The coming tsunami from a healthcare provider’s perspective

Earlier this week I contacted a friend who is a healthcare provider in an urban Northeastern city. They offered to share their personal experiences and perspective on the pandemic as time and energy allow. I am grateful for their insights and commitment to serving the public. I promised that they would not be identified.

March 19, 2020
Let me preface these reflections by stating that I am not truly on the “front lines” at this moment, but I do work with both inpatients and outpatients at a large hospital in the Northeast.  My job brings me into direct contact with people who have infectious diseases, some of which may be undiagnosed, on a regular basis.  In the past, I worked in EMS through the HIV/AIDs crisis, the Swine flu, SARS, H1N1 and was never as apprehensive as I am right now.

The anxiety and fear here are palpable.  It’s like waiting for a predicted tsunami, but a tsunami scenario from which there is almost nowhere to escape.  Most of my social circle (which includes medical and non-medical people) are experiencing this same feeling.  If you aren’t concerned you should be.  Those of us providing healthcare at any level have an increasing sense of dread and worry about what is happening. We wonder about tomorrow, next week, next month and what we will be doing – fear of the unknown.  We hear the cries of our colleagues in Italy and other countries who have more sick patients than they can handle, making heart wrenching decisions over who can be saved, trying to allocate scarce equipment resources appropriately, and daily having to choose who will get the chance to live and who will be left to die.  It’s a situation that medical providers face in any disaster, but this pandemic may last months.  The weight of all of this is already taking a physiological and emotional toll.

As we reduce and eventually eliminate outpatient services and move towards telemedicine provider visits, it means that healthcare providers will most likely transition to other areas of the hospital to supplement staff.  Imagine being told that instead of your marketing job, tomorrow you will be doing engineering. You know the product and its capabilities, but you don’t know its design or how to troubleshoot problems when it breaks down.  Yes, some skills and knowledge can be carried over to another role, but there is a big learning curve…and in this case lives are at stake.  This is a scary situation for care providers because we pride ourselves on providing safe, competent, efficient, and compassionate care.  But as patient numbers increase and providers become sick, this situation is inevitable.  Angst. Worry. The feeling of impending doom.

While much of the public is shielded from hourly updates on COVID-19, we are not.  Our protocols, procedures, staffing, equipment, and communication with coworkers have all changed and continue to update throughout each workday.  As the daily stress levels mount for us, we stare in disbelief and horror at the news watching thousands of people on the beach in Florida, or out in Spring Break mobs in bars, carelessly crowding each other and spreading this virus.  We have difficult conversations with friends and loved ones who still may be amongst the “non-believers”.  We know it is real.  This is not the flu.  This is not hysteria or the fault of the media.  Get your head out of the sand before you infect your elderly parents or grandparents, your neighbor, your friends.

Some may not survive this.  Some of my coworkers may not survive this.  I don’t want to see your loved one die alone – yes, ALONE. Think on that for a bit.  That thought terrifies me and it should terrify you.  We have the benefit of learning from the experiences of China, South Korea, and Italy.  They have told us to listen to their lessons, their mistakes.  Let me tell you that I wept listening to health care providers talk about their dire situation.  It’s the recipe for career ending post-traumatic stress disorder.  I have already experienced enough sadness in the healthcare field in my prior role as a street EMS provider.  I don’t need to take on more.  But that is what the healthcare providers need to do, and what we are expected to do.  I am willing to do my part, to go where I am needed, to do anything I can to help you or your loved ones in this pandemic.  Please do your part and stay home.  My life may depend on important action.

Van Jones put his finger on it last night

Last Thursday I drove to Hendersonville, North Carolina for an annual event called Life Is A Verb Camp. On the way home Sunday afternoon I opted for less interstate and more two lane roads.

In addition to the fall-colored leaves I saw lots of Trump/Pence signs, which really didn’t surprise me as a fellow Southern rural citizen. What had been floating around in the back of mind for a long time began to move more to the front of my thoughts; how are the polls capturing the rural voter? Are they getting to us at all? Am I underestimating the urban turnout?

Last week Nate Silver of FiveThirtyEight polling and punditry kept setting aside the poll numbers at a certain point in his figuring, which dogged me about who people say they will vote for and what they will do in the privacy of the voting booth.

Last night Van Jones put his finger on what I was thinking: white-lash. It has been a large and unspoken element in the room on top of the anti-Muslim, anti-LGBTQ, anti-Semitic, anti-woman, my version of Christianity is the only one, anti-choice, denying access to affordable health care, putting profits before our natural resources, loosening gun control laws, and the list goes on and on.

I live among the voters who showed up in force at the polls and elected Donald Trump and Mike Pence; white rural Americans.

It should not be a surprise to readers of Rural and Progressive that I write from a perspective that there are two Americas, an urban and a rural America. Many rural Americans harbor some level of racism. I’ve heard it and seen it. For some people that has been the unspoken driver behind opposition to all-things Obama. And it brought people out in force to elect a TV personality whose favorite line is, “You’re fired.”

Yesterday white rural America told Donald Trump and Mike Pence, “You’re hired.”

I may live in rural America, but the not so subtle racism and divisive values espoused by Trump and Pence are not my values. And they aren’t the values of every rural American.

I’m no less proud of being a Hillary supporter today than I was yesterday, because I believe in a country where diversity is valued and celebrated. That’s the country I will continue to help build.