heroics
Chris Chang
My patient calls me a ‘hero’ for being ‘on the frontline’
but really I’m an imposter,
just the ‘firstline’ in the healthcare system.
In this COVID-19 battle
I’m a bullet sponge
for my patients’ surplus emotions.
Did you know
there is an ICD-10 code for “Worried well”?
Every visit now includes a COVID primer; it depends on the patient whether the visit starts or ends with it.
It’s not my first time hearing my spiel, but it is for my patient.
I don’t have the heart to explain,
“Remember how I called you 15 minutes late for your telemedicine appointment? It’s because I had to give this exact same talk four times in the past hour.”
Anxiety about illness, about exposure, about immunity, about contagion, about resurgent mental health issues, about relapse, about exercise regimens abandoned, about canceled plans, about job insecurity, about finances, about when will this end when will this end when will this end.
Telemedicine is exhausting for both my patients and me.
I’m not sure why the lighting in the second photo makes your cellulitis look worse than in the first photo.
No, I can’t do your Pap smear over a video visit.
No, I can’t diagnose a testicular torsion over a video visit.
No, please don’t send me a photo of your rectal mass. It’s probably a hemorrhoid just like it was in the photo you sent me last week.
(I envision Captain Picard on the Enterprise bridge communicating with an enemy captain and dealing with my telemedicine glitches. The Klingon commander appears on the view screen, laughing silently to himself because the audio feed has cut out. “No, turn on your microphone,” mouths Picard. The Klingon stops laughing, frowns, turns off and turns on his view screen. He looks inquisitive. “I am Captain Jean-Luc Picard of the Federa—“ The Klingon frowns at the screen again and waves. Captain Picard sighs. “Did you enable plug-ins on your starship?”)
I imagine what it would be like to volunteer in a hot zone.
Walking down row after row of gasping patients, I flit from one bed to another with stethoscope in hand.
After auscultating the lungs I valiantly make the call that will save this patient’s life:
“Page respiratory therapy.”
I remind myself that epidemics cause both direct and indirect deaths.
As a PCP my role in the healthcare system during this time is to ensure uninterrupted access to and ongoing delivery of routine care for the management of chronic diseases.
I click on the ninth Adderall refill request in my In Basket.
I wonder what it would be like to take classes online.
We are on wartime footing
swishing by other masked and gowned figures in the halls
there are no smiles, or perhaps just unseen behind masks
no frivolous greetings
no droplets spread by breath spared for ‘hello’.
There is honor in soldiering on, in providing a steady hand for patients, in sincerely delivering the false reassurances of a parent by saying, “It’s going to be okay. We’ll get through this.”
Statistically speaking my 94-year-old patient may not get through this despite my telemedicine efforts.
The phone call makes us both feel better.
Maybe that’s what my patients mean when they call me a hero, even if they don’t realize it. They don’t see the tedium of my day or understand the extraordinary ordinariness of my job, but they are thankful that I am here doing it for them. Before my patient can notice the long pause, I say, “Thank you,” and hang up the phone.
Chris Chang is a 2014 graduate of the Worcester Family Medicine Residency program and was a chief resident for Barre Family Health Center. He is currently working at Austin Regional Clinic in Austin, Texas. He lives in Austin with his wife Serena Hon, who is also a WFMR graduate, and their one-year-old daughter.
