Letter to the Editor
Intensive Care Medicine: Quiet leadership versus protagonist in times of SARS-CoV-2 pandemic crisis
Medicina Intensiva: Liderazgo callado frente al protagonismo en tiempos de crisis por la pandemia causada por SARS-CoV-2
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Estella" "autores" => array:1 [ 0 => array:4 [ "nombre" => "Á." "apellidos" => "Estella" "email" => array:1 [ 0 => "litoestella@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Intensiva, Hospital Universitario de Jerez, Cádiz, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Medicina, Universidad de Cádiz, Cádiz, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Medicina Intensiva: Liderazgo callado frente al protagonismo en tiempos de crisis por la pandemia causada por SARS-CoV-2" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The SARS-CoV-2 pandemic has evidenced human frailty in the face of Nature, and we have seen that the modern healthcare systems of the Western world are not as widely capable as we had come to believe.</p><p id="par0010" class="elsevierStylePara elsevierViewall">It seemed little imaginable that the scarcity of healthcare resources suffered in the Europe of today would prove reminiscent of the situation experienced almost a century ago during the Copenhagen polio epidemic.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> We not only lacked structural resources during the hardest days but also suffered or feared possible shortcomings in crucial areas such as personal protection equipment, consumables and even drugs - forcing us to ration the available resources and reorganize ourselves under precarious conditions.</p><p id="par0015" class="elsevierStylePara elsevierViewall">It is in such situations of extreme need when professionals - in the maximum sense of the word - emerge. The medical and nursing staff of the Intensive Care Units have worked to exhaustion during the hardest days, in an act of sacrifice until there was practically nothing left.</p><p id="par0020" class="elsevierStylePara elsevierViewall">We have learned on the run from the immediately preceding experiences of our colleagues in other countries, and even from other Spanish regions that were particularly heavily affected in the first days, and who were combating the “snowball” effect we were witnessing, with an exponential increase in the number of cases. The social networks proved crucial in the process of sharing information among professionals, and as such constituted a truly unprecedented form of communication.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Within the profession we also witnessed a negative phenomenon from the deontological perspective: a desire for protagonism. Particularly in the social networks, but also in the communications media, we have seen interviews of healthcare professionals seeking their moment of glory in the midst of the crisis – making a populist and scantly professional use of information, and acting as prophets moved more by inspiration than by science. Another example of such opportunism has been the demand on the part of some individuals – in the hardest times of the crisis – for a personal place in the interventional organogram designed to cope with the disease, attributing themselves with capacities not consistent with their own specialization. A truce in this classical power struggle between specialties would have been desirable, as an act of elegance and in respect for the victims and the profession. It is in the great historical moments – and this has been one such moment – when the role of the professionals takes on special significance and importance.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The specialty of Intensive Care Medicine has participated in the crisis exerting a quiet leadership evidenced at the point of care and by the generation of documents of enormous value – not only in view of the moment in which they were published,<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> but also due to the prudence and rigor of their contents and the teamwork of the working groups of the Spanish Society of Intensive Care Medicine.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,5</span></a> The public appearances fundamentally rested upon the Chairperson of the SEMICYUC and the main coordinators of the national contingency plan and the working groups. It was not a moment to seek protagonism and public notoriety but rather to establish alliances with other specialties which – through the coordination of the intensivists – afforded crucial collaboration in the care of the critically ill. The organizational capacity shown in the situation of crisis has been notorious, in the same way as professional friendship in the compassionate care of the patients and the companionship and gratitude towards the colleagues of other specialties who adapted their activities in order to help in the hardest moments. The vocation to serve and the capacity demonstrated are a support allowing us to prepare for the next situation in which our work again becomes so necessary.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0035" class="elsevierStylePara elsevierViewall">None.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">None.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Financial support" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflicts of interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Estella Á. Medicina Intensiva: Liderazgo callado frente al protagonismo en tiempos de crisis por la pandemia causada por SARS-CoV-2. Med Intensiva. 2021;45:566–567.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A preliminary report on the 1952 epidemic of poliomyelitis in Copenhagen with special reference to the treatment of acute respiratory insufficiency" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H.C. 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Zapata" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medin.2020.04.006" "Revista" => array:2 [ "tituloSerie" => "Med Intensiva" "fecha" => "2020" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recomendaciones de «hacer» y «no hacer» en el tratamiento de los pacientes críticos ante la pandemia por coronavirus causante de COVID-19 de los Grupos de Trabajo de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.Á. Ballesteros Sanz" 1 => "A. Hernández-Tejedor" 2 => "Á. Estella" 3 => "J.J. Jiménez Rivera" 4 => "F.J. González de Molina Ortiz" 5 => "A. Sandiumenge Camps" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medin.2020.04.001" "Revista" => array:2 [ "tituloSerie" => "Med Intensiva" "fecha" => "2020" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recomendaciones de consenso respecto al soporte respiratorio no invasivo en el paciente adulto con insuficiencia respiratoria aguda secundaria a infección por SARS-CoV-2" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Cinesi Gómez" 1 => "Ó. Peñuelas Rodríguez" 2 => "M.L. Luján Torné" 3 => "C. Egea Santaolalla" 4 => "J.F. Masa Jiménez" 5 => "J. García Fernández" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.redar.2020.03.006" "Revista" => array:5 [ "tituloSerie" => "Rev Esp Anestesiol Reanim" "fecha" => "2020" "volumen" => "67" "paginaInicial" => "261" "paginaFinal" => "270" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735727/0000004500000009/v2_202201010839/S2173572721001405/v2_202201010839/en/main.assets" "Apartado" => array:4 [ "identificador" => "64604" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004500000009/v2_202201010839/S2173572721001405/v2_202201010839/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572721001405?idApp=WMIE" ]
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