Emergentology
2021; Lippincott Williams & Wilkins; Volume: 43; Issue: 10 Linguagem: Inglês
10.1097/01.eem.0000795824.73754.f4
ISSN1552-3624
Autores Tópico(s)Paranormal Experiences and Beliefs
ResumoFigure: EP life, COVID-19, burnoutFigureI'm eight days overdue in writing this column. I just don't have much to say right now. (Strike that. I have plenty to say—ask my colleagues.) But none of it is productive anymore. I've been writing this column for 10 years, if you can believe it. I started just after graduating residency, right before my 31st birthday, and now I write what is, at least for a while, my last column, just after I turned 41. It's been an absolute pleasure to have a space to output my thoughts and feelings over the past decade. As I scroll through my 120 columns, I don't know that I had a clear theme, but I thank my editor, Lisa Hoffman, for giving me the space to say whatever I wanted to you readers. It's been a privilege to have your eyes for a few minutes each month (fully acknowledging that it's probably while you're looking for something to keep you awake at 3:47 a.m.). I really wanted to have some sort of profound reflection on emergency medicine or what I've learned from writing about medicine for 10 years, but unfortunately, COVID has taken that from me too. Out of Ideas I just don't have anything insightful or interesting to write about these days. I keep a running list of column ideas on my phone, and I haven't added a single one in months. I don't want to write about COVID; I'm tired of it. I don't want to write about vaccination; I'm exhausted by it. A few months ago, I started seeing reports of the delta variant on social media, and it felt just like reading about COVID decimating Italy in February 2020. I wanted to believe we had learned our lesson and heeded a warning or two. There's a quote misattributed to Winston Churchill (it was actually said by Israeli politician Abba Eban long after Churchill died): “You can always count on Americans to do the right thing after they've tried everything else.” It feels applicable here. It is ironic, sad, depressing, frustrating, angering, disgusting, pitiful, idiotic, selfish, and mind-boggling that we're seeing vaccination rates go up seemingly only due to hospitals being overwhelmed and patients needlessly dying. Is that what we've become? In our time of greatest need, when our health care workers have literally begged people to do this one safe thing to help others and prevent hospitals from being overrun again, we have fallen flat on our faces. It feels like we're about a third of the way into a 5K run and thought, “Sheesh, this is hard! I'm out of breath! Why don't I just walk the rest of the way?” If this were a zombie movie, the United States would be the clueless guy wearing headphones and eating Twizzlers, completely oblivious to the approaching horde. Dead in the first three minutes of the film. Whenever I'm writing these columns, I always want to have a solution at the end: “OK, Graham, you've spent the past 750 words complaining, so what should we do if you were in charge?” I don't really have an answer. Not a Robot Every single one of us in emergency medicine is hurt. Damaged. Tired. Upset. Disappointed. I look back at some of my columns with naïveté, thinking, “Wow, you thought things were bad back then? Just wait!” I haven't slept well since March. Of 2020. I've seen doctors and nurses go from a standard, mild annoyance at a ridiculous chief complaint to immediate, vocal anger. It is hard not to be frustrated. Patients don't really get it or seem to care that their doctors and nurses are having a hard time. Unfortunately, I think we've taught them that they're always right, that anything they consider to be an emergency is an emergency, and that to keep them happy, it's appropriate during a pandemic to come to the ED for anything, anytime. I'm not sure I agree with that anymore. And maybe, in a finish-with-a-solution way, I'll end with this: It's important that we talk with each other about how we're doing, and it's important that we share our stories and thoughts and feelings. The old medical mantra of “don't share; keep it inside” is a failed approach to human beings trying to heal other human beings. Psychiatrists have therapy sessions to help them deal with the burden they carry from their patients, and if the medical system wants to keep its doctors and nurses (and not just burn through them), we need to have a place to share, connect, celebrate, and even grieve with each other. Ironically, the same complaints we all share—“I'm not a doctor robot; I'm a person”—exist because we're part of a system that exists to fix problems, not help humans. A final thank you to all of you who've read my columns over the past 10 years, to Emergency Medicine News and my editor, Lisa Hoffman, to my husband AJ, and to my parents who always encouraged me to be curious and try to make sense out of this strange world. You can find me @grahamwalker on Twitter still trying to make sense of the world and also sharing sarcasm and memes. Share this article on Twitter and Facebook. Access the links in EMN by reading this on our website, www.EM-News.com. Comments? Write to us at [email protected]. Dr. Walkeris an emergency physician at Kaiser San Francisco. He is the developer and co-creator of MDCalc (www.mdcalc.com), a medical calculator for clinical scores, equations, and risk stratifications, which also has an app (http://apps.mdcalc.com/), and The NNT (www.thennt.com), a number-needed-to-treat tool to communicate benefit and harm. Follow him on Twitter@grahamwalker, and read his past columns athttp://bit.ly/EMN-Emergentology.
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