5 - Stories from a Pandemic: Helpless
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What does the episode introduction reveal about being on the sidelines of a pandemic?
You're listening to The Nocturnists, stories from a pandemic. I'm Emily Silverman. A pandemic is an all-hands-on-deck situation. We've heard from outpatient doctors going back into the hospital, generalists who are learning how to operate ventilators, and medical students who are graduating early to lend a hand. But at the same time, appointments are being canceled, elective procedures are being postponed, and hospitals are cutting back. Some of our diarists are finding themselves without a job, along with many other Americans. Others are finding themselves sidelined because of their own health issues, or those of their loved ones. In this episode, we explore what it's like to be on the outside of this pandemic looking in.
It's called Helpless.
There's an article in the Winter 2015 edition of the Wilson Quarterly entitled Left Out of the Greatest Generation about a group of men who, for whatever reason, were left stateside during World War II. It describes their feeling of isolation and feeling left out from what became a defining moment in American history. I now know how those men feel, at least to an extent. You see, with my wife's cancer, my partners have made arrangements such that I will not have to care for patients with COVID. I'll be seeing patients in clinic virtually and performing logistics and leadership functions for our group, but will not be expected to take any of the night call or be in the intensive care unit during this time.
I'm extremely grateful for this gesture. It's clearly one of sacrifice and love, and I'm just beside myself with pride and happiness at having partners who are like this. And at the same time, I can't help feeling left out of what will likely be the defining critical care illness of an entire generation of intensivists. So I'm ambivalent On one hand, I'm extremely grateful because bringing home a virus like this to my wife in an immunocompromised state would be devastating. And on the other hand, not leading from the front is very difficult. I think about that a lot. Hi, it's Rachel. I haven't posted anything this week because I haven't done any in-person patient care for kind of a tough reason, which is that I decided that I should stop.
I have pretty severe asthma. I have been hospitalized a number of times for severe asthma in the setting of viral infections. And take... prednisone a couple times a year for such exacerbations even when it's well controlled and so I have done a lot of soul searching this week about whether it's a good idea for me to see patients in this time I think on the one hand we all expect and I think honestly let's be real not we all I went into medicine because I like to help people and I want to make them better and I The whole bedrock of medical professionalism sometimes seems based on self-sacrifice. Like, yeah, you're tired and that person is coding, so do CPR and figure it out later. And so I really imagined that in a situation like this, I would be on the front lines.
I have a lot of the skills to be on the front lines. Not only am I a primary care doctor, I'm also, until this past year, a hospitalist and totally capable of caring for patients with COVID. People like me are needed, but I should not be working. And so we're not seeing patients in person. But I just feel like an asshole. I feel like I'm leaving my colleagues in a bind. I thought that this wouldn't be an issue because most of the clinics on our network have essentially have vastly scaled back in-person operations and are doing telephone visits. And I said, great, that sounds perfect. But then my clinic, because it's physically located in the same address as the hospital, got turned into overflow urgent care for the city, which is another way of saying that it's overflow urgent care for the emergency department.
And we're being understandably asked to do more clinical shifts to upstaff it. And so... I was having to decide whether I was going to see eight patients in a half day over and over and over again with my crap shit lungs, which also have chosen this moment to get worse.
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Chapters
3 chapters
1
What does the episode introduction reveal about being on the sidelines of a pandemic?
0:03–8:26
2
How does a primary‑care doctor describe feeling grateful yet helpless while protecting a spouse with cancer?
8:26–19:02
3
Why does a primary‑care doctor with severe asthma struggle with returning to in‑person care?
19:02–25:46