WHO: AARON GOLDBERG, 48, EMERGENCY MEDICINE PHYSICIAN, AURORA ST. LUKE’S MEDICAL CENTER
It takes forever to take care of patients with COVID-19 because keeping them isolated is critical. We can’t risk exposure of our staff: nurses, techs, clerical, housekeeping. So we have one completely isolated area in the ER for people with COVID. We have to keep the vulnerable, chronically medically out of that area, or they are going to die.
Treating people at this time is difficult because the symptoms of COVID vary. Sometimes it’s just diarrhea, fever and an upper respiratory infection. So we have to assume every patient has it.
Fortunately, we have adequate supplies — masks, gowns, face shields — but we have to be careful with them. When we intubate, we put on hazmat suits and helmets with a HEPA filter and respirator. Any time you intubate, it’s very high risk, because the virus gets aerosolized from the respiratory tract. It goes into the air, stays there and travels.
Intubations have to happen in a negative pressure room. That’s one where a blower pulls air into the room and doesn’t spread to the rest of the hospital. We also don’t clean those rooms for several hours after patients leave.
At home, we — my wife and I and our two teenaged children — have major concerns. My wife, Catherine Aleman, is an internal medicine physician, but she is videoconferencing with her patients. As for me, I change out of my scrubs at work, go home, take off my clothes immediately and shower. I spend most of my time in a separate bedroom with a separate bathroom, and I wear a mask when I’m in common areas of the house. I wash my hands like crazy.
Wearing a mask almost all the time gets a little annoying. I have an N95 mask at work, but that’s really tight. At home, I wear a less restrictive one.
Until this past week [April 13], people with noncritical illnesses stayed away from the ER, so the people who did come in were sicker than average. We weren’t seeing people with minor complaints: fractures, minor lacerations, bruises, bumps, cold symptoms, urinary tract infections. They got the message that the ER was not a good place to be. They were afraid to come in, and that’s good. I commend our city for that. Plus, we had the benefit of seeing what happened in Italy and New York.
The medical community is doing a heck of a job. It’s like they flipped a switch from clinic visits to video visits. They’re managing patients without actually seeing them, and this has helped emergency rooms not be overwhelmed.
We are just now starting to get back to normal. We’re seeing more people come in with illnesses that are difficult to manage over the phone or through videoconferencing: people with heart failure, kidney disease, chronic neurological problems. Clinics are closed, and these people need help. Doctors are doing the best they can, but they can’t do everything remotely. So a lot of the time, people have no choice but us.
Essential treatment is getting done, chemotherapy for cancer, for example. But you can’t put off everything forever. We’ll slowly start doing everything we’ve always done: screenings, mammograms, colonoscopies. Even “comfort” procedures, such as hip replacements, will start happening.
I think we’re past the worst.
– As told to Carolyn Kott Washburne
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