Marshall Medical M.D. Gives an Insider View

by Placerville Newswire / Jan 02, 2021 / comments

[Samuel Ceridon, Physician at Marshall Medical Center, 1/2/21]
# - This is the personal OPINION of one doctor after days of overtime work and telling some people that their worst fears have come true. This is NOT the official position of Marshall Medical.


It's 4 am.  I'm tired.

I've been up since 1 am.  That's when a young lady called me.  She has a job night-shifting it at a local nursing home - Assisted Living, not a Skilled Nursing Facility.  She's worried.  A COVID patient isn't doing well and the deterioration of health has been rapid.  She's never had to deal with this before (COVID illness), and is doing her best.  But this is too much for her.

I go to see the patient because we've made this deal, you see.  It's a committment to protect the ER and, by extension, the hospital.  We will be on call, for the duration, to assess patients in long-term care facilities and determine if transport is truly necessary.  This saves EMS time and capacity.  Likewise for the ER.  Assessing the patients at the source allows the ER and hospital to see and take care of those most in need.  It keeps them open...helps delay what may be inevitable...being overwhelmed.

The staff at these care facilities were not trained to make those decisions.  So, a group of us providers (MDs and FNPs) have made the committment to help them make those decisions - transport to the ER or care for the patient at the nursing home.

So, I'm tired.  I want to sleep.. But my brain is moving.  So, I write.  

You want to know what I'm really tired of?

Showering.  Showering before I can enter the rest of my house...before I eat dinner ( which is sometimes after 8 pm lately)...before I can kiss my wife and hug my boys...sit down and watch a movie.  Sometimes, I shower several times a day.

I'm tired of wearing masks.  Taking care not to improperly handle possibly-contaminated masks.  Washing masks.  Choosing the right mask for the occasion or situation.  Wondering if the number of times I've doffed and donned my N95 today is beyond the limit before it has to be retired or sent for 'reclamation'.

Same goes for scrubs, procedure gowns and scrub caps.  I'm tired of washing those too. (I've geeked out and purchased cloth gowns and caps to preserve the waxing-and-waning supply of disposable ones).  And towels I use when often showering.  Been washing those a lot too.

Did I say I'm tired of showering? I used to LOVE hot showers.

I'm tired of washing my hands every five minutes or using hand sanitizer every 39.2 seconds.  I'm exaggerating, but my hands don't know it.

I'm tired of hearing about shortages because, even now after all these months, supply lines of PPE can't seem to quite keep up with the burn rate we are currently experiencing.

I'm tired of meetings.  I'm tired of computers.  I'm tired of numbers...looking at them; monitoring them for climb rate; hoping for a declination; determining what they mean for the community vs. the County at large vs. the general region.  I'm tired of defending our interpretations of those numbers against the opinions of those who are truly on the outside.

I'm tired of the bickering, disbelief and blatant disregard of protocol and safety ('cause, you know, freedom!).  It's coming from those for whom I constantly pray won't need first hand experience to get them to understand that this is real.  These are the same people who disrespect me for wanting to be safe...those who tell me I can "just stay home if I'm scared".  Well, I'm not scared.  I'm concerned.  I'm worried.  And I can't stay home.

And I'm tired of explaining that.

I'm tired of the heartbreaking conversations I've had to have with people and their families about this Pandemic and how it now personally affects them...sometimes devastatingly so.  I'm tired of seeing my patients through steamed up goggles and speaking to them through a Darth Vader-esque mask system (N95 covered by a procedure mask).  I'm tired of giving human beings, that are scared out of their wits, the emotional support and human connection they despirately need to live...through a layer of polycarbonate.  I know that the extent to which I've had to suffer this particular experience has been far less than it could be...but even one episode, even one conversation has been one too many in my eyes. 

And I'm tired of explaining that too.  Numbers,  no matter how low they may be to you, don't mean a damn thing when you are the one forced to have the conversation.  ONE is a really BIG number in that case.

I'm tired.  Tired of the relentless pace we've been running since March of 2020.  We have been forced to repeatedly sprint during what has turned into a marathon.  And this second surge has hit us at a time when fatigue was starting to set in.  We were fortunate in this county during the initial stages.  Our numbers were almost non-existant.  But that made many complacent and gave many, especially the non-believers, reason to not take care and follow safety protocols, even in the face of rapidly climbing numbers.  The surge is here and the danger is real.  People are getting sick, suffering and dying, despite our best efforts.

I'm tired because that pace has picked up recently.  I'm personally on almost 3 weeks straight...even through the holidays...most days have been 12, 14, 16-hour days.  Those around are experiencing similar days.  Promised days off, even hours off have evaporated because you can't say "No" during a time like this...although the real need to say "No" is coming soon (tomorrow? Sunday?).  And...understand...my experience pales in comparison to those of my peers outside this county...some of whom I know personally.  They have had to put in far more days - filled with far more hours, and much more death and suffering - than I have had to experience.  And they truly can't say, "No"...because there is literally no one left behind them to meet the need if they leave.  They truly have to hold the line because no one else can.  I'm not in that situation yet...but how close are we from reaching that point? Should I, should those working with me, stop so we can all find out? (F*** no.)

So...I'm tired...fatigued (not yet exhausted)...of a lot of things  So, if you want to argue with me about my opinions, experience or concerns...you might just get a simple "F*** you" (or F*** off) and nothing else but a dismissal...no matter how long we've been friends or family.  I still love you, but I'm done arguing.  I'm tired of that too.

God has truly kept watch over me, blessed me and my family and kept us alive and healthy..  My experiences have been mild.  Others who are in my position have seen more, been through more and suffered worse than I have.  So, considering how I feel, I cannot begin to imagine how they feel.  

Understand, if you have been unaffected by what is going on right now...there are whole lot of people out there around you keeping you safe.  They have put in a Hell of a lot of work to allow you to feel that way.  You may not know it, but you are safe because of those efforts.

This isn't a challenge to bring some misguided counterpoint to a conversation.  This isn't even a conversation starter.  This is a rant...a venting...a stream of tired ramblings...and a release of energy so my brain will slow down and I can finally fall asleep before my morning debriefings, tasks and rounds start anew in a few hours.  Don't take as anything other than that.
Stay safe.  Look out for one another."

- Samuel Ceridon.