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We Need to Speak Up to Avoid Death by Silence

Op-Med is a collection of original articles contributed by Doximity members.

How often do we take the things that life has to offer and fail to recognize that they are good fortune or gifts? We observe special things such as the health of our family members, our dwelling, our two cars, the fact that we are healthy and fortunate enough to have employment and that some of us can choose to operate today, consult tomorrow, or care for patients in our office the following day. There is always food on our tables, a place for our heads at night, a trusty CPAP (continuous positive airway pressure) machine that makes me sound like Darth Vader, parents, children, and grandchildren. Both my son and daughter are employed, my son as an RN and an actor, and my daughter as vice president of a company in New York City.

Life is not as rewarding for everyone. What if you lived in a town in the Midwest hit by a tornado? What if your home was washed away or destroyed by torrential rain? Consider the individuals who get into their car, drive to work, and are suddenly hit by a truck or SUV. They wake up in an intensive care unit fighting for their lives.

Life is always in flux and situations can change from minute to minute; you or a family member could undergo a complete change in destiny.

I’ve been a practicing clinician for 46 years. I have worked closely with my physician assistants and nurse practitioners, as well as with physicians and administrative colleagues. I have come to realize that we all do not share the same attitudes or enthusiasms. I am a joiner, a worker, a professional, and a visionary. I manage to place my thoughts on paper to make compelling arguments. I have served as president of a state chapter and three national organizations and have represented both the American Academy of Physician Assistants and the American College of Cardiology, and have worked with the American College of Surgeons as a liaison. And I have been aghast by the attitudes of some of my colleagues who will not only refuse to join a committee but who fail to join either their state, specialty, or national organization. Their attitudes reflect a lack of concern for their profession or a self-centeredness that allows them to let someone else pay dues and carry them in the direction that WE HOPE TO ATTAIN. This has a damaging effect on our leadership, on our organizations, and on our specialties.

Destiny is not a matter of chance; it is a matter of choice! We must choose a path that will lead us to a place of security, for both the present and the future. It requires involvement today, not tomorrow. Survivors in combat receive that esteemed title—“survivor”—with constant vigilance (e.g., awareness of crowds, recognizing “booby traps,” etc.).

You and I share the responsibility of being vigilant and staying informed. Knowledge is the key to understanding the issues, and that knowledge cannot be attained by existing in a vacuum. The issues that we face, we face together, and there is no room for bystanders. If you look back at the accomplishments that have been made this year, they would not have been successful without joint effort and the desire to improve.

On an epitaph of an ancient city, the words deletia silentia are inscribed. Legend has it that the city’s prince was alarmed without cause and ordered that no evil tidings should ever be brought under penalty of death. One day, while a sentry walked the wall, the enemy approached. The sentry focused on self-preservation, failed to sound the alarm, and escaped from the city. The enemy entered the city, and it was ravaged, plundered, and burned. Its destruction was described as deletia silentia—death by silence. The sound of silence can sometimes be as loud as an earthquake.

The exact opposite of urgency is apathy. We cannot choose to be observers. We cannot fail to join our organizations, to gather together at conferences, to build the power and excitement of an intelligent, united front. Membership is an honor, a privilege, and an opportunity to gain knowledge (and an insurance policy) in the future of patient care. When legislative climates are changing (and they are); when activity is on the rise (and it is); when business people dressed in Armani suits dictate healthcare policy with their pet congressional leaders … the result is based a decline in healthcare benefits for everyone. When sacred cows like Social Security and Medicare become the target of national debt reduction initiatives, it is time for Americans to stand up and to stand together. We need to become a wall of revolution that will not allow this to happen in our country. We need to say, like some early Americans: “Don’t Tread on Me.”

So, here is the challenge for 2019 and the big question: How will you demonstrate your urgency? Will you close your eyes, ears, and mouths? Will deletia silentia become the epitaph of our great professions, who have done so much for patient care?

Margaret Meade said, “Never doubt that a small group of committed people can change the world. Indeed, it is the only thing that ever has.” We are that small group of people. We need each other. We need to close ranks and stand together. Are you up for the challenge and willing to become part of the plan for victory? I am!

Image: filizbbr / gettyimages

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