What COVID-19 taught me about autonomy

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I came back from a family vacation to Italy one day before the first case of novel coronavirus was reported there.  Two days later, the CDC issued a Level 3 travel warning for visitors to Italy.  Eight days later, and six days after returning to work, I got a fever.

I live in Indiana, where no cases have been diagnosed, and our protocols are still green. When I self-reported my symptoms to the health department and my institution’s infection prevention department, things moved impressively quickly. Because I was not ill enough to require hospitalization, I did not meet the criteria for COVID-19 testing by Indiana’s initially-published algorithm.  Still fearing the worst, my institution did the next best thing they could do and tested me for a battery of alternate possible etiologies.  I was ushered into a clinic through a back hall that didn’t expose me to other patients.  The nurses in the clinic gowned and wore N95 masks as they swabbed and stuck me. Infection prevention and the health department called every hour or two to update me on the evolution of the situation.

Later that night, the Indiana State Department of Health called to say they had liberalized the algorithm and would provide testing, which involved a midnight trip to the local emergency room and another set of staff trying to protect other patients from me.  Thankfully, the test resulted quickly and negatively.  The next day, my case was the subject of discussion for my department as they strategized policy going forward for illness, travel, and patient exposure.

I confess that I’d never given much thought to what a patient with a highly infectious disease must feel.  The sense of being a liability and a source of anxiety for others, the guilt of putting people at risk with your presence – these are things I had never even considered, let alone experienced.  The idea that my body was being discussed by my colleagues was completely alien to me.  Although I know it was necessary, the feeling of fear and exposure surprised me as someone who considers themselves a pragmatist.  I know that in my state, my workplace, and my patients, their health absolutely outranks my privacy when a pandemic is brewing, and it should.  But, on the other side of this brief experience, I will be a more empathetic provider in a way I could not have been before.  I will hold the autonomy and trust of my patients with a more vivid sense of respect.  I will understand the vulnerability of my patients more intimately, not just because I touch their bodies but because I am privileged to their personal information.  I’m grateful to be healthy, and I am even more grateful for this chance to grow.

Anna Gaddy is a nephrology fellow.

Image credit: Shutterstock.com

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