I practice medicine in the suburbs west of Washington, DC, and everywhere I look I see 30 or more inches of snow. I keep reminding myself of where I am –not unlike a man pinching himself to ascertain wakefulness–because the view my window affords me is tailor made for the usual snow typical to Buffalo, NY. Two days after the snow stopped falling, schools are cancelled indefinitely, most side streets have yet to see a plow, and tens of thousands are without electricity including my partner’s family huddled together like in a dark basement enjoying the extra two or three degrees of warmth to be found there.
It is hard, but not impossible, to practice medicine when the pace of modern society grinds to a halt. Yet at least we, here, enjoy the benefits of living in a country with a well developed infrastructure prepared to rebound instead of recoiling from nature. To compare our “snowmageddon” (a term used on the news here) and the earthquake in Haiti would be both inappropriate and naïve; yet, our daily lives have distinctly altered and in that an understanding of the fragility of society and the responsibility of a physician is possible. Still, there are many differences. We ask when our power will be returned, not if; snow will melt, but buildings don’t un-crumble; and while my neighbors shiver together in their homes, many Haitians seek their loved ones with a shovel.
I know a few physicians who have been to Haiti and spoke with another today whose trip is planned for next week. I admire them all. Another doctor recently returned from Haiti was on the local news last night, shoveling the mountain of snow that had been waiting for him on his return home, a smile was on his face. Tbhe story they tell of Haiti isn’t funny, it is one of an absent medical infrastructure and chaos; and still they go. One doctor described the coordination of Haitian medical relief as being akin to a group of five-year-olds playing soccer. Another story tells of doctors fleeing an angry crowd surrounding an unequipped hospital, their guards brandishing M16 rifles.
Nothing we see here could ever compare to these stories. However, people have died of carbon monoxide poisoning, accidents, and the inevitable snow-shoveling heart attacks. My concern must be with my family and patients here and now. What do they need? What role should I play to best serve them today? We have been unable to open our office, let alone get to it but my practice does not rely on seeing patients face-to-face to treat. We don’t have to generate insurance paper-work to keep the lights on or meet our over-head. Our laptops are open and pharmacies are filling our prescriptions. In our practice we continue to care for our patients using the telephone and email to apply basic triage to patients we have already met and know. Most phone call visits are limited to upper and lower back pains plus a medley of other sore muscles, ligaments, and then attitudes as the forecast for Wednesday morning’s weather included up to 20 more inches of snow for our area.
American doctors, fortunate enough to practice medicine in the 21st century, should not become complacent or too dependent on the daily flow of patients through our offices. We must be able to adapt to circumstance and react to emergency. Society will depend on us and I, for one, am optimistic that our profession stands ready and will meet any challenges thrown our way as evidenced by recent events. The bravery of physicians volunteering in Haiti ennobles our entire profession and we can all feel pride in their actions. The responsibility towards all of our patients will not lessen after unforeseen events. Rather, it will increase and the chance to respond magnificently awaits us all as we support our patients in the seemingly mundane affairs of day-to-day living.
Until next week I remain yours in primary care,
Steve Simmons, MD