麻豆传媒

Just saying...

Only this week I went back to work after contracting COVID-19 (my wife thinks she gave it to me, but I think I gave it to her), and it's been incredibly hard to watch things happening over the past 2 weeks from the couch instead of actually being in the office taking care of our patients and each other.

I can tell you that the illness was a b*tch, watching myself desat to 86% just walking to the bathroom, but I'm incredibly lucky and blessed that I didn't need to be admitted or intubated. I know so many have it worse, and so many have suffered and died, and my heart cries out for all of them.

Before I got sick, we'd started up our cough/cold/fever clinic, doing evaluations to try and rule out COVID-19, and figure out who needed to be admitted and who could be safely managed at home, and we transformed much of our practice away from chronic disease management to acute care, massively implementing telehealth and video visits, which have dramatically changed the way our practice looks.

Staff and providers in scrubs and draped in personal protective equipment (PPE). Empty waiting rooms usually packed with patients.

Besides our cough/cold/fever clinic here at Weill Cornell in New York City, we only physically saw eight patients in the practice yesterday, compared to the usual 300 that come through our doors each day. We've been collaborating with the emergency department, with the inpatient teams, with multiple other specialties, figuring out better ways to take care of patients, allocate new roles and skills, and protect our staff and providers, while still delivering outstanding care to our city that is suffering so much.

Lots of people are doing lots of really incredible things already, thinking of new ways to take care of different types of illnesses, thinking of new ways to collect and analyze data, and all hands are on deck. We are just in the early stages of redeployment, where people are going to be called on to do jobs they may not have done for 20 years (or never), and without doubt everyone among us is going to be up to the challenge.

Not that I really think that anyone really wants me working in the ICU. The last time I touched a ventilator was when I was a junior resident in the ICU at the county hospital, and one time, when I tried to adjust the vent settings, the respiratory therapist and the ICU nurse yelled at me not to touch their ventilator -- probably rightly so.

But innovation is happening all over the place, and much of it is coming from the hands and hearts and minds of those who are on the front lines, seeing what works, see where the need is, rapid cycling through multiple iterations and Plan-Do-Study-Act cycles (PDSAs), trying this idea, tossing that one, starting from scratch, building on the foundations we have. Every day, all the members of the healthcare team, from the people who are screening patients at the hospital entrances to the intensivists spending their entire day in PPE, are putting their lives on the line, giving their all 24/7, to make sure we get through this, that we come out the other side, that our patients get the care they need and deserve.

Now's not the time to point fingers, to talk about how broken our healthcare system has been, how the infrastructure has corroded away and has failed, and in how many ways this has led to potential harm. Once things quiet down, there will be plenty of time for reflection, and hopefully we'll have learned a lot of lessons that will inform how we need to change everything in our fractured healthcare system.

So many people saw this coming, but now is not the time to distribute blame -- rather, it is the time to celebrate those who are doing the hard work, doing what needs to be done. Later on we can figure out how to improve the Strategic National Stockpile, to build better ways to detect emerging health crises and communicate across the spectrum of care, and to collaborate and innovate, but for now we've just got to get through each day.

Everyone is giving it their all, everyone is chipping in, everyone is doing what they can, and I want to give a virtual hug to every single one of you out there fighting the good fight. I thought about listing all the roles, all the job titles, all the different things that people are doing, but I fear I would leave someone out, and that's the last thing I want to do.

So know that we are here, doing what we can with what we've got, rising to the challenge, never giving up. We will take care of each other, and society will take care of us.

Walking home from work every day, or just sticking my head out the window when I'm still stuck at the office at 7:00 P.M., my heart swells when I hear New Yorkers stick their heads out the window and start to whoop and holler, cheer and applaud, bang on pots and pans, and scream their thanks. We can all sleep well at night, knowing we're doing what we can, and this sort of thing makes it easy to get up the next day and come in to do it all again.

I'm just saying.

, of Weill Cornell Internal Medicine Associates and , follows what's going on in the world of primary care medicine from the perspective of his own practice.

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