As the world steps back, healthcare professionals from around the globe are going above and beyond to serve those in need during this COVID-19 crisis. Dr. Kristofer Smith, naviHealth’s President of Home-Based Medical Care, is one of these dedicated workers, tirelessly answering the call to volunteer for the cause despite not practicing acute care medicine in over a decade. These are his daily stories – uncut and untouched, as told from the front lines.
Day 8 – Tired
We have been going for 12 days straight. The load has been climbing – we have an average census of 22 patients with around six admissions a day and, sadly, one death every 24 hours. We are getting tired.
The initial excitement of kicking off a new unit and volunteering on the front line has faded, replaced by the relentless and complex demands of our patients and the nagging stress of being out of one’s comfort zone clinically. We watch as seemingly stable patients crumble in hours, requiring intubation and transfer uptown to a MICU. We wonder what we should have done differently.
As the simple patients are siphoned off to settings like the Javits Center, we are faced with complex hematologic, psychiatric, infectious and endocrinologic comorbidities. We are thankful for the quick and unwavering help from subspecialist colleagues uptown, many of who are readily available via video visits on telemedicine carts, but we hope we are doing enough.
As we acknowledge being drained physically and emotionally, there are signs of hope. In much of the city, the number of patients in the ICUs have stabilized. The most extreme scenarios of putting patients in field hospitals in churches and sports arenas are seemingly going to be unnecessary. The patients, too, are fighting through.
A patient who early on in our work became septic and had to return to the hospital uptown, came back to us. We were surprised and relieved. We had thought for sure he would not make it. He was overjoyed to be back. He buoyed us by reflecting back to us that our attention to his needs had been appreciated and that he felt cared for in an almost loving way that was too often missing from his many prior hospitalizations. His improvement, and others, steady us for the days ahead. That, as well as donations of chocolate, ice cream and the promise of a day off.
Catch up on the entire series of “Trials and Triumphs” featuring Dr. Kristofer Smith.