Telemedicine in a Terrible Time: A Resident Physician’s Perspective
“Hello? Can you hear me?” Tightly holding the phone, I heard only an old man’s distant yelling and the shattering of dishes being thrown against the wall.
“Hello? Can you hear me?” Tightly holding the phone, I heard only an old man’s distant yelling and the shattering of dishes being thrown against the wall.
My husband Tom isn’t afraid of anything; strapping on a bulletproof vest every day for work will do that to a man. Tom wasn’t scared until I couldn’t breathe.
“The United States reports first death from COVID-19 in Washington State.” It was the end of February as I glanced over this news alert. For the past month, my inbox was flooded with emails regarding the COVID-19 outbreak. I saw my patients as usual throughout the day, albeit washing my hands and using hand sanitizers more often.
The nurses noticed the behavior first — how he answered for her, his arms on her shoulders, and, on the day of discharge, his refusal to leave her room to retrieve her medications. The labor & delivery floor was already in full swing when her nurse came over.
When I found out I was going to be deployed to treat patients with COVID, I dealt with a lot of existential dread. I remember feeling like I was leaving medicine behind when I matched to a psychiatry residency, and again after I finished the medicine portion of my intern year.
In medical school, I was taught to sit at eye level when speaking to patients, ask how they would prefer to be addressed, and ask open-ended questions to allow them to express themselves. I learned to interject with “That must be really difficult for you,” or “I can only imagine how that makes you feel,” as a way to show empathy and foster better connection with patients.
I was appointed to do the morning shift in the COVID ward of our respected hospital. The unit is a negative pressure area and, to us doctors, it is comforting as we embark on the Icarus flight.
As I enter rooms filled with aerosolized forms of the coronavirus, realizing that I am at high risk of catching this highly contagious disease, I set aside my fears to hold the hands of patients — strangers and friends, all alike. I love what I do.
Today, I made a two-year-old cry because I wanted to look into his eyes to rule out vision-threatening disease. The light was too bright, the lens was too close, and the attention was too much.
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.
It was a beautiful late winter Sunday, and my husband and I decided to drive to Plum Island, in the quaint sea town of Newburyport just north of Boston, for some bird-watching and ocean views. I wondered how my sister-in-law was doing — her wedding was scheduled in just seven days, and she and her fiancé had already been faced with tough decisions because of the coronavirus pandemic.