COVID reminded me why I became a doctor. Below is an unpublished account (in short story form) of my most memorable day during the peak of COVID. It’s a reminder that we can stay true to our intrinsic motivators rather than fall victim to extrinsic factors. And most of us still have the opportunity to choose each day which power governs our day: intrinsic or extrinsic.
On a Tuesday morning in mid-August 2021, during our Delta SARS-CoV-2 variant spike, we received an email request to our incident command center inbox, asking to include the daily number of COVID deaths in our daily report, broken down by those vaccinated and those not vaccinated.
Our information officer handed a paper copy of the letter to the incident commander (IC), who read the email aloud. Our IC tends to process information aloud, so that’s not unusual for us. After he finished reading the note, he started processing the reporting request out loud. He was standing by the command center door, which was wide open for anyone passing by to glimpse the room or hear a sentence.
With a loud and irritated voice, IC said, “What’s the difference? Dead people. This is a pandemic. Dead people!”
I shot up from my seat on my computer desktop station, furthest from the open hallway door, and almost hit the IC when I reached to close the door, screaming all the way “Close the door! Close the front door! Close the door of mom’s truck! There are people out there who can hear you!” I didn’t use the right words. I dropped the proverbial f-bomb from a great height.
A few days later, around 9:00 a.m., my CEO came to the command center and bowed to me, saying, “I need some time alone with you. Now.” For the record, it was the IC who noisily declared that the person who died in the pandemic was the same person as my CEO. Furthermore, the CEO’s “need for alone time” was coded language for requests to have an important conversation with me. He walked out of the room it was as sharp as the one he had entered moments before.
I trudged on to follow the boss into his office (walking a long way down the hall from the command center), and he politely and professionally closed the door behind me as I entered the room. It seems very clear to me what will happen. He instructed me to sit down at his conference table, and he sat across from me, arms folded. He said, with his head shaking, “What were you doing the other day? Not good. Not good. No (pauses for effect) OK. You can’t do that. Disrespectful to me and everyone in the room.
Silence erupted between us. I nodded slightly, acknowledging his status, sage advice, and warning all at once. But then, I very carefully and with as much restraint as I could, replied, “But talking about death in a pandemic like that without a care, factual as it is, is equally disrespectful and has the potential to trigger everyone in the room as well.” . like everyone else in the hall.”
Volcanic silence erupted at this point. And, in addition, we are now participating in a kindergarten gazing contest. Neither of us blinked or said a word for what felt like an hour (probably 7 or 8 seconds in reality). I broke the silence and stated that I agreed never to do anything like that to him, to the incident commander, to the team, or to the hallway staff again. I got up from my chair without waiting for any acknowledgment, either verbal or nonverbal, and I walked out of the room not knowing if it would be the last day of my job.
The rest of the week is usually amazing in every way. We are still in a COVID wave like no other to date. We smashed chalkboards with census numbers, staffing needs, critical care bed availability. We worked on the phones, preparing our daily reports, making calls with county officials and county hospitals. It’s our daily grind, and it washes, rinses, repeats, for days. Nobody mentioned DoorDash Day.
On Tuesday the following week, I returned to my workplace. I’ve been working all weekend as an IC, and now I’m back at my specialist medical/technical workplace in a CC, unshaven, with a scrub. It was nearing lunch time, and I was starving, dropping a few pounds from my body. We just reached an all-time high number of COVID hospitalizations, 338 to be exact, a little over half of our entire inpatient census. It’s no different from other hospital systems going through the same ordeal, but unheard of in the modern era, where half of your in-patients all have the same diagnosis.
I sat there, staring at my monitor, starving, and a styrofoam box placed in front of me. Between me and the keyboard. Between me and the monitor displaying all kinds of data, unopened emails, news headlines, pharmacy information, and countless other windows of digital detritus.
I opened the lid of the polymer box and saw inside a soggy, greasy, musty po-boy sandwich with a side of cold fries and NO ketchup to be found within reach. Other essential supply items are currently unavailable.
I put my face down on the box, carefully picking up the mess of bread and filling, and took a big bite of what would suddenly be the worst sandwich of my life. I’m having fun. I had bombed my boss (and somehow still got a job), I no longer cared about how I looked, I wasn’t taking care of myself properly, and I wasn’t enjoying that sandwich.
In general, it is classic fatigue. Fatigue. Depersonalization. Compassion fatigue. But if you interviewed me right then and there to ask if I was suffering, I would tell you I feel great. Really great. And I’m starting to like that awful sandwich.
And later that day, I asked myself; why did i feel like that at that moment?
I had zigzagged my whole life up to that point. I left everyone and everything in my northern state to move far south for my training after graduating medical school. I left the fellowship one year early to start practicing. I left two decades of clinical practice and broke the hearts of all my patients (and my nurses and partners) to go into administration full time. I became an executive doctor; not a doctor or an executive, but both simultaneously. But always a doctor first. To do no harm.
To have the opportunity to advocate for staff who are triggered and collectively traumatized day in and day out, to manage a cohesive medical response for the fifty percent of the entire single-disease hospital census that we have never seen, let alone trained for, and to teach CEOs a lesson about humility, compassion, and empathy (and, yes, maybe a bit of righteous anger).
If I’m really miserable on email day or stare down day or sandwich day, I can rationalize to myself my choices to make myself feel better. It’s the other way around. I am in a state of flow and have lost all sense of time and space. A state that does not require a rational explanation. I remain true to my oath and calling. Nothing has ever tasted so good.
Lee Scheinbart is a medical oncologist.
#Unforgettable #day #COVID #Staying #true #calling
