Friday, March 27, 2020

Estoy operando en el corazón.

COVID continues to take over the hospital. Overnight all non-COVID patients of two of our ICUs were moved to the pre-op area of the ACP operating suite. Ambulatory Care Pavilion, a large 7 story addition to WMC that just opened a few months ago. The area was not built to house ICU patients, but we're making due. Next steps, converting ORs to house ICU patients. Patient's sharing rooms and ventilators. And last...deciding who gets the ventilator, and who dies.

It's already proved to be so in other countries. It happened in Italy, a country with more hospital capacity per capita than us. If it happened to them, it'll happen to us. Numbers wise we broke 7000 cases in Westchester county today. Considering 1,000,000 to be the number of people in this county, means we haven't even hit 1% yet.

As the infections, and now deaths, rise around us, I've noticed my fellow co-residents getting increasingly jumpy. About masks, about the cleaning of our lounge and call rooms, about any cough no matter how small. This morning, one of my co-residents realized she couldn't smell anything and started panicking until she remembered... she was still wearing her N95 mask. For the most part we all recognize it and laugh at ourselves. My last call we had ordered food and sat in the lounge waiting for it's arrival, very pensively my chief spoke up "you know, one if us will probably die." My junior, who is jumpy at baseline, just about fell out of his seat with a startled surprise. And we were all able to laugh. I personally don't think any of us are going to die... end up on a ventilator maybe, but die no.

I myself know that I've had positive COVID exposure. Thus far, am asymptomatic, so I know what I'd be told. Wear a mask, go to work, call us back if symptomatic. So am I actually infected, probably not, but I act in the hospital as if I'm a carrier at least. Purell before and after touching anything, and always wear a mask... it makes drinking my coffee rather difficult. Upon entering the hospital there are stations to check everyone's temperature, and I find myself holding my breath until they tell me I'm good.  Perhaps, I'm a bit jumpy too. A bit upset as well, just at the idea that I could have the virus. Here I am warming the bench, saying "Put me in Coach, I'm ready!" Only to be taken out before even getting to fight? I don't like that idea.

I also had a conversation with one of our prelim residents who will be transitioning to Radiology for next year. In accordance with her interest, she had been looking over all the chest xrays and ct scans of COVID patients. She commented that by the time a patient has become symptomatic, the extent of the fibrosis within the lung is already quite severe. In five years time, 10 or 20 years time, what will be the effect of COVID on its survivors down the road. Another idea I don't like to think of as a potential reality for my future.

You know what I do like to think about? Surgery!! I got to operate on a beating heart today. It was just for a small bit, we were setting up to go on bypass, and the Attending handed me the suture. It's one of the things that I admire and respect so much about Cardiac surgeons (at least all that I have been blessed to work with), their rock-solid steady hands when working on a jumping target. It's like artwork, it's beautiful, takes my breath away and makes my fingers tingle. And I got to do it today!

Much Love.

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