Letter from the Chair

How does one even begin this letter?  I humbly sit in front of my computer with a thousand thoughts zooming through my brain, with a heart that is overwhelmed with adoration and yet simultaneously broken with sorrow and a mouth that is temporarily silenced.  There are so many layers of how and why we got to the place we currently exist.  And here we are: at the Front Line; bruised and battered but moving forward; one day at a time, one shift at a time, one patient at a time. For those of you who don’t know, I was one of the founders of my institution’s High-Risk Infectious Disease (HRID) aka “Ebola Team.”  I was the medical director and the main instructor in this team’s training.  Part of the didactic portion of the initial 3-day course was “team dynamics.”  I would explain to them that modern healthcare was often in a pyramid design with the patient placed at the highest point or apex and then with all the healthcare workers positioned underneath in varying layers depending on their role.  I was adamant the trainees realize in our HRID unit the “pyramid” structure was obsolete and dangerous.  Instead, we introduced a “wagon wheel” approach.  Everyone in the HRID unit was valuable, needed and equal.  Everyone was a “spoke” on the wheel and that included the patient.  No one’s health or safety was above or below the other.  For if any spoke became weakened or broken, then the whole wheel became non-functional.  Friends, my trainees were volunteers who chose to work in a high-risk infectious environment.  They boldly entered the unit with the confidence training and high-tech protective gear provide.  We, as Emergency Medicine physicians, now find ourselves thrown into a new world for which many of us feel unprepared.  Not unwilling, please don’t misunderstand….no, we are a group of “do-ers” who instinctually want to fix and help.  But unprepared and unprotected, yes.  I urge you all to be a voice in this unprecedented time for modern healthcare.  I know that we have been saying for at least a decade that there were not enough hospital beds, not enough ventilators, etc.   I know that.  You know that.  Please don’t be silenced.  You are not a layer in a pyramid.  You a vital spoke in a complicated, ever moving wheel that without you will fall apart. 

You are the Front Line.

Kathy Lehman-Huskamp, MD, FACEP, FAAP
Medical University of South
Carolina
Associate Professor
Pediatric Emergency
Medicine
American College of
Emergency Physicians
Chair, Disaster Section