A family physician is redeployed to the emergency department

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Two years ago, I shared my thoughts on the joy of family medicine.  Two years ago, I was a senior resident working in Ann Arbor, thinking about who I will be when I graduate.  Two years ago, my biggest worry was if I could finish my notes in time for sign out and meet friends to play volleyball.  Today, I come with mixed but honest feelings considering recent events.

As I started my sports medicine fellowship in Detroit, Michigan, my goals and aspirations to learn were endless.  I worked with and became friends with some amazing schools, coaches, athletic trainers, athletes, and sports medicine colleagues.  I soaked in the wealth of knowledge.  At the same time, I kept my roots in primary care and family medicine by having a clinic in downtown Detroit near the water that separates the automotive heart of the country and Canada.  Life was quite routine; see patients in the clinic, grab lunch, drive to the training room, cover a game, drive home, shower, sleep, and repeat.  Things were going well.  I was on the job hunt, searching for my first “attending” job.  However, things drastically changed.

I remember the first day I had to put on full PPE in the family medicine clinic to see all the respiratory illness visits.  I remember thinking, “This is like any other visit you’ve done, Anthony.  You just have a couple of extra things on.”  At that time, at the beginning of March, my initial naïve thoughts that COVID-19 was a small issue were quickly thwarted.  Multiple emails were sent daily on the ever-changing algorithms for treatment/testing and personal protective gear.  Sifting through these emails, the email regarding redeployment arrived.

As more cases of COVID-19 were being confirmed in what we now know as one of the hot zones of the current pandemic, our health system was gearing up to prepare for the incoming surge of COVID-19 patients that required emergency attention.  My redeployment was to the emergency department, the gates to the hospital.  My initial thoughts, to be honest, were very mixed.  Part of me felt this huge drive and need to do my part as a primary care provider and help in any way I could.  The other part of me was completely terrified.  “What if I get COVID?  What if I end up transmitting it to someone unknowingly due to my exposure?”  Trying not to completely freak out, I, like many of us do, went to my colleagues and friends to reason through my thoughts and fears.  They too had the same thoughts.  Thankfully, our health system did a great job of providing personal protective gear and allowed us to bring our own gear, which did ease my mind.

My main shifts in the ER consisted of either triaging patients as they came in or swabbing patients for COVID-19.  Working as the triage provider, I saw every single person who screened positive for COVID-19 symptoms (cough, fever, shortness of breath, chest pain, diarrhea, etc.).  My job was to determine if they could be discharged, with precautions, in the pandemic tent prior to entering the physical building or if they needed additional workup and be transferred to our isolation unit in the emergency department.  I saw firsthand the fear and anxiety these patients had regarding the disease.  “Do I need to be tested? Why can’t I be tested? Can’t you give me that medicine they talked about on the news? What am I supposed to do now? My loved one is intubated in the hospital right now.  I don’t have a place to go back to.”  My heart felt for each one of these patients.  I once again found myself in joy when I was able to calm each of these patients in times of a pandemic.  My hope was that with the work of social distancing and good hygiene, our city could curb the rising cases and slowly return back to a sense of normalcy.

Day by day, I, like many of our medical colleagues, grieve the many lives we have lost and continue to lose.  But we continue to extubate and discharge patients from the hospital.  I know it can be hard to stay positive in times of crisis; however, keep looking for those positive moments in a dark world. These moments will be our “joy in medicine.”

Anthony Tam is a family physician.

Image credit: Shutterstock.com

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