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A US doctor on bracing for theworst of covid-19:“We show up despite knowingthe risks”
田纳西 洪东校友的女儿 Jennifer Hong April 2,2020
Jennifer Hong describes how ather US hospital, uncertainty weighs heavily as providers prepare themselves forthe upcoming surge of covid-19 cases
The walk to work is eerily empty. At thehospital entrance, in a surreal dystopia, staff members silently flash theirIDs and are ushered in through one door, visitors through another. Theelevators in the morning are still crowded, but there’s a determined effort tolimit contact with each other and with all hard surfaces.
The moment I escape enclosed quarters, I dousemy hands in hand sanitizer, then smother my workspace with a disinfectant wiperight after. I go to the protective equipment dispensary stations to pick up myrations: one mask for the shift, one face shield for the week. They’re packagedand distributed in brown paper sandwich bags, our names in bold Sharpie print.Sometimes, I add a smiley face.
To say these last few weeks in the hospitalhave been stressful is a gross understatement of the obvious. I work as amedical resident, and although our hospital has tried diligently to stay aheadof the impending crisis by opening units dedicated to the care of patients withcovid-19, the pressures of uncertainty weigh heavily. Which patients can wetest for covid-19? Which rooms can they go to? What tests can they receiveunder their precautions? How do we protect healthcare workers or other patientswho may have been exposed? The permutations are endless, and the answers oftenhazy. Aggravating these stressors is the acute lack of resources—from rationedprotective gear, to the trimming of teams because colleagues have gone intoquarantine, with symptoms or possible exposure risk.
The policies around covid-19 have changedalmost hourly, and the lack of available testing in the preceding weeks hascrippled care. It has fallen to individual institutions to develop in-housetesting or contracts with labs to expand testing capacity. Despite the hope forwider available testing in the oncoming days, all the signs indicate that nowis the calm before the storm. News from friends and colleagues in New York haveus on edge, with the exponential increase in critical cases leading to fourthyear medical students graduating early so they can start working and residents having their duty hour restrictions removed.
Around the country, we are preparing for theworst: will all residents, regardless of specialty, have to learn how tointubate and manage patients on ventilators? Will we have to make decisionslike the physicians in Italy did, determining who gets to be ventilated when werun out? Amid all of this, will we run out of protective gear, and will we alsofall ill?
We are all keenly aware of the ethicalquandaries that doctors and nurses in the thick of the pandemic have had toconfront, as well as the multiple reports of young, healthy providers who havebecome critically sick or died after being on the frontlines with and withoutadequate protective equipment. The omnipresence of covid-19 weighs heavily,exacerbating the existing anxieties of our jobs.
Regardless, everyone in my residency hasfervently shown up to work, committed to providing care, and offered to take onextra shifts if needed. Nurses, respiratory therapists, security officers, andsanitation workers are all working overtime in an effort to reduce the numberof people in the hospital, anticipating that we must keep a reserve availablefor when our numbers surely dwindle. The fear—and I want to acknowledge thisfear, because it’s easy to think that recognising it is weak when it’s not—isreal, but we swore an oath. And so, we show up despite knowing the risks,despite grappling with the unknown.
Given what we’re facing, it doesn’t seemunreasonable for me to hold our federal leaders to the same standards that ourhealthcare system holds of young professionals. It therefore baffles me thatmembers of our administration have exclusively referred to covid-19 as the“Chinese Virus,” scapegoating people of Asian descent and putting them at risk of harassment, rather than focusing on solutions to ourcountry’s horrible preparation for this pandemic. It baffles me thatasymptomatic elected officials who advocated against providing emergencycoronavirus funding were tested in a time when we have struggled to testhospitalised patients. It baffles me that while hundreds of thousands ofAmericans are asked to stay at home without any reliable source of pay,Congress has floundered at providing immediate financial assistance during atime of crisis.
If the Trump administration thinks this is wartime, then healthcare workers are soldiers.Our landscape is unfamiliar, but we are adapting and changing our practices ona daily basis, bracing ourselves for what is to come. Yet soldiers need to besent into the field with adequate armor. It is not acceptable to yield tothe CDC’s recommendation that we can use bandanas or scarves asalternatives to protective gear, rather than mandate the procurement andproduction of adequate equipment. Do not compromise our safety, and do not takeadvantage of our oath. We will show up and do our jobs to serve and protect ourpatients. We expect our government leaders to do the same.
Jennifer Hong is a second year resident inthe internal medicine program at Brigham and Women’s Hospital with an interestin narrative medicine, health equity, and primary care. Twitter @jennyyhong
Competing interests: I have no financialor organizational conflicts of interest to declare. The opinions expressed inthis article are solely my own and do not reflect the views and opinions ofBrigham and Women’s Hospital.
An earlier version of this piece was publishedon the author’s personal Medium page.
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