ve been reviewing critical care guides and online resources on protocols and reading up caring for a COVID-19 positive patient. I’m on several virtual physician discussion groups both time-tested and specific to this new threat.
Some doctors may choose not to help because of health concerns that make them more vulnerable to the virus. If they do not want to put themselves (or those that depend on them) at risk, that is understandable. Everyone needs to be honest about what they are willing to do (and not do) for the greater good.
All we need at this point are those of us with a foundation of basic medical experience, humility to allow ourselves to learn what we don’t know yet, and most importantly, willingness to care.
Oh, and PPE. That would be nice, too.
Heather Richardson, MD, FACS
Bedford Breast Center