Dispatch From the COVID-19 Frontlines: ‘It Really is Our Duty’
When I became a practicing physician 22 years ago, I took the Hippocratic Oath, “to treat the ill to the best of one’s ability,” regardless of the illness. This is why I now don the required PPE and head to New York’s Mount Sinai Hospital (epicenter of the U.S. pandemic), where I have a gastroenterology practice, to take care of people with the potentially fatal coronavirus.
Instead of entering through the main entrance, I have to go through a separate door away from patients and change into my scrubs, N95 surgical mask and screen before going into the areas populated with COVID-19 patients. Then I go to meet my team.
Walking through my hospital, which I know like the back of my hand, now feels like a surreal experience. The first thing you notice is that everyone is masked. Makeshift hospital beds are set up everywhere, even in the main lobby. When you get to the floors, you notice that all of the patient doors are closed and affixed with warning signs that remind us to “gown-up” before entering.
My team meets ahead of time to review each patient in detail. It’s at this point that we go over their labs, x-rays, and overall clinical status to develop an agenda prior to each examination. From there we round on each patient so we can get an up to the minute impression of their medical status. Following this, we alter our plans as necessary, order the appropriate tests, and call advisable consults. Perhaps the most useful thing we do at this time is contact patients’ family members to give them an update, since they cannot come in to see their loved ones. This can be difficult, as they are often emotional, but I am glad to be their point of contact and able to answer their questions.
The conditions of our patients vary from stable to critical. We have learned not to be complacent when our patients are stable, because they can crash very quickly as the virus moves to attack the lungs.
Never before have I experienced the kind of uncertainty that I do at this time. We have the best possible medical technology to support our patients, but we still don’t have the treatment for this virus.
I’m not going to lie. We are all somewhat scared … about a lot of things. We’re scared for our patients, scared that we can’t save everyone and, yes, scared for our own health. There is also a mild sense of helplessness. I have never been in a situation like this before. We were all afraid during the AIDS epidemic, but it was in no way contagious the way this infection is, and SARS and MERS did not hit us like this pandemic. We risk our lives as medical providers because our patients are dying from this infection, and they really need us now more than ever. Now that we have adequate PPE, we are more confident that we have the right protection.
Am I afraid for my life? Absolutely. Just before my deployment, I made sure to go through all of my insurance policies and accounts to assure that my family is well taken care of in case of an emergency. And I take special steps when I do return home.
Self-quarantining has been difficult. I first change out of my hospital gear into clean clothing in a safe area in the hospital. I then put a clean mask on to go home, using one that did not enter the hospital. I remove my shoes at the door, drop my clothes into a laundry bag and jump into the shower. I am then locked away from the rest of my family, eating and sleeping separately. I will remain there for a few days prior to rejoining them. It can be lonely, but it’s something I have to do.
I know people consider healthcare providers as heroes, and I do appreciate the honor, but I feel it really is our duty. We have the training to help the sick and make a difference, and if there was ever a time to be needed, it is now. I don’t feel like a hero, but I do feel a sense of pride.
