As one of the newest recruits to a well-established Plastic Surgery Department, my first reaction to the question of redeployment was ‘absolutely’, ‘no worries’, ‘wherever my services are required’.
Having most recently spent 3 years as a junior medical officer and the subsequent 7 years as a specialist surgical registrar or fellow frequenting the departments of Emergency Medicine and Intensive Care, I felt I was probably the most appropriate department member to provide my services as a ‘Covid-19 Doctor’. From what I was reading and hearing from colleagues and institutions abroad, it seemed we were all headed this way anyway.
The fortunately delayed and slowed onset of disease in Australia however, facilitated by both geography and experiences abroad, halted the need for senior medical staff redeployment… at least for now anyway. Whilst I remain ‘on the ready’, dare I say I am somewhat relieved.
As a Plastic and Reconstructive Surgeon, specialising in cancer and trauma surgery in departments of more demographically ‘at risk’ colleagues; it became increasingly evident that perhaps the most valuable place for me to provide services during this pandemic was exactly where I was.
As we entered the world of Covid-19, the war analogies came fast and frequent, and in most scenarios seem appropriate. This is a global war, and we are the soldiers. The global community is uniting against a common enemy, invisible, but deadly. Patients have and will die; some of us have and will get hurt. But it’s civil responsibility and global solidarity rather than warfare that will allow us to overcome this enemy.
While I have felt somewhat ‘isolated’ from the death and disaster, the horror stories are real and cannot be ignored. The Covid literature is plentiful, confronting and often conflicting, but it is my duty to regularly review and disseminate it as it applies to my patients, staff, colleagues and practice. This has become increasingly challenging in the digital world of vast misinformation we live in, with scarcely sourced manuscript reprints and the ever-growing ‘beast’ that is social media.
Lessons learnt from an academic career of ‘evidence-based medicine’ seems somewhat irrelevant as the lag between evidence and practice becomes ever so real and essentially impractical. Epidemiology and its application to triaging and risk assessment of patients seemed like the logical first priority. The limitations and statistical strength of diagnostic tools already in clinical practice and pending evaluation fell next in line. The search for clarification on the criteria for patient screening, hospital discharges and self-quarantine periods is ongoing. Accurate information pertinent to improving prevention strategies for our patients, staff and selves has been less pressing but of upmost importance moving forward.
The recurring themes or thought processes as I emerge from (yet another) Covid literature hole is that one must focus on what they do best (or are trained to do)… and not be afraid to embrace the ‘silver lining’ in the face of threat and disaster.
Refining policies and practices for the management of hand and reconstructive plastic surgery patients remains the focus of my everyday practice. Embracing and optimising telemedicine to ensure continuity of care for patients during and beyond these times of isolation and uncertainty. Developing and maintaining education for medical students and trainees to preserve the quality and future of our medical workforce. Reviewing and disseminating information to our patients and the wider community as our knowledge, understanding and approach to this pandemic evolves.
Dare I say the silver linings have come faster and more frequent than the war analogies as I’ve learnt to weather the Covid storm. The unparalleled camaraderie between colleagues and specialties. Displays of valour and sacrifice along most corridors that I walk. Shifting focuses in the home to mental, emotional and physical resilience. Transforming paradigms of social interaction between family, friends and the wider community.
While we cling to the optimism of governing bodies demonstrating ‘flattening of the curve’ and potential dates for review of current ‘life restrictions’, we cannot lose sight of the threat. We have trained for years, mastering the knowledge and skills of our profession. Countless challenges have risen along the way, mostly conquered but not without scars. Saving lives is not a new thing, but for some reason Covid-19 feels different. Either way, we can only do different the best way we know how… and embrace the ‘silver lining’ in preparation for life beyond.
