In the year 2000 there were a bit over 200,000 soldiers in the Army Reserve. It was a popular choice for those that needed an income supplement, one weekend a month and a longer stint in the summer to be prepared for the unthinkable and maybe provide a little extra money to provide for a vacation or a second car. Looking around it didn’t look like much of a risk. Did anyone really think we were going to go to war, at least in such a substantial way that the Reserves would be called out? Impossible. Plus I’ll get tuition assistance. No way I thought I could afford college. This is perfect!

Then the towers came down and the Bush administration pounced on the opportunity, and you can only imagine the shock and awe. As a reservist it wasn’t long before you went from a weekend warrior to a full time G.I. What seemed like a safe way to improve your life prospects became a life threatening responsibility that you had taken on willingly, if not, perhaps, with your eyes wide open. The trade-off for the benefits Reserve life afforded was the possibility of the worst possible outcome that life can offer. War, and all the atrocities that go with it.

Some would die, others would come back wishing they had, others finished that job when they got home. Military suicide is at epidemic proportions. Tons of kids that had no idea what they were getting into, and for good reason. We entered a war in a way that the United States had never done. We unloaded on a country that did not attack us and did not have the capability of doing so. Reservists never saw it coming. Contractually they were stuck. They could not walk away from the responsibility the oath had burdened them with.

Most of these people would serve without complaint, but how many were stuck in a nightmare they could never have imagined, and thus hadn’t imagined. They never considered this is what they were signing up for. The TV ads sure didn’t emphasize that. But there they were.

Fast forward to 2019. The economy is reportedly fantastic with unemployment rates as low as anyone can remember, but just below the surface is the reality that most of these jobs suck, paying poverty wages and requiring folks to take more than one of these great new economic opportunities. It was a sellers market for labor, but somehow that wasn’t translating into increased wages. The whole thing was stagnant, companies taking advantage of the economic storm while workers patiently waited for their opportunity to partcipate in the boom.

It hasn’t come yet.

Within that context, there was a bright spot out there for young people looking to build a future. Nursing was exploding. Good jobs that paid well and could be a lifetime of fulfilling employment. Those that could stand up to the rigors of the academic requirements to make it through would find a welcoming job market and a paycheck that could provide dignity and a lifestyle that was sustainable for the long term. The American Dream was alive and well for these serious minded young people that could figure out how to pay for the education and enter into a life of service to the health sector.

Enter Covid-19.

Suddenly these same folks were drafted into a war zone. Overwhelming amounts of work, much of it being unsuccessful, death being a daily companion all around you, your own death being a possibility you think about on an hourly basis, an industry not prepared to protect you in a way that honors the risks being taken. As things descend, colleagues are let go for even mentioning the risks being taken and the PPE needs that are graphically revealed. Though completely untrained in ICU procedures, you might get drafted to help anyway, taking what you know and adapting it to the needs at hand, being trained on the fly. Maybe you go home at night, maybe instead you avoid the husband and the kids and stay in the trailer in the driveway or a hotel down the street, isolated from loved ones for weeks or months at a time. Support is minimal, fear constant.

And yet, they show up.

I doubt the sacrifice of these people will ever be truly appreciated. The numbers of deaths within the care-giving community is enormous. The risk is not theoretical. It’s a daily reality.

And yet, they show up.

This is something that the professionals in epidemiology saw coming. They were the only ones. They tried to let people know. There were Ted talks and white papers and alarm bells, but they never reached the public in any impactful way. It never impacted nursing school applications. Just lke the reservists in 2000, there was no existential fear of pursuing this profession. It was simply a great opportunity.

Within a months time, from January to February, their whole world turned upside-down. The unthinkable became the reality, schedules became unpredictable, work loads unmanageable, risk exponentially elevated. These are not people who were unable to make a voluntary decision to dig in and help. They had no unbreakable contract that would have them face legal consequences for them not showing up. They had a job. There were other jobs.

And yet, they show up.

This is not a condemnation of the Reservists. Many heroes came from their ranks, men and women that performed at the highest levels of bravery and sacrifice despite the misguided mission. But at no time did they have a choice. Not all of them were cut out for it, and many made either the ultimate sacrifice or the more long term sacrifice of compromised mental health or physical impairment. They were trapped, enticed by the advertising, overwhelmed by the reality.

But that isn’t the case for the medical heroes. They are voluntarily staying. They have a job, and you can quit a job. You don’t go to jail for quitting a job. You aren’t villified as a coward or a traitor. You simply move on. There is no reported national trend of medical workers heading for the doors. They are there opening them, bringing the next stretcher through them and doing everything they can to help. Each stretcher represents a new threat to their own personal safety, a new opportunity to be a guinea pig in the national experiment of how to treat a pandemic safely. There are casualties, just as there are in any war, and they know it. Colleagues they worked with yesterday are gone the next, sequestered or dead.

And still they show up.

All heroes do not wear camo. Some wear scrubs, and masks and latex gloves, when they can get them. Sometimes they can’t.

And still…they come.

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