The crisis has refocused us with laser-like intensity on what matters most: the patient in front of us.
We’re working with limited resources even in Boston — out of basic critical care sedatives and analgesia, unable to utilize advanced imaging and other technologies due to the risk of spreading the contagion. Despite all that, we’re showing up in force, in New York, in Boston, everywhere. We’re showing up because this is what we were born for, especially for those of us in intensive care. This is what we’ve trained for.
Every patient is sick. Every patient needs our particular expertise. We’re working overtime and volunteering to staff the COVID ICUs, which expand with new teams and new beds pulled from thin air every week. It is amazing to see the drive, the passion, the camaraderie. We know who we are.
But what scares me the most about this crisis is the knowledge — the certainty — that we were already burned out in February. We were emotionally exhausted, we felt like our work was meaningless — all EMR, no patient — and we were cynical.
Although the pandemic has given us our own surge of energy and enthusiasm, I worry. I worry because I know we can’t fuel a broken health care system with enthusiasm anymore — the fumes of that fuel burned out years ago. I worry because this pandemic will leave behind patients with chronic, undiagnosed, and untreated disease, and it will take years to remedy that as much as we can. Not to mention the many months ahead of intense care required to care for the direct victims of the virus. We have stepped up and thrown ourselves into the face of the pandemic, pouring everything into an all-out sprit.
But this is a marathon. If we don’t change the way we finance and deliver health care, if we don’t burn down fee-for-service medicine and replace it with a system funded on the moral determinants of health, we’ll be just as broken. Although patients are infected with the virus today, health care has been festering for years.