The front desk staff member who checks you in at your primary care physician’s office is 64 years old with a history of hypertension and coronary artery disease. She unexpectedly became a widower five years ago and is planning to work until the age of 68 to secure adequate retirement savings. She is worried about contracting SARS-CoV-2 from a patient as they check-in despite being vigilant about her personal hygiene practices. Still today, she is sitting at the front desk of your doctor’s office, initiating your encounter so that you can get the medical attention you need.
The emergency department physician, who intubated your cousin when he came in with progressive respiratory distress leading to respiratory failure, is 36 years old and healthy, but she also lives with her 71-year-old father with type 2 diabetes mellitus and stage 3 chronic kidney disease. She often replays her patient encounters and procedures, wondering if she donned and doffed appropriately enough to prevent the transfer of secretions from high-risk patients during high-risk procedures. Today, she came to work and saved your cousin’s life.
The environmental services worker, who cleans and sanitizes your assigned patient room before you can be wheeled in, has a six-year-old daughter with severe persistent asthma who has been intubated and admitted to the pediatric intensive care unit (ICU) twice before. Upon returning home from work, he changes out of his uniform in the garage, puts his work clothes directly into the washing machine on the highest heat setting, and hops into the shower— all before greeting his daughter— constantly afraid to be the cause of another ICU admission. Today, he is the reason you have a clean room to recover in.
The medical assistant who inquires about your chief complaint and takes your vital signs at the local urgent care is 29 years old and recently returned to work after a ten-week maternity leave, leaving her 2.5-month old and toddler at home with a babysitter. Greater than 50% of her salary is spent on childcare. She is nervous about being a carrier of SARS-CoV-2 and unknowingly bringing it home to her children. However, today, she is taking your temperature, checking your pulse, counting your respirations, and obtaining your blood pressure so that the rest of the patient care team has an accurate picture of your clinical status.
The registered nurse who administers your mother’s intravenous antibiotics during her admission to the general medical floor for a urinary tract infection, has an immunocompromised wife at home, who is currently receiving chemotherapy for breast cancer. He constantly worries about the possibility that his “mild cold’ could become a serious illness in his wife and, due to his high risk of exposure to COVID-19, he is temporarily residing in a separate home. Today, he is at the hospital taking care of your mom and helping to ensure her infection, currently limited to the urinary tract, does not turn into sepsis.
The pediatric oncologist, who is infusing your child’s intrathecal chemotherapy, is careful not to go to the physician’s lounge or the hospital cafeteria for fear of exposure to another health care provider who may have asymptomatic SARS-CoV-2. He practices modified social distancing even while working, and his hands are dry and cracked from excessive scrubbing prior to procedures and rounds. Today, he is here for your child because cancer cells do not stop multiplying even during a pandemic.
While many of you may feel like the medical community has created a lot of commotion over “nothing” because COVID-19 has not directly affected you, I implore you to be cognizant of those who would happily welcome the many inconvenient side effects of social distancing and sheltering in place that you are experiencing. Essential personnel in the health care field and emergency services, cashiers and customer service representatives, gas station attendants, small business owners, and waste management employees continue to serve you and, in doing so, are putting their own lives at risk. The warranted emphasis on health care workers and first responders is due to their significant and recurrent exposure to patients with COVID-19. These health care workers go to work each day, hoping that there is a simple surgical mask available for them during their shift. They decontaminate themselves upon returning home, often in their garages and backyards, to protect their families as much as possible. Some have even gone as far as isolating themselves in a separate residence altogether or sending their children to live with relatives. These health care workers have personal medical conditions, family obligations, financial concerns, and many other burdens that are being put on the back-burner to prioritize your health care needs.
If you rearrange the titles and stories I have shared above, these people become my friends, my family members, and my colleagues. They are integral members of the health care system, and I plead with you to do your part to keep them safe. That means staying home and thinking twice about whether or not an errand is essential. That means using the health care system wisely— emergency departments for emergencies only, primary care offices for essential visits and telemedicine visits or phone calls for other concerns when appropriate. Last but not least, it means embracing the seventh time watching Frozen 2 with your children, laughing at the blunders that occur during video conferences thanks to your colleague’s attention-seeking Yorkie, and celebrating the mundane day to day activities that are often overlooked and undervalued. Please do these things for us and know that we will continue to do our best for you.
Alpa Patel Shah is a pediatrician.
Image credit: Shutterstock.com
