Day 1. Well actually today is day 2. Or really it’s day 6. I guess it doesn’t matter. For the past week, I have been the attending physician at the ICU in my hospital. We have mostly been waiting for this thing to hit. Everyone is a bit on edge. There are many PUIs (persons under investigation), most of whom are longshots, and none that have turned positive.
ICU doctors by nature are not prone to panic and overreaction. Long hours, high stress, and lots of very sick patients is sort of our gig. But, there was something different in the air. My partner and I were discussing ways to hook two patients up to a single ventilator. We were thinking of ICU overflow to other parts of the hospital. I had thoughts of stories that I heard about hospitals in New Orleans after Hurricane Katrina. It was surreal and made for interesting conversation and thought experiments, but it was still something off in the distance – Wuhan, Italy, Seattle.
There have been many meetings and discussions about rationing masks and running low on supplies.
My practice has been working on developing plans for backing each other up in case we get sick. We would have to pull doctors from other hospitals and work longer hours, but we would manage.
That all changed yesterday afternoon, my personal day 1. I had been taking my temperature twice a day as a precaution and was exercising to prove I was well. I had no cough, headache, or symptoms of any kind (aside from the sleep deprivation induced fatigue not unusual for working a week in the ICU). But early in the evening I started feeling a bit hoarse. I then developed a bit of a dry cough. It wasn’t severe and I otherwise felt fine. No fevers, no fatigue, just a nagging dry cough. I even called in to a group chat answering questions about the virus for a few hundred people in the community.
Then the anxiety crept in. What if I had it? Don’t even thing about it. It can’t be. Not me.
Don’t get me wrong, I really was not and still am not concerned about my health. All the data puts me in the demographic that you’d bet on doing well. My first concern was self centered and ugly although undeniably human:
I didn’t want to be typhoid Mary. I didn’t want to be known as the guy who spread this around Baltimore or around my hospital. I didn’t want to be seen as a scourge sickened with the plague that we have all been fearing to be avoided and cursed.
Then came the second fear. This one was not as personal but much more altruistic. If I was infected, I had pretty much turned the entire ICU staff into “close contacts”. In other contexts they would be recommended to self quarantine for 14 days, but this was a hospital. You can’t have the entire staff of the ICU leave for 2 weeks. There aren’t enough back ups to fill in the gap. What would happen?
So I started the internal discussion. Maybe it was allergies. We did have some flowers around the house and perhaps I was developing asthma. Maybe it was from speaking too much on rounds. Could it be acid reflux?
I do have a tendency to hypochondriasis whenever my kids get sick. I usually feel a psychosomatic ache and pain, a scratchy throat, a mild headache. My wife usually rolls her eyes when I say I’m pretty sure I’m sick. Usually it’s gone the next morning.
That was the internal struggle I was dealing with that evening but I suppose my better Angels got the best of me and I called my partners and arranged for someone to cover me the next day. I called the infectious disease specialist at the hospital who was managing things to get advice. He told me to get tested in the morning. Piece of cake, or was it…