25
Mar
2020

A Surge of Gratitude, From a Doctor on the Front Lines of COVID-19 in Boston

Alex Harding, MD, associate, Atlas Venture

Eleven days ago I wrote an article for Timmerman Report on my initial emotions as a doctor on the front lines of the COVID-19 pandemic: fear, frustration, and confusion.

Today, I’d like to add another emotion to that list. Gratitude.

Above all, I am grateful that I can do something to help. My impact is small—miniscule in fact. I’m working about 4 evenings per week at MGH as I balance with my job at Atlas Venture, and usually can’t see more than 8 or 10 patients per shift. But it’s enough to keep me busy and give me some direction in a world that otherwise could feel adrift. What I did not expect, though, was to see how other people have found disparate ways to help.

Over the past week and a half, I have witnessed more impossibilities become reality than I can list here.

At Mass General Hospital, people have united behind the common goal of confronting this pandemic and protecting our patients. Outpatient practices have cut back to skeleton staff as routine appointments have moved online or been canceled. Normally bustling surgical suites are deserted. Instead, it’s all hands at our front-line clinics receiving patients with respiratory illnesses and testing (when appropriate) for COVID-19.

Orthopedic surgeons are working alongside psychiatrists, neurologists teamed with endocrinologists and anesthesiologists. In the medical community, large cultural and stylistic differences have historically separated the specialties. Normally, we don’t talk much. In this crisis, whatever differences we have between our specialties no longer matter. We’re all doctors. We’re all doing everything we can to bring this outbreak under control.

Since my last article on Mar. 14, my clinic has been converted from the Medical Walk-In Unit—a quiet clinic intended to help patients with issues like urinary tract infections and sprained ankles—to the Respiratory Illness Clinic. It’s a highly controlled, carefully sanitized environment intended to exclusively manage patients at high risk for COVID-19.

Everything about our clinical workflow has changed. The tests we can order, how we counsel patients, and how we manage them. The waiting room has been transformed by sealed plastic walls that isolate the patients, who are potentially infectious, from the patient services coordinator who registers them. Seats in the waiting room are spaced six feet apart. Everyone—patients, nurses, doctors, medical assistants, security guards—wears a surgical mask.

Everyone’s job has also completely transformed over the past week. People have been thrust into unfamiliar—and sometimes hazardous—environments all over the hospital. Remarkably, people have adapted without complaint.

I’m grateful to work with people who are doing whatever it takes to fight this virus off. It’s the only way we’re going to win.

Outside of the hospital, I have been surprised over and over by the support and appreciation people express for me and my colleagues working to take care of patients with COVID-19. As healthcare workers, we see ourselves as just doing our jobs, even if we never expected a situation quite like this. But under these circumstances, the community support is uplifting. It helps with morale. I’m grateful for it.

One of the great things I’m seeing is the creativity in how non-healthcare workers are finding myriad ways they can help. A relative, who is currently recovering from COVID-19 and doing well, actually offered to help screen patients since she may be immune to the virus once her infection is cleared. (Given the need for specialized training in the proper use of PPE and patient management, I told her ‘thanks, but no thanks.’)

In the biotechnology industry, the desire to take action seems universal. Companies have donated masks and gloves from their facilities to help replenish depleted stores of PPE in hospitals. Companies are starting up compassionate use programs for their medications that hold promise for treating COVID-19. Other companies are crafting entirely new programs against COVID-19 – whether their expertise is in diagnostics, treatments, or vaccines. Despite knowing the odds are not in their favor to create an effective treatment for this disease, companies are pouring their limited resources into these risky programs.

I have friends and acquaintances asking me how they can set up their home 3D printers to help make face masks to protect healthcare workers. Others are writing me notes to see how they can donate spare masks they have at home, researching the best evidence for potential COVID-19 treatments, organizing webinars, and tweeting words of encouragement. Even the simple act of staying at home to avoid spreading the disease is an act of solidarity for which I’m grateful.

I don’t intend to sugarcoat the dire situation we’re in. Hospitals in New York are overrun as you read this; workers there are haphazardly reusing protective equipment and wondering when they will run out of ventilators. Even in Boston, cases are rising exponentially and our inpatient units are starting to fill up. The uncoordinated response at the state and national levels is baffling. But I’m still grateful to be surrounded by so many people on the front lines, united in the singular goal of defeating this virus.

The other day I had a young patient with a viral infection and asthma. To use some medical jargon, she was “pretty sick.” She had a wheeze and shortness of breath, as well as the telltale fever and cough typical for COVID-19. She was wearing a navy blue cloth mask. She told me she had bought it a few months ago on a trip to Indonesia to protect against pollution. I wore a paper gown, rubber gloves, a mask, and goggles. I prescribed her an inhaler, adjusted her other medications, and sent her to be tested for COVID-19. On her way out, she turned around, looked me in the eye through my flimsy plastic goggles, and thanked me for being there.

I could honestly tell her, without any exaggeration, that there was no other place I would rather be.

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