"An efficient reminder of our agency": One ER Physician’s Pandemic Lessons

By Vibhu Krishna and Owen Akeley

Dr. Michele Harper has worked as an emergency room physician for more than a decade, including as chief resident at Lincoln Hospital in the South Bronx and in the emergency department at the Veterans Affairs Medical Center in Philadelphia. She is a graduate of Harvard University and the Renaissance School of Medicine at Stony Brook University. She is the author of the forthcoming book The Beauty in Breaking (July 2020) and the incredibly powerful COVID-era essay “When This War Is Over, Many of Us Will Leave Medicine“ on Medium. For more, visit www.micheleharper.com

Dr. Harper spoke with Faces of the Frontline on the realities of emergency medicine during the pandemic, how she stays grounded, and “being the storm.”

Photo by Ashkan Forouzani via Unsplash

Q: What's one thing about being an ER doctor that most people wouldn't know, that you would want them to know?

A: This answer applies to workers in many industries— ER doctors, grocery store clerks, transit operators, farmers... the list goes on. We are human beings who assume significant risk to keep this country going. During this pandemic, ER doctors are among those who have faced indignities including pay cuts, staffing shortages, and inadequate workplace protective measures while we are still expected to tirelessly complete our work. Some physicians have even been fired for bringing awareness to these issues. Of course, these are all symptoms of broken systems in this country. American healthcare is one of the broken systems. So the critical questions are: what will each of us demand and do in order to fix them?

Q: What sort of emotional support has been given to you by your workplace, and has it been adequate?

A: We pull together as a team. This is generally the orientation of the ER; it's just what we do. As I give this answer, I realize this is a credit to my colleagues. I suppose that's an indirect answer to your question that speaks volumes.

Q: Share with us one aspect of your daily routine. How do you ground yourself?

A: On my clinical days, I listen to an Eckhart Tolle audiobook on my commute to work— A New Earth is on repeat of late. When I’m not working clinically, it’s YOGA! 

Q: Can you give us an estimate of how many intubations you've had to do? What is something non-medical you've learned from doing them?

A: No, but it's not as many as you think. There were more in the beginning, then the acuity trailed off. Plus, we're using intubation sparing procedures such as high flow oxygen and BiPAP instead of intubations.

What I continue to learn from all of this is presencing, which makes sense, because I suspect my biggest life lesson is grounding in the face of uncertainty.

Q: How do you envision your career after this is over?

A: There are hopes I have for healthcare: access to healthcare for all; fair healthcare that abolishes disparities and commits to wellness for all; equitable pay and benefits for all healthcare providers. Goddess only knows whether or not these will occur, but I commit to doing what I can in service of these outcomes.

Then there's my non-clinical work. The release date for my memoir, The Beauty in Breaking, is July 2020. While this is my first book, I see my literary path continuing in ways that are varied and interesting.

Q: What systemic changes would you like to see to the provision of mental health resources for ER doctors?

A: The only way to address this effectively is to remodel healthcare so that it fulfills the mission of providing health and wellness to all. The mission can no longer be ‘profits for some.’ It simply cannot if we intend health for both those who provide and for those who utilize healthcare services.

Q: If you could (safely) hug one person in the world right now, without PPE on, who would it be?

A: Where to begin?! Eckhart Tolle, Oprah, Arundhati Roy, Dolores Huerta.... I could go on. I know that's more that one person, but this question is so fun!

Photo by Marco Bianchetti via Unsplash

Q: Do you have a favorite quote or mantra that has been getting you through this?

A: Here are three:

“Every system is perfectly designed to get the results it gets” — W. Edwards Deming. 

An efficient reminder of our agency in this process. There are disparities in care, essential workers who are not treated as essential, wealth that is concentrated at the top. These are not coincidences. This quote is a reminder of how we can employ our agency to obtain different outcomes.

“The pandemic is a portal.” — Arundhati Roy. 

It's the title of a recent essay by Roy, but I think it works as a mantra as well. Another reminder of our agency to choose better, do better, and be better, as individuals and as a nation.

Then, my Boss Bitch quote for when things are tough in the trenches: 

“The devil whispered in my ear, ‘You're not strong enough to withstand the storm.’ I whispered back, ‘I am the storm.’”  (I haven’t been able to find an attribution for this one)

Faces of the Frontline thanks Dr. Harper for her honesty, fortitude, and ability to inspire others through her selfless action and perspective. We are honored to feature her here.

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