The COVID-19 diaries part two: “Don’t let the mask fool you” – The Indian SCENE

The COVID-19 diaries part two: “Don’t let the mask fool you”

As the coronavirus crisis devastates Detroit, family medicine physician Asha Shajahan is providing The Indian SCENE daily dispatches about her experience on the frontlines.

This is the second installment of Dr. Asha Shajahan’s essay series on being a healthcare worker during a pandemic.
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This is the second installment of Dr. Asha Shajahan’s essay series on being a healthcare worker during a pandemic. Read the first part here.

Day 4: The Economic Impact of COVID-19

The Emergency Command Center of the hospital had good news; the patient census was going down. The number of discharges and successful weans off the ventilator were encouraging. A familiar pair of eyes caught my attention. It was my old medical assistant! What was she doing here at this hour? It was 11 p.m. We ran to each other, about to hug, when we suddenly realized that hugs, handshakes and elbow bumps were things of the past. We air hugged. She explained she had been redeployed.

With clinic visits down, she’d been given the option of being laid off or working evening shifts stocking PPE in the hospital. Many people are afraid for their jobs. In the four weeks before I write this, 22 million Americans have filed for unemployment. The economic impact of this illness is devastating. I’ve been working about 72 to 80 hours a week since COVID hit; normally I work about 40. Even still, I wonder if my job is secure.

Healthcare workers are facing pay cuts, reassignments, and furloughs. Despite severe staffing shortages, hospitals across the nation are laying off thousands of medical workers. They have no choice. It seems so cruel at a time when healthcare workers have been working so hard. But what job loss isn’t cruel? Every industry is hit by this pandemic. Healthcare, sadly, is no different.

I went to check on my friend who had been having difficulty breathing the previous night. It was hospital day five for him. He was still on oxygen, but he was joking and cheerful. “You got so lucky,” I told him. “It’s not luck. It’s my guardian angel looking out for me,” he said, pointing upward. “Guardian angel, please watch over everyone here tonight,” I whispered under my breath. My friend was discharged and went home the next morning. His guardian angel had done well.

Day 5: Nurses

The first nurse I ever met in life was my mother. She worked for decades as a coronary care unit (CCU) nurse. She taught me that nurses were sacrificial, kind, compassionate and hard working. When I was a medical student, my mother gave me advice that still rings in my ears: “A nurse will make or break you.” As I went through my residency training, I learned that to be absolutely true. Nurses were the ones who spent the most time with patients. They saw the family. They knew the pain levels. They gave medications. They were the key to understanding a patient’s every need.

Making my rounds today, I noticed motivational messages posted on a wall by children from a local elementary school. A word cloud with “nurse” at the center had these words in it: brave, hero, helpful, amazing, kind, hardworking, and loving. Those kids were spot on.

The nurses I worked with this week were incredible. When a young patient died from COVID, the nurse caring for the patient was found crying in a corner. Ten minutes later, that same nurse was caring for another sick patient, making jokes to bring cheer to the patient. Don’t let the mask fool you. Emotions are written in the eyes. The masks may cover their faces, but their hearts will never be covered. Nurses inspire me every day. It also feels like my mom is with me on every shift.

In the intensive care unit (ICU), I asked the charge nurse how the unit was looking. She handed me an envelope and a piece of chocolate. “What’s this?” I asked. Her eyes smiled at me and she shrugged her shoulders and walked off. It was a thank you card. I should be giving the thank you cards to these incredible workers, not the other way around. Humbled, I gladly ate the chocolate and made a mental note for my journal of the lesson learned today: Kindness is infectious.

Day 6: Video Visit

My patient was requesting Xanax, an anti-anxiety medicine. Just months ago with the opioid crisis dominating the news, a thorough investigation would be done prior to prescribing a patient Xanax, including a urine drug screen and a controlled substance agreement. Now, circumstances were different. She took her husband to the hospital for difficulty breathing. She didn’t think it was COVID — in fact, she thought it was his chronic obstructive pulmonary disease acting up. She was wrong. It was all a blur, but after his vitals were taken, he was admitted. She wasn’t allowed to go inside. She was given a number to call for updates. She drove home, called the number, and got terrible news.

He was intubated in the ICU. He was a cancer survivor, she went on to tell me. “He isn’t going to make it. I can’t stop shaking. I need something for my anxiety.” I called her the next day to check on her, and she had foreshadowed correctly. Her husband died, and she wasn’t able to be with him. She herself was now spiking a fever. Imagine losing a loved one and being too sick to even process it. This is such an unbearable virus.

The day continued, with back-to-back video visits with 18 patients and their depressing stories. People wanted anxiety medication or wanted curbside testing. People were panicking, crying, yelling. I was exhausted by the end of the day. An average therapist sees maybe 8 patients a day, for an hour at a time. But every 15 minutes, I was hearing tragedy after tragedy.

My cousins decided to do a Zoom chat that night. My tears were a surprise even to me. “People are suffering a lot,” I told them. I didn’t realize how much sadness I was holding in. Every healthcare worker is taking in a lot of trauma. I worry about the post-traumatic stress that will remain months after this is over. We really need to take care of each other so that we will have post-traumatic growth, instead of trauma. Our physical health is not the only thing at risk with COVID-19. Our mental well-being is threatened, because one doesn’t need to get COVID to suffer the mental angst that accompanies it.

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