On Saturday I received an email from the Office of Personnel Management in Washington, with the subject line: “What did you do last week?” OPM manages civil service and, as a critical care doctor and medical director of intensive care units in federal, local and rural hospitals, I am partly a government employee.
I wondered how to respond to email. Was it supposed to highlight what really mattered, human lives in my care, or enumerate what OPM could consider important, in a bureaucratic exercise? Without context, the application felt mainly as a demand, not a legitimate investigation. The lack of respect was palpable. A colleague had to point out news articles about email, a new wrinkle in the chaotic approach of the Trump administration for government efficiency, before I could determine if it was a hoax or a phishing scam.
If Washington really seeks to understand the work I do, or to encourage organizational change, common sense tells you that there are better ways. Effective leadership requires clear communication, a reflexive analysis and, above all, trust. This email had nothing like that.
But since they asked, this is what I did last week:
- I took care of Darrell, a 70 -year -old veteran with a kidney and sepsis transplant. He had a painful and potentially deadly collection of liquids in his chest that I drained to relieve the pressure.
- I sat for hours with the family of an 85 -year -old veteran with Parkinson, heart failure and a recurring infection of Mrsa. Together, we navigate the complex landscape often politicized of attention at the end of life.
- I diagnosed and evaluated the severity of lung disease for more than 50 veteran patients.
- I audited 20 patients of patients for coding precision and strategy on how to improve compliance.
- I supervised, trained and trained almost 10 medical apprentices daily in the care of critical patients.
- I worked with pharmacy and nursing supervisors to refine a new protocol to treat alcohol abstinence, a potentially deadly condition.
- I coordinated with pharmacists, nurses and cardiotoral surgeons in safe and profitable dosing strategies for amiodarone, a heart rate medication.
- I organized the complex transfer to another hospital of a veteran with liver failure and an acute joint infection that required specialized surgery, and tried to calm his anxiety, even if the insurance would cover it when he arrived there.
- I answered detailed questions about blood transfusions for an 84 -year -old man with metastatic bone cancer whose transfusions had exacerbated heart failure into a suburban hospital.
- Intubé to an 82 -year -old man and put him in a fan after he returned from Europe with a devastating respiratory virus. Before sedation, he said goodbye to his family, not knowing if he would wake up again.
- I managed the doctors's schedules in a rural UCI full of perpetual financing deficit.
- I treated a former 62 -year -old nurse who suffered severe depression and alcohol use disorder that had suicide overdose in multiple antidepressant medications.
- I arrived at a UCI nurse to the emergency department when it fell halfway, burning with 103.5 degrees fever.
- I stated strategies to request possible philanthropic support for medical exhaustion research given the fund cuts of the National Health Institutes.
- I took care of an 80 -year -old man with multiple cerebral hemorrhages and an obstructed intestine, stabilizing his blood pressure with infusions.
- I comforted the family of a 76 -year -old woman whose uncontrolled hypertension had caused catastrophic cerebral hemorrhage. She was at a nearby point. After hours of discussion, they chose Hospice, and she died peacefully that night.
I could continue.
Here is my question: What did the staff management office last week? Did you help me take care of these patients, or loaded a system that already fashed under their own weight?
Before OPM responds, I would suggest that I recognize that the work that my colleagues and I do is accurately measured not on a spreadsheet, but in the lives we save, the families that we guide through the loss and the next generation of Doctors we train to do the same. .
That is what I did last week. What will OPM then?
Venktesh Ramnath is pulmonologist and critical care doctor in southern California. He is an associated professor at UC San Diego Health, medical director of the Intensive Venaries Care Unit of San Diego and Medical Director of the Intensive Care Unit of the El Centro Regional Medical Center.
