One Team, One Fight

Hesham A. Hassaballa: This is Healthcare Musings. I'm your host, Dr. Hashem Hasabala. Welcome to Healthcare Musings, everybody. Happy to have you with me. I'm reflecting on the fantastic and insightful conversation I had with Dr. Rod Fontanet. He's one of my partners. He is a board certified emergency medicine physician and a board-certified critical care physician. And we had a very fun back and forth on the episode entitled ERIC Wars. Where you know I can finally say what I've been wanting to say to emergency medicine physicians for a long time, but didn't have the courage to do so. It was it was great. And what I came away with was such a greater appreciation and understanding of the difficulty of being an emergency medicine physician and the fact, and I wrote this in my re newsletter reflection about the episode. You can check it out that the that the brokenness of the healthcare system falls on the shoulders of emergency medicine clinicians all the time. And that it's part of the reason why there's a lot of burnout in emergency medicine. And and I, you know what? I I couldn't do it. I did one shift, like I said, and I said, this is for the birds. There's no way that I could do this. and in if somebody who's not in the field listens to that. Episode, you know, I said to him several times, you know, you just you put you you put them on biped for for 20 minutes and then you say, Well, they failed, and then it becomes my problem. Or, you know, you give them a cup of coffee bolus, and then they're still hypotensive, as they probably are going to be. You start them on vasopressors, and then it becomes my problem. And and people be like, What do you mean it's your problem, right? And again, that's just you know, internal talk between physicians, and still when I thought about that. It's not a problem. It's not my problem. it's it's my privilege. It's my privilege to to to care for that patient. Now, I think I have a duty as an intensivist to protect the resource of critical care beds because there's a fixed amount of critical care beds, and we can't keep taking non-critical care critically ill patients because then the next one who is really critically ill, the most dangerous place for them after resuscitation is to sit in the ER for hours and hours waiting for an ICU bed because they it's just the the emergency room, nothing against the clinicians. The emergency room is just not equipped to handle ICU patients, critically ill patients. They just are not. It's just not what they do. So yes, I have to be a kind of a judicious steward of that resource. And it's not a problem. It's not a burden. It's my privilege. It's it's what I it's what I want to do. And and that's why at the end of the episode, and this is one of this is the main s brunt brunt of this reflection today, is he said in the military, they say, one team, one fight. Because I think in the military, you know, they have branches, they have the air for he was he was he he was in the air force. They have army, they have navy, they air force, they have marines, Coast Guard. National Guard rights have all these branches, and it's very easy, just like in medicine, just like we have the us and them, and it's the ER docs versus the intensivists versus the hospitalists versus the surgeons versus the the anesthesiologists. Everyone can go into their silos. Well, I'm in the in in the military. I'm sure there's that there's that silo thinking. And so they always try to remind themselves: one team, one fight. The military's one team. We are one. We are one team fighting the war to defend our country, right? And I and I my you know my hats off to everyone who serves in the military. They're doing something that I am too cowardly to do. So thank you for your service. one team and and and and we're all one team. We're all on the same team. The emergency medicine physician is on this is as is on my team. The hospitalist is on my team. The surgeon is on my team. The cardiologist is on my team. every is every clinician in the hospital, in the outpatient setting, they're on my team. We're all on the same team. and and we have to we have to keep reminding ourselves of that. It's so important. And I mean in in our group and sound physicians, we're literally on the same team. We're we're one medical group, right? With hospital medicine, anesthesia, emergency medicine, and and and any hospital that's privileged to have multiple service lines from sound, we are on we are out we're literally on the same team. We you have to keep reminding ourselves and not It's so easily, it's part of human nature to become tribal. And we have to resist that that that temptation to to to retreat into our tribes, into our silos. And remember, we're all one team. We're all one team. We're all in it together. And then he, you know, one team, one fight. Just like of the the military has the fight against the enemy. Well, what is our fight? We're all in it for the patient. So when you when someone hears, my God, it becomes my problem, well, it's not a problem. My job, my privilege, my duty is to take care of that patient. And that's the other thing. We can never forget why we're here is for the patient, to care for that patient. And what's that fight? That fight is the fight against illness to to to help the patient battle illness and be as well and healthy as possible. with critical care, we are battling a fierce enemy of critical illness that is literally actively working to try to kill the patient. And we are literally actively working to try to stop that from happening as best as possible. And thank God we're successful most of the time. That's the fight. We're all in it together. You know, he he he told me, we need you. We need the ophthalmologist. We need the surgeon. We need the hospitalist. We need the intensivist. We need to well, you know, his job is to take care of them. There, they come undifferentiated, resuscitate, start the the treatment plan, and then hand off to us where we continue the the treatment moving forward. And then the fight is the same. This the patient is at the center of what we do. And so just like in the military, one team, one fight. We in medicine, we are one team, one fight. And we can't forget that. And I love that he said that. And it's going to be something that I'm going to continue to try to remind myself over and over and over again. What's the point? You know, and I told them my pledge to be nicer to emergency medicine talks whenever I'm I'm either a telemedicine shift or I'm on site. because I I have a much better under understanding and appreciation of what they're going through. And we have to remember always, always, it's not a problem. You know, I you know, I said it, whatever. And this is the this is the reflection. It's it's a privilege, it's a duty. And we cannot forget that we are one team, all in this together for the sake of the patient, and we are all waging the same fight, which is the fight against illness, and in my case, critical illness, and in in many cases for the emergency medicine physician. And APP and clinician critical illness, it's the same fight again for the sake of the patient. And I am so grateful and so privileged to be on that team and fighting that good fight. Thanks everybody for your time and attention, and we'll see you next time on Healthcare Musings. Thanks for listening. Healthcare Musings is a production of FaithfulWord Media. Sign up at drhasabala.com to get every episode delivered directly to your inbox. And please don't forget to give the show a five-star review. Thanks so much.