Walking out of the ICU: Dr. X, Patient Safety, and the Battle Between Coronavirus Common Sense and the Hospital Bottom Line

As American hospitals struggle to admit waves of coughing, feverish patients to medical wards and intensive care units, physicians are finding themselves at war with the competing interests of other hospital employees. Early in the American days of the COVID-19 pandemic, one critical care physician resigned her position due to the unsafe practices she felt were endangering her patients and her staff. She feels she must remain anonymous, given the notorious cancel culture within medicine.

She had started the job only recently, a prestigious academic position. She was doubly trained, as an anesthesiologist and as an intensivist — an ICU specialist.

In other words, she is very good at keeping people alive, which she had been doing half-time in the operating room, watching vital signs like a hawk while surgeons operated, and half-time in the ICU, curing bad pneumonias and helping people with brand-new hearts live.

The job ruffled her sense of right and wrong from the beginning. Instead of adjusting protocols for patient care for ventricular assist device or transplant patients to reflect new journal articles and the latest scientific evidence, she heard a lot of “We’ve always done it this way, this is how we are going to do it.”

As a petite female, she felt unheard and unacknowledged, just a money-generating cog there to do the work of the surgeons. When she had concerns about how a patient was being handled in the ICU, “it would be conflated as me being histrionic [dramatic],” she says. “ I was a gnat, they kept smacking me away. Get in line and do what you’re told.”

On March 11, a specialist in COVID came to her department to lecture. During the meeting, it became clear to her that the university hospital didn’t include a plan for how to protect the emergency doctors, operating room anesthesiologists, and ICU doctors who could unknowingly do an airway procedure on an undiagnosed COVID patient, like an intubation. These procedures cause the risk of coming in contact with airborne COVID virus to skyrocket.

“I sent an email to my chairman and division director speaking all my concerns,” she says…