FigureTo the people I love, I trained for this. My calling to emergency medicine was fueled by the adrenaline of youth, a sense of invincibility, and, most intensely, by the inner hero I always hoped would be there when I needed him. I have had 19 years of that catecholamine-powered career. The surge is what keeps me going, what keeps me at the hospital 18 hours a day during the fight of my life, against a seemingly invincible yet invisible opponent. To my colleagues, you are the smartest, most innovative, most creative, and boldest brothers and sisters I have ever known or imagined. The intellectual conversations this pandemic has sparked help to keep things normal, even sane. Thinking through endless strategies to stay safe, help our patients, and even win the battle (which we will) is necessary to ground us in the science and art of medicine that have served us so well in our work. To my nurses, you are my heroes. Fearless, you are committed to your patients to a degree of selflessness that approaches sainthood. I walk into the room, look at the monitor, make my plan, and walk out to the computer to make work for you. You gown up, glove up, and mask and shield up to put yourselves immediately in front of the murderous virus that would be just as glad to attack you as it is attacking your patient. You show love in the face of death and caring in the face of the utter desperation and loneliness that you see in the eyes of your patient. I am inspired in a way that I never thought possible. You warm me with the inferno of your strength. To my patients, you do not deserve this. You are the innocent victims of an assassin you did not provoke, one that has attacked you violently, indiscriminately. We will save as many of you as we can, even though we don't have all the answers. We will try anything and everything we can to help get you through. If we cannot do that, we will ease your suffering. We will console your families, even if only by telephone. Most importantly, we will never forget you. You are the reason we entered this profession. I hope someday we will forgive ourselves for failing you. To my hospital administrators, you have held the fort. You have planned well; you have calmed our nerves. You have provided what we needed to care well and safely for our patients. I know you don't fully know what it is like to look death in the eyes, to see the pain, fear, and suffering that we see in every bed, but you have earned my respect for letting us do what we do best. To the regulators, you have failed all of us. You have tortured us for years about dust bunnies. In your infinite wisdom, you didn't see this coming, did you? You have punished us for attending to our own basic human needs while risking our lives. Interestingly, you are absent now, so I can actually sneak my N95 off for three seconds to take a sip of the water you otherwise wouldn't have let me have in the nursing station a few months ago. But if you are brave enough to be here, you better not even look at me sideways. Lastly, to our families, please understand that we love and cherish you. We are deathly afraid of infecting you with this creeping death. I am sorry that I cannot hug you, that I come and go in the early morning and the late night like a zombie in your house. I promise I'll make it up to you when this is over. Health care must change after this. It has to stop being only about sepsis compliance, door-to-needle times, and patient experience scores. Ask patients who just survived COVID-19 if they care about any of those things. I'm pretty sure that they don't know, don't care, and would rather we keep doing what we do—easing their suffering and saving their lives. It's time for change. Otherwise, I'm afraid the doctors, APPs, nurses, and allied health professionals will no longer be able to face the previous reality of micromanaged, overregulated, financially driven, and non-patient-centric care we have all endured. I liken my awakening to the scene in “The Matrix” where Keanu Reeves has to decide between the red pill and the blue pill. This global pandemic has not offered me the choice, but rather has rammed the red pill down my throat, and my mind has been freed.
