As our calendars roll forward into the month of June, the summer season brings thoughts of family vacations, graduation ceremonies, and outdoor gatherings to many. But for me and others along the Gulf Coast, June 1 carries added meaning as the first day of the “fifth season.” Hurricane season.
Hurricane season brings months of planning, forecasting, and preparation. Having practiced in south Louisiana for over 25 years through residency and beyond, I have witnessed the impacts of these natural disasters at both a personal and professional level. And while it is some of the most meaningful work I have been part of, it also exposes the harshest of conflict between personal and professional life, as well as amplifies the disparities present in our health care systems.
On an individual level, taking a last look at home when faced with voluntary or mandatory evacuations, one must decide what matters most in life. What to bring with you, what to leave behind. Survival decisions at times have us think with the heart, not with the mind. Where does our health fit in compared to physical possessions, to the safety and well-being of those we love? Sadly, these decisions are also impacted by wide variation in personal and financial resources. For many, options are severely limited, adding to the desperation and fear already present.
As a physician, practicing just far enough inland of the evacuation areas of our coastline, these storms bring an unsatiable conflict between personal and professional obligations. For my colleagues and me, these professional duties include not just our “usual” clinic and hospital care, but also our assistance in temporary medical shelters in our city. How can one hope to find “balance” when choosing between personal family needs and our calling to provide care to our patients and our communities in times of heightened need? How can one find time to prepare your own home and safety while work needs you more than ever? How can equitable workforce decisions be made on who can stay behind versus who can choose to leave? As a mother of young children during my first few major hurricane shelter experiences, I found my having the benefit of incredible local family support gave me the freedom to fully embrace my calling to the community, yet did not relieve the guilt of leaving my children for others to protect and comfort. These conflicts affect not just physicians, but all members of the vital health care teams needed to provide care. But I have also found that caring for people in these moments reminds me of the power in human interaction as physicians, providing comfort and understanding in times of tremendous uncertainty and vulnerability.
For our health care systems, storms of this magnitude bring environmental impacts to the community as a whole, but also to the health care infrastructure. Climate change promises to only further enhance the potential frequency and severity of storms and their impacts, and the American College of Physicians (ACP), my professional home, published a paper on the health impacts of climate change. In addition to the storms themselves, environmental change brings new and shifting geographic patterns of infectious diseases and other health conditions. How will changes to vaccine recommendations and access to health insurance further exacerbate these shifts? Natural disasters expose and amplify the disparities present in health care as well as in community resources and support systems. Although no one is spared, those with means have some advantage in weathering the storms. Those most vulnerable, even before the storm, suffer disproportionately, both in immediate impact and in hopes for long-term recovery. Another ACP paper looks at the impacts of social determinants of health.
And so, as I face the start of the fifth season with some fear and worry, I choose to focus on what matters most in both my professional and personal life. I choose to create within me a renewed resolve to bring comfort in times of fear and desperation, to lead in times of chaos and uncertainty, and to continue to demand better for our patients and our health care systems.
Angela C. Johnson, MD, FACP, is a member of ACP’s Board of Regents, the main policy-making body for the college. Dr. Johnson is an internal medicine physician who is currently professor of clinical medicine and section chief of internal medicine at the Louisiana State University (LSU) School of Medicine’s Baton Rouge campus.
The American College of Physicians is the largest medical specialty organization in the United States, boasting members in over 145 countries worldwide. ACP’s membership encompasses 163,000 internal medicine physicians, related subspecialists, and medical students. Internal medicine physicians are specialists who utilize scientific knowledge and clinical expertise for diagnosing, treating, and providing compassionate care to adults, spanning from those in good health to individuals with complex illnesses. Stay connected with ACP on X @ACPIMPhysicians, Facebook, LinkedIn, and Instagram @acpimphysicians.
