First Responders First//

A Pediatrician Shares Her Experience Caring for Adult COVID-19 Patients

"A harrowing alert went out on our phones this weekend — not a flash flood warning, but a call for physicians to volunteer."⁣

I am a pediatrician and adolescent medicine specialist, and was deployed to take care of hospitalized adult patients who were facing COVID-19 in one of the hardest hit areas on the planet — Bronx, N.Y. Never have I ever felt such imposter syndrome as I did when my New York City children’s hospital changed call signs from a “pediatric hospital” to a “pediatric and adult hospital.”

Honestly, maybe imposter syndrome isn’t correct. I think it was straight fear. Fear for my personal safety given the tenuous PPE situation back in March, fear for my preschool-age children and husband’s safety, fear of causing harm from lack of knowledge, fear of job security, and the most chilling — the fear of facing the rapid-fire loss of patient life that I had been hearing about. By all accounts, it sounded like war and I didn’t sign up for that — at least that is what I said to myself. 

It felt like a stab in my stomach. Once I shared this feeling with my doctor friends, I realized I was not alone. I wrote in my diary in March: “A harrowing alert went out on our phones this weekend — not a flash flood warning, but a call for physicians to volunteer. Volunteer, how desperate must this be, and the cases are just steadily climbing with no end in sight.”⁣

I thought, how can I possibly do this? I was afraid and uneasy the morning of my first shift. Then, with literally the first adult patient I cared for, I realized very quickly that, although adults are not simply larger children, I had actually been speaking with adults, as parents of my patients, my entire career, and this was no different. I was there in the moment, I was prepared and supported by my colleagues and hospital. I felt deeply at peace. I don’t think there is any higher calling than doing what we do and I am grateful for the opportunity.

As the days went on, after PPE stock came in, after deep conversations with my parents, sibling and husband, after a commitment from our nanny to continue to be there for us so I could work, my fears softened and were replaced with a fire to jump in. Backup plans were made in case I got sick — how I would separate from my family if needed to keep them safe. Looking back it felt like the switch just flipped from coward to “hero.” 

It wasn’t overnight, but with more data and my family’s support, I moved to organizing and educating myself to prepare for deployment. I worked with several grass-roots efforts to get health care workers PPE and helped to create donation lists to get supportive items like cell phone chargers, snacks and hot meals to our front lines. 

Over time, I found great comfort in my privilege to be able to care for COVID-19 patients. I felt comfort, perspective, and even relief to be able to help when so much suffering surrounded me. I wrote in my journal in  April, “We are facing the peak of N.Y.C. COVID this week and so, I will be placing my worry on pause for a moment, taking deep breaths, and controlling what I can.”

In other times of crisis in my life, I have used the three-good-things journal method to steady myself. I suffered years and years of infertility, and fortunately much of the coping skills I used to get through those challenging times just bubbled up and out of me. I sort of knew what I needed to do, because this was not my first rodeo show with anxiety, fear, or crisis. So, I started writing it out each night, sometimes shared with family and just as it had in years past, it really gave me comfort to look at my little lists and study how a few days, a week, a month looked. 

Doctor’s Day was somewhere in the midst of all this in New York. I have never felt more proud to be a physician and closer to my colleagues as a group. I wrote in my journal: “Doctor’s Week comes to a close today and while I don’t feel brave, I don’t particularly want to be a hero, in N.Y.C. there is not much choice for my soul, but to help. I’ll be joining the front lines, caring for adults (even though I am a pediatrician) this week.” At my own hospital, I was so inspired by my colleagues who led our efforts and organized a crash course on what we knew to date on COVID-19, as well as with colleagues on social media who shared knowledge so freely towards our preparation. 

Writing was also a huge comfort to me. Just before the pandemic hit, I had launched my professional Instagram account @teenhealthdoc as I was feeling burned out and wanted to flex my creative muscles with writing and design. I hoped to connect with teens, their parents, and anyone working with teens who might be interested in teen health. I had no idea it would turn into a journal of sorts as we all made our ways through the pandemic. Looking back, reading some of the posts, I can feel my fear and anxiety jumping off the page and yet I know that every time “I got it out” by writing I felt better. 

I really felt as though we as a health care community came together. I commend my hospital for not only securing physical PPE, but supporting us with psychological PPE as well. From the start, our children’s hospital launched bi-weekly Zoom sessions to de-brief and be coached through the storm. They also created a respite room staffed with yummy goodies, coffee and most important, one of the behavioral health colleagues from the department of psychiatry to be there for in-person support. To help drown out tragic code bells, they instituted a happy code, whereby for each successful COVID patient extubation or hospital discharge, Alicia Keys’ “Empire State of Mind” played overhead. 

Click here for information about how Thrive Global is supporting our healthcare workers on the front lines of the coronavirus pandemic, and find out how you can support the cause by donating to #FirstRespondersFirst.

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