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No Man Is an Island
By Michelle B.Caughey, M.D.
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Michelle
Caughey, M.D. “All mankind is of one author, and is one volume; when one man dies, one chapter is not torn out of the book, but translated into a better language; and every chapter must be so translated. . . . As therefore the bell that rings to a sermon, calls not upon the preacher only, but upon the congregation to come: so this bell calls us all: but how much more me, who am brought so near the door by this sickness. . . . No man is an island, entire of itself . . . any man’s death diminishes me, because I am involved in mankind; and therefore never send to know for whom the bell tolls; it tolls for thee.” Meditation XVII: No man is an island... John Donne We
are all touched deeply by the tragedies in the New Orleans/Gulf Coast
area. Physicians, imagine how it might be to deliver care to
hospitalized patients without electricity, clean water, security,
transportation, telephones, beepers, the Internet, and information
access, etc. Any one of these deficiencies would create difficulties,
but all together they made it impossible to take care of the sick. We
listened, paralyzed, as the physicians at Charity Hospital described
their patients slipping away. The bells were
tolling loudly for physicians, ringing out warning that the same could
happen anywhere in the country. While communities and hospitals can’t
prepare for every contingency, there are local, countywide, state, and
federal plans of action. A former president of SMCMA, Don Cheu, M.D.,
spent much of his retirement building a more robust disaster response
organization. Even modest disaster response planning in private offices,
in homes, workplaces, and schools would benefit community members. Ask
about your hospital’s or community’s plans. Volunteer for a local
advisory board and bring your medical knowledge to bear before something
happens. Many medical
personnel volunteered immediately to fly to the disaster area and give
aid. Sadly, overall organization was so poor that it was almost a week
before outsiders made their way to the refugee centers or effectively
evacuated patients. The bell is ringing, we hear it, but there is no way
to respond. Because we might have responded, we are brought nearer the
deaths. Do we have a collective responsibility to urge our legislators
to listen, learn, criticize, and then refocus the federal emergency
management agency? Was there a cost to our own people of diverting
military resources to Iraq and Afghanistan? How do we have that dialogue
with our national leaders? Even though this
column will not be published for several weeks after the immedi1ate
disaster, I believe the need for additional medical care for the
displaced will continue for several months. Interest in volunteering
will wane, so we will try to keep you informed of medical needs in real
time. Steve Kmucha, M.D.,
forwarded a memo from the Louisiana Department of
Health and Hospitals, which briefly says that during a public
health emergency that “health care providers shall not be civilly
liable except in the event of gross negligence or willful misconduct.
This should reassure some who wish to step forward. Physicians who wish
to volunteer may contact the U.S. Department of HHS at 1-866-KAT-MEDI. For those who do
volunteer, many thanks from your colleagues in San Mateo, and please
send us descriptions, stories, and insights, so we may all learn about
disaster management. Michelle Caughey,
M.D. Physician-in-Chief
SSF 1200 El Camino Real South San Francisco,
CA 94080 650-742-2549
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