|NARRATIVE MEDICINE SYMPOSIUM ON COVID-19: INDIVIDUAL CONTRIBUTIONS
|Year : 2020 | Volume
| Issue : 2 | Page : 132-133
COVID-19 in NYC: Emergency medicine resident perspective
William Haussner, Manish Garg
Department of Emergency Medicine, Weill Cornell Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York City, NY, USA
|Date of Submission||27-Apr-2020|
|Date of Acceptance||10-May-2020|
|Date of Web Publication||29-Jun-2020|
Dr. William Haussner
NewYork-Presbyterian Hospital, 525 E 68th Street, New York, NY 10065
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Haussner W, Garg M. COVID-19 in NYC: Emergency medicine resident perspective. Int J Acad Med 2020;6:132-3
Working as an emergency medicine resident during COVID-19 in New York City instills fear both inside and outside the hospital. Internationally, the destruction the virus does to the human body has been extensively discussed, while damage to our morale and social constructs have been neglected. We can wear personal protective equipment (PPE) at work and practice social distancing at home to protect ourselves from contacting COVID, but much of this physical isolation has spilled over into our lives in ways we did not expect.
”I'm sorry that I'm here” he said, while removing a bandage off his large, bleeding hand laceration. “I know you guys are very busy, and I am probably wasting your time, but it kept bleeding through the gauze I was placing.” The laceration was large, gaping, and clearly needed sutures. I was shocked that he apologized. Sorry?, I thought to myself. This is why I am here. Never once in the last year since I became a doctor had anyone apologized for being in the emergency room (ER). “Do you have any better gauze? I would prefer to get out of here as quickly as possible,” he said, while adjusting his mask. COVID-19 had clearly changed the climate of the emergency department; a place where many patients would make themselves at home, was now dirty, and even dangerous. People could not stand to stay in it, when in the past they were relieved to be there.
Just 1 month earlier, as my shift was coming to an end, I saw a woman ushered into a negative pressure room by nurses and security. I wonder what that is about, I thought as I sat at my computer. Probably someone from jail, maybe acting rowdy, I rationalized as my computer logged on. I noted this patient's status was “to be seen,” so I looked through the triage information in preparation to see this patient myself. To my surprise, she had presented to the ER with a cough and shortness of breath upon returning from China. She was not a prisoner at all. Seeing this, I was filled with angst. My mind raced through images from the news of patients on ventilators in Italy and China. I had thought the virus would not reach our shores, let alone my ER.
Seeing as it was, I knew I had to procure the right equipment to protect myself. As I walked toward where the patient was located and began to methodically fasten my mask and don my gloves, she began pounding on the glass door, startling me. It was clear she wanted to speak to me, but I did not want to get close to her or the door, because I was not yet completely dressed in PPE. Frustrated, she began frantically pointing to the restroom. How I am going to get her to the bathroom without infecting myself or the rest of the ER, I thought. As various ideas crossed my mind, such as giving her a mask or helmet, she was handed a bed pan through a minute opening in the door. As soon as her fingers grasped the pan, the door was swiftly closed. She may as well have been a prisoner.
My shift ended shortly thereafter, and I walked home. I questioned if I had washed my hands thoroughly enough, or if I had at some point inadvertently infected myself. My mind began to spin, thinking about getting ill and becoming like that patient: locked in a room alone, or worse, on the ventilator. I also worried about getting my family sick. Maybe I should skip dancing lessons just in case I get contaminated, I thought. I did not want to get my fiancée or instructor sick. However, my wedding was shortly approaching, and my two left feet needed those lessons desperately. When I got home, I washed my hands twice, fearing that my wedding day might be spent locked in a room in the hospital.
Over the coming month, the tracking board filled with patients at various stages of this illness, and I began to evaluate them myself, as there were too many for just the attending. Taking care of these patients is unlike what I was used to in the ER. The history was all the same: Fever, cough, shortness of breath. The examination was brief, as to not cause undue exposure. As time went on, the line between COVID and non-COVID patients became blurred, and soon everyone was treated the same. Gone were the times of sitting on the end of the patient's bed and laughing at how the avocado is the culprit of the hand laceration. Instead, the history is taken from 6 feet away in full PPE. Gone too are the days of having a stethoscope around my neck and the long white coat I waited 4 years of medical school to wear. All of these things add to the risk of being infected, and still I felt like it wasn't enough, that I already was infected.
On my way to work at 7 pm the city erupted with cheers, celebrating health care heroes and the sacrifice to treat the pandemic. People applauded from those who were on their way to or from work to treat patients. However, as I walked on the street in my usual scrubs, I could tell people were staring at me, revolted at what germs my clothes could be soiled in. Presumably, not wanting to find out, they would abruptly walk to the other side of the street. I quickly learned to change my clothes in the hospital, not only to limit the potential spread of the virus, but to hide the public announcement that I care for COVID patients. Regardless, when my Uber driver pulled up and realized I was near the hospital entrance, he sped off; the ride was cancelled.
As time progressed there were few patients in the ER without a respiratory complaint, let alone an avocado injury. The ER which was once there to treat “anything at any time” had become feared, as it filled with patients with COVID and even converted partially into an ICU. Not only did my life at work completely change, but the pandemic led to my own wedding being postponed. At least I have more time to practice dancing. But while I would not spend my wedding day enclosed in a negative pressure room on a ventilator in the hospital, as I had once feared, I would still be confined—instead in my apartment. There has been nothing left untouched by COVID.
Working during this time as a physician has become increasingly isolating, both physically and emotionally. My life has become completely consumed by COVID. Chief complaints are all respiratory. When my family calls, they can't help but ask about COVID and “What the ER was like?” My colleagues in the ER are slowly replaced with unfamiliar faces as staff gets sick. The fear of COVID is hard to escape, and I am sure the emotional stresses expand far greater than those in the health care profession. The virus is infectious and toxic, not just because of particles, but because of the way it has infiltrated our lives. And unfortunately, there is no PPE or isolation room for that.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
Ethical conduct of research
This project was conducted in accordance with the ethical standards guidelines provided by the CPCSEA and World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Humans.