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.
In the first two months of 2020, I watched with alarm as a cordon sanitaire descended on Wuhan. I lived there as an anthropologist completing my research on Chinese medicine in 2017. Friends from Wuhan — most of them doctors — were suddenly describing scenes out of a dystopian nightmare.
Has social distancing paradoxically made us closer? Can disease be tragically beautiful? I pondered these questions as I reminisced over the past few weeks working on one of the medicine floors in my hospital, grappling with these thoughts almost every moment as I have witnessed the world respond to the COVID-19 pandemic.
It is difficult to put into words the level of frustration and despair that I have felt over the last few days watching the schizophrenic national response to this COVID-19 crisis and its detrimental effects on the work conditions of my colleagues. As an internal medicine physician working in Utah, it feels like it is the calm before the storm as emergency room and urgent care volumes are down as people try to socially distance to correct the spread of this virus. Other areas of the country are not so lucky.
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.
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.
As a program director, I am worried about my trainees who are already challenged with the usual stressors of graduate medical education (GME). This new illness is threatening to upend and disrupt our program in ways that I cannot even imagine, and therefore cannot plan for.
The other day at work, there were a few employees that were unnecessarily spreading panic on a message board by comparing the novel coronavirus COVID-19 to the infections mentioned in Jared Diamond’s book Guns, Germs and Steel — one commenter wrote that “every once in a while in history an infection comes along like this.”