It feels odd to have family members in the hospital regularly again. My patient’s wife approaches cautiously; for a second I pretend not to see her. She looks like she wants to talk and I’m afraid she wants good news I can’t give, promises I can’t make, and time I don’t feel like I have. She wants time to tell me her loved one’s stories.
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.
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.
by Dr. Ritu Nahar, MD, internal medicine resident physician in Philadelphia, Pennsylvania, written for COVID-19: Inside the Global Epicenter: Personal Accounts from NYC Frontline Healthcare Providers by Krutika Parasar Raulkar, MD Prior to starting the COVID service, I was eating and drinking fear and anxiety — there were wakeless nights and internet research, scrutinizing countless emails taking notes on the latest Jefferson COVID guidelines. I was alternating between feeling like a strong and resilient knight …
I have finally had enough. As a health care provider, COVID-19 brought about a lot of uncertainty and many changes in preparation for what might unfold. But over the last few months, the social unrest surrounding police brutality and the disproportionate occurrence of these cases towards people of color has added to my physical exhaustion by conflating it with both emotional and mental fatigue. After 32 years of tolerating systemic racism, it is finally my turn to say something.
When do you leap into the unknown and venture into the uncomfortable? Is it after methodical deliberation or is it much more abrupt, emboldened by a critical decision? Perhaps it is a deep drive within you, one that propels you forward in a way in which you cannot look back.
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.”
Day 50 something? I haven’t been counting. I had to look it up, from the first day we got the hint things were really wrong … March 3, 68 days ago. That was the day all domestic travel to conferences was banned.
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 didn’t start out thinking I was going to be a physician. I was going to be an actor. I committed myself to a life of emotional expression, artistic fulfillment and likely poverty, and pursued an undergraduate conservatory degree in theater, which I quickly found is one of the most nebulous forms of education one can obtain.