5 ms·

A Doctor’s Dark Year

78 points by wglb 6y ago

mrlagmer 6y ago
It is interesting to read stuff like this. We never had it bad in Australia so when you read something like this it makes you thankful for how we have handled it. Amazing that we will have 80,000 people at a football game on Sunday.
- taxicabjesus 6y ago
  One speculation I've read is that Australian/Japan/New Zealand's very-bad 2019 flu season was SARS-CoV-2 before it could be diagnosed. My understanding is that most cases of "flu" are suspected, not laboratory-confirmed. Just found this October 4, 2019 NY Times story: Australia Just Had a Bad Flu Season. That May Be a Warning for the U.S., https://www.nytimes.com/2019/10/04/health/flu-australia-america.html https://www.nytimes.com/2019/10/04/health/flu-australia-amer... From this NY times article: "This year’s Australian outbreak began in April [2019], two months earlier than usual, and persisted into October." COVID-19 cases in the US probably started November-ish. COVID-19 was found in US blood samples from December 2019. I had a day with an odd headache sometime around December 2019 or January 2020. I suspect I had a case of #EarlyCovid. Lots of other people in North America were super-sick in November/December 2019 and January 2020. Others have been using the hashtag for longer than I: https://twitter.com/search?q=%23EarlyCovid https://twitter.com/search?q=%23EarlyCovid Edit: At least 4 downvotes in 16 minutes. This indicates many of you do not believe SARS-CoV-2 could have been spreading before it was isolated in Wuhan China in December 2019, or that I and many others might have had a case of non-diagnosed SARS-CoV-2 before tests became available in the US in March 2020. https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pande... "A September 2020 review noted "The possibility that the COVID-19 infection had already spread to Europe at the end of last year is now indicated by abundant, even if partially circumstantial, evidence", including pneumonia case numbers and radiology in France and Italy in November and December." - https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_2019 https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pande... What does it mean if the COVID-19 timeline is wrong?
  - taxicabjesus 6y ago
    (note to self: comment above quickly went to -4, then saw at +2, now at -1, so at least 14 votes.)
  - projectileboy 6y ago
    I’m not totally sure why you’re being downvoted, it’s an interesting question. My niece in Seattle had a very bad “flu” for about three weeks early last year, well before the initial wave in the Pacific Northwest. I hope we will eventually learn a bit more about how and where this started and how and where it spread, so that we can do a better job next time. (Putting aside the obvious ways the US and other parts of the world chose to deny reality, there still is much to learn.)
    - tharkun__ 6y ago
      I can completely believe this. Unfortunately we can't prove any of this but personally I think my team was at least exposed to Covid in early 2020 as well. We had a guy in our (small) team room out sick from Thursday to Monday and he reported being 'floored' and coughing his lungs out. His SO got the same a few days after. Nobody else really got sick but given the close quarters and what we know about aerosol spread and incubation periods now, I think we were practically bathing in virus soup.
  - viraptor 6y ago
    While not impossible, there are a few things that I think would need good explanations: - labs would get more flu swabs which test negative - there would be enough globally to make someone suspicious - why did we see only one strain of covid initially if it was already spreading early (and as I understand it the strain hierarchy always points to the Wuhan one on top) - we haven't seen the cases drop completely without special measures in any country (there's a drop in summer, but only partial) - why was Australia pretty much covid free initially with all the assumed 2019 cases?
    - taxicabjesus 6y ago
      1. Flu cases numbers are estimates. Flu cases have disappeared, presumably on account of everyone getting SARS-CoV-2 instead. https://www.cdc.gov/flu/about/burden/index.html https://www.cdc.gov/flu/about/burden/index.html https://www.cdc.gov/flu/about/burden/faq.htm https://www.cdc.gov/flu/about/burden/faq.htm https://blogs.scientificamerican.com/observations/comparing-covid-19-deaths-to-flu-deaths-is-like-comparing-apples-to-oranges/ https://blogs.scientificamerican.com/observations/comparing-... 2. Figuring out if a person has a strain requires genetic sequencing of samples that tested positive for generic COVID-19. I don't know when this became possible. https://www.ctvnews.ca/health/coronavirus/how-are-covid-19-variants-discovered-tested-and-tracked-1.5312988 https://www.ctvnews.ca/health/coronavirus/how-are-covid-19-v... 3. Some populations are healthier than others. I think 'Special measures' are mostly theater.
- decafninja 6y ago
  The Asian countries that fared relatively well - Taiwan/Japan/Korea/etc.etc. - I guess you could chalk it up to cultural differences, but what and how did Australia, a "Western" country that I reckon is culturally more similar to the USA and Europe than to say, Japan or Korea, do so well and differently vs. the USA? Correct me if wrong, but Aussie culture has an individualistic streak like the USA too, doesn't it?
  - vmception 6y ago
    Geography, topology, authoritative control, non-porous border which was closed, mandatory two week quarantine for any exception
    - rvn1045 6y ago
      + a small population of 25 million
      - vmception 6y ago
        yes thats useful context, I was mentally grouping that into topology kind of stretching that to the few areas where people live and how desolate the rest is
    - BelenusMordred 6y ago
      Australia abandoned their own citizens abroad to thundering applause. No other country on Earth did that. The number of people allowed back into the country is minuscule and right now, foreign business travellers get priority on flights because they can pay more for seats.
    - shoo 6y ago
      another factor could be how cohesive / fragmented the government response is -- maybe this is another facet of "authoritative control". here's a crude model as a straw-man thought experiment: australia has a federal government with some degree of control but the 8 local state/territory governments still get a reasonable amount of ability to make local decisions. The states often disagree with the federal government, and with each other, and have disagreed about the appropriate responses to covid in many cases. Suppose the federal government has no ability to control anything. Each local government has a 95% chance of doing something reasonable in response to a pandemic and a 5% chance of doing something stupid. If we make the poor working assumption that each local government decides what to do independently of the others, then about 2/3rds of the time we would expect all 8 australian local governments to do something reasonable, and 1/3 of the time one or more local government will respond to the pandemic in a stupid way. So maybe we got to see the 2/3rds outcome in australia -- or perhaps we actually saw a 1/3rd outcome where stupid decisions were made that dramatically elevated risk, but we simply got lucky. In contrast the US has say 51 local government regions, so there's about a 7% chance that they all do something reasonable and a 93% chance that at least one local government region does something stupid. Then if it is hard or impossible to isolate the impacts of bad decisions to each local region, the impact of poor decisions in one region can help outbreaks spread in connected regions. On another hand, a downside of having a strong central control of the entire country's response is that if that central response is stupid, then the entire country starts cohesively doing something stupid, whereas a country with more fragmented/decentralised decision making might fare a bit better locally.
- jjcm 6y ago
  I’m one of the rare ones who had covid in Australia, but also spent time in the states during the pandemic so I’ve seen both sides, and experienced how a positive case is addressed here in Aus. Australians care far, far more. I saw more people wearing masks on Sydney trains at zero cases than I did in a US supermarket at the peak. Politics don’t play into whether or not you wear a mask in Australia. In addition, Australian’s have made sacrifices for the greater good of all in the past (giving up guns for example). This just isn’t a thing in America. While both are western countries, there are major differences in mindset. When I tested positive in Australia, I was immediately moved to my own private apartment dedicated for covid patients, free of charge. I wasn’t allowed to leave, but was fed and had doctors visiting me twice a day for vitals. I had very mild symptoms through all of this, but they treated it very seriously. In America they just send you home. Australia invested more up front to keep the curve low. Despite having some complications with the duration of my stay, which lead me to be quarantined for 31 days[1], I vastly prefer Australia’s approach to the pandemic. [1] https://www.abc.net.au/news/2021-01-15/sydney-man-covid-policies-stuck-quarantine-hotel-no-end-date/13058440 https://www.abc.net.au/news/2021-01-15/sydney-man-covid-poli...
  - decafninja 6y ago
    I always thought Australian culture had its individualistic streak like American culture. I guess I was wrong, or at least it's a different flavor of individualism.
    - mrec 6y ago
      I didn't get the impression that individualism was the USA's problem here, so much as political tribalism. Mask-wearing seemed to get established very early on as a tribal marker, and everything else followed from that.
      - decafninja 6y ago
        I guess political tribalism was certainly a big factor, but I always thought it was something that amplified an already existing characteristic for "rugged individualism", as in, a tendency for people not liking being told what they can or can't do. It exists to various degrees in pretty much any culture (even highly collectivist cultures like some Asian countries), but in the USA, I think it's seen as a bedrock upon which the country was founded on and successful with. I don't disagree, and I think this individualist go-get-em culture contributed to some of the country's successes, but in times like this, it certainly shows its dark side. You could chalk up the whole US healthcare system fiasco to this too.
bengale 6y ago
I tend to find the overuse of the word hero bothers me, but I don’t know what other word would describe people like this.
- pmiller2 6y ago
  This would be a correct usage, not a performative usage like corporations calling grocery store workers "heroes" because they have to go to work or lose jobs they depend on.
  - eertami 6y ago
    You and I also depend on grocery store workers. We would be in even greater chaos without them. I'm not sure where you're going with this.
    - h4waii 6y ago
      I believe they are essentially saying this: https://i.redd.it/pmori9td3ar51.jpg https://i.redd.it/pmori9td3ar51.jpg I hate just drive-by posting an image of a tweet from Reddit, which may not even be true, but I think it's succinct.
      - pmiller2 6y ago
        Which part do you think might not be true? That the daughter is a slave of capitalism? I'd say that's the part most likely to be true. There were times early on in the pandemic when people were seriously questioning whether they should go to work and risk their health, or stay home and lose their jobs. Don't forget, the CARES act didn't pass until late March last year.
        h4waii 6y ago
        Oh, just that the "conversation" ever happened, I have no doubt this is a situation a lot of people are in, and it's saddening.
raunak 6y ago
https://archive.is/hEoUL https://archive.is/hEoUL
throwawayboise 6y ago
Doctors always see people at their sickest and most fragile. I'm not sure I could do it, but it's what they sign up for.
- GavinMcG 6y ago
  What are you trying to say? "It's what they signed up for" sounds like it's hinting at a further claim, but it's not clear what it is.
  - throwawayboise 6y ago
    Doctors that I know don't get personally invested. They know what they can do, and they do the best they can for any patient. When you're a trauma surgeon in Detroit, you treat gunshot wounds every day. You can't save them all, and you don't take that home with you or as a personal failing or you will not stay sane.
    - GavinMcG 6y ago
      The whole point of the article is that many doctors have had to step into roles or acuity levels that were not every day material for them and not what they signed up for. A trauma surgeon expecting gunshot wounds could well find it much more challenging to be working as an ICU physician, where you can't detach yourself as easily, and where you can't use your most-practiced skills, and where you can't know by the end of the procedure whether the patient's odds are good. They specifically didn't sign up for that. It's easy to say "don't get personally invested" but even if you're not getting attached to particular patients, it's demoralizing to go from an environment where you see a range of outcomes (including some bad ones) to one where you're constantly surrounded by patients near death with little chance for improvement and where your skills don't necessarily seem to matter. That's not about being invested.
perardi 6y ago
At the risk of minimizing the amazing efforts of doctors this past hell year: spare a thought or two for nurses. https://www.nytimes.com/2021/01/15/nyregion/filipino-nurses-coronavirus.html https://www.nytimes.com/2021/01/15/nyregion/filipino-nurses-... Been a hard year for nurses. (And respiratory therapists. And paramedics.)
calltrak 6y ago
I live in New York City and the media was telling us the were digging mass graves in New York City. You remember that? I still cant find those mass graves. This pandemic was pure bullshit . They renamed the common flu. And the media and the government duped everyone... now make sure you get your certificates of vaccination i's and passports to get your little freedom back.
Fomite 6y ago
As an epidemiologist, this has been the hardest year of my life. I've had a couple complete, "curled up in the stairwell having a breakdown" breakdowns, etc. and I'm relatively safe. The sheer, unrelenting stress this has put on doctors, nurses, EMTs and other hospital staff is going to have long term consequences. Morale among those who graduated into the teeth of this is really bad.
- perardi 6y ago
  “Fomite”: name checks out for an epidemiologist. But then seriously, my partner is a paramedic in a large North American city. He has been, to put in bluntly, lucky, because this non-American city implemented a reasonable sick plan, and he serves a chunk of the city that has not been hard-hit. (Which is to say: no warehouses, no food processing.) But just the constant hyper-vigilant PPE dance wears and wears you down. Nothing is “simple” now; the simplest slip-and-fall becomes a scene out of the Andromeda Strain, because you don’t want to get infected, and you certainly don’t want to pass something on when you are harboring the virus but not presenting obvious symptoms. (Too bad said city also had one hell of a testing bottleneck, and you couldn’t just test test test to make sure the front-line staff is virus-free.)
- deleted 6y ago
  [deleted]
munificent 6y ago
What a harrowing, intense read about an incredibly strong person.
throwawayemdee 6y ago
Just want to comment with an alternate point of view, and in no way intend to demean to diminish the emotional impact like those described in the article. Just how I feel: I'm an intensive care physician and also function part-time as a hospitalist (acute care medical floor patients). Yes, there have been some stressful, uncertain, and fear-driven moments. But I also chose to work at a place that has a physician-led and supportive administration, and I investigated those things as part of the interview process. We had adequate staffing, a robust peer-support system (look up the "second victim" phenomenon), and my colleagues and I seem to have good coping mechanisms in place, which I assumed doctors in these kinds of specialties needed as a basic requirement. Bottom line, I'm doing just fine, and my inpatient physician colleagues, with some exceptions, report the same. This is a difficult job at baseline without COVID. It didn't change my approach at all.
- nexuist 6y ago
  > But I also chose to work at a place that has a physician-led and supportive administration Your positive experience seems to confirm that working in a place with good management has a positive effect on employee morale, although I'm not sure anyone was questioning that in the first place. It is however uplifting to note that workplaces like yours exist. I also think it depends on the area you serve. I imagine for many hospitals COVID was a case of "do everything right and everything still goes wrong" - especially when you reach max capacity, it doesn't matter how good of a doctor you are, you can't heal people with your bare hands. Likewise, it doesn't matter how well you use PPE or social distance or stay at home if thousands of others in your area ignore the safety measures and get each other sick, and it doesn't matter how much you care about keeping people safe if your local or federal governments don't take the issue seriously. This has been a huge stress point not just for doctors but for everyone I think, the knowledge that so much misery and death could have been avoided if we just did what we knew we should do when this mess started.
  - throwawaemdee 6y ago
    You're absolutely right. I think a lot of the stress-related stories we're seeing do depend on the location, demographics, and a ton of other factors; a large city academic center might have a lot higher load and resource stress than a smaller hospital. But overall, I just like to point out to people that some of us in medicine and nursing are doing just fine through all of this. A lot of people assume that we're all miserable because we work in the acute hospital/ICU setting.

78 points by wglb 6y ago

It is interesting to read stuff like this. We never had it bad in Australia so when you read something like this it makes you thankful for how we have handled it. Amazing that we will have 80,000 people at a football game on Sunday.

taxicabjesus 6y ago
One speculation I've read is that Australian/Japan/New Zealand's very-bad 2019 flu season was SARS-CoV-2 before it could be diagnosed. My understanding is that most cases of "flu" are suspected, not laboratory-confirmed. Just found this October 4, 2019 NY Times story: Australia Just Had a Bad Flu Season. That May Be a Warning for the U.S., https://www.nytimes.com/2019/10/04/health/flu-australia-america.html https://www.nytimes.com/2019/10/04/health/flu-australia-amer... From this NY times article: "This year’s Australian outbreak began in April [2019], two months earlier than usual, and persisted into October." COVID-19 cases in the US probably started November-ish. COVID-19 was found in US blood samples from December 2019. I had a day with an odd headache sometime around December 2019 or January 2020. I suspect I had a case of #EarlyCovid. Lots of other people in North America were super-sick in November/December 2019 and January 2020. Others have been using the hashtag for longer than I: https://twitter.com/search?q=%23EarlyCovid https://twitter.com/search?q=%23EarlyCovid Edit: At least 4 downvotes in 16 minutes. This indicates many of you do not believe SARS-CoV-2 could have been spreading before it was isolated in Wuhan China in December 2019, or that I and many others might have had a case of non-diagnosed SARS-CoV-2 before tests became available in the US in March 2020. https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pande... "A September 2020 review noted "The possibility that the COVID-19 infection had already spread to Europe at the end of last year is now indicated by abundant, even if partially circumstantial, evidence", including pneumonia case numbers and radiology in France and Italy in November and December." - https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_2019 https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pande... What does it mean if the COVID-19 timeline is wrong?
- taxicabjesus 6y ago
  (note to self: comment above quickly went to -4, then saw at +2, now at -1, so at least 14 votes.)
- projectileboy 6y ago
  I’m not totally sure why you’re being downvoted, it’s an interesting question. My niece in Seattle had a very bad “flu” for about three weeks early last year, well before the initial wave in the Pacific Northwest. I hope we will eventually learn a bit more about how and where this started and how and where it spread, so that we can do a better job next time. (Putting aside the obvious ways the US and other parts of the world chose to deny reality, there still is much to learn.)
  - tharkun__ 6y ago
    I can completely believe this. Unfortunately we can't prove any of this but personally I think my team was at least exposed to Covid in early 2020 as well. We had a guy in our (small) team room out sick from Thursday to Monday and he reported being 'floored' and coughing his lungs out. His SO got the same a few days after. Nobody else really got sick but given the close quarters and what we know about aerosol spread and incubation periods now, I think we were practically bathing in virus soup.
- viraptor 6y ago
  While not impossible, there are a few things that I think would need good explanations: - labs would get more flu swabs which test negative - there would be enough globally to make someone suspicious - why did we see only one strain of covid initially if it was already spreading early (and as I understand it the strain hierarchy always points to the Wuhan one on top) - we haven't seen the cases drop completely without special measures in any country (there's a drop in summer, but only partial) - why was Australia pretty much covid free initially with all the assumed 2019 cases?
  - taxicabjesus 6y ago
    1. Flu cases numbers are estimates. Flu cases have disappeared, presumably on account of everyone getting SARS-CoV-2 instead. https://www.cdc.gov/flu/about/burden/index.html https://www.cdc.gov/flu/about/burden/index.html https://www.cdc.gov/flu/about/burden/faq.htm https://www.cdc.gov/flu/about/burden/faq.htm https://blogs.scientificamerican.com/observations/comparing-covid-19-deaths-to-flu-deaths-is-like-comparing-apples-to-oranges/ https://blogs.scientificamerican.com/observations/comparing-... 2. Figuring out if a person has a strain requires genetic sequencing of samples that tested positive for generic COVID-19. I don't know when this became possible. https://www.ctvnews.ca/health/coronavirus/how-are-covid-19-variants-discovered-tested-and-tracked-1.5312988 https://www.ctvnews.ca/health/coronavirus/how-are-covid-19-v... 3. Some populations are healthier than others. I think 'Special measures' are mostly theater.
decafninja 6y ago
The Asian countries that fared relatively well - Taiwan/Japan/Korea/etc.etc. - I guess you could chalk it up to cultural differences, but what and how did Australia, a "Western" country that I reckon is culturally more similar to the USA and Europe than to say, Japan or Korea, do so well and differently vs. the USA? Correct me if wrong, but Aussie culture has an individualistic streak like the USA too, doesn't it?
- vmception 6y ago
  Geography, topology, authoritative control, non-porous border which was closed, mandatory two week quarantine for any exception
  - rvn1045 6y ago
    + a small population of 25 million
    - vmception 6y ago
      yes thats useful context, I was mentally grouping that into topology kind of stretching that to the few areas where people live and how desolate the rest is
  - BelenusMordred 6y ago
    Australia abandoned their own citizens abroad to thundering applause. No other country on Earth did that. The number of people allowed back into the country is minuscule and right now, foreign business travellers get priority on flights because they can pay more for seats.
  - shoo 6y ago
    another factor could be how cohesive / fragmented the government response is -- maybe this is another facet of "authoritative control". here's a crude model as a straw-man thought experiment: australia has a federal government with some degree of control but the 8 local state/territory governments still get a reasonable amount of ability to make local decisions. The states often disagree with the federal government, and with each other, and have disagreed about the appropriate responses to covid in many cases. Suppose the federal government has no ability to control anything. Each local government has a 95% chance of doing something reasonable in response to a pandemic and a 5% chance of doing something stupid. If we make the poor working assumption that each local government decides what to do independently of the others, then about 2/3rds of the time we would expect all 8 australian local governments to do something reasonable, and 1/3 of the time one or more local government will respond to the pandemic in a stupid way. So maybe we got to see the 2/3rds outcome in australia -- or perhaps we actually saw a 1/3rd outcome where stupid decisions were made that dramatically elevated risk, but we simply got lucky. In contrast the US has say 51 local government regions, so there's about a 7% chance that they all do something reasonable and a 93% chance that at least one local government region does something stupid. Then if it is hard or impossible to isolate the impacts of bad decisions to each local region, the impact of poor decisions in one region can help outbreaks spread in connected regions. On another hand, a downside of having a strong central control of the entire country's response is that if that central response is stupid, then the entire country starts cohesively doing something stupid, whereas a country with more fragmented/decentralised decision making might fare a bit better locally.
jjcm 6y ago
I’m one of the rare ones who had covid in Australia, but also spent time in the states during the pandemic so I’ve seen both sides, and experienced how a positive case is addressed here in Aus. Australians care far, far more. I saw more people wearing masks on Sydney trains at zero cases than I did in a US supermarket at the peak. Politics don’t play into whether or not you wear a mask in Australia. In addition, Australian’s have made sacrifices for the greater good of all in the past (giving up guns for example). This just isn’t a thing in America. While both are western countries, there are major differences in mindset. When I tested positive in Australia, I was immediately moved to my own private apartment dedicated for covid patients, free of charge. I wasn’t allowed to leave, but was fed and had doctors visiting me twice a day for vitals. I had very mild symptoms through all of this, but they treated it very seriously. In America they just send you home. Australia invested more up front to keep the curve low. Despite having some complications with the duration of my stay, which lead me to be quarantined for 31 days[1], I vastly prefer Australia’s approach to the pandemic. [1] https://www.abc.net.au/news/2021-01-15/sydney-man-covid-policies-stuck-quarantine-hotel-no-end-date/13058440 https://www.abc.net.au/news/2021-01-15/sydney-man-covid-poli...
- decafninja 6y ago
  I always thought Australian culture had its individualistic streak like American culture. I guess I was wrong, or at least it's a different flavor of individualism.
  - mrec 6y ago
    I didn't get the impression that individualism was the USA's problem here, so much as political tribalism. Mask-wearing seemed to get established very early on as a tribal marker, and everything else followed from that.
    - decafninja 6y ago
      I guess political tribalism was certainly a big factor, but I always thought it was something that amplified an already existing characteristic for "rugged individualism", as in, a tendency for people not liking being told what they can or can't do. It exists to various degrees in pretty much any culture (even highly collectivist cultures like some Asian countries), but in the USA, I think it's seen as a bedrock upon which the country was founded on and successful with. I don't disagree, and I think this individualist go-get-em culture contributed to some of the country's successes, but in times like this, it certainly shows its dark side. You could chalk up the whole US healthcare system fiasco to this too.

bengale 6y ago

I tend to find the overuse of the word hero bothers me, but I don’t know what other word would describe people like this.

pmiller2 6y ago
This would be a correct usage, not a performative usage like corporations calling grocery store workers "heroes" because they have to go to work or lose jobs they depend on.
- eertami 6y ago
  You and I also depend on grocery store workers. We would be in even greater chaos without them. I'm not sure where you're going with this.
  - h4waii 6y ago
    I believe they are essentially saying this: https://i.redd.it/pmori9td3ar51.jpg https://i.redd.it/pmori9td3ar51.jpg I hate just drive-by posting an image of a tweet from Reddit, which may not even be true, but I think it's succinct.
    - pmiller2 6y ago
      Which part do you think might not be true? That the daughter is a slave of capitalism? I'd say that's the part most likely to be true. There were times early on in the pandemic when people were seriously questioning whether they should go to work and risk their health, or stay home and lose their jobs. Don't forget, the CARES act didn't pass until late March last year.
      - h4waii 6y ago
        Oh, just that the "conversation" ever happened, I have no doubt this is a situation a lot of people are in, and it's saddening.

raunak 6y ago

https://archive.is/hEoUL https://archive.is/hEoUL

throwawayboise 6y ago

Doctors always see people at their sickest and most fragile. I'm not sure I could do it, but it's what they sign up for.

GavinMcG 6y ago
What are you trying to say? "It's what they signed up for" sounds like it's hinting at a further claim, but it's not clear what it is.
- throwawayboise 6y ago
  Doctors that I know don't get personally invested. They know what they can do, and they do the best they can for any patient. When you're a trauma surgeon in Detroit, you treat gunshot wounds every day. You can't save them all, and you don't take that home with you or as a personal failing or you will not stay sane.
  - GavinMcG 6y ago
    The whole point of the article is that many doctors have had to step into roles or acuity levels that were not every day material for them and not what they signed up for. A trauma surgeon expecting gunshot wounds could well find it much more challenging to be working as an ICU physician, where you can't detach yourself as easily, and where you can't use your most-practiced skills, and where you can't know by the end of the procedure whether the patient's odds are good. They specifically didn't sign up for that. It's easy to say "don't get personally invested" but even if you're not getting attached to particular patients, it's demoralizing to go from an environment where you see a range of outcomes (including some bad ones) to one where you're constantly surrounded by patients near death with little chance for improvement and where your skills don't necessarily seem to matter. That's not about being invested.

perardi 6y ago

At the risk of minimizing the amazing efforts of doctors this past hell year: spare a thought or two for nurses. https://www.nytimes.com/2021/01/15/nyregion/filipino-nurses-coronavirus.html https://www.nytimes.com/2021/01/15/nyregion/filipino-nurses-... Been a hard year for nurses. (And respiratory therapists. And paramedics.)

calltrak 6y ago

I live in New York City and the media was telling us the were digging mass graves in New York City. You remember that? I still cant find those mass graves. This pandemic was pure bullshit . They renamed the common flu. And the media and the government duped everyone... now make sure you get your certificates of vaccination i's and passports to get your little freedom back.

Fomite 6y ago

As an epidemiologist, this has been the hardest year of my life. I've had a couple complete, "curled up in the stairwell having a breakdown" breakdowns, etc. and I'm relatively safe. The sheer, unrelenting stress this has put on doctors, nurses, EMTs and other hospital staff is going to have long term consequences. Morale among those who graduated into the teeth of this is really bad.

perardi 6y ago
“Fomite”: name checks out for an epidemiologist. But then seriously, my partner is a paramedic in a large North American city. He has been, to put in bluntly, lucky, because this non-American city implemented a reasonable sick plan, and he serves a chunk of the city that has not been hard-hit. (Which is to say: no warehouses, no food processing.) But just the constant hyper-vigilant PPE dance wears and wears you down. Nothing is “simple” now; the simplest slip-and-fall becomes a scene out of the Andromeda Strain, because you don’t want to get infected, and you certainly don’t want to pass something on when you are harboring the virus but not presenting obvious symptoms. (Too bad said city also had one hell of a testing bottleneck, and you couldn’t just test test test to make sure the front-line staff is virus-free.)
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munificent 6y ago

What a harrowing, intense read about an incredibly strong person.

throwawayemdee 6y ago

Just want to comment with an alternate point of view, and in no way intend to demean to diminish the emotional impact like those described in the article. Just how I feel: I'm an intensive care physician and also function part-time as a hospitalist (acute care medical floor patients). Yes, there have been some stressful, uncertain, and fear-driven moments. But I also chose to work at a place that has a physician-led and supportive administration, and I investigated those things as part of the interview process. We had adequate staffing, a robust peer-support system (look up the "second victim" phenomenon), and my colleagues and I seem to have good coping mechanisms in place, which I assumed doctors in these kinds of specialties needed as a basic requirement. Bottom line, I'm doing just fine, and my inpatient physician colleagues, with some exceptions, report the same. This is a difficult job at baseline without COVID. It didn't change my approach at all.

nexuist 6y ago
> But I also chose to work at a place that has a physician-led and supportive administration Your positive experience seems to confirm that working in a place with good management has a positive effect on employee morale, although I'm not sure anyone was questioning that in the first place. It is however uplifting to note that workplaces like yours exist. I also think it depends on the area you serve. I imagine for many hospitals COVID was a case of "do everything right and everything still goes wrong" - especially when you reach max capacity, it doesn't matter how good of a doctor you are, you can't heal people with your bare hands. Likewise, it doesn't matter how well you use PPE or social distance or stay at home if thousands of others in your area ignore the safety measures and get each other sick, and it doesn't matter how much you care about keeping people safe if your local or federal governments don't take the issue seriously. This has been a huge stress point not just for doctors but for everyone I think, the knowledge that so much misery and death could have been avoided if we just did what we knew we should do when this mess started.
- throwawaemdee 6y ago
  You're absolutely right. I think a lot of the stress-related stories we're seeing do depend on the location, demographics, and a ton of other factors; a large city academic center might have a lot higher load and resource stress than a smaller hospital. But overall, I just like to point out to people that some of us in medicine and nursing are doing just fine through all of this. A lot of people assume that we're all miserable because we work in the acute hospital/ICU setting.