An emergency room physician, who I interviewed recently, rented an Airbnb to protect his wife from the virus. He is now separated from his family, alone and fighting to keep safe in New York City, with limited resources and PPE or personal protection equipment. When we turn what is vital to our physician’s protection into an anacronym, PPE, it loses intensity and meaning. The words “personal protection” is also a misnomer because it should be personal and patient protection equipment: Patients and doctors are at risk if you are reusing contaminated equipment. Reused equipment can inadvertently infect a patient and the doctor.
The coronavirus is novel, and we have limited knowledge of how it is transmitted. We need to protect everyone from this virus, and we need to treat the seriousness of not having this equipment with the same urgency as if we had no guns to fight a war. You can’t avoid a bullet if you don’t have a bulletproof vest.
You can’t just throw doctors away as if they are disposable items like gloves or masks. Doctors are not easily replaceable. More than ever, we need to revere our doctors on the frontline who are struggling to survive the onslaught of COVID-infected patients. Many doctors and nurses are already preparing for the worse by having their final wishes and wills written. They are fully aware of their vulnerability.
Before the out brake of the COVID-19 pandemic, about 400 doctors were dying by suicide every year. Did anyone listen to the roar and the rumblings then? Doctors were killing themselves before the COVID-19 virus showed up because working conditions were onerous with long hours and a massive amount of patients. Physicians were burning out then, and more will be burned out now.
Some doctors were terminated when they spoke up about the injustices to the hospital administration. Nurses protested in the Bronx after one nurse died from the coronavirus. The nurse and his colleagues had posted on Instagram the use of contractor trash bags for personal protection. Nurses needed to resort to dehumanizing methods to protect themselves when the hospitals didn’t.
Healthcare workers, doctors, and nurses are not superhumans. We have the same fears and struggles, and we are called to help others, even if it means we risk our own lives. We are soldiers in action. We don’t have superpowers. We don’t want to be heroes. We want protection because we are vulnerable, even more so, because of our continued exposures.
An emergency physician at Brookdale hospital was interviewed on CNN. During the interview, she was wearing an N95 mask that moved up and down as she spoke, her eyes were unshielded, and she had a thin hair bonnet over her head, a paper gown that was loose at the shoulders exposing her clothes underneath. The emergency room was lined with stretchers in the hallways, a sea of infected patients waiting. The journalist who interviewed the emergency room physician was in a hazmat like a suit covered from head to toe, goggles over his eyes, headgear, double-masked, and double gloved. The journalist who was onsite in the ER for a short time was more protected than the staff people on the front lines. How does the journalist get this equipment, and the doctor doesn’t? Are the journalists more critical than the doctor or nurse who is working in the viral laden trenches? What is the message we are giving the public?
Sixty doctors died in Italy, one of the countries hardest hit by COVID-19. Here in the United States, doctors and nurses are getting sick and dying too. I remember being a medical student and resident during the AIDS crisis, and we didn’t know the origin of the disease when it began. It was easy for some to feel exempt from the HIV virus because it initially hit a very specific population, gay men. The novel coronavirus is different; it does not discriminate. Some would like to blame Chinese people, and there’s been evidence of xenophobia and discrimination towards Asians as a result. Then, there was the prevailing belief that it was mainly elderly and the immunocompromised who were most susceptible. In New York, there are twenty-year-old COVID patients on ventilators, without comorbid conditions, and we are learning everyone is vulnerable. This was a surprising revelation. The initial misunderstanding that only the elderly died may have caused the virus to spread more rapidly, as many young people felt they were more likely to be asymptomatic. When we see disease as “other,” only affecting one group and not another, it is easy for some to disregard it as not dangerous.
I am a psychiatrist who will be taking care of my colleagues during this crisis and beyond the aftermath. I can help with the stress and anxiety that is afflicting all of us. The mental health strain is enormous for those on the frontline, and my heart goes out to them.
Living in NYC, where thousands of people are dying, and Central Park is now a makeshift hospital with tents, the reality is facing me square in the face. The Jacob Javits Convention Center and Central Park are set up as hospital sites for another 800 plus beds. Freezer trucks now line hospital back doors to hold the dead bodies, because the morgues in the hospitals have reached capacity. It is an apocalypse, and our doctors are suffering mentally and physically from the strain.
I was told by one of my physician colleagues that New York University would graduate medical students early and pay them slightly above minimum wage. Medical students and interns are a valuable asset, a precious diamond in the making. A sixteen dollar an hour wage is a sad statement on the value placed on these brand new young doctor’s lives who are eager to serve.
Many of us went into medicine because it was a calling. We are all scared for ourselves and scared for each other, but we march on because we see it as a call to duty. Honor us for our service and our humanness. We are just like you, with families, personal ailments, vulnerable and brilliant. Doctors are precious jewels, treat them as such.
Hisla Bates is a psychiatrist.
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