Editorials & Other Articles

OhioChick

(23,218 posts) Thu Apr 22, 2021, 06:12 AM Apr 2021

A Doctor's Dark Year (Good Read.....See What Our Doctors are Dealing With)

In the heart of the pandemic, a trauma surgeon travels to the edge and back.
By Dhruv Khullar
April 20, 2021
For many physicians, the carnage caused by COVID-19 has felt suffocating and endless.

Brittany Bankhead-Kendall arrived in Boston in July of 2019. Tall and trim, with straight, blond hair, bright-blue eyes, and an easy smile, she has a sunny disposition and the hint of a Texas drawl. She had just finished a general-surgery residency in Texas, and, at Massachusetts General Hospital, she would complete her training as a trauma and critical-care surgeon. As summer eased into fall, she struggled to acclimate to the weather. At the hospital, she operated on patients who’d suffered serious injuries—people hurt in car accidents or house fires, or by gunshots. Patients would arrive with fractured skulls and ruptured spleens, collapsed lungs and bleeding bowels. Bankhead-Kendall got good with gore.

In March, 2020, as the coronavirus descended on Boston, she learned that her role would evolve. She would be stationed in the I.C.U., where the sickest COVID-19 patients would be treated, and start working primarily as a physician, not a surgeon. Bankhead-Kendall read with care the flurry of hospital-wide e-mails detailing new procedures and protocols: where patients would be isolated, how P.P.E. would be rationed, when additional staff would be called in. Keeping track of new information felt like a full-time job. Still, at first, the surge didn’t materialize. “There was just this impending sense of doom,” she told me recently, over Zoom. “Then, all of a sudden, it was at our doorstep.”

The first COVID-19 patient she cared for was a woman in her mid-thirties. (Some details have been changed to protect patient privacy.) The woman was admitted to a step-down unit—the rung between an I.C.U. and a general-medicine floor—and, though previously healthy, she now needed concentrated oxygen delivered through a nasal tube to insure safe levels in her blood. Bankhead-Kendall’s shifts began in the evenings. When she arrived, she’d stop by the patient’s room. She’d watch her breathing through a window, record her vital signs, review her blood tests, and consider whether and when she should intubate her. For a few days, the woman was the only COVID-19 patient in the hospital.

Then things accelerated. One patient became three, three became ten, ten became thirty—an overwhelming deluge of COVID-19 patients. Her nightly rounds transformed into an escalating struggle. “We just tried to stay afloat,” Bankhead-Kendall said. “It was pure survival mode.” She was tapped to join the hospital’s “airway team”—a group who rushed to intubate patients when their breathing collapsed. The airway team received emergency pages and overhead alerts; when the alerts came, with alarming frequency, Bankhead-Kendall sprinted with a neon backpack full of supplies to the patient’s room, where doctors, nurses, and respiratory therapists had converged. A swift, coördinated ritual commenced. The patient could be unconscious or heaving and coughing, spraying virus everywhere. A mask connected to an oxygen bag would be placed over his nose and mouth. Someone would lower the head of the bed, another would guide a catheter into a vein (or, if that failed, drill it into a bone), and a third would administer sedative medications. Yet another doctor—sometimes Bankhead-Kendall—would peer down the patient’s throat, spy the vocal cords, and insert a plastic tube, while others monitored, prepared to perform C.P.R.

More: https://www.newyorker.com/science/medical-dispatch/a-doctors-dark-year?utm_source=pocket-newtab

Doctors are Going Through Hell.