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Young physicians belong on the battlefront

Ajit Rai, MD

Physician

April 29, 2020

In the last month, we have seen surgeons and shrinks alike leave the comfort of their suburban perches in order to fight on the front lines of the coronavirus war in America. While it should be inspiring to watch retired physicians return to the field to engage in the battle of their lifetimes, we should be wincing—the odds of suffering severe complications from COVID-19 are demonstrably greater amongst the older …

My frontline is the sideline

Nicole Kucine, MD

Physician

April 29, 2020

During a recent Zoom call discussing issues of physician wellness, a common theme emerged among some of our pediatric faculty – a form of imposter syndrome. 7 p.m. cheers in New York City ring out for essential workers and medical staff. Calls, texts, and messages come in from friends and family thanking us for working on the frontlines of the COVID-19 crisis. Yet those cheers don’t feel like they are …

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My frontline is the sideline

The question you will be asked after the pandemic

Jason Lee, TCRN, CCRN

Conditions and Diseases

April 29, 2020

I am an ICU nurse in Manhattan. I have seen my share of trauma, critical illness, and sorrow. But what is happening in my hospital and hospitals across America is on a scale of tragedy not even the most seasoned clinician has experienced.

My hospital looks like any hospital in America. Serene on the outside. Typical day. Any day of the year. …

The pandemic reinforces the need of listening to patients

Jessica Lee, MD

Physician

April 29, 2020

Three months ago, none of us thought we would be shifting our practices from office visits and hospital rounds to telemedicine and virtual check-ins. In fact, we would have not only denied it was possible, but touted concern for the decline in patient care. As pandemic concerns reached the United States in March, telemedicine visits began to climb, and many practices have reported increases of 500 percent or more for …

Not all physicians wear a stethoscope, even during a pandemic

Cory L. Simpson, MD, PhD

Physician

April 29, 2020

I’m a dermatologist, so I’m not on the front lines of this pandemic. And thanks to public health measures, I may never be called to work at coronavirus drive-thru testing sites because we are flattening the curve of infections. Nevertheless, my clinic is reserved as a hospital “surge unit,” so I’ve converted to telemedicine to keep caring for patients—it’s easy to forget amidst a pandemic that other diseases persist and worsen if …

Can patients see my smile behind all of this PPE?

Maria Michaelis, MD

Physician

April 29, 2020

I walk into my fifth operating room of the morning.

“Good morning, Mr. Jacobs. My name is Dr. Michaelis. I will be the anesthesiologist helping to safely get your breathing tube in as we get your surgery started today.” He nods and closes his eyes. That’s all he can see of me. My eyes. I am wearing my PAPR (powered air purifying respirator) and mask. For the second day this week, …

The burden of essential business: How independent pharmacies are struggling to stay open

Palak Patel

Health Policy

April 29, 2020

My parents’ pharmacy is a low slung, white brick building on the corner of East and Main. The front door is strung with silver bells; a jar of red licorice sits by the cash register; automatic scooters line the front of the shop, gleaming like cars at the races.

Most days, the pharmacy is a small business owner’s dream. The phone rings off the hook; and with twenty-nine employees, there’s always …

How to cope during COVID-19

Ken Zweig, MD

Physician

April 29, 2020

Lately, in the face of the coronavirus outbreak, I’ve been fielding calls from patients asking for help with anxiety, depression, and insomnia. People are worried about their health, their families, their jobs, and whether society will be able to get back on track. Trying to stay positive in the face of this unprecedented adversity is certainly not easy.

While I’m deeply sensitive to the distress being felt by the community, I’ve …

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How to cope during COVID-19

Emergency physicians want you to have the talk about end of life care

Gregory Jasani, MD and Rebecca Rubenstein, MD

Conditions and Diseases

April 28, 2020

Currently, over 60,000 people in the United States are projected to die from coronavirus. While this is lower than earlier predictions, it is still an appallingly high number. As two emergency medicine physicians, we have been steeling ourselves for the grim task that lies ahead of us in the coming weeks and months. We will continue to go to work to try and provide the best care we can to …

It’s time for health care professionals to acknowledge our vulnerability and allow others in

Victor H. Hatcher Jr.

Conditions and Diseases

April 28, 2020

It was only day one, and I was covered in blood halfway to my elbows from doing chest compressions in the operating room. The room was filled with doctors, nurses, and other OR staff. Empty bags that once contained life-saving blood, plasma, and platelets lay scattered across the floor. She was young, not the kind of patient you would ever suspect you’d be sweating over as you frantically recall what …

Strategies to foster meaningful connection during telemedicine visits

Megha Shankar, MD, Meredith Fischer, MA, Cati Brown-Johnson, PhD, Nadia Safaeinili, MPH, Marie Haverfield, PhD, Jonathan Shaw, MD, Sonoo Israni, MBA, Abraham Verghese, MD, and Donna Zulman, MD

Physician

April 28, 2020

The COVID-19 pandemic has upended health care, with telemedicine emerging as a strategy to reduce risk exposures for patients and clinicians. Originating from the Greek root tēle-, tēl-, tēle meaning “far off, afar, at or to a distance,” telemedicine encompasses virtual clinical services. Video visits, in particular, can be effective for many types of clinical care and offer convenience and savings for patients. As care …

The final words that are a precious reminder of why I went into medicine

Andy Lamb, MD

Conditions and Diseases

April 28, 2020

I have cared for them both, husband and wife, now in their 80s, for almost 20 years. She is a retired nurse and him from his business. They are so typical of this “greatest generation”: tough, enduring, hard-working, deeply faithful, fervently independent, those characteristics that allowed them to survive the Great Depression, World War II, and the many challenges that come with life. They have seen their share of joy …

Health care workers: What do you need?

Tracy Asamoah, MD

Conditions and Diseases

April 28, 2020

What do you need? What do you need right now, and what will you need days, weeks, months from now?

Do you need PPE or time off? Do you need hand sanitizer or disinfectant wipes? How about testing kits? Swabs? Do you need help keeping your practice afloat or managing a pay cut? Do you need your organization to acknowledge your struggles and make changes to prioritize the health and well-being …

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Health care workers: What do you need?

COVID-19 and the value of human life: What if the vulnerable population was flipped?

Jessica D. Lee, MD

Conditions and Diseases

April 28, 2020

As I lay awake in the wee hours of the morning, after having yet another debate regarding COVID-19 and reopening the economy, my thoughts were rambling. I am ready for some return of any semblance of normalcy—like most everyone in the world right now—whatever that “new normal” may look like. I look forward to a nice dinner out, to seeing my extended family again, to seeing patients in person in …

Strategies for lifting COVID-19 mitigation restrictions

Nicolas K. Fletcher

Health Policy

April 28, 2020

Over the last 100 years, the U.S. has had to respond to five avian flu pandemics. The most severe was the 1918 avian influenza infecting 1/3 of the world’s population and killing 650,000 Americans. It was also the last time wide-spread containment, mitigation, and isolation strategies were used in the U.S. Seldom mentioned about the 1918 pandemic are the three “waves” or cycles of resurgence and the subsequent deaths associated …

Combining emotion and reason in decision making

Robert Frolichstein, MD

Physician

April 28, 2020

We are living in unprecedented times. Times filled with emotion and very little hard science. We are faced with the rapid spread of a new disease that has devastating consequences. The rapid spread is overwhelming our system that is designed for a steady state. Periodically, we are faced with events that overwhelm our system; mass shootings are a prime example. The duration of those events is measured in hours. We …

The guilt of not being on the frontlines of the pandemic

Theresa Rohr-Kirchgraber, MD, Sylk Sotto, EdD, Cynthia Brown, MD, Diane M. Donegan, MD, Erin M. Crowley, MD, Sacha Sharp, PhD, Christen Dilly, MD, Heather O’Leary, PhD

Physician

April 28, 2020

Do all physicians and scientists not on the frontlines of this pandemic feel this, or is it unique to women? Women in medicine and science have long struggled with the sense of never having “done enough” and have pushed themselves even harder to get the same recognition accorded our male colleagues. Does that make us more vulnerable to guilt, or are we holding ourselves to unreasonable expectations? We arranged to …

Why I wear a mask in public: to protect our unsung heroes

Heather Ballard, MD

Conditions and Diseases

April 28, 2020

With over 900,000 infections and 50,000 deaths in the United States from COVID-19, wearing a mask in public is now a popular thing to do. In fact, the Centers for Disease Control is recommending that everyone wear “cloth face coverings” and many cities and states have placed orders for universal masking. Even First Lady Melania Trump has a picture of herself wearing a medical mask on her Twitter page. Many …

After COVID-19, can we really stomach the minutiae that comes with the next Joint Commission review?

Steve M. Grant, MD

Conditions and Diseases

April 28, 2020

I’ve always been fascinated with dystopian novels and zombie movies. When the apocalypse comes, we stop sweating the small stuff. Important tasks like sculpting our abs or finding the perfect area rug suddenly take a back seat to the new primary directive: survival. Nothing else matters.

Healthcare workers have taken a similar survival first approach to COVID. We’ve put aside our tiny tragedies and banded together to save our communities. It’s …

It is OK to be scared, but it is not OK to let our own anxieties harm our patients

Sami El-Dalati, MD

Conditions and Diseases

April 27, 2020

“Our current guidelines from the hospital and our national societies are if the patient is not at risk for a major cardiac event in the next week we should defer surgery.” The words hang in the now virtual air of the hospital’s weekly multidisciplinary endocarditis conference. The young woman whose case we are discussing has bacteremia with two different organisms and a very large infectious mass on one of her …

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