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Lessons Learned from My Stint as a Hospitalist

Image of Anjoinette Minors, MD
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As COVID-19 swept across New York City and the Bronx, we were faced with the unprecedented challenge of assembling medical teams to manage the sheer volume of patients. Unbeknownst to my family and friends, I was not mandated to be redeployed to Internal Medicine: I volunteered. When our colleagues in Internal Medicine requested physicians to volunteer to assist with coverage, there was no hesitation. How could I not? Saying yes was always the answer. 

And honestly, I would do it all over again. Sure, there was the fear of contracting COVID-19, or worse, unknowingly infecting my family. But I trusted in the power of PPE, hand washing, and an abundance of caution. What I did fear was the regret I would later face if I did not do my part to fight in this battle. After a month-long transposition to the COVID-19 unit, I learned so much about who we are as health care workers, as employees of a public hospital, and as a society and about myself.

Coming Together while Staying Apart

While we practiced social distancing outside of the hospital, inside the hospital I witnessed nothing less than a coming together of resources, equipment, and the minds and hearts of people. Our staff, alongside health care professionals from across the nation, came together, becoming a true team in our moment of crisis to take care of our patients and each other.

What It Means to Be a Physician

My biggest fear in changing specialties overnight was fear of the unknown. I immediately starting reviewing topics from medical school that I do not routinely encounter as an obstetrician–gynecologist. I read as many news reports, articles, studies, and commentaries specific to COVID-19 as possible. I relied heavily on social media from those in the medical field and resources from COVID-19 interest groups, which are an amazing source of real-time learning and story sharing. What I quickly learned is that I did not need to know it all. I was reminded of the importance of functioning within a team and soliciting input from other physicians, residents, physician assistants, nurses, and respiratory therapists across many disciplines and specialties. By practicing with a true team approach, we provided much better care than anyone alone.

I also learned that my role as a physician could vary from day to day. Some of my most important work included triaging higher-risk patients to the ICU, calling family members with updates, disclosing bad news, debriefing with residents and trainees after a patient death, holding a patient’s hand and saying a prayer as he took his last breaths, and feeding a patient pudding for lunch with a few sips of water when no one else was available to do so. I realized the moments that make the difference are not the big ones, but rather all of the little ones in between.

Working in an Inner-City Public Hospital

This has always come with its set of challenges: lack of funding, resources, support. But it was the very challenges that we faced in our day to day that made us stronger and even more resilient in the face of a crisis. We are accustomed to providing care to patients from all walks of life; to doing more with less; to fighting for survival, for our patients, and for our institutions. It takes a great deal of tenacity and resilience to work within a public health care system, and this same tenacity and resilience spread like wildfire during the height of COVID-19, helping us to do what we always try to do: the very best for our patients.

It’s Okay to Be a Hero

I struggled with the terms “hero” and “essential” from the very beginning. We are health care professionals just doing our jobs. Now we just do it in a slightly different way, with heightened precaution and with increased volume. We’ve restructured our entire way of practicing medicine to attend to patients in the acute crisis phase with attention to sustainability in health care. We are just doing our jobs. But I have realized now that although we may not always feel like “heroes,” it’s quite okay to be one. 

Courage in the Face of Fear

During my time as a hospitalist, I learned to draw on my courage from within. I saw patients who appeared well decompensate so rapidly. I saw patients who were so ill that I knew they would never make it back home. I saw patients on the cusp, waiting breathlessly to see what the next day would bring. In these moments, I was reminded that in times of helplessness and hopelessness, there was something more I could give to my patients and my team: my time. Instead of spending less time with patients in an effort to decrease exposure, I found that spending a bit more time was exactly what many needed. A helping hand to assist with eating or getting to the restroom, video chatting with family for updates, or even last words and goodbyes, or just an ear to listen in a time of isolation. I also drew on courage to lead my team, who were residents from varied disciplines coming together to provide care to our patients. I witnessed some of the most dedicated residents do their work with grace and dignity as they faced a nearly unimaginable circumstance. Still, they relied on me to lead them in the right direction, continue teaching and educating, and guide decision-making. Yet my most valuable lesson to them had nothing to do with science or medicine, but rather the importance of humanism in medicine and courage in the face of fear.

We Are All Essential

They call us essential workers, but the truth is that we are all essential. We all have had a role to play, whether that role is to continue working full time, working from home, providing childcare and education to our children, wearing a mask, or simply staying home. We all have an essential role to play in this fight, and we can only win it together.


Dr. Anjoinette M. Minors is an attending physician in the Department of Obstetrics and Gynecology at NYC Health + Hospitals/Jacobi and Assistant Professor in the Department of Obstetrics and Gynecology at Albert Einstein College of Medicine.

 

Disclaimer: The thoughts and opinions in the Frontline Voices initiative reflect experiences of individual ACOG members and do not represent official organizational opinions of ACOG.

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