I’m a primary care physician at the VA, and I have about 1,000 patients. Maybe I was in denial, or just too much of an optimist, but it took me awhile to realize that COVID-19 was going to hit the United States so hard. I came to this realization about a month ago, when I started comparing the trajectories of the curves in Italy vs. the United States, and it …
A physician’s plea to protect veterans
As I sit here writing this, one of my friends and colleagues is on a ventilator. He’s fighting for his life. He’s a very healthy guy who runs marathons; we even did some race training together a couple of years back. And now, he’s in critical condition and may not survive. He’s one of the numerous physicians and other healthcare workers to be stricken with COVID-19. I do not know …
We are losing the COVID-19 war. Here’s how we can turn the tide.
It seems that many physicians finally realize that they are expendable. The fact that U.S. health care institutions view doctors (and every other employee) as disposable cogs in a machine is not a new phenomenon. I learned this lesson over a year ago as a vulnerable type of provider – a resident physician.
From someone who has already been …
Are you angry, doctor? It’s about time.
Our 23 bed ICU has been converted to COVID-19 patients. All of them.
I want to tell myself this is science fiction, but it’s not. It’s real. And we are scared.
As I enter the unit to start my night shift, we have a huddle of the off-going and oncoming nurses.
We are committed to fighting this invisible monster.
After a brief update of all of our patients, we bow our heads and say …
As an ICU nurse, I have never seen such an incredible death threat
Tonight will be my first night shift in the medical ICU (MICU) since COVID began ravaging New York City. I was on the hospital floors as an internal medicine resident during the early period of the COVID-19 pandemic. Since then, my clinic block was canceled, and I was placed on sick call, though I didn’t get called into any additional shifts. I felt uneasy in the days leading …
A physician’s first night at the MICU in New York City
I am an ER doctor, and my husband is a pediatrician. This story starts two weeks ago when COVID-19 was first changing all our lives. I am a travel doctor and was returning home. I saw a few patients that I was sure had COVID-19 (later confirmed). Fortunately, I worked in one of the rare ERs that had enough PPE, and I had worn it with each of those patients, …
How COVID-19 invaded my house and my family
I grew up with one guiding principle. One religion. One stone temple that I bowed to faithfully. I kneeled at the glorious shrine of medicine. It was the only thing I ever wanted to do with my life.
My education was vigorous. I stayed at home and studied while my high school buddies were goofing around at the mall. I spent quiet Saturday mornings in the law library while over a …
During times of stress, true colors show. The United States is a global leader and literally a dream for millions around the world. During the pandemic pandemonium, we should want to be proud to be American. What does that mean right now, though?
After the government’s expansive recent transformations in their role with emergency programs becoming available in light of the CARES Act being approved, I cannot help but think about …
COVID-19 and America’s true colors
I was quite young, but I could sense the unease in my mother when she first sent me off to elementary school amidst an uncertain risk of paralytic polio in the 1950’s era. She maintained her frightened countenance until 1960 when the Sabin vaccine miraculously appeared. Many years later, my wife, a pediatrician, had intubated a young patient with measles who needed ventilatory support. A few days later, she …
COVID-19: What can we learn from history?
I have been reading, thinking and consulting for a while about the occupational health syndrome commonly referred to as burnout. As initially defined back in the 1970s, burnout is a state of mental and physical exhaustion caused by one’s professional life. Extensive research shows that burnout (also called work “strain”) is the result of working conditions in which people have too much work, too little control, and too few resources.
Despite …
From physician to provider to health care worker: Names matter, even in a pandemic
The world is paused. But is it? Just because the world is experiencing a pandemic does not mean that the rest of the world’s ailments all of a sudden go away. Their priority may fall in ranking, but they persist. Health and disease continue.
I ate lunch and had severe abdominal pain shortly thereafter. Perhaps a bout of bad acid reflux, I thought, but the pain persisted into dinner, and when …
Undergoing an appendectomy in a pandemic
There have been increasing statements in the media to the effect that, for the COVID-19 pandemic, “the cure is worse than the disease,” and that the economic impact of the drastic and widespread quarantines will cause a severe recession that will result in excess deaths. This is very unlikely, as the overall U.S. mortality from unchecked COVID-19 would likely exceed the mortality from an economic recession resulting from the public …
COVID-19: Will the disease or the cure cause more death?
COVID-19 has given us many things, some of which we expected. Scarce resources, anxiety about keeping ourselves and our families safe, a sense of unparalleled vulnerability, and a solid helping of helplessness, knowing ultimately we may not be able to function as the doctors we strive to be when it matters most.
Personally, COVID-19 has given me an unexpected gift—one I really hadn’t seen coming. Psychologists call it the “dissociative state,” …
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It has been a month since the first case of SARS-CoV-2 presented in my hospital in South Jersey. The virus has been causing devastation around the globe since December 2019, and before the United States – China, Italy, and Spain suffered the greatest casualties. Like many physicians, I continue to blog in order to spread awareness and also to ensure that we are well-prepared as a society to face an …
A physician’s predictions about COVID-19
As COVID-19 continues to spread throughout the country and leave lasting impacts on our economy, many of us are trying our best to cope with the changes. While this can take a huge toll on our mental health and leave us unsure of our next move, there’s one thing we need to do in the midst of the chaos: Buy long-term disability insurance. Here are six things you …
In the midst of coronavirus: Buy disability insurance
Lisa’s heart pauses every time her phone rings. She’s unsure if the call she is answering is going to be the final update she will ever receive from the intensive care doctor caring for her love, John. Her 55-year-old husband of 31 years was placed on the ventilator eight days ago for a lung infection due to coronavirus. He resides in the ICU of the local academic hospital, …
The unintended consequences of isolating our dying COVID-19 patients
As a health care provider, husband, father, and friend, I felt compelled to share my perspective with colleagues, loved ones, and the community as we continue to manage COVID-19. These are unprecedented times we are facing, and there is a myriad of information and guidance we are asked to review and assimilate. This is not more information or guidance. Instead, it’s a message of hope to reduce the hysteria, fear, …
A different perspective on PPE during the COVID-19 crisis
The CDC’s overseas epidemic prevention activities, a veritable gift from America to the world, were effectively eviscerated in early 2018 by Trump and the then Republican-controlled Congress in alignment with the White House’s “America First” ideology. This wholesale slaughter on global public health preparedness later left China unable to take advantage of the CDC’s expertise once the novel coronavirus had been detected, thereby propagating the crisis around the world. What …
The oath we took does not include compromising our own safety
As researchers and physicians race to investigate innovative therapeutics against the novel SARS-CoV-2 virus, unanswered questions remain regarding the ethics and design of clinical trials. Namely, what is the most ethically and scientifically rigorous approach to test unproven novel or repurposed therapeutic agents during a major public health emergency? Canonically, randomized controlled trials (RCTs) have represented the gold standard for evidence-based medicine. In this approach, the efficacy of an intervention …
An ethical approach for clinical trials during the COVID-19 pandemic
I have been a physician for almost twenty years. The AIDS pandemic has been the greatest public health calamity of my career. Global Health Observatory data estimates that approximately 32 million people have died from HIV-related illnesses since the disease was formally identified in the early 80s. AIDS had already gained a firm foothold in the United States before the administration of the time publicly mentioned the name. Now, the …
COVID-19 is a different world for our most vulnerable citizens
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