When I first met Rita, she didn’t make things easy. She fired a barrage of questions at me, punctuating her litany with the dreaded blow to every resident’s ego — “Are you a student?” — before slouching back on her bed, sweat glistening on her gray-streaked temples as though she had run a marathon.
As I check in on my patients each morning, I wonder if some will unexpectedly decompensate and die over the coming weeks. I think about myself and my co-residents who are in the hospital all day swabbing patients for COVID-19 without adequate personal protective equipment. Many of my co-residents are on home isolation as a result of this exposure, waiting for their test results and praying that our government will step up and fund more mask production, or civilians will return the N95s they’ve hoarded, or the set of a TV medical drama will donate their props to us.
Earlier last week, one patient had been referred in from their family physician, and the onsite senior resident, Adam, had been the doctor to assess them. Symptoms were vague — generally unwell, off food, bit of a cough, possible headache. Viral swabs were taken, because pretty much anyone that had lately walked through the hospital door with even a suspicion of sepsis now had samples sent off.
As an internal medicine resident working at Mount Sinai Hospital in Manhattan, COVID-19 has taken over our workroom conversations as the number of new cases enters exponential growth. As an anthropologist who lived in Wuhan for a year and has regularly kept in touch with physicians there since the city was placed under lockdown on January 23, 2020, COVID-19 has proved to be an unprecedented crisis.
You could feel it in the air, in how the nurses double-checked the orders, how the attendings’ notes bloated in size, and even in how the patients, despite their general lack of knowledge towards the inner workings of the hospital, exuded mild apprehension. It was day one of the academic year, the day that the new interns — my new interns — started.
Caffeine’s effect waned, stomachs rumbled, attention spans faded after rounding on nine acutely ill patients on university wards. It was nearing lunch. I was the senior resident, so I chose the order in which we saw patients. As we arrived at our last patient’s room, I snapped out of my under-caffeinated daze and realized I had made the rookie mistake of leaving our newest and sickest patient for last.
When I am asked about my future plans, my response is rightfully met with confusion. I am entering the workforce as an academic internal medicine physician devoting my practice entirely to the outpatient setting. Yet, two-thirds of my residency training has been managing patients within the walls of a hospital. That disconnect raises interesting questions about my career choice, and, naturally, makes me an anomaly among my peers.
Listen to the track “PGY3” by Dr. Roy Souaid and his band “John Lebanon.” The song started in New Orleans during the American College of Physicians National Conference in May 2018 and has been a yearlong project inspired by street buskers, hospital sounds and jazz. It captures the medical resident’s work flow and is set in the medical intensive care unit at the Miriam Hospital in Providence, Rhode Island.
At first, my heart pauses: frozen from shock. / But, within a few seconds, I start to take stock.
A smear of what I assumed was cat poop obstructed a narrow asphalt path that led to a mobile home. It was raining. I tiptoed around the sopping heap of excrement. Behind me, the wound care attending physician followed.
I remember feeling resentful that he seemed too healthy to have come to the ER in the first place, while I, on the other hand, was shuffling around as if walking ankle-deep in wet cement, dead tired and longing to stretch out on the gurney in the adjoining cubicle.
I did not stay down / I did not give up