The COVID-19 diaries part three: "Side effects"

The COVID-19 diaries part three: “Side effects”

As Detroit recovers from the coronavirus crisis, family medicine physician Asha Shajahan provides The Indian SCENE her third dispatch from the frontlines.

As Detroit recovers from the coronavirus crisis, family medicine physician Asha Shajahan provides The Indian SCENE her third dispatch from the frontlines. (All photos courtesy Dr. Asha Shajahan)
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This is the third installment of Dr. Asha Shajahan’s essay series on being a healthcare worker during a pandemic. Read the first and second

Day Seven: My Off Day

When the pandemic started, before I was pulled to work the COVID-19 inpatient unit, I spent three days a week volunteering at a homeless shelter. I wasn’t able to go for a week due to my shifts. So on my first day off, I went straight to the shelter. It was an old church in downtown Detroit that served meals to about 170 people six days a week. They offered showers, laundry services and medical care. Prior to the pandemic, I would bring my medical residents to the clinic and work 2 to 4 days a month. With COVID-19, many of their services were forced to close, leaving the homeless without a place to go.

The center set up hand washing stations, portable toilets and heated tents outside. Instead of serving meals indoors, meals were prepared to go and picked up at the side door of the building. The center went from serving 170 people to about 400 people since the pandemic hit. My job was to screen patients for symptoms, checking temperatures, oxygen levels and doing exams to see if they required further testing. There were a few patients who had a cough or a wheeze without fever which I treated with antibiotics.   Many patients needed wound care for diabetic foot ulcers as they had no access to soap and water to keep their wounds clean. Detroit was a hotspot for COVID-19, just behind New York City and some cities in New Jersey. Many are puzzled as to why.

My time at the shelter opened up my eyes to poverty in Detroit; 22 percent of Detroit’s population lives in poverty. There’s an average of 2,100 homeless people on a given night. Once you see them, you can’t un-see them. Next time you drive down the freeway, pay attention to the freeway bridges. They are hidden homes to many.

I thought about those of us complaining about having to stay home. The homeless didn’t have a home to stay safe in.  Staying at home is a privilege; working from home is a privilege. For the homeless, there is no haven to rest. There is no access to information via television or internet. They can’t wash their hands nor disinfect their surroundings. Many of us are upset that sports, which served as our leisure enjoyment, have been cancelled, while several others, now homeless, relied on working the parking lots for these sporting events as income.

Many faces were new at the shelter. A couple’s home burned down and they had been kicked out of a hotel when they couldn’t pay the hotel bill due to job losses. I saw numerous younger individuals, which wasn’t the norm. An 18-year-old pregnant woman didn’t feel safe at her home due to domestic violence and was now on the streets. A 22-year-old male had been staying with friends but was asked to leave once the virus hit due to his inability to pay for his own food.  One gentleman’s bike tire was flat. As a result, he couldn’t’ pick up his medication from the pharmacy. There were no bike shops open and biking was his main means of transportation.

The doctors’ offices only offer telemedicine via phone or video visits, which isn’t always an option for the homeless due to lack of electronic resources. The mere inconveniences we face are nothing compared to those on the streets.

I counted my blessings that night. I missed seeing my friends and family. I was lonely, bored and tired of staying home. Although I live alone, I have a home, a phone, a computer, a television, a shower, laundry machines and a bed. I jotted down in my gratitude journal that night, thank you for giving me a home to stay safe in.

Day Eight: Ear Trauma

My phone rang. It was one of the nurses who worked on the COVID unit. This time, she wasn’t calling about a patient, but about herself. “My ear is bleeding,” she said. She had been wearing a mask for all of her shifts and started experiencing skin breakdown on the back of her right ear. I came to take a look. It was red, hot, swollen and oozing—infected. She looked irritated. She couldn’t get in to see her doctor for a few weeks.

This is just one of the “side effects” of working these COVID shifts. Ears bleeding, faces bruising from masks, fatigue and emotional turmoil. The illness is the virus, the treatment is the supportive care given by healthcare workers and the side effects for the workers are the collateral physical and mental injuries of working long hours. I cleaned her ear, prescribed her antibiotics for the skin infection, and advised an anti-inflammatory for the swelling.

Often forgotten on the night shift was an administrative member of the emergency response team. Both clinical and non-clinical individuals were putting forth so much effort to be there for patients. The administration team member that was on-call that night helped me locate another mask for the nurse that clipped on the back of her head rather than around her ears. We joked about manufacturing hair clips that held masks by holding your hair up in a fashionable way.

After we clipped her new mask onto her ponytail, she was ready to head back to her shift. That nurse wasn’t upset about her ear. She was annoyed that her ear was a nuisance getting in her way of providing care to others. Most would complain about having these “side effects” of COVID care.  Instead, her mindset was to fix her ear so that she could get back to caring for others.

It’s moments like this that are the most sobering. With so much negative news about people driven by financial interests, selfish motives and political gain, it was refreshing to see that there are genuinely good people in our world. If only we could elevate these people and spread their goodwill as quickly as COVID-19 spreads. They say one coronavirus positive person can quickly infect 3 to 4 people.  Wouldn’t it be wonderful if benevolence were spread in the same way?

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