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He heard agonizing screams, saw burned flesh and penetrating trauma. He stood in pools of blood, tending to Marines with severed spinal cords, missing limbs, and intestines bulging through gaping wounds. He emptied the pockets of the dead, collecting baby pictures and ultrasound photos, removed dog tags, and stacked bodies, sometimes two and three at a time, into refrigerated trailers.

He still has PTSD, though he returned from the war 16 years ago.

Even so, that experience did not prepare him for the coronavirus. You may have pandemic fatigue, but Gilman is flat-out exhausted. That voice got him into trouble late last month, after he sent out a tweet about the lack of ICU beds in Arizona. He was fired, he said, despite severe staff shortages at his hospital, Yuma Regional Medical Center. But the coronavirus was still burning through Yuma.

More than new cases in inmates had surfaced in recent weeks at the state prison complex in town.

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When the hospital called last week, Gilman suited up and returned to work. T he fact that Gilman became a doctor at all was unlikely.

A ‘duty to warn’: an er doctor, shaped by war and hardship, chronicles the searing realities of covid

He eventually returned and graduated, but was turned down for job after job. Like many Black teens he grew up with, he was hassled by police, once at gunpoint. It was during one of those encounters that Gilman, literally, saw his path out.

He enlisted. There are no borders in this war. A high score on a military vocational test gave Gilman a wide choice of career paths.

Your mouth is the window to your health

He was caring for a stroke patient one day, when he glanced at a TV and saw a plane flying into the Twin Towers. It may have been the best, and hardest, medical training he could have received.

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The memories are still painful. Black officers. Black doctors. A few of the medical officers had taken notice of Gilman as he helped stabilize wounded Marines. They encouraged him to pursue a medical degree. Gilman decided he was going to make himself a doctor. Gilman started his post-military life in San Diego, enrolling in Southwestern College. He promptly got an F in algebra. A fellow student told him he should study with the solution sets to homework problems that were available at the bookstore.

Gilman left his apartment each morning with a gallon of water and some cooked chicken and rice and spent his entire day either in class or the library. After earning his associate degree, Gilman was admitted to several four-year schools, including the University of California, Berkeley.

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He did. Teitel said she had no doubt he would succeed. He wrote after each shift in the emergency department, exhausted and sometimes through tears, about the barbers, nannies, construction workers, bartenders, waitresses, and store clerks he was trying to keep alive. Two nights later, when the city recorded 6, cases, he took a moment to look around as 80 patients waited for admission. The onslaught of coronavirus patients at the hospital was so difficult, even veteran doctors were shaken.

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With this, not only did we have an overwhelming of patients infected, we saw our own colleagues falling down before our eyes. The fear and anxiety was real. This was no time to shield residents, Mital said.

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They were needed to help, as were colleagues in ophthalmology and dermatology. Mital recalls meeting Gilman on his first shift as an intern in She was also surprised to see someone choosing such an exhausting field of medicine at a relatively late age.

He had learned early on he could stop stumbling over a word by replacing it with a synonym. To arm himself with words, he read dictionaries from front to back. At 12, while attending a summer camp sponsored by the rapper LL Cool J, he discovered his stutter disappeared when he rhymed.

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Shortly before the pandemic, Gilman was gaining notice in medical societies by rapping about topics like clinician burnout and health insurance. Gilman thinks health care workers have to shed the mantle of hero and be more open about their worries. As the spring wore on, there were moments of joy — patients and colleagues who were weaned off their ventilators and recovered. But mostly, there was a lot of death. The PPE was protecting Gilman from the virus, but not from the pain. Her death shook him to his core. He thinks the isolation Breen suffered while off duty to recover from the virus and the mental strain it caused was her undoing.

But he was worried.

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He was leaving a city that had dramatically curbed the spread of the virus and moving to a state where businesses were reopening and the governor, Doug Ducey, refused to issue a statewide mask mandate. He knew doctors were supposed to stay in their lane. He knew senior physicians that had been disciplined, or lost their jobs, for speaking out.

Gilman kept up a steady stream of commentary, warning about the rise in cases in Arizona, the lack of resources, the many, many young people suffering from Covid in his ER, and the need to wear masks and ban large gatherings. And because there are few restrictions on activities, his ER is still shouldering a full load of regular emergencies even as new coronavirus patients arrive day after day. Why are you here? This is not an emergency. Sometimes out of beds to handle the influx of new Covid patients, Gilman said he has had to resort to treating patients in the ER waiting room.

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More recently, Gilman has been using his platform to amplify the plight of health care workers who are penalized for speaking out and to highlight the deaths of young, ly healthy patients who were killed by the virus. Press had been sent home from his local ER in New Jersey twice, Gilman said, after being told his chest pains were just anxiety. In November, he received a phone call from President-elect Biden, a fellow stutterer Gilman has long admired. The two bonded immediately.

For now, Gilman is happy to be back in the ER, where he returned last week. He has every intention, he said, of continuing his personal deployment against the virus, and continuing to speak out. Usha covers the toll of Covid as well as people and trends behind biomedical advances in the western U. Thanks for the arrest and that billboard you are now Dr.

As a retired nurse I remember one night 3 of my patients died and in report that morning my relief could not understand why I was cryingI still tear up even writing this so I have a very faint idea of what you face each day. Give yourself a hug from me. You know what hurts there are so many in the black communities who think cov19 is not real. Great article.

Thank you for highlighting such an extraordinary, caring and devoted person. Gilman you are absolutely an amazing man. Thank you for being you. Thank you!

Great story. Gilman is one to watch. We need millions just like him right now all over America. Keep up your outstanding work and leadership. And keep speaking out!! Mask orders, closure mandates. Large big box retail stays open but a small store selling the same item must close?

Ministers arrested and or fined? Liquor and MJ stores are critical business? I am a physician too. You sir do not have a monopoly on virtue and caring since you see only one part. Overdoses have hit a record level in last 12 months. There are now more fatal overdoses in LA than covid deaths.

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How many people and businesses have been ruined by one size fits all mandates rather than allowing some leeway to fit specific conditions? Give recommendations but respect indivudual choice. If you have a problem with individual choice and are now a complainer and whiner regarding the huge cross you bear then get out of medicine.

I dont think i want a guy like you in my ER. We now project overdeaths by April 1. So, science has proven that people who refuse to abide by mask wearing, social distancing, etc. Sounds equitable to me. What a story.

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I admire his willingness to speak out with truth to political power, and support his outrage.