Notes from the Front Line: Flexibility & Courage in the ED

Written by Joseph Ravera, M.D.’10, assistant professor of surgery at the UVM Larner College of Medicine and emergency medicine physician at UVM Medical Center

Flexibility is a must for any emergency physician. We never know what the next ambulance is going to bring.  The COVID-19 pandemic has forced us into a new paradigm. Instead of seeing pediatric patients, I’m in an outdoor screening area trying to treat low-risk individuals who may have COVID -19 in an effort to keep the ED as sterile as possible. While I feel trained and up to the challenge, there is overwhelming anxiety not knowing exactly what to do or what will come.  Give me a patient with a broken arm, stroke or heart attack and I can speak intelligently about the disease process, the treatment options, and what to expect. When a patient with COVID-19 looks at me and asks me about their prognosis, it’s hard to answer with ‘I don’t know,’ as there is so much we are still discovering about this new disease. When a family member asks me on the phone how long their loved one will be in the hospital, the answer again is unknown. I have the same response when a friend texts or calls me to ask when we will be able to ease physical distancing guidelines. We’re in uncharted territory here in Vermont and across the globe.

I try to find strength in all of the doctors and nurses that came before me dealing with the anxiety of a new epidemic like AIDS, polio, small pox, and the plague. Humanity was able to survive those ills through the courage of health care providers with far less medical knowledge than we have today. I also find strength in the incredible cohesiveness of my co-workers. We know we are going to get through this together. While we have not seen a huge surge in Vermont yet (thank you physical distancing), I know that we are as prepared as we are going to be.  We may never see the surge, and I hope that six months from now we look back on this and are thankful we didn’t have to make heart-wrenching decisions about ventilators.  All I can do now is keep showing up to work and treating patients with the same care and respect that I always do.