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Hopeful….that is how I feel. Appreciative and Hopeful.

I am Appreciative that forewarned became forearmed, and in Oregon we sacrificed and did our part to maintain social distance in response to COVID-19. We stayed at home and flattened the curve. I was Hopeful that it was enough, but the numbers are increasing.

I am Appreciative of the work of the scientific community in helping to understand and manage during this pandemic, and I am Hopeful that as with almost all viruses that we have encountered, we will manage the risks, work toward appropriate medical management or a vaccine. I am Hopeful that it is ultimately treated like the flu, whereby ‘at risk’ individuals get their COVID vaccine, or hopefully we get some amount of herd immunity, and we continue on.

Is This the New Normal?I am Hopeful that the “new normal” does not stick. I realize that I do not like the “new normal.” I do not like hearing from my pediatric colleagues about parents not getting appropriate treatment for their child’s asthma, bordering on status asthmaticus, because they cannot go to, or are afraid to go to the doctor’s office.

I do not like hearing from my general surgery colleagues about increased rates of ruptured appendices, and acute abdomens with perforated bowels, some fatal, because patients were delayed in seeking care due to being afraid to go to the hospital. I do not like hearing from my ophthalmology colleagues that patients are delaying treatment for glaucoma or even emergent vision threatening conditions because they are afraid to come into the doctor’s office. And I do not like hearing about the increase in deaths from cardiovascular disease.

This...cannot be the “new normal.”

I am appreciative of the expansion of Telemedicine, and believe strongly that it can serve many, for medical issues such as diabetes, hypertension, a post-op wound check, or even mental health, particularly in rural areas with limited access. It has truly been a lifeline during the COVID-19 emergency, and should continue to be integrated into patient care between physical visits, but I am hopeful that the digital experience is not the “new normal”.

The last four months, to me, have only highlighted the importance of human touch, and how much we take it for granted.

Is This the New Normal?

The examination is important for almost all musculoskeletal conditions, and is key to the practice of Orthopedics. Yes, one can obtain a history through telehealth, but much of what we need cannot be obtained from a telehealth visit, such as x-rays and or a CT or MRI. And ultimately, we must lay hands on the patient. Often the physical examination is diagnostic and there is no need for advanced imaging. And even if advanced imaging is obtained, it must be correlated with the physical examination, lest we start misdiagnosing patients with, and operating on patients for, incidental MRI findings... Additionally, and as importantly, in many patients who are injured or sick, touch is also reassuring, expresses caring, eases distress and makes people feel less alone. That is the intangible…and I was Hopeful that we were on the other side of the curve, because this cannot be the “new normal.” And so it is alarming that the hospitalizations are again increasing. And I only have one question for anyone who feels negatively about wearing a mask, whatever the you want to go through the last three months all over again? If the answer is “no”, then suck it up, wear the mask, distance as necessary, and hasten the recovery.

Ultimately, though, I remain Hopeful that I can once again provide that personal level of care that we are all missing right now. For now, I will do what I can with a mask and gloves, Hopeful that this is not our “new normal.”