Doctor offers thoughts from the bedside amid the pandemic

As an infectious disease doctor who specializes in HIV, I never imagined that my entire medical world would be turned upside down. Due to the coincidence of being on call the last week of February, I took care of the first patient in our state with pneumonia caused by SARS-CoV-2. During the next eight weeks, standard medical care came to a halt as our entire group focused on caring for patients admitted to the hospital with COVID-19 pneumonia. (Note: The novel coronavirus is named SARS-CoV-2, while COVID-19 refers to the disease the novel coronavirus causes.)

For our patients, the key to good medical care depended on the extraordinary dedication of our nurses. They suffered the same shortage of personal protective equipment (PPE) as the doctors, but they went in to provide care at the bedside day in and day out. The care they provided was heroic. I’ve told many of my colleagues that I thought heaven would be full of nurses, and they “might” let the occasional doctor in as well.

We’ve learned a tremendous amount in the last few months. We did make mistakes early on. Initial guidelines recommended early intubation with the use of a ventilator until clinicians observed that patients did very well with very high flow supplemental oxygen and thereby often could avoid intubation. Randomized trials now indicate that the use of the antiviral medication Remdesivir and the use of anti-inflammatory steroids can be beneficial.

The most painful aspect of this epidemic has been that patients and those that are most vulnerable are forced to be alone. Families cannot sit with their loved ones in the hospital; chaplains often have very limited access; our elderly in our nursing homes are often deprived of family visits. As Christians, we are first and foremost a people of hope because Jesus is the light that overcame the darkness, Who conquered death and never leaves us alone. But it is easy for us to forget. By calling on the name of Jesus and by praying with our patients, we can rekindle that hope. There is no contradiction inherent in being both a doctor and a deacon. Both allow us to participate in the healing power of grace.

Anxiety and outright fear is a commonality in the midst of any new epidemic, whether it’s HIV in the 1980s, Ebola in West Africa, or this global pandemic. Caution and prudence is always warranted. But above and beyond that, anxiety and fear should be acknowledged, and we need to support one another as we venture into the unknown. Finger pointing, “blame-gaming,” and politicization of this epidemic is understandable, but often it is more destructive than constructive.

Poorer communities where many families often live closely together (without back yards) are being hit much harder. Many of our churches and inner-city Catholic schools that were struggling in the best of times will not be able to stay open without our help. Instead of retreating into our “safe bubble,” we need to reach out and offer assistance. Kindness and mutual support in the midst of this challenge is what we need.

DEACON TIMOTHY FLANIGAN, M.D., Boston Chapter Legate, is professor of medicine and infectious diseases at the Alpert Medical School of Brown University in Providence, RI. He also is a permanent deacon in the parishes of St. Theresa and St. Christopher in Tiverton, RI.