Note: This thread is related to #Coronavirus #COVID19

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Colleen Farrell, MD+ Your Authors @colleenmfarrell Internal medicine resident in New York City. Soon-to-be pulmonary and critical care fellow. Writer. Creator of @MedHumChat. Views mine. Jun. 05, 2020 2 min read + Your Authors

The video of police shoving an 75 year old man over, his head slamming the pavement, really, really hurts to watch.

One of the core elements of my training in medicine has been fall prevention for our elders. Let me explain... 1/

Falls in the elderly are dangerous and life threatening. A fall might cause a broken hip which isn’t a simple mechanical problem—people die from the complications, like hospital acquired infections, blood clots, stress on their cardiovascular system. 2/

Many older people take blood thinners for irregular heart rhythms. Blood thinners prevent strokes, ie prevent death and disability. But, if someone on a blood thinner strikes their head in a fall, the risk of a brain bleed is substantially higher. 3/

We often care for elderly patients who have fallen and were unable to get up for hours. As a result they are often severely dehydrated, with injury to their kidneys, heart and muscles. 4/

Even if we can correct all these problems—broken bones, kidney injury, brain bleeds—recovery takes a big toll. Most older people don’t just bounce back from a hospitalization. They need weeks of physical rehabilitation. They may have a permanent loss of function. 5/

Knowing the profound toll of falls in the elderly, it will be no surprise to you that primary care physicians and geriatricians devote extensive time and focus to *preventing* falls in our elderly patients. Here’s what I’ve been trained to do: 6/

-carefully review all meds for fall risk. weigh risk/benefit
-arrange home visit to remove tripping risks (loose rugs, wires)
-assess gait, help obtain cane or walker as needed (sometimes battle w insurance)
-teach strength exercises
-assess vision

-try to improve underlying medical conditions that damage nerves and circulation (diabetes, peripheral artery disease)
-screen for and address alcohol use (2 beers at 80 is different than at 40)

My point is: we work hard at preventing falls. Really hard. 8/

As covid surged through NYC, I have witnessed so many of our elders die from this disease. I have FaceTimed their families to say goodbye. Many have died alone. Even those who have gone home are still likely recovering.

They called us heroes for this work. 9/

So now, there is a deep and painful irony witnessing our incredibly well funded police so thoughtlessly and callously push over a 75 year old man. It just shows that for all the talk of healthcare heroes, much of this country is far more invested in destruction than healing. 10/

The work of tending to our elders, helping them thrive day by day, isn’t glamorous medicine. It’s not the big save. It’s the beautiful, mundane work of caretaking.

Police brutality is so wrong and so destructive. It must stop. /fin #BlackLivesMatter #StopPoliceBrutality

You can follow @colleenmfarrell.


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