President's Message

Monique Schaulis, MD, MPH, FAAHPM

HANG IN THERE, EVERYONE

"As we move into our second Covid autumn, we must harness those moments of beauty that give us the fortitude to carry on."

When I started writing this column in June, it was with

optimism. As I wrote, “We have made it mid- way through the year! So much positive change is happening in our communities. The days are longer. Mass vaccination is over. We’ve brought our middle schoolers into the vaccinated bubble and they are now able to re-stretch their wings. As are the rest of us...”

For a few weeks at work, I didn’t wear an N95 or a face shield, just a surgical mask. I felt so physically and emotionally liberated. My patients could actually hear and see me. I went almost six weeks without seeing patients with Covid. As I look back at those innocent words from June, July seems so much more complex, and I feel foreboding about August. After seeing a downtrend for months, we are so clearly headed in the wrong direction. In the last few days, we’ve reinstituted mandatory eye protection on the job; I’m back to screaming through my N95 and face shield so my patients can hear me.

And perhaps most disconcertingly, the feeling of being truly protected by the vaccine is waning. I have taken to telling ER patients that I’m not too proud to beg them to get vaccinated. Rarely, it works. In the meantime, I read climate horror stories from around the world. Record breaking heat, drought, floods, and smoke. We’re not even close to done with Covid but climate change won’t wait. The annual fire season promises to be severe. I’ve already started repetitively checking the Air Quality Index. My kids asked me recently, “Will we have another orange day when the sun doesn’t rise?” Urgent environmental action is imperative but we are distracted by a multitude of crises. Melancholy seems a fitting emotion for these grey summer days.

And yet, I know I am fortunate. I can breathe. I am housed and have a good job. The fog protects me from the scorching temperatures nearby. I can expect that my children will attend school in the fall. On my last dawn bike ride to work, I saw baby coyotes and a barn owl in Golden Gate Park. I felt a small rush of joy as I pedaled past and saw the flash of wings passing close. As we move into our second Covid autumn, we must harness those moments of beauty that give us the fortitude to carry on. Hang on everyone,

Monique

Dr. Monique Schaulis, MD, MPH, FAAHPM, is a graduate of the University of Chicago Pritzker School of Medicine. She practices Emergency and Palliative Medicine with The Permanente Medical Group in San Francisco. She is President of SFMMS and serves as faculty for Vital Talk, a non-profit that teaches communication skills for serious illness. Dr. Schaulis chairs the Medical Aid in Dying special interest group for the American Academy of Hospice and Palliative Medicine.

FROM THE EDITORS –As Dr. Schaulis notes above, these are trying times. We hope all our members and readers are doing well enough. In this edition of our journal, you can find fodder for thought and action on many fronts. With substance abuse spiking along with COVID, faculty from the recent SFMMS Addiction conference present leading-edge perspectives. San Francisco’s first AMA president-elect in decades indicates that the medical profession’s largest association will be in good hands. Our “wellness” activities are open to all of you to help get through challenges. Schools can reopen, thanks in part to medical leadership, including locally. Our state’s proposed health budget looks, yes, healthy. Our first installment of local pioneering AIDS physician Paul Volberding’s memoir reminds us that we have been through very big challenges here before. And there’s more; we hope you learn from and enjoy this issue.