Resident Physician Contributing Author
Cohen Children's Medical Center
Joseph Burns is a resident in pediatrics at Cohen Children’s Medical Center of New York in Queens, NY. He is a native of Orlando, FL and is an alumnus of Stetson University. He is a 2019 graduate of the Herbert Wertheim College of Medicine at Florida International University in Miami, FL. His research interests include congenital heart disease with a focus on bicuspid aortic valve and Native American health. He is passionate about the arts and community engagement. He hopes to pursue a career in pediatric cardiology.
Thinking back to January 2020, I recalled the whispers throughout the hospital of the first confirmed case of COVID-19 in the United States, mere minutes from my home institution. Aside from my perspective as a pediatrician, I was also forced to confront my own anxieties regarding exposure to this virus as an adult living with repaired congenital heart disease.
The novel coronavirus pandemic (COVID-19) has drastically increased the number of critically ill and dying patients presenting for hospitalized management of dyspnea, acute respiratory failure and other serious complications. The emergence and spread of SARS-CoV-2 has created unprecedented demands on all avenues of inpatient hospitalist medicine. One of the many services in high demand includes palliative care, with increased need for complex end of life planning.
On the morning of January 6, I awoke ecstatic to the news of Reverend Raphael Warnock and Jon Ossoff’s predicted wins in the Georgia run-off elections. To be frank, I have become hesitant to hope while inured by the near-daily attacks on civil rights by the Trump administration via executive orders and federal policies. Over the past four years, I witnessed with pride — but also fear — as community activists tirelessly organized to combat racist policies.
Above all else, do no harm. This is a basic tenet of a physician’s oath, but this oath does not always align with the religious and cultural beliefs of each patient. In cases where beliefs of faith, salvation or religion play a major factor in a patient’s desire to commit suicide, it can be difficult to draw the line between the traditional ethical guidelines of patient autonomy and non-maleficence.
In my home city of Washington, D.C., citizens have taken the changes brought on by COVID-19 very seriously; social distancing, masking and frequent hand hygiene are now routine. These days, I am startled when I see the bottom half of someone’s face out in public. Our homes have become our sanctuaries. In the hospital, however, much of our work continues unabated. Orders are written, notes are signed, lab work is drawn, imaging is performed. Housestaff are on the front lines with nurses, respiratory therapists and patient care technicians taking care of the sickest patients day-in, day-out.
Earlier in February of this year, before COVID-19’s onslaught in London, UK, I was covering service on a respiratory ward when a young medical student made herself known to the physician’s office. “Could I borrow your stethoscope? I’m here to practice my respiratory examinations.”
When the pandemic hit, many psychiatry departments across the United States had to rapidly adapt and respond in innovative ways to serve the needs of their patient population. After an initial struggle, many found a platform best-suited for this need and transitioned to telepsychiatry as a way to see and treat patients.
I first met Ruth in the emergency department when I was a third-year medical student on my psychiatry rotation. She was an “elderly female with psychosis — medical workup negative.” My resident had received a page with a request for her admission and sent me to the ED to speak with her first.
I am a 25-year-old resident physician of anesthesiology /
My sister and I are bonded by genetics, anatomy and biology /
I am a senior in high school at age 18. / My sister and I are bonded by love and everything in between.
For the first time in history, a pandemic has shut down the entire globe. COVID-19 has affected our lives in many ways, including significantly impacting health care services. Many people, sensing an unseen danger looming in the air, have become increasingly afraid to visit their primary care physicians, and we are now discovering the catastrophic consequences of this delay.
I constantly have to deal with racism and homophobia. In Boston. In America. When I leave work and go home, I have to prepare to deal with the same prejudices the following day. Why would I ever go out of my way to read such stories in my spare time, as I recover from the day behind me?
This elderly yet jolly gentleman answers our unending questions about his physical health, but it is his question to us that makes me pause. Do I have time for a poem? This busy clinic day, I stop reflecting on why his heart stopped beating and instead what motivates his heart to beat in the first place.
Fellow Physician Contributing Writer
Stanford University School of Medicine
Megha Shankar is a health services research fellow at the Palo Alto VA and CHP/PCOR at Stanford University. She completed her undergraduate degree in anthropology and biology at the University of Chicago, medical school at the University of Illinois at Chicago College of Medicine, and internal medicine residency at the University of Washington.
