Reports from the Frontline Part II

Sunday, April 19th, 2020

My colleagues and I have started testing ourselves for COVID antibodies. Jim had ordered these highly coveted, but not easily accessible tests from an online distributor a few weeks ago and I was surprised to find them delivered to our doorsteps so soon. Everyone got super excited about this, because the test will allow us to see if any of us have actually been exposed and developed antibodies to the virus. So far, none of my physician colleagues and mid-level providers have had symptoms of COVID and for that I am extremely grateful. But at the same time, I’ve been hopeful for some glimpse of immunity…

The test looks a lot like a store bought pregnancy test, except you are using blood serum instead of urine. You have to obtain a small amount of blood and drop it into an appropriate slot on the plastic rectangle, followed by two drops of provided buffer. You then wait ten minutes for optimum results. I got to be the very first person to get tested. As I watched the line of buffer and blood move slowly across the white strip, I felt anxiety rising in my chest. What if it showed antibodies for immunity but also presence of potential virus in my body? I have not been feeling sick, but part of me always worries that I may be a carrier…The test, however, did not show any of that. It came out to be completely negative. Even though slightly disappointing, the results confirmed (in a way) that I have been wearing my PPE appropriately all this time and taking all the necessary precautions not to get exposed. That in itself is reassuring.

Monday, April 20th, 2020

The test has become super popular lately and I’ve tested a good number of friends and family for corona antibodies. A touching story about this: a health care worker I know came to me requesting to get tested. She recently became a grandmother for the second time, but has not been able to meet this baby grandchild as of yet. She has been meeting the newborn by the window of her son’s house, unable to touch or hold her, for the fear of infecting her or spreading the virus. This has been really difficult on her and everyone in the family. So when she finally got tested and it came back completely negative, tears welled up in her eyes. The resultant plain white strip with no other visible lines except control reassured her that she at least is not an active carrier at this time. And with no additional scheduled hospital shift this week, she’ll be meeting her baby granddaughter for the first time this weekend! It was such a touching moment to experience. Who would have thought that a a test like this and a drop of blood can hold such power in people’s lives? What strange times we are living in…

Thursday, April 23rd, 2020

Today was a big day for me. For the first time ever, I had been interviewed for two different podcasts, a photography podcast and a lifestyle podcast. Both of these are pretty well known in the podcast world and both invitations came pretty unexpectedly. The first one, the photography podcast known as The Candid Frame I have known and listened to for a long time. Its author and photographer himself, th great Ibarionex, had reached out to me a few weeks earlier and commented on some of my photos from the COVID project. I, in turn, humbly offered to get interviewed, which he gladly accepted. The second podcast, known as Listen Hunnay is the prodigy of Jeannie Mai whom I admit I did not know before, but who found me through Instagram hashtags and invited me to the show. Come to think of it, some pretty great things have happened to me specifically through Instagram…Social media can be such a powerful thing in many ways.

The interviews were scheduled for 7 and 8PM. So at 6:30PM I chose one of my favorite dresses to wear, put on my red lipstick and sat in front of my laptop waiting for the recording to start. I believe dressing the part, even if you’re going to be recorded in the comforts of your own home, really makes a difference in the final outcome. And I’m really glad I did dress the part as the podcasters were able to see me and recorded me on video camera 🙂

Both talks turned out wonderful and felt more like a conversation than a formal interview. I got to speak a little about medicine and, in the case of the first one, a lot about photography. We specifically discussed this project, Reports from the Frontline, how it came about and where it’s heading. It was a real pleasure to be the guest on both shows. I cannot wait for the final recordings to come out.

Friday, April 24th, 2020

Every time I see an X-Ray of COVID pneumonia in one of my patient’s, I get a little sinking feeling inside. The “bilateral fluffy infiltrates” has become almost an identifying factor in persons in whom we suspect the disease.  This sign usually indicates an advancing disease and impending hypoxia – low oxygen levels in the person’s blood. The infiltrates can occur in anyone presenting with the disease: the young, the old, the cardiac or asthma patient…The level of “white out” varies among individuals and the outcome can be unpredictable. Some people continue to drop their oxygen levels and have to be moved to the ICU, placed on their abdomens to improve oxygenation to the lowest and deepest parts of their lungs. Some end up on ventilators and oftentimes never make it. To whom this will most likely happen we never really know. COVID 19 has proven to be a wild and capricious beast, one that is capable of destroying everything in its path despite our best efforts. This unpredictability and viciousness has been the most anxiety-provoking aspect of it all. Will this ever change? I am not sure. I do know that faced with this beast head on, physicians all over the world have been relentless in combining efforts and their on going experience to come up with the most effective methods to manage the disease. It’s a work in progress, an evolving matter. The approach changes all the time. What we thought worked well in the beginning often turns out no longer applicable. But I feel as though we get more efficient every day. This, combined with a potential vaccine, will most definitely change the course of the pandemic. I’m hoping that in a few years to come, this will all be merely like the seasonal flu, or rather a cold, the one we all get at some point but barely even remember. Or, even better yet, this will all be nothing but a sad yet distant memory.

Monday, April 27th, 2020

This morning I decided to catch up on the news a little, since I have been avoiding it for the past several days. I tried to click only on the titles that seemed to deliver facts, not opinions and that did not sound like the doom and gloom we normally see. The theme seems to be that in the upcoming days, the world will slowly start re-opening. Small business are going to start taking in their customers, restaurants will allow seating inside, sports team will again begin practicing in the stadiums…I’m feeling slightly conflicted about this. Part of me really, really wants to go back to our “normal” lives. I miss hanging out with my friends, going out for brunch, not to mention dancing…But the biggest concern remains: will corona blow up again once we return to normal activities? Will we continue to spread the virus at the same rate we had been before we implemented the quarantine? Are we going to have to wear masks and “elbow bump” instead of hug each other for the indefinite time to come? So many questions remain. Of course we cannot stay in quarantine forever. There must come a time when we finally go back to living our lives…I just truly hope that the virus won’t come back with a vengeance :/

Saturday, May 2nd, 2020

Last night, as I was heading in to work, I encountered a man at the physician parking lot, looking up at the hospital building and waving. You could barely make out the shadow of the person he was waving at, standing in one of the top floor windows. I asked him who he was trying to wave to. “Oh, it’s my wife,” he said. “She’s been admitted for a few days now and even though I am not allowed to visit her, I come here every afternoon so we can see each other through the window.” He was wearing headphones and chatting with her at the same time. My heart sank a little bit. This has been one of the most difficult aspects of this pandemic – families unable to see each other once a one of them gets admitted to the hospital. So many patients have died alone, their families unable to say good bye, to hold their hand while they take their last breath…I cannot imagine the psychological impact this will have for months to come. It is something I think a lot about and have a hard time to come to grips with. It sounded as this man’s wife was going to be fine and will reunite with him soon enough, but for many, this has not been the case. Not being able to say good bye must be one of the most difficult things any human being can go through.

In the last several days, despite the no visitor policy adopted across the hospitals in the nation, we have been letting families come and say good bye to the patients who died in our ED due to non COVID related causes. I keep my 6 feet physical distance to deliver the grueling news of a loved one dying, but I try not to keep the mask on when I say it. It is difficult enough to say something like this to the hopeful family members, it feels inhumane to mumble it behind my thick, impenetrable N95. I don’t want to have to repeat those difficult words because my voice sounds muffled, I want to deliver the message clearly and let the process of grieving begin right there and then. I’m glad that when the question “Can I see him/her?” finally comes, I can say, yes of course, you can definitely do so.” 

As I gathered my shift essentials from the car, I wished the man and his ill wife speedy recovery and a prompt reunion. He sounded hopeful and thanked me for being on the frontlines and for helping people like his wife. In return I appreciated his gratitude. In the end, this couple is one of the lucky ones. So many will not get to reunite, to hold each other again, to express love and appreciation for one another…The truth is, we on the frontlines are witnesses to such situations all year round, whether there is a pandemic or not. Accidents happen, people die unexpectedly, lives are forever changed in one minute. But never before have we witnessed this at such magnitude and frequency as during the COVID crisis. Seeing this every single day, several times a day can be incredibly taxing on the heart and spirit, even for the most hardened physicians. COVID is not leaving us unscathed and it will take a while to heal the wounds…