Dr. Julianna Batizy says she initially didn’t think of the coronavirus when she began to develop muscle pains and a headache one Saturday in March. She attributed it to her workout routine or the demands of her job as an emergency room physician in Denver. But as her symptoms worsened, Batizy and her employer decided she should get tested for the coronavirus. The test came back positive.
“I cried quite a bit the first day that I found out. Partly because I didn’t feel well, but partly because I had a lot of anxiety about how this was going to play out,” Batizy told Yahoo News. “I wasn’t thinking about the 80 percent of people that do fine; I was thinking about all of the terrible ‘what ifs’ and feeling incredibly vulnerable.”
While self-isolating in a room at her home, Batizy decided to write letters to her children, stepchildren and husband.
“There’s a lot of milestones ahead in their lives that if something were to happen to me now I wouldn’t be there for, and I had a lot on my mind that I wanted to share with them,” Batizy said. “I just felt that in the event this thing took a turn — and there was no way to know whether it would or not — there were some things I felt I needed to say.”
Batizy is one of many hospital employees who are now reckoning with their own mortality as they face the pandemic head-on, seeing patients with COVID-19 and sometimes going from caregiver to patient when they contract the disease themselves.
“I know that a lot of my physician friends have drafted their wills for their first time,” Dr. Dara Kass, a New York City-based emergency room physician and associate professor of emergency medicine at Columbia University Irving Medical Center, told Yahoo News. “I think anyone that works in a hospital has realized for the first time ever that their job maybe also risks their life. And we’re not firemen. We’re not soldiers. This isn’t what we agreed to, and we’re doing it, but it wasn’t part of the decision-making process.”
Kass had been treating patients by telemedicine as well as in the emergency room when in mid-March she began to notice herself exhibiting some of the same symptoms as her patients. So she decided to schedule a telemedicine appointment for herself. A test at a drive-through center confirmed that she was positive for the coronavirus. Kass says the diagnosis was a relief because it ended the uncertainty about whether she had the virus.
But Kass also felt apprehensive about what lay ahead. For health care professionals who are diagnosed with the coronavirus, the knowledge and experience they’ve accumulated from treating patients can bring with it additional anxiety.
“I had seen patients who had done well for the first four days, even the first six days, and they started to feel better and then all of a sudden they got sicker,” Kass said. “The same time that I got infected, I had friends that had to go to the hospital because their oxygen numbers dropped and they needed oxygen through the nose. They needed to even be intubated. And there’s nothing scarier than watching your friends get sicker and you’re sitting there waiting to find out if that’s going to be you too.”
“Because I knew how the disease can progress, in addition to not feeling well I had a lot of anxiety as I entered day 7, day 8, day 9, because I know that that’s when the cytokine storm starts to happen, if you’re going to have it happen,” Batizy said, referring to a phenomenon that can occur when the body’s immune becomes overactive and starts attacking healthy cells. “And sometimes the fear of it is as bad as the thing itself.”
Being in self-isolation can also present other frustrations for health care workers who feel sidelined as their colleagues battle a pandemic, with resources, personal protective equipment and manpower already in short supply.
“I longed to go back,” Dr. Yale Tung Chen, an emergency room physician at the Hospital Universitario La Paz in Madrid, told Yahoo News. “Because I received so many support messages and messages from my friends and colleagues from the hospital that they were struggling to see so many patients like never before.”
Spain has been hit hard by the pandemic. With over 180,000 cases and more than 19,000 deaths, the country is second only to the United States in casualty numbers.
Chen tested positive for the coronavirus in early March after exhibiting what he describes as mild, cold-like symptoms that eventually worsened with inflammation in his lungs and a bacterial infection. Chen never needed to be hospitalized, though he was prescribed an antibiotic and hydroxychloroquine — an antimalarial drug that has been floated as a possible therapy for COVID-19 — as well as Tylenol and acetaminophen for his muscle pain and cough.
Though he couldn’t assist in the ER during his three-week self-isolation, Chen found other ways to be useful, by documenting his own symptoms and oxygen saturation at home and using an ultrasound machine to monitor the inflammation in his lungs.
“I wanted to share that information to the medical community,” Chen said.
He began posting daily updates on Twitter, including videos of his ultrasound scans to show the progress of the disease. The ultrasound “turned out to be a useful tool,” he said.
“Now, with that gained experience, I am using it with every single patient that I’m treating in my hospital. I use the ultrasound because it’s portable, cost effective and has no side effects.”
Kass was able to continue seeing patients via telemedicine while she was recovering at home and found it gave her a unique way to connect with her patients.
“I will say that taking care of patients who were symptomatic for coronavirus while I was symptomatic for coronavirus, and then after I found out I had it, was actually a gift that I wasn’t expecting for my ability to be a really compassionate and empathetic doctor,” Kass said.
“I actually started using this analogy about the Hair Club for Men — that I wasn’t just a doctor, but I was also a patient,” Kass quipped, alluding to the 1980s television ad. “And people laughed.”
Kass, Chen and Batizy have recovered and returned to work in the emergency room, following the Centers for Disease Control and Prevention guidance that health care workers can return to work after either a negative test or three days of no symptoms and at least seven days after symptoms appeared. But after weeks away, returning to the ER presents a new set of psychological challenges.
Kass says she was “petrified” going into her first shift back. Her colleagues had kept her informed of the worsening conditions in the emergency room.
“By the time I was going back to work, New York City had changed,” Kass said.
New York has become the epicenter of the coronavirus pandemic, with over 200,000 cases and more than 10,000 deaths in New York state alone.
“Every patient, regardless of original presenting complaint, had turned into a coronavirus patient,” Kass said. “So it didn’t matter if you had a broken leg or pneumonia, everybody was coronavirus positive. And that was overwhelming to everybody.”
“We are seeing many co-workers, friends, colleagues, mates, that have fallen into the disease,” Chen said of his hospital in Spain, where he said 60 percent of his colleagues have become ill.
“Many of the physicians, health care workers, we cry. We struggle. We face the worst time of our lives,” Chen said. “But don’t lose hope.”
“I was actually having a lot of anxiety about it beforehand,” Batizy said of returning to work. “Not so much just for myself, but in Colorado we’re kind of on the upswing with our cases. So I was nervous about what I was going to encounter at work.”
Batizy says that while she was ill, a colleague and friend in New Jersey died from COVID-19 after contracting the virus while working as an emergency room physician.
“He was all about compassion and empathy in your approach to patient care, and I think that that’s really what has to be at the heart of what you do, or you really don’t belong in medicine.”
She’s keeping the letters she wrote to her family to give to them “when the inevitable day comes and it’s my time — which I hope is a long ways away.”
Batizy, whose 73-year-old father is also a practicing emergency physician, has a daughter in nursing school and a daughter currently applying to medical school. She says her letters to them impart advice on “life philosophy,” such as approaching life and others with love and kindness, and reiterate guidance she has given them on life in the medical profession.
“They were long letters,” Batizy said. “I’ve had conversations with them about medicine before this hit, but this pandemic underscores the advice that I’ve always given them, which is that you go into medicine because you have a passion to want to help people, and you enjoy the challenge of the science.
“You don’t go into it for any other reason.”
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