An NYC Doctor’s Life During COVID-19

“I’m not heroic. I was never planning to be.”

A 30-something year old New York City doctor gives an account of how COVID-19 has affected her life at work and home. The edited interview took place on April 6th and was given under condition of anonymity because she could be fired for speaking about her experiences at the hospital. A few terms which she uses are: Intubation – the process of putting a breathing tube into someone’s lungs, connected to a ventilator. Decompensate – to be worsening towards death while being medically treated.

What’s the biggest difference in your work-life now?

Work is completely different. Before, I was an anesthesiologist for mostly elective surgeries. Now I intubate all the patients who have COVID-19 and who are decompensating. Then we turn them, meaning we put them on their stomach, which helps with the lungs. It’s a very dangerous time-consuming procedure. Yesterday I went to turn a patient and he died, so it’s not a harmless thing to do. That’s what we do on our shift. And every time I return for a new shift we’ve opened a new floor for intubated patients.

What was the sequence of events when that patient died?

The sad thing about him was he was 35 with a family. At first I didn’t even know anything about him other than he needed to be turned. Then his oxygen saturation started dropping, so we turned him back and called for the primary and intensivist teams. You know, to walk in and out of these patient rooms you have to don all the protective equipment so it’s a whole process. You can’t just run in and out. The main doctor popped his head in and was just like, “Do your best, if he dies he dies.” I do everything I can do to try and get him back and nothing helps. His chart said he’d been decompensating for at least two days and was supposed to die. This would be a huge deal any other time – there would be people who know his medical history thinking, what can we change? The whole thing took about an hour. I couldn’t leave but I also couldn’t do anything because nothing that I did helped. The situation is surreal when you’re in one of the best hospitals in Manhattan and a 35 year old previously healthy person is dying in front of you and there’s no fuss. You want the fuss.

Why do you turn people?

It helps open up the lungs. It helps with the breathing. In fact, for my friends who are relatively healthy but still experiencing symptoms of COVID-19 I tell them to sleep on their stomach as much as possible and when resting to lie on their stomach.

W​hat are some of the biggest frustrations that you have with the situation?

The Italians were telling us how bad it was going to get. The surgeon general said to stop elective surgeries. We all knew a tsunami was about to hit us and yet we continued doing elective surgeries for profit, despite the fact that we were going to have a shortage of basically all medications. You don’t have a choice to not use medications if you have a full roster of elective surgeries for the day.

Next is the lack of protective equipment. We were given an N95 mask at first and were told, “You’ll have to reuse it for a week.” Now mind you we’ve never re-used a mask. And then a week later you’re told maybe another week with the same mask. The hospital didn’t stockpile this stuff or think about conserving it or buying it earlier.

In anesthesia, you’re always preparing for the worst. You have to have a plan and you have to prepare stuff and put it aside and you know like 99% of the time you aren’t going to touch that stuff and yet you prepare it every single day. And the administration didn’t act that way. They hoped for the best case scenario, but they did not prepare for the worst. And in anesthesia it is not ok to do that. It is not ok to just hope for the best. Because that’s how you lose patients.

How has your homelife been affected?

Because I am on the intubating team for COVID-19 patients I am at a very high risk. So I moved out of my apartment. I still come home to see my family but I wear a mask 100% of the time at home. I don’t sleep with them and I don’t eat with them. I try to minimize time with my child but she can’t tolerate not seeing me and besides, there’s no end point that we know of. This could last another two, three months. I don’t think I could not see my kid for that long.

How does your husband feel about this?

My husband’s number one fear was that I would die. Even though I’m young and healthy, there’re a lot of young healthy doctors who’ve ended up on ventilators and who’ve ended up dead. We know that being exposed to so much virus predisposes people to getting more sick than their demographics would suggest. At first he tried to convince me that I should avoid working. I have a family. I have a responsibility to them, to my kid, to be a mother to her. I was very acutely aware of that before I went to my first shift. But this is my job. This is not something that I can elect not to do. And it’s also my responsibility. If not I then who?

What should people expect if one of their loved ones does go to a hospital?

We’re trying to keep people out of the hospital as much as possible. So if they’re healthier, we try to send people home. We don’t have any visitors. The same for those who are dying. And usually this would be the time that family comes and says their goodbyes and sits with the person even if they’re not conscious, but sits and holds their hand, and it gives closure for the family. But now we don’t have any of that.

Did you ever consider scenarios like this when you were becoming a doctor?

Not at all. You kind of get this image of a heroic doctor. But [laughing] I’m not heroic. I was never planning to be. I still don’t think I am. That was never me. That wasn’t going to be me. I was going to be a doctor in Manhattan. I wasn’t going to go into battle. And now our hospital looks like a battlefield.