For a doctor during COVID-19, even time loses its normal meaning
A cardiac surgery resident reflects on a typical morning a Philadelphia hospital.
It’s 6:03 a.m. BEEP BEEP BEEE … click. It’s the hospital pager, signaling the beginning of a long, busy day. The cacophonous wail immediately drowns me in stress like the sound of nails scratching a chalkboard, the only medium I can think of in that moment as antiquated as the pager.
On its dim screen reads a familiar message: Ms. K has 10/10 pain — Room 536. I hurriedly flip through the patient list, 12 pages in total until … there she is! Ms. K, 42 years old. It’s been one day since her operation (“post-op day 1”). The overnight intern told me she did just fine (“I didn’t get called once about her”). She’s young and has no other medical history, so, it’s probably not a heart attack or a stroke. Good, it’s probably just pain. This can wait a few minutes.
The floodgates have opened, and an efficient triage system is essential. I sit at the nearest (“Wait! I’m already using that one”), at the nearest available computer and type my ID. Hanjas: Fragments of your first and last names melded together using a seemingly different rule for everyone. The screen is loading slowly, and I am frustrated already. My shoulders are tightening. I can feel my pulse quickening. How many minutes do I spend each day logging on and off at a computer?
“Due to hospital regulations your password will expire in one day.” I better change it now. I just change the “1” at the end to “2.” Otherwise I’ll be locked out tomorrow during some emergency and need to be on the phone with IT for 20 minutes unable to justify how in the world I could have missed the obvious countdown that …
BEEP BEEP BEEE … click.
It’s pre-op: Your patient doesn’t have a consent form // in the chart and // can’t go back to the OR // until …” Oh no! This cannot wait. My attending is going to be livid. “Please don’t log me out, I just logged in and I’ll be right back!” I run down the stairs.
RING RING RING. It’s the chief resident: Hey, did you hear about this consent? “Yeah, I’m on it!” This kind of mistake is only allowed in July. “I’m sorry, this won’t hap …” BEEP BEEP BEE … click. “Sorry, chief, let me call you back.”
It’s the same nurse: Pt now having 11 out of 10 pain // she is pointing to her chest. What is going on? What should I do? I just got down the stairs … and the consent! But chest pain cannot wait.
As I head back up the stairs I wonder when did I … huff … get so out … puff … of shape? I used to run every day before … I really shouldn’t think about this.
What room was this patient in again? What was her name again? The list … where is my list? Shoot, I must have left it at the computer. I’m going to need to log-on here. Hanjas. Why is my password not working? Why is there a crowd gathered outside of that room? BEEP.
The hospital overhead alarm makes my heart sink every time: Code Call Room 536. Code Call Room 536. Why does that room number sound familiar? I hope it’s not one of my patients.
A nurse recognizes me from down the hallway. Doc! There you are! It’s Ms. K. We need you! Ms. K, 42 years old, otherwise healthy, no problems overnight, 10/10 pain … what am I missing?
RING RING. “Hello? Yes, I heard, chief, I’m here already … No, I don’t know what happened! See you in a few.” Click “I need someone to start chest comp …”
RING RING RING. “What? No, I can’t talk right now, I’m in a code. Call you back.” Click. “Where is the defibrillator? What happened? Did someone notify the attending surgeon?”
RING RING. Someone answers for me. It’s pre-op: Doc, they want to know if you forgot about the consent. “Tell them I can’t this minute! I’m about to … let’s make sure to keep track of time so we know how long we have been doing chest compressions.”
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I look up. It’s 6:10 AM.
Jason Han is a cardiac surgery resident at a Philadelphia hospital.