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“If you knew we are like the ‘Two Fridas,’
that our hearts are connected,
would you change your mind?
Would you stop
as you are about to cut
the artery feeding your heart and mine?
If you knew that when you cry because of your loneliness,
because of your longing for your family,
that I cry, too, (though behind your back,
after I have comforted you)
would you change your mind?
If you knew that your isolation,
with the tubes and gadgets
coming from you or going into you,
extend to me
would you change your mind then?”
Rosemary Eseh-Logue is an internal medicine physician.
She shares her story and discusses her KevinMD article, “Unrequited: love in the time of COVID-19.”
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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.
Transcript
Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show we have Rosemary Eseh-Logue. She is an internal medicine physician, and she wrote the KevinMD article “Unrequited: love in the time of COVID-19.” Rosemary, welcome to the show.
Rosemary Eseh-Logue: Thank you for having me.
Kevin Pho: So we’ll get into your article in a little bit, but first off, can you share your story and journey to where you are today?
Rosemary Eseh-Logue: Sure. So I am originally from Nigeria. I came to the United States when I was 16, and then went to school and finished high school in New York. Then I went to Wells College for my undergraduate, and after that I went to George Washington University for medical school. Then I trained at Baylor College of Medicine for my internal medicine residency program. I currently work as a hospitalist, and I have my own mobile urgent care practice, which I love.
Kevin Pho: So tell me some of the challenges you face today, both in urgent care and being a hospitalist.
Rosemary Eseh-Logue: Right. So I think the biggest challenge from a hospitalist perspective is the COVID-19 pandemic, obviously. I think the biggest challenge is really just facing the lack of control that you feel, one, for the problem, which is COVID-19. We don’t have as great of treatments as we would like to have. And then there’s also the lack of control in terms of patients and their willingness to get vaccinated. So during the Delta wave variant, it was just a very emotional, very painful time to be a physician, to see patients die.
And in helping them to get better and to live, from an urgent care perspective, it has been good to be able to bridge the care. Because of the COVID-19 pandemic, a lot of patients who needed to be in the hospital could not get there. We just had no beds available; they would have been occupied by COVID-19 patients. So by the time they presented, it was either just too late or just more severe than it needed to be. And so that was the idea for my practice, the urgent care practice, in particular a mobile urgent care practice, where we go into the homes of these patients and intervene, and provide the urgent care that they need before it becomes something that really, really does require a hospital visit.
Kevin Pho: So tell me more about this mobile urgent care practice, because I don’t hear about very many practices like this. How exactly would that work?
Rosemary Eseh-Logue: Right. There are a lot of mobile practices. A lot of them focus on primary care, delivering primary care at the patient’s home. This is something that is not new. There are patients who are homebound, and so there have been a lot of efforts to get physicians to go to the patient’s home and provide care there.
For an urgent care practice like mine, the goal is to go and meet patients where they are, in their home, their hotel, their office, rather than have them come into the emergency room, for safety reasons: their safety and the safety of other people. So what that entails is we get a call for patients who are sick, we go to their home, and we assess them, do labs, and make a diagnosis and offer treatments, whether that’s IV medication, or even monoclonal antibodies, which are something that we want to be able to offer. Again, it’s just a way to avoid patients going to the hospital if they don’t need to, if it’s something we can manage at home, and then that allows that to be available for the patients who really do need it. It also helps patients who are immunocompromised not to go to the ER unnecessarily, because they are at very high risk for COVID-19 even when they are vaccinated. So it’s a really important gap in care that we’re providing.
Kevin Pho: Now, do you work by yourself or in the context of a team?
Rosemary Eseh-Logue: I do work by myself, in a team. I have assistants and a nurse, but the goal is to expand that further and have other physicians join us.
Kevin Pho: How difficult is it to start a mobile urgent care practice?
Rosemary Eseh-Logue: You know, more difficult than I thought it was going to be. You think, “You’re a doctor, you just come up with a name and then start seeing patients.” But there are a lot of regulations that you have to comply with, so it was harder than I thought. It’s taken a little longer to get it all done because I’ve done it myself, but it has been eye-opening in terms of just how many states practice the over-regulation, in my opinion, of medical practice. But it has been an educational process, for sure.
Kevin Pho: All right, let’s talk about the KevinMD article that you wrote. It’s really a poem that you wrote. It’s titled “Unrequited: love in the time of COVID-19.” Now, for those of you who get a chance to read this piece, can you just walk my audience through it and share the story of why you decided to write it?
Rosemary Eseh-Logue: Right. So, if you don’t mind, I will just read a portion of it, and then I’ll talk about how it came about. So it says, “If you knew we are like the ‘Two Fridas,’ that our hearts are connected, would you change your mind? Would you stop as you’re about to cut the artery feeding your heart and mine? If you knew that when you cried because of your loneliness, because of your longing for your family, that I cried, too, though behind your back, after I have comforted you, would you change your mind? If you knew that your isolation, with the tubes and gadgets coming from you or going into you, extend to me, would you change your mind then?”
And so this poem came about while I was working as a hospitalist during the Delta wave. We had a young patient who had severe COVID-19, and she was, you know, in her final hours, dying from it. And, you know, with me all dressed up, she pulled me close to her face and said to me, with all the energy that she had, “I want to see my baby.” In that moment, it was just an emotional moment.
Prior to this, I had been feeling kind of cold-hearted with just the way the pandemic had been going, seeing a lot of patients die. I saw more patients die in the previous two weeks than I’d seen in my entire career as a physician, and so it was very challenging. But to see this patient, in that moment, acknowledge her wish that she knew better, that she didn’t rely on misinformation, or that she just took the advice, even of her family members, to get vaccinated. I really just fell in love with her in that moment, because she’s human. We make mistakes, and it’s noble to be able to admit your mistake. It’s never too late to do that. I just felt really touched by her humility, really touched by her desire to live, her passion for her family.
And so after I left the room, I was really emotional and just cried, and I wrote this poem out of that interaction. It really is a dedication to her and a dedication to the patient-physician relationship, which can be emotional.
Kevin Pho: So when you’re a hospitalist during the heights of the various waves, and you saw the majority of patients who were unvaccinated and were in critical care in a hospital because of COVID, how angry did that make you? How frustrated did that make you as a physician?
Rosemary Eseh-Logue: I’m very frustrated, to be honest. I think in the beginning it was just like, “OK, people are getting used to the idea of being vaccinated.” And for some people, with vaccinations, they’ve had negative experiences, or they’ve heard of somebody having a negative experience, even though in the grand scheme of things a lot of people are vaccinated. Our children are vaccinated. They’re required to be, to go to school, to do just some of the things that we’ve come to expect for good health. So initially it was not as frustrating.
But once we started losing patients, once we started seeing patients die, and overwhelmingly, all of the patients I lost, every single one of them, was unvaccinated. We had a patient who was vaccinated and severely sick, you know, and she made it. But all the patients we lost were unvaccinated. So once we got to that point during the Delta wave, where we had data showing that the vaccines were safe, we had data debunking some of the misinformation out there, and we had data about the effectiveness of this vaccine, that’s when the coldness and the frustration set in, because we felt helpless.
You know, COVID is still something where we’re still trying to get to that place where we can say we have control, that we can cure it, and we’re just not there. So during that time, it definitely was frustrating. But this encounter with this patient really reminded me that COVID-19 patients, or in particular patients who are not vaccinated against COVID-19, are just like our other patients who refuse our recommendations for whatever reason. It is our duty as physicians to still treat them as human beings worthy of attention and care, because their dignity is never given up, or never lost, just because they don’t follow our recommendation. Rather, we can win them over, really, just by our persistence and our continued care.
And so I really love this form, again, because it does highlight that even to the end of it, even as I wished we could go a different route, even as she chose a different route, at the end of it, I’m going to be there for my patients right to the end, regardless of whatever choices got them there.
Kevin Pho: So in your poem, when you express these feelings, you mentioned the Two Fridas. Talk about that. What is that?
Rosemary Eseh-Logue: Right. So The Two Fridas is a painting by Frida Kahlo. She’s a Mexican artist whom I love. It basically shows two Fridas, two versions of herself, one in native attire and one in more modern attire, and it shows the two Fridas are connected. But one of the Fridas is holding scissors, and she’s about to cut that artery that feeds to her heart, and that artery also connects to the other Frida. So if she cuts that artery, she’s essentially, you know, causing her own demise, but then she also causes the demise of the other Frida. Now the question is, does she know that her artery is connected to that of the other Frida? You know, that’s something we don’t know.
And so I think when it came to COVID-19, and the wave in particular, I really felt like the patient and the doctor became the Two Fridas, and the patient is the one holding the scissors. The poem is really a plea to say, “Please don’t cut that artery.” Because what happens to you, you may be doing this just for you, because you want to do something. You know, you want to be in control of your own body, of your own health. But what you do actually does affect me, your physician, because when you hurt, I hurt; when you’re in pain, I’m in pain. And it is my job to help you feel better and get better, and you cutting that artery is going to not help either of us.
Kevin Pho: During the pandemic, we’ve had so many physicians come on the show and really express their emotion and share their stories. You chose to do so in a poem. Why a poem?
Rosemary Eseh-Logue: Well, I chose to communicate my feelings about the patient-physician relationship through a poem because I know that poems allow you the ability to interact both in a fictional world and in a nonfictional world, to bring truth and imagination together in a way that tells a beautiful story. And so the poem definitely is inspired by my interaction with this patient, but then it brings the fictional element of my imaginations, my hopes, and her hopes, which are all, again, my imaginations, into the picture to paint a story about the importance of the patient-physician relationship, the complexities in that patient-physician relationship, as well as the beauty of it, with all its sorrow and the joy, and ultimately the way it should end, which is together.
Kevin Pho: We’re talking to Rosemary Eseh-Logue. She is an internal medicine physician. She wrote the KevinMD poem “Unrequited: love in the time of COVID-19.” Rosemary, what are some of your take-home messages that you want to leave with the KevinMD audience?
Rosemary Eseh-Logue: And the take-home message that I want to leave with the KevinMD audience is that, one, we need to let our patients know that we are people, that we cry, that we hurt. They need to know that; it’s important for the patient-physician relationship. We also need to acknowledge that we are people, that medicine is not all we are or who we are in our entirety. And so once we understand that, and we allow our patients to understand that, I think we’ll find that we are able to better connect with our patients. We are able to better provide just excellent care, because we know the boundary of ourselves and we know the boundary of the patient, and we can then interact in a healthy way.
Kevin Pho: Rosemary, thank you so much for sharing your story, time, and insight, and thanks again for being on the show.
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