When Viktoria Koskenoja was in college, she sat in the hospital at the bedside of her mother, who lay dying of leukemia, and studied for her medical school entrance exams. She was determined to one day speak the language of the doctors who swooped in and out of the room discussing the case. Later, in medical school and then in residency, Koskenoja found herself drawn to emergency medicine, with its unpredictability, its tapestry of characters, and its imperative to establish immediate trust with the constant stream of brand-new patients coming through the door. She had found her calling.
Her first position out of residency was her dream job, working in a Level 2 trauma center at a hospital in rural Michigan, where she'd grown up. And at first it truly was a dream. "Small community, really great group of physicians, really great group of nurses," she recalls. "It just felt like we had everything that keeps the hospital running."
But the facility had just been bought out by a private equity firm, and Dr. Koskenoja watched in real time as things began to change. "Cuts were made everywhere in every possible way," she says. Cuts that seemed harmful to patients, the very people they were there to help.
Doctors and nurses were let go or had their hours drastically reduced. "I'd walk into a room," Dr. Koskenoja recalls, "and see a patient with a blood pressure of 60/40," which is dangerously low. Before the buyout, "the nurses would have been all over that," she says. "But I would have to find a nurse, if I could, and try to get them to start fluids, or start them myself."
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