What happens when your faith, commitment and professional integrity collide with great personal risk? This is what I imagine is happening across the country to physicians, nurses and other health care workers as we all face the Ebola tragedy.
Sure, people dying in far away Africa bring an ache to our hearts. Admiration for those working with aide groups brings the passing thought so easily conjured from the safety of our homes: I would go if I didn’t have … fill in the blank: young kids, aging parent, needy spouse or any other valid reason.
But now the newest scourge is here: Ebola is causing fear and panic across hospitals and clinics as we face the latest Armageddon. For those of us who grew up in the pre-AIDS era, we feel deja vu — but with a strong twist. We examined young HIV infected men’s open lesions with barely a glove. And fortunately we survived untouched. This seems different even though the CDC says the transmission is the same. The virulence, the fluids or some other factor is making this outbreak seem like a B horror movie.
I work with young physicians in training: devoted, caring and hard working. They serve as part of the front line in our hospital and clinic. Each is silently wondering, what if it’s my night on call? What will I do? Every nurse is wondering about the lottery of shifts and what they have to lose when it’s their turn to care for an infected patient.
As with all great fear, the actual fear may be larger than the real risks. But the shifting messages from the CDC leave us with doubt. The protective gear training seems inadequate and fraught with danger. The infection control team’s basement desk looks protective and reassuring compared to facing a patient with a fever from Liberia in the flesh.
Where does that leave the Hippocratic oath? How does the pledge of healing the sick feel now? Where is our faith in our own commitment? It’s still here but challenged in a new and frightening way for this generation of health care workers.
As a teaching physician, I am left to counsel quietly trembling doctors and staff who cringe at acknowledging their perceived weakness. What can we do? I can mostly offer facing our fears together. We can use a buddy system to care for a patient — allowing a trusted colleague to watch for breaches in protocol and giving timely advice on how to handle a retching, bleeding soul. Because souls they are and we have pledged our lives — but we do not need to be reckless. We do need an abundance of caution, above the CDC guidelines, and a renewed faith in our government to screen and detain travelers.
While our nation’s physicians, nurses and health workers commitment may be strong, our faith in the ability of hospitals and government to protect us is wavering. However, the confidence in our pledge to heal can be propped up with real solutions from our leaders. We need enhanced safety from our facilities, an organized response from our health care systems and the strength that comes from facing our fear of death together.
Pamela Davis is program director, Northridge Family Medicine Residency Program.
