Disaster Axioms
#acep21 These remarks seem more important now.
On receiving ACEP's Disaster Medical Sciences Award, Oct 2019...
These remarks are mine alone and do not represent those of the U.S. government.
(Axiom: an unprovable rule or first principle accepted as true because it is self-evident or particularly useful)
AXIOM: There is a relentless march of patients coming to the ED. Likewise, there is a relentless ever-growing march of disasters coming to the world.
Don’t stick your head in the sand. Know that disasters are going to keep coming at us. Commitment to improving our response is important.
AXIOM: There is no well-recognized career path for physicians in disaster medicine.
Two emergency medicine faculty told me they wanted to dedicate their careers to disaster medicine after September 11th. As Chair of EM at SUNY Upstate Medical University, telling them that I couldn’t promote them based on disaster medicine alone was devastating. Build an academic medicine career path in the house of medicine good enough to be a subspecialty.
AXIOM: Without disaster medicine research, there is no new knowledge.
Do the research and push ACEP and government policymakers to support it. Otherwise, we will stay stuck doing precisely what we have done before.
AXIOM: After Action Reviews are insufficient in discovering preventable mortality from disasters.
Preventable mortality studies drove the development of trauma systems. An NTSB equivalent for disasters is desperately needed to identify preventable mortality from system or patient care errors. We can’t fix it if we can’t identify the mistakes. The feds can’t do it alone, and the docs can’t do it alone. It has to be done together so that docs can access patient records.
AXIOM: In the really big ones with overwhelming numbers of patients, there just aren’t enough trained clinicians. #medicine
The people will save lives. Find the helpers. Engage them now and show them how to save lives.
AXIOM: The choir keeps preaching to the choir.
Build a much, much bigger tent and add new partners. They will help you.
AXIOM: Us emergency medicine docs have big egos, but we underestimate what we can do.
I never imagined my journey from the ED to the White House. At my departure party at the White House, I was extraordinarily proud to say that emergency medicine was what prepared me best for the National Security Council when the world seemed to be coming to an end with Ebola and the horrific shootings.
Don’t underestimate what each one of you can do. With humility, think big and do things that really, really matter.
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The views expressed are those of the author and do not necessarily represent the official policies of the National Institute of Allergy and Infectious Diseases, the National Institutes of Health, the Centers for Disease Control and Prevention, or the Office of the Assistant Secretary for Preparedness and Response, U.S. Department of Health and Human Services.