EricC's response reminded me of the following story from last year. To add a 
little tasty sugar to the message, imagine hospitals with full ICU and ED beds, 
with entire floors closed because 40% of the staff is out sick or simply quit 
from burnout, etc. I guess we'll all be better off when the hospital staff are 
all emotionless robots. Free speech will surely flourish at that point.


https://threadreaderapp.com/thread/1333391178738274305.html
Thread by @tnicholsmd on Thread

He came in by ambulance short of breath. Already on CPAP by EMS. Still, he was 
clearly working hard to breathe. He looked sick.  Uncomfortable. Scared.  As we 
got him over to the gurney and his shirt off to switch a a hospital gown, we all 
noticed the number of Nazi tattoos. 1/

He was solidly built. Older. His methamphetamine use over the years had taken 
its usual toll and his teeth were all but gone.  The swastika stood out boldly 
on his chest. SS tattoos and other insignia that had previously been covered by 
his shirt were now obvious to the room. 2/

“Don’t let me die, doc.” He said breathlessly as the RT switched him over from 
CPAP by EMS to our mask and machine.  I reassured him that we were all going to 
work hard to take care of him and keep him alive as best as we could. 3/

All of us being a team that included a Jewish physician, a Black nurse, and an 
Asian respiratory therapist.  We all saw. The symbols of hate on his body 
outwardly and proudly announced his views. We all knew what he thought of us. 
How he valued our lives. 4/

Yet here we were, working seamlessly as a team to make sure we gave him the 
best chance to survive that we could. All while wearing masks, gowns, face 
shields, gloves. The moment perfectly captured what we are going though as 
healthcare workers as this pandemic accelerates. 5/

We exist in cycle of fear and isolation. Fear of getting sick on the front 
lines. Fear of bringing a virus home and exposing our families.  Fear of the 
developing surge of patients. Fear of losing our colleagues. Fear of not having 
what we need to take care of patients. 6/

And isolation because we don’t want to be responsible for spreading the virus, 
knowing that we are surrounded by it on a daily basis. Isolation because no one 
else can truly understand this feeling, these fears, the toll of this work. But 
we soldier on. 7/

Unfortunately, society has proven unwilling to listen to the science or to our 
pleas. Begging for people to take this seriously, to stay home, wear a mask, to 
be the break in the chain of transmission. 8/

Instead, they’ve called the pandemic a hoax, called us liars and corrupt, told 
us we are being too political by worrying about patients dying and trying to 
save lives.  They’ve stopped caring about our lives, our families, our fears, 
worried only about their own. 9/

He was already on high respiratory support and still working hard to breathe so 
I asked him about his code status and if he would want to be intubated, knowing 
that was all but inevitable and before the hypoxia made him more confused and 
unable to answer. 10/

He said that if a breathing tube was the only way he could survive, he wanted 
us to do everything we could. So we would. We were out of other options by this 
point, so we prepared. 11/

I’ve faced these situations countless times since medical school.  Not the 
intubation - which is routine at this point for me and my team. The swastikas. 
The racist patients. Every single time I feel a bit shaken, but I went into 
this job wanting to save lives... 12/

... and every single time I’ve been able to smoothly and quickly move though 
those emotions to do so. “They came here needing a doctor, and dammit Taylor, 
you’re a doctor” is a mantra I’ve repeated to myself when I feel like my 
empathic core wanes. 13/

As I stepped out of the room to gear up for a high risk procedure and grab 
equipment, I checked my PPE. I had my N95, face shield, gown, gloves. Was I 
safe? Was my team safe? I pause to check and make sure I had all my equipment 
and backups if needed. 14/

I run through the meds and plan with the nurse and RT. I pause. I see the SS 
tattoo and think about what he might think about having Jewish physician taking 
care of him now, or how much he would have cared about my life if the roles 
were reversed. 16/

For the first time, I recognize that I hesitated, ambivalent.  The pandemic has 
worn on me, and my mantra isn’t having the same impact in the moment. All this 
time soldiering on against the headwinds, gladiators in the pit.  And I realize 
that maybe I’m not ok. End/



--
glen
Theorem 3. There exists a double master function.


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