I am an orthopedic surgeon in New Jersey and recently started a new practice. Less than a week after starting, news of COVID-19 arriving in NYC was everywhere. My family, my hospital system, and the rest of the country was trying to get a handle on this virus when my daughter spiked a fever that weekend. I spent an hour calling DOH at 5 a.m. trying to figure out if it was safe to go into my office because my three year old may have a potentially lethal virus. I imagine in the background the entire medical community was similarly fumbling for answers.
The following week was spent launching telehealth. Unfortunately, my patient population does not necessarily have access to great Wi-Fi or smartphones. My now afebrile three-year-old had been at home for over a week with no end in sight. My husband was still working as a physical therapist. We checked our temperatures and pulse ox daily before leaving for work. The only thing keeping us going was knowing data suggested that children are largely spared the worst of COVID. We try to help our daughter understand why she can’t see her friends while stumbling along blindly, along with the rest of the world, worrying about our health, our livelihood, and the faltering economy.
There is a discussion of canceling our yearly academic meeting. Other medical bodies are canceling their meetings, and this is unheard of. These meetings don’t get canceled. It represents a year’s worth of research and work. Flights and hotels are booked already. In hindsight, this is a blip in the story of COVID, but at the time, the fact that people much smarter than I am were so concerned was terrifying.
It is the third week of March, and I’m watching tents and refrigerated trucks go up outside the hospital. Friends from medical school are posting stories of PACUs being used as ICU extensions. Everyone is working remotely, and the news is telling us to stay home. We are on a nationwide pause. It has been the longest March in the history of my 35+ years.
I keep hearing hospitals are getting overwhelmed. I’m young, healthy, and available. My kids are healthy, and my husband is seeing patients anyway. I can risk exposure. I reach out and ask to put where I can be of use. I’m an orthopedist. I can’t run vents and you don’t want me running codes, but I can run supplies, call families, or be trained for anything else. Less than 24 hours later, I’m covered head to toe in a cap, N95 mask and surgical mask, plastic goggles, isolation gown, and gloves. I get deployed to a COVID unit calling patients’ families starving for information on loved ones they cannot visit and who are too short of breath to speak on the phone. These families were immensely grateful for those calls. I made zero treatment decisions, but the families thanked me profusely anyway. The unit clerk and nurses were grateful to be able to offload calls without having to stop in the middle of their workload. I received numerous calls and texts of gratitude from my administration. I did not think then and do not think now that I did anything extraordinary.
A week later, I was asked if I was willing to help the respiratory team. I reflexively agreed. My husband asked me to explain what the respiratory team does and what exactly I would be helping with. I told him that among other things, respiratory responds to all the codes because if a patient is intubated, they set up the vent. He paused, then repeated, “so you are responding to codes … codes on COVID-positive patients.” I paused, realizing that he was concerned for my increased exposure, and nodded my head.
The following morning I met up with the respiratory team and saw how clearly busy they were. I followed one person trying to orient myself. The only problem was that every time we got called to a code I could not bring myself to pay attention to the equipment I was supposed to be helping with. There was a person doing chest compressions and shouting instructions at the same time. I can do chest compressions. I cannot set up the vent, I am not going to attempt to run the code, and there is a person literally dying in front of me, so I do the one thing I know how to do: I jump in and do chest compressions relieving the person who knows more than I do. I did this six times in two hours. That was with one respiratory therapist on one morning. This one therapist out of several was at six codes in two hours.
At a certain point, someone in the ICU saw me drenched in sweat and patted me on the shoulder, asking if I was OK. I nodded, asked where the water was, and walked away. There have been maybe four times in my life where I stopped to take in my surroundings and wondered out loud, “What the hell am I doing here?” This was one of them. My arms were killing me, I was covered in sweat, and I could not breathe under the two layers of masks. My body was reminding me that I don’t normally do this. I heard codes called overhead several times an hour for a couple of weeks. I watched one code team in action over and over again, and after a certain point, they did not even look phased. This was becoming the new norm. That is terrifying.
I have a phenomenal support network. Even with that, nothing will undo what I have seen COVID do to families, doctors, nurses, children, everyone. I spent five weeks basically as an intern and medical student again. I would do it again in a heartbeat, but I’m hoping I am never needed in any capacity other than as an orthopedic surgeon again.
Nicole M. Montero Lopez is an orthopedic surgeon.
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