Estoy ajustando.

Dare I say, a new normal is settling on the hospital during this time of COVID. The shock of what the virus is capable of, the stress of being overwhelmed, the fear and isolation acutely glaring have all become glazed over as we desensitize and adjust. Co-residents that have been out sick are slowly improving and with that, are able to start returning to work. No one ever talks about how the operating rooms used to be fully operational, except to express just how long ago it seems that they were. New York was predicted to plateau this week, and it seems to be the case. I now fear that with a plateau of new admissions, if we all catch and try to hold that glimmer of hope, a second spike of cases may be more detrimental than these past two months (emotionally and psychologically speaking). I wonder what this coming week will bring? What is expected is new admissions to stay plateau'd, but deaths continue to spike as patients that have lingered for the past couple of weeks finally succumb. Along with the plateau at Westchester, have come a handful of patients improving and slowly, one by one coming off the ventilators in a successful manner. They are few, but nice to see.

The persistent busyness of the pediatric surgery service has helped this past week to fly by for me. I get to be one of the few surgery residents that still is operating during this time. As far away from the hospital that all should stay these days, little kids unfortunately still get sick, or fall off their skateboards and bicycles, etc. Or in one particular case, as I was discussing surgery with mom while facetiming with dad, it became painfully obvious that up to that point no one had used the term 'cancer' with them. Despite being separated and scared, they handled everything well. Even post operatively, Mom pointed at the ventilator and expressed "we're lucky to have that aren't we?" I was rather surprised at their own understanding of what was not openly expressed to them of what it means to be sick in the current times.

Now is not a time to be sick, and if sick pray you don't need hospitalization. However, emergencies still happen. This past week an article was published in the New York Times, "Where Have All the Heart Attacks Gone?" There is a noticeable decline in heart attack and stroke presentations to hospitals, not only in the US but globally. My past few weeks on cardiac surgery, I still performed bypass surgery for many, but not at the rate that I was expecting, or was in the past normal for the Cardiac surgeons.  In addition, there was not a single acute dissection that presented during my time on the service.  On general surgery call, I keep expecting patients to show up with acute abdomens after having stayed at home for days with belly pain instead of coming to the hospital and presenting only after their only option is to rush to the OR. But, that has not really been happening either. I'm sure any cause and effect will make much more sense retrospectively, but for the time being, I just pray that its simply true emergencies are in fact at a low and not just ignored.

Much Love and Prayers