I was the attending in the emergency department triage area, working with Jessica. We were seeing a lot of patients with flu/cold/COVID symptoms, most of whom were getting triaged to fast track. A patient presented complaining of these types of symptoms, and Jessica immediately noticed there was something different about this patient. Even though her job was to triage and obtain vitals, she immediately notified me about her concern about a neck mass she noticed as she obtained vital signs.

The patient had been in the ED a few weeks before for the same symptoms and was discharged home, but her alerting me to the neck mass changed his ED trajectory. He was triaged to the main ED, where he received a neck CT, ENT was consulted, and within 24 hours, he had gone to the OR for an urgent tracheotomy. The CT revealed a critical airway compromise secondary to the mass invading his airway space. Had Jessica not advocated for the Veteran in triage, it is not clear if his neck mass would have been identified or if it had, it may have been much later in his ED course and his CT scan delayed. Throughout my several years working with Jessica, she has always shown integrity, commitment, and advocacy for Veterans.