When Maura Sammon leaves work, no one is outside banging pots and pans, celebrating her and colleagues at Temple University Hospital as they fight to save the lives of coronavirus patients.
At first, when she was working 16-hour days, seven days a week, people acted like she was a hero. But now, Philadelphia sidewalks are empty of color, the chalk messages of cheer and encouragement for her colleagues long gone. When she goes to the grocery store, no one tells first responders like her to skip the line. People no longer come up to thank her when they see her wearing scrubs.
And that’s fine. She doesn’t want the hero worship. At the same time, she and her exhausted colleagues are not getting what they need from the public.
After she and her coworkers leave the hospital, they confront an infuriating alternative reality, where people go forward with large Thanksgiving gatherings, complain about not being able to dine indoors, and ignore basic safety measures, like wearing a mask and maintaining social distance.
Doctors and nurses have become so frustrated and alarmed by people not recognizing the virus is real and deadly that some said it takes all their energy to restrain themselves from yelling out loud at their partying neighbors.
Inside the hospital, they described the enduring trauma of treating patients during the pandemic. As they gear up to battle what could be the most threatening surge of cases yet, they are tired from treating the critically ill, from worrying about bringing the virus home to their spouse or children, and from the ripple effects the pandemic is having on the rest of everyday life.
“Our families are suffering horribly and disproportionately,” Sammon said. “Of course I am feeling burned out, but I don’t have the time to be burned out.”
‘Screaming into the abyss’
Although we know more about the virus now, and results of recent vaccine studies look hopeful, the Philadelphia-area physicians and nurses who spoke to The Inquirer said they worry about what they are seeing now.
They said they see rampant community spread infecting health-care workers outside the hospital. If health-care workers get sick this time around, some said they worry there won’t be enough backup resources. During springtime surges on the East Coast, health-care workers from other areas flew in to help. But now, the entire country is a hot spot.
Doctors and nurses worry about being able to care for as many patients as they want to help. They are alarmed by the rising cases and hospitalizations coinciding with the winter, which is already a busy time for hospitals in normal years, as people catch the flu or other illnesses worsen. An increase of severely ill COVID-19 patients could threaten to overwhelm the system.
“It is very isolating to be almost screaming into the abyss that we see all this data and all the science pointing toward a catastrophe, yet no one wants to hear it,” said Mona Masood, a Philadelphia-based psychiatrist who is the founder of Physician Support Line, a support line launched in March to provide free emotional help to physicians during the pandemic.
As a Drexel University postdoctoral research fellow, Tiffany M. Montgomery feels like practicing nursing helps with her research, so she also works as a per diem labor and delivery nurse at Einstein Medical Center. But she didn’t think she would be dealing with the coronavirus for nine months straight. She is praying to find answers for what to do this winter, but would be surprised if she made it through the next two months without resigning.
“I had no idea we would be doing it for this long and I’m just tired,” Montgomery said. “I don’t want to be your superhero. I want to be safe. I don’t want to have to deal with this anymore. I want you to listen to health-care providers and your officials are telling you. I don’t want praise and I certainly don’t want to be your martyr.”
In Camden County, cases have skyrocketed with 5,397 new cases this month, as of Tuesday, representing nearly a third of all reported cases in the county throughout the pandemic. Sarab Sodhi, an emergency room physician at Cooper Hospital in Camden, is worried this will only increase over the winter.
He has trouble sleeping, thinking of those patients throughout the pandemic he might have saved.
“If you work in health care you have all these ghosts following you around, and they’re all the ghosts of things you could have done differently,” Sodhi said. “They’re all faces and names that stick with me, and they wander with me, as I walk through the hospital. I used to have a few of those, maybe a handful, and now I have a lot.”
‘A slap in the face’
When Mari Siegel sees a friend out without a mask, she takes it as a personal insult.
They know she is an attending physician at Temple University Hospital’s emergency department and on the palliative care team. She’s worked throughout the pandemic to take care of everyone else, even while her 3-year-old son undergoes chemotherapy for leukemia.
“To not heed our warnings, is a slap in the face,” Siegel said. “We’re tired. You can do this once, but to have to do it again, and to have seemingly slipped backward. … I want to shout. I want to walk around with posters of what we see in the ICUs.”
Health-care workers are also juggling the ripple effects of the pandemic outside the hospital, like issues with child care, virtual schooling, loss of holiday celebrations, isolation, and loneliness.
Patricia Henwood, who has been leading the Emergency Medicine response to COVID-19 at Jefferson Health, said unlike other members of the general public who have not been forced to confront the pandemic every day since March, “we don’t have any ability to essentially walk away from that because we feel that at home and we feel that at work.”
Henwood is struggling with child care after her 3-year-old’s day care had a COVID-19 outbreak.
“Seeing cases spread like wildfire and not seeing as much of the public response in terms of reining in gatherings, … that contributes to the fatigue " Henwood said. “I think everyone wants to feel like we’re all on the same team.”
Kit Delgado, an attending physician in the Penn Presbyterian Medical Center emergency room, has been tweeting throughout the pandemic about the dire state inside hospital walls. He is asking everyone to please, just care again.
“It went from celebrating our health-care heroes, to everyone being brought into this pandemic fatigue, people not adhering to precautions, or some people still thinking this is a hoax,” Delgado said. “It’s disheartening.”
Sammon, the Temple emergency room doctor, is bracing for the second wave even as she hasn’t recovered from the stress of the first.
It’s personal for her. Her parents were infected and hospitalized, and her 12-year-old son logging into virtual school is now struggling with anxiety and depression.
She’ll be spending Thanksgiving working at the hospital, away from her two children. As she helps her patients, she says she’ll be thinking about the families holding big dinner parties, the ones who will soon be in her care.
If you’re a health-care worker who needs mental health help, you can call the Physician Support Line, a free and confidential service staffed by psychiatrist volunteers, at: 1 (888) 409-0141. It is open every day from 8 a.m. to 1 a.m. You may also be able to receive support from your employer, as some Philly hospitals have introduced coronavirus-specific wellness programs.