Now again with the COVID-19 pandemic, we are sharing information like where to get wipes, surgical masks, face shields, and air purifiers.

All these things have made me more humble and more grateful for the gifts we have received. We exchanged information about which gas stations or grocery stores gave doctors the right to go straight to the front of the line without having to wait for hours for gas or getting into places for essential products and materials. The usual discussions of ENT problems in the practice became less important as we now shared how to do oil changes in our power plants and install electrical connections with transfer switches, as well as discussed how many watts the refrigerator consumed and how to fix the water tank pump. With no electricity and no internet, we were back to writing notes and paper charts.

The office was only open in the early hours to catch the morning breeze with open windows, and we were using battery-powered otoscopes and headlamps and performing larynx examinations with mirrors. My ENT practice, back in the early days after the hurricane, was like it had been in the past. Who had electricity, the internet, or water? Where was gasoline or diesel available? Days became weeks and weeks became months. Sometime just after Hurricane Maria, the Society of Otolaryngology – Head and Neck Surgery of Puerto Rico WhatsApp forum became the source of information sharing between us. Social media has been a source of help to us. We have gone through death, destruction, landscape devastation, and human suffering, besides the lack of essential services like water and electricity for months. My ENT peers in Puerto Rico may not have been to war together, but after two major hurricanes in 2017-Irma and Maria-tropical storms, a major earthquake on January 6, 2020, and its ensuing aftershocks, Sahara dust thick as fog for days, and the COVID-19 worldwide pandemic, it has been like going to war.

Charles Juarbe, MD, AAO-HNS Board of Governors Member for the Society of Otolaryngology – Head and Neck Surgery of Puerto Rico

The ents are going to war