COMMENTARY: COVID-19 Diary Day 5: Facing Deployment

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APRIL 09, 2020 — Bolted awake at 5 AM again today with the same sense of panic, followed by the mantra I’ve been using all week to calm down: “I’m home, everyone’s safe.” Thankfully, there are no urgent alerts in my email. The residents are still with us on the inpatient hematology-oncology ward, and no faculty in my division are out with COVID-19. There’s been no systemwide alert that we are being overwhelmed with people who are infected; for the time being, we have sufficient personal protective equipment.Still, it’s surreal. I was at Newport Hospital for my clinic yesterday and drove Route 24 from Massachusetts to Newport, Rhode Island, passing through Portsmouth and Middleborough. It was idyllic: temperatures in the 50s with the sun out, set against a brilliant blue sky. The hour-long trek took 45 minutes today. Highway alerts usually warning of slowdowns and traffic accidents now remind folks of stay-at-home orders, quarantines, and closed beaches and parks. The hospital parking lot now houses a drive-up COVID-19 testing station. Hospital entrances have been secured; even staff must attest that we have been without fevers and respiratory or other symptoms of a possible infection. The hospital’s corridors are empty. Everyone is masked.

Yet, we all know that cancer doesn’t quarantine. In clinic, I speak with my partner, Dr Julia Tassinari, who leads the breast center and is our primary breast surgeon. People with cancer are still able to have surgery, even now, but the logistics are difficult. We prioritize, putting off surgeries that can be reasonably delayed and holding radiation for women in whom a delay is not likely to affect outcomes.

This is our new normal, but today we also discuss something else: deployment. I tell her the weeks I’ve signed up for as the inpatient back-up and consult attending. My role will be to see patients not hospitalized on the oncology floor (which we’ve insisted on maintaining as COVID-19 free) and seeing all consults, including those with COVID-19. She may get assigned to inpatient hours as well, staffing the ICU or the emergency department. Both of us have young children, and as we talk, we share the same fears about keeping them safe. We wonder aloud whether we will have to staff the field hospitals being set up.

Continued

I’m awaiting orders, like a soldier at war. But I can’t see the enemy. I see the havoc that it has wrought upon the world, in China, Italy, Spain, and New York City. I’m standing witness to a world on lockdown, where a hug may turn into a cluster of contagion. Multiple times a day I hear these words repeated—a different mantra, one for hospital staff: “Prepare for the surge.”

Will tomorrow bring the same level of anxiety? Will all hell break loose?

I desperately hope that it’s more of the same, because tomorrow is special—my twins turn 12.


Don S. Dizon, MD, is an oncologist who specializes in women’s cancers. He is the director of women’s cancers at Lifespan Cancer Institute and director of medical oncology at Rhode Island Hospital.


Medscape Medical News


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