In the best of times, internal medicine residents form the backbone of most academic medical centers. In this age of COVID-19, the role of 51勛圖窪蹋 School of Medicine internal medicine residents has become even more important.
At UMC, the medical schools chief training hospital, the residents manage patients in areas critical care, infectious disease, pulmonology, gastroenterology, cardiology, neurology, endocrinology, and nephrology. outpatient clinics? Yes, they still see patients there, too. When it comes to COVID-19 patients, they take care of patients who arent on ventilators as well as those in the ICU who need the support of medical machinery to breathe.
, the internal medicine program director, notes that residents have never forgotten that the loved ones of patients cannot visit during the pandemic.
Our residents call the families of patients each day to let them know how their loved ones are doing, she said. They understand just how important it is for families. You can imagine just how emotional families get, how thankful they are for news about someone they love.
Singh stressed that residents seeing patients for issues other than coronavirus must strategize patient rounds. They want to ensure they are not exposing other patients, and minimize having to change back and forth out of their personal protection equipment (PPE), she said. It brings a different element to patient care that residents have become very thoughtful about.
Some of the more than 50 residents who have cared for patients with COVID-19 recently spoke about their experiences.
Dr. Yen Cao
Dr. Yen Cao
In the ICU, she cares for some of the most critical COVID-19 patients in ICU. At home, she nurses her 10-month-old daughter and continues to pump breast milk for her little one. Previous studies (on coronaviruses) did not demonstrate significant viral load in breast milk but we still dont know whether COVID-19 is transmitted in breast milk, Cao said. I choose to continue pumping for Audrey as there is an abundance of benefits from breast milk, including antibodies. I just take precautionary measures to ensure that its done under clean conditions washing my hands, and sanitizing the pump equipment.
The son of a Las Vegas gastroenterologist, Shafi said he is blessed to be in a position to help people with the coronavirus. He said its extremely important to remain calm in phone calls to families worried about their loved ones. It is so easy to get emotionally involved and then people wont get the important information they need, he said. Sometimes Im on the phone with an interpreter because the patient is Spanish-speaking, and I always worry that the essence of what Im saying could get lost.
Dr. Annie Hong
Dr. Annie Hong
Pregnant, she is due at the end of May. Because she is so close to giving birth, she is no longer seeing critically ill patients. I definitely wish I was on the front lines, she said. But I understand
Now Hong is reviewing the work of the infectious disease team, trying to ensure that testing for the coronavirus is as accurate as possible. Its like an extra check, she said. Sometimes there are false negatives. Weve developed a system in order to determine which patients must be retested. Its so important to have a correct diagnosis. We dont want to expose people to the virus.
Dr. Pallavi Satuluri
Dr. Pallavi Satuluri
On the ICU rotation with a young child at home, she was, according to Dr. Singh, among the physicians who realized there would be a great need for interpreters for the loved ones of Spanish-speaking patients with COVID-19. I can understand the fear of families, Satuluri said. We call every day and those who cant understand English need to know whats going on. Theres so much fear and we need to do all we can to calm them.
Its difficult for Satuluri's tiny daughter to stay calm when mom gets home. No matter how much she cries when I get home, I make sure not to touch her, to disinfect before I hold her.
Dr. Zachary Hanson
Dr. Zachary Hanson
He cant forget his first COVID-19 patient. He pretty much came in without any respiratory symptoms. In 12 hours, he not only developed symptoms but he had to go on mechanical ventilation. Thankfully, he recovered quickly. He was off the ventilator in five days.
Hanson says he has wanted to be a physician since he was 10 years old. There were medical issues in my family and I wanted to be able to stop that kind of suffering. Thats what I still want to do stop peoples suffering today.
Dr. Tyler Heeren
Dr. Tyler Heeren
He said he was freaked out when he saw young guys his age (in their early 30s) on ventilators. It was scary. They had no medical history and the virus was laying people out flat in the hospital. Heeren said he was struck by how a man in his late 70s was barely showing symptoms of the coronavirus while another young guy with a complex medical history died shortly after he entered the hospital. We did everything we could, he said. Talking with the loved ones of patients is both necessary and challenging, he said. Giving false hope is worse than being honest.
Dr. Wilson Chan
Dr. Wilson Chan
He noted that many of the most critically ill COVID-19 patients hes dealt with have numerous organ complications, including renal failure requiring dialysis, liver failure requiring transfusions, and infections requiring antibiotics. He remembers one patient that he had admitted to the hospital directly from the emergency department. I was there when the decision was made to intubate the patient (put on a ventilator) as the patients respiratory status had declined to the point that the patient could no longer protect her airway. I was really sad when the patient said before being intubated that she did not want to die and that she had trusted everyone involved in her care in helping her get better.
Dr. Gabriel Washington
Dr. Gabriel Washington
A Stanford Medical School graduate, Washington said that after working with COVID-19 patients in the ICU, the only thing he has time for when he comes home is to eat and go to sleep. He said hes found it particularly difficult to speak with the families of loved ones with COVID-19 where there are few signs of progress. Theyre waiting eagerly for some positive news and you cant give it to them. I know how difficult it has to be for them, and when I cant give them good news, its very hard.
Dr. Hui Annie Feng
Dr. Hui Annie Feng
As shes worked on the front line of the coronavirus pandemic, Feng has missed the socializing shes done with other residents. Were a very social program, but with the social distancing we cant get together like we used to, like go to lunch together.
With that in mind, she organized an initiative to give every resident a care bag. It includes a stress ball to squeeze, an aromatherapy candle, a coloring book, popcorn, chocolate, lip balm, water bottle, and hand lotion. She wanted to do something positive to boost morale during this difficult time, Singh said.
An enduring 51勛圖窪蹋 end-of-semester tradition is to highlight exceptional students who embody the academic, research, and community impact of the graduating class.
