Worried that his hospital was doing too little to prevent the spread of coronavirus, Dr. Ming Lin took his concerns to his superiors.
Still not satisfied, he turned to social media, and in a series of posts over 11 days, called for greater protections for doctors, nurses and patients at PeaceHealth St. Joseph Medical Center in Bellingham, Wash., where he worked in the emergency room.
“I do fear for my staff,” he said in a video recorded March 26 on YouTube. “Morally, when you see something wrong, I think you have to speak out.”
The next day he was fired, turning him into something of a folk hero to a growing army of medical workers and others who followed him on Facebook.
Across the country, doctors and nurses on the front lines of the pandemic say that dwindling supplies have forced them to reuse disposable masks, face shields and other protective equipment and that hospitals have done too little to protect them.
Reports are increasing nationwide of sickened healthcare workers. More than 500 employees of major hospitals in Massachusetts have contracted COVID-19. Nurses have died in New York. A Seattle emergency room doctor in his 40s was still listed in critical but stable condition Friday, almost three weeks after being admitted to his own hospital.
More hospital employees are speaking up, but few have gone public for fear of losing their jobs.
Dr. Ryan Stanton, a board member of the American College of Emergency Physicians, which represents ER doctors, said some doctors and nurses had been fired or threatened for voicing criticism.
“Punishing them for having a conscience is really unfortunate during this time,” said Stanton, who works in an emergency room in Lexington, Ky.
Lin went public with his concerns on March 15, as the death toll in Washington state — where the first U.S. case was detected — climbed past 40.
In a letter to a superior that he shared on Facebook, Lin wrote that the medical center was “so far behind when it comes to protecting patients and the community, but even worse when it comes to protecting the staff.”
He called for drive-through testing for the coronavirus, faster turnaround of test results and screening of patients and staff as they entered the facility.
Subsequent posts said that nurses were given gowns offering little protection and that some had been told not to wear masks.
He said the hospital, where he had worked for 17 years, lacked an area where workers could disinfect to avoid carrying the virus back to their families and the community.
Lin said in an interview that the situation was a sharp contrast to his experience treating scores of patients at St. Vincent's Hospital in New York on Sept. 11, 2001, when the World Trade Center was attacked.
"It was just amazing to watch and be part of how efficiently that hospital ran it," he said.
The difference — and a growing sense of urgency — led him to speak out, said the 57-year-old doctor, who immigrated from Taiwan as a young boy with his parents to Galveston, Texas, where his father worked in a medical center.
He chose emergency medicine because he relished the challenge and the pace. Every patient was a puzzle to solve as quickly as possible.
COVID patients present a particularly difficult puzzle in that the virus can remain hidden for so long, he said.
Before Lin was ousted, he said that St. Joseph had made plans to put staff members through health screenings and temperature checks, although there was no mention of doing the same with visitors. By March 18, he wrote on Facebook, managers were talking of erecting an emergency triage tent and considering ending elective surgeries.
Lin's followers flooded his Facebook page with messages of encouragement — and outrage after his firing.
"Are they insane?" one man asked. "At the beginning of an international crisis, this is the time?"
"He was our ER doc when Sam had spinal meningitis," a woman wrote. "It was clear how seriously he took infectious disease. I've lost respect for PeaceHealth, treating a great asset to our community with petty retribution."
"No one should be punished for speaking the truth. Reinstate Dr. Lin," another wrote.
Charles Prosper, the chief executive of PeaceHealth Northwest, said in a statement last week that "misinformation and rumors" on social media had caused unnecessary fear and that St. Joseph hospital was taking "every precaution necessary" to ensure the health of caregivers and patients.
A spokeswoman for St. Joseph said that Lin did not work for the hospital and referred questions about his dismissal to TeamHealth, the medical staffing firm that employed him.
TeamHealth said in a statement that it would work with Lin to find the right location for him.
But Lin was busy consulting at a hospital at the Lummi Reservation west of Bellingham, where members of the Native American community conducted video triage and required patients and staff members to wear masks.
"I do wonder whether I can save more lives by speaking out about this than actually working in the ER," Lin said. "The hospital is kind of a mop-up job, and prevention and preparedness probably do a lot more to save people's lives than anything else."