Working as an emergency physician at a level 1 trauma center and as an Army reserve officer, you learn to expect the unexpected – but working as the ER doctor taking care of patients impacted by the most deadly and destructive wildfire in California history last year changed me.
As I walked into work last year to start my clinical shift as the attending emergency physician, our hospital began receiving multiple patients with severe fire injuries. In only a few hours, our emergency department quickly filled with additional fire victims with multiple patients requiring intubation, resuscitation, and escharotomies (a surgical procedure to treat severe burns). The scale of the disaster was immediately apparent to those working as we moved quickly to triage, stabilize, and treat the countless patients that had arrived.
Despite the immense suffering, loss, and death I witnessed that evening, what is also shocking is the continued threat that fire continues to have on the lives and welfare of Californians across our great state – and the need for immediate political will and policy solutions.
The Camp Fire tragically illustrated the lack of infrastructure investment in rural communities and the lives that were lost as a result. My patient’s stories highlighted the real impact and vital solutions needed to be better prepared in our emergency response. While it has become increasingly clear to the public how an outdated and poorly managed electrical line sparked the fire, patients also described to me the impact of unreliable communications systems, which made the emergency and evacuation notifications less effective. Moreover, patients described the lack of adequate roads for the evacuation of people trapped by the fire.
The threat and impact of fire have also economically devastated millions of Californians. In addition to multiple other destructive fires throughout the state, the PG&E power outages, and the lack of access to affordable homeowners insurance, continue to plaque Californians’ livelihoods. The PG&E power outages have put a spotlight on corporate incompetence and malfeasance in a decades-long failure of PG&E in putting their shareholders’ dividends ahead of maintenance and public safety. I have also seen the financial impact of this emergency on the availability and cost of fire insurance for homeowners and the growing concern by counties on the loss of property tax revenue to support essential services in our communities. With property tax revenue being a major contributor to fire services, this makes for a continued disastrous economic and emergency preparedness impact.
In addition to my work as an ER doctor, I realize the need to advocate for my patients outside the hospital. Our democracy is at its strongest when we collectively work to improve issues affecting our daily lives by sharing our voices. We should all be asking our local, state, and federal officials what their plans are to solve this emergency. Taking care of emergency patients requires a team-based approach, and it will require a collective voice to manage and mobilize this state of emergency.
Joshua Elder is an emergency physician and can be reached on Twitter @joshuawelder.
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