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Program Director Notes

The Most Uncomfortable Nasal Probe Ever

8/4/2020

I woke up with a sore throat Monday.  I spent the first 15 minutes creatively attempting to think my way out of my sore throat:  I slept in air conditioning; maybe my throat was just dry, or maybe it was the spicy Ethiopian food I had eaten the night before.  I swallowed multiple times.  Still sore.  I began to think more creatively: I hadn’t been close to non-family members in days, there was no way this was COVID – nothing to see here!  After a week with my kids, I was eager to get out of the house and back to work.  I tested my voice – totally normal – if I didn’t get tested, no one would know I had symptoms.  The temptation to ignore my symptoms and move on with my day was immense.

 

The more fully awake I became, the less able I was to justify the idea that I could avoid testing.  I called the COVID hotline (staffed from 6am-7pm).  Within five minutes, I had an appointment behind the helicopter hangar for the most unpleasant nasal probe ever (I worry now about what I do to patients when I insert a nasogastric tube!).  I spent the afternoon completing all my meetings via webex on my deck, intermittently attacked by children crying boredom or unfairness (mental note: I need to give my nanny a big raise).   Yesterday, I was fortunate that I could do my work from home; when my daughter, Lily, contracted strep throat in May, Parin Shah had to come in and cover for me for the day that it took to get a negative COVID test back.  Then, I felt guilty that I was healthy, catching up on emails from home, while he was working for me.

 

You know I like to focus on the positive (you will find what you seek – I’d rather find good things).  We have a reliable COVID test, and clinical workers such as ourselves qualify for free rapid testing; a co-resident from my training days was exposed to COVID at his workplace in North Carolina, and had to drive two hours to South Carolina for a 48 hour turnaround test as the hospitals in his area rely on a six day turnaround test.  It is easy to get tested at DHMC, and even easier to find the results (do NOT look yourself up in eDH, use MyD-H). Looking purely at prevalence, the likelihood that the test will be negative is so overwhelming that I might even be tempted to bet on it.  None of this changes the fact that this year, we will all be called to stay out of work for minor ailments we would have ignored a year ago, and for the ailments of those we live with. 

 

Because you are all so clinically active, is highly likely that if you are called to stay home, due to your illness or that of your family or housemate’s, that a peer will be called to cover your work.  This is new and different from prior years, and it is not going to change anytime soon.  Many of you have noted that our current backup/jeopardy system is woefully inadequate to deal with the recurrent call-outs that are the new reality… and it isn’t even flu season yet.  Our backup/jeopardy system was not designed for a chronic pandemic, and needs to be redesigned.  I don’t know how we should do this; I need your help – bring your suggestions to me, the chiefs, or the coordinators.  Tell us what we should do (or what we absolutely shouldn’t!).  Talk to your friends at other programs and find out what they are doing.  I want to create a system that feels fair and is robust enough that we aren’t regularly calling people who thought they had the weekend off to come in.

 

Stay safe; stay healthy!

P.S. Test was negative!

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