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Dn over 30 years as a medic and officer in the US Air Force and Air National Guard, including deployment to Iraq, I have witnessed close to combat trauma and fatigue. I have seen the immense toll that relentless physical and emotional stress takes on the minds and bodies of soldiers – people in perfect physical condition.
It worried me to see this same fear and exhaustion among young doctors recently as I did a 100 hour, seven day teaching internship at a small community hospital near my home on the North Carolina coast. South. Fueled by the deadly Delta variant and a low vaccination rate, the fourth wave of the pandemic is punishing my beloved home state, pushing the local health care system to its breaking point. Our community hospital was operating at over 100% of capacity last month, a time when all responders are on deck, which means long and intense days with clinicians and other healthcare workers often working on duty. extra shifts to fill staff shortages.
Hour after hour, day after day, patients with Covid-19 fill the hospital’s intensive care unit. Intensive care beds spill out into the hallways. The young doctors and residents in my group worked tirelessly and took on any challenges that were thrown at them. But it has been impossible to escape the enormity of this health crisis, and despite our best efforts to lean on each other, the mood is grim.
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For the first time in this pandemic, and for the first time in nearly four decades of medicine, I worry about the future of medical care in the United States I worry about what we have asked young doctors, residents and even medical students to take responsibility for the past 18 months and the lasting impact of the physical and emotional trauma they are experiencing.
Above all, I fear that an entire generation of young doctors, confronted closely with the horrors of this ever-evolving virus, will at some point rethink their commitments to medicine and choose careers that are less emotionally taxing.
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Almost two years after the start of this pandemic, no one can say for sure what the ultimate impact of Covid-19 will be on medicine, on the U.S. healthcare system, and on the national psyche. But it is impossible to experience it on the front line and not to feel fear and dread for all healthcare workers – doctors, nurses, respiratory therapists, laboratory and radiology technicians, service providers. food, security personnel, housekeepers and all other hospital staff in the country.
Doctors were under enormous pressure long before the arrival of Covid-19. More than 4 in 10 physicians will be of retirement age over the next decade – including me – at a time when the baby boom generation will need more intensive long-term care. Added to this is the exorbitant debt of medical students and a steady increase in physician burnout resulting from over-regulation and other ever-growing barriers to patient care. It’s no wonder the country faces a shortage of up to 124,000 doctors by 2034.
The same concerns can also be raised about the nation’s chronically overworked nursing community, nearly 4 million strong, which has endured so much this pandemic and is facing its own staffing shortages over the next decade.
Years from now, I fear Covid-19 will be seen as a major flashpoint for medicine, widely cited as a reason physicians, especially those in high-intensity hospitals, have left the profession. Consider that the number of Covid-19 patients at my community hospital in South Carolina has gone from zero on July 1 to an average of 50 over the past three weeks. The vast majority of them – all but three – are not vaccinated against Covid-19, and the influx of patients has forced the hospital, once again, to delay or cancel all non-essential surgeries and procedures .
The number of deaths is also increasing: people in their 40s, 50s and 60s, many of whom do not have serious underlying issues. Much has been learned from the early stages of the pandemic about the care and treatment of Covid-19. But if someone does not respond to the proven treatments that exist, there is little else they can do but bring their loved ones together – fully dressed in gowns, masks, face shields and other personal protective equipment – for a last goodbye.
These heartbreaking scenes take place every day in hospital intensive care units. And while doctors are well trained to deal with the death of a patient, what we cannot stand is the fact that the vast majority of those deaths would not have happened if the person had been vaccinated. Science has given us weapons to fight the SARS-CoV-2 virus, but far too many Americans are choosing not to use them. It’s hard to watch, not only for surviving family members, but also for doctors, nurses and others who have to attend a multitude of bedside memorials every week.
Our best chance to ease the burden on healthcare workers is to continue to build confidence in immunization, one person at a time. But it’s not easy, even for doctors like me who know half of the Covid patients entering their hospitals. These are people and families that I have helped during other medical emergencies or that I have met at social events in town. Or, in the case of an unvaccinated 40-year-old man with Covid-19 whom I intubated last month, someone I had served as the Commander of the National Guard for. He died three weeks after being admitted.
Trying to break through the bubble of vaccine misinformation is emotionally draining. Trying to reach people who would take your medical advice on anything except Covid-19 vaccines is exhausting and frustrating.
But what choice do doctors have? We have a duty to be advocates for science and quality medical care, but we also have to listen to our patients and their concerns. This can sometimes be an untenable position.
One thing is certain: we must support each other, especially the young doctors who are suffering the full brunt of Covid-19, and continue to be the leaders our colleagues and our nation need at this most urgent time. .
Gerald E. Harmon, family physician, is president of the American Medical Association.
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