Ignoring a problem won’t make it go away. I say this all the time, with love and compassion, to my patients who are having trouble accepting a diagnosis. Ignoring your Type 2 Diabetes, for example, won’t make it any less real. It will only land you in renal failure and on dialysis, or with a foot amputation, or a heart attack or stroke. Sometimes, we have to set ego aside. …
Ignoring COVID-19 won’t make it go away
The global pandemic of COVID-19 presents a serious threat of overwhelming our health care system’s capacity. With the lack of a clear, decisive response from the federal government to minimize early virus transmission, it’s becoming rapidly clear that the spike in critical patients flooding the health care system within Italy will likely soon be a problem that the United States will face …
What about the other 80%? Medical students at all levels of training can help beat COVID-19.
I am addicted to Facebook these days. Like everyone else, I am glued to social media, riveted by the drama unfolding around me. I read from the perspective of a primary care doctor in Seattle, the site of the first case of COVID-19 in the country. My friends and family send me regular thanks for being “on the frontlines.” In truth, I am not on the frontlines. I am not …
Don’t praise physicians, protect them
The unparalleled and pervasive nature of the evolving COVID-19 pandemic has touched all of us in some way. There is limited, albeit growing, research on the mental health effects of disasters. A recent review article pointed out the potentially negative consequences of prolonged quarantine, while other research from Wuhan, China, highlighted the impact of COVID-19, particularly amongst healthcare personnel. Psychiatrists and mental health professionals will play a …
Redefining the role of psychiatrists in the time of COVID-19
In college, I learned about the Frank-Starling law of the heart. It is fascinating and demonstrates just one of the bewildering number of human physiologic responses needed to adapt to the demands we place upon our bodies every day. In brief, the Frank-Starling law states that a healthy, normally functioning heart will respond to increases in demand for blood supply and oxygen by increasing the strength of cardiac contractility. This …
The heart of America’s health care system is failing
Fourteen days of social distancing have passed. Emotions are high all around. The wicked foreboding of the mysteriously menacing novel Coronavirus has spared no one. Everyone is scared. The cleaning staff, scrubbing, and wiping just one more time. The techs, maintaining stoicism behind masked faces. The patients, eyes darting with fear. The nurses, bravely caring for their patients. The reality is that the physicians are scared too. We are all …
A few weeks into COVID-19: Alternating between sadness, fear, optimism, and anger
Arrival to isolation room 45: Recently diagnosed with COVID-19, brought in by ambulance for re-evaluation.
I don my new uniform of colorful barriers: red-rimmed eye shield, green N-95, yellow gown, purple gloves. I carefully walk through two sets of doors into the room and find the most sterile spot. I used to touch, shake hands, sit; now I stand on a clean tile away from his bed.
“So I …
Within the COVID-19 tragedy, there are real people admirably grappling with their new realities
As a 4th-year neurosurgery resident, I’ve tried to sink my heels into every aspect of neurosurgical care in order to harness the skills, the knowledge, and the confidence to know that I’ll be ready to provide exceptional care to my own patients at the end of seven years of training. If you asked me before the COVID-19 pandemic, I would have never considered that telehealth and virtual care would not …
Virtual care for surgical subspecialties
When the COVID-19 pandemic is finally over, health care providers around the world will be asking themselves how we got here. Buying PPE off eBay. Soliciting the public to sew masks. While, as a country, we could have been better prepared, it would not have been practical to stockpile the 3.5 billion masks that HHS estimates will be needed throughout this pandemic. …
Doctors in harm’s way: The stage was set for a PPE shortage long before COVID-19
An emergency room physician, who I interviewed recently, rented an Airbnb to protect his wife from the virus. He is now separated from his family, alone and fighting to keep safe in New York City, with limited resources and PPE or personal protection equipment. When we turn what is vital to our physician’s protection into an acronym, PPE, it loses intensity and meaning. The words “personal protection” is also a misnomer …
Health care workers are precious jewels. Treat them as such.
When I was 18, I decided I wanted to be a doctor. I wanted to help people. I wanted to make things better for others. So, I studied hard in college. I couldn’t afford to pay for test prep classes for the medical school entrance exam, so I studied on my own. I would lock myself in my room and study for six to eight hours at a time for …
I am a physician and I am not your enemy
It’s 8 p.m., and I stumble into my apartment and fall into bed. Somehow, I avoided nodding off in the car driving home. I just finished a 36-hour shift, something I thought was an inhumane task.
Somehow, I survived on two hours of sleep, incessant phone calls, pages, and a granola bar.
This morning I saw a cat in my apartment, except I don’t have a cat.
I fumbled through patient care all …
Medicine will make you sick if you don’t sleep
In between snippets of conversation exchanged with my husband about how the first day of remote learning went for our 9 year old and whether the latest nanny was likely to quit given health risks associated with working in a two-physician frontline worker household in the context of COVID-19, we also discuss some potentially dangerous scenarios. The discussion is quite mundane, between what we are having for dinner and how …
Should physicians shy away from accepting their mortalities?
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As the medical director of a Midwest community emergency department that has yet to see the New York City-levels of devastation, I am begging hospital administrators across the country to begin leading their front line health care workers in preparation to meet the enemy head-on.
It has become painfully clear in our hospital daily incident command briefings and discussions with our hospital leadership that no one is making decisions. The decisions …
A call to arms for hospital administrators
Growing evidence suggests that the novel COVID-19 virus can be aerosolized. To adequately protect employees, providers require not just “droplet,” but “airborne” precautions and the appropriate healthcare worker personal protective equipment (PPE).
Appropriate PPE mandates an N95 mask. News reports for weeks have described hospitals working without the necessary protection for health care providers.
This is the case in Boston-area hospitals, which are running short on these masks. One of the city’s …
Are Boston hospitals prioritizing money over the safety of their employees and patients?
I’ve been reading a lot of posts expressing disappointment with the way that COVID-19 has been covered in the media and worry about the economic consequences of prolonged social distancing. This is long, and you might not care, but here’s my perspective as a former ICU nurse that witnessed many deaths, a nurse anesthetist who is dealing with both the administrative headaches that go with dealing with this disaster and …
We are not being too alarmist about COVID-19
“It’s a strange time to be having a baby,” my patient said as she sat alone in her labor room. The state order to shelter-in-place in California had left her family with few options as her husband had to stay home to take care of their toddler. She is one of many pregnant women who do not have the choice to even consider a home birth due to her congenital …
Giving birth during the COVID-19 pandemic: an obstetric anesthesiologist’s perspective
Social distancing.
It is a mantra that seemed to have been plucked straight out of obscurity for those who had never heard of it before just as the coronavirus pandemic dug its ugly claws into the fabric of American life. And since then, it has been perfusing our cultural ether for the last several weeks—aggressively occupying the webpages across the internet, leaping onto the headlines of newspapers, and frequently serving as …
Try social loving instead of social distancing
My friends ask me how I’m doing. The short answer is always, “We’re OK.” But the real answer is much longer.
I feel a lot of anxiety these days. It’s always there, sometimes with more intensity than others. But a constant, ever-present, lurking beneath our routine.
Like everyone else, sheltering in place is a component of it. There are the combined aspects of keeping my four children entertained, keeping them from fighting, …
How are we doing? The short answer is that we’re OK. The real answer is much longer.
On Doctors’ Day, my hospital celebrated our work by giving us each a pair of cheap headphones, and also announced the death of an attending. Though the personal risk to each of us was highlighted by the recent death, the administration did not give hazard pay, or PPE comparable to other countries’, or even a guaranteed supply of isolation gowns. Just headphones a different color than the ones they gave …
The hospital doesn’t care: Physicians must advocate for themselves
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