A dermatologist on the COVID-19 front lines

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Let’s get the jokes out first. Yes, I am a dermatologist who is on the front lines of the COVID-19 pandemic at my hospital, and no, you do not want me to intubate you.

I’m a little different than most dermatologists. I also trained in internal medicine, and I regularly spend time on the medicine service. While I was redeployed to the COVID-19 clinics early on in the pandemic, I’ve spent the rest of my time at home trying to do my part to flatten the curve. But as I looked toward my scheduled time on the front-lines as a medicine attending, what I came to realize is that despite my training, my redeployment, my eagerness to contribute, I was scared.

The rational side of my mind would point out all the protective factors in my own narrative. My age, my normal BMI, my generally good health. However, the horror stories inevitably took ahold of my thoughts. I read tweets about younger physicians dying from COVID-19. I texted with my friends from medical school about their patients who were now intubated despite no risk factors. But the days march on, and soon enough, it was time to put on my internist hat.

As I walked onto the wards, my first time in the hospital since March, things were both familiar and foreign at the same time. The familiar laughter of staff at the nursing station (albeit slightly muffled from everyone’s masks) was a welcome distraction. I looked at the PPE cart dumbfounded by what the new protocol was to be. My co-attending kindly walked me through the process of marking my N95 mask, my PPE bucket, and my face-shield. I confided in her that this was all new to me and thanked her profusely. She looked at me with a sympathetic eye and said, “We’ve all been there. Welcome.”

I greeted my team and acknowledged the “new normal” that we were all dealing with. Gone were the conferences with free food. Gone were the smirks and frowns, all hidden behind hospital issued surgical masks. Our nonverbal communication relied solely on body language and the furtive glances we shared. We went around our team discussing our learning objectives for our time together. Everyone seemed to be mourning the loss of the excitement for teaching and learning, desperately searching for the spark that was once there. The past three months had been all COVID all the time, and we were cautiously optimistic that getting back into our traditional teaching structures might translate into the ability to talk about something different and new.

So, what did I learn after spending time on the front lines?

First of all, we can and will adapt to anything. Only a few days into my medicine time and donning and doffing PPE became second nature. Walking into a COVID-19 patient’s room was no longer something to fear. It just was. Adapting is human nature. Many of us have sacrificed so much by staying home and wearing masks. While these changes are hopefully temporary, we can and will get through it.

I am unbelievably grateful for my colleagues that have been on the front lines for months bearing the brunt of the COVID-19 surge. The doctors and nurses that came before me not only welcomed me with open arms (figuratively, of course), but taught me all they know to ensure my safety and comfort. But it isn’t just about the doctors and nurses, but the physical therapists, the case managers, the cooks, the cashiers that also have to spend all day in PPE. I’m grateful for my friends who keep masks on and socially distance for the sake of flattening the curve. I am grateful to my hospital, for having provided me a safe work environment. I am grateful for the businesses that have supported the front-line workers. I am grateful for life.

I’ve also reignited my love for the practice of medicine. In an era where every physical exam maneuver is second-guessed, where every second in a COVID patient’s room is counted, I’ve realized that I’ve missed seeing my patients. I miss sharing a laugh with them without a mask, asking about their families, and hugging them when they cry. I hope that when this pandemic is behind us, I can do all those things again. But until then, I still strive to be present, to lend a sympathetic ear, and to comfort them with my words and my presence, if not my touch.

Perhaps, most importantly, I’m reminded that we are all human. The tears we shed for the fallen, the fear we sense for the unknown, and the hope we cling to for the future are constants in my conversations. So many of us are doing our part to contribute to the healing of our communities. Thank you for letting this dermatologist be a part of it.

Steven Chen is a dermatologist.

Image credit: Shutterstock.com

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