The Covid Surgeon

I wrote this at the height of the pandemic on 3/30/20. At the time we had no PPP and people were dying exponentially. Although we have vaccines and we are conditioned to accept Covid deaths as normal, I believe it is important to remember how inadequately we were prepared and to apply the concept of Never Again. So here are those thoughts in the raw:

I am not on the frontline for Covid 19. Being an orthopaedic surgeon is my passion but I am the guy who stands on the beach in disbelief while the tsunami towers ten stories over his head. I can’t treat pneumonia, or diagnose DIC, or treat myocardial infarction. I don’t painstakingly change into antiviral armor from room to room, all the while hoping I don’t die next week or even worse infect my spouse or children. I am not in the ER where 6 people who can’t breath showed up at once. I am not in the ICU where the cycle of intubation followed by death happens over and over again.

Surgeons often see themselves as important, necessary and talented. It is the ego trip required to some degree to take risks with another person’s body that many of my colleagues couldn’t stomach in medical school and beyond. I have been thanked and hugged ten thousand times and more for a repair here or a replacement there. I loved touting that I don’t save lives, I save their quality of life. It is true to some extent, but it is more about magnifying my impact than reality. Today I am a hair dresser or a makeup artist at the Oscars . Because I am surrounded by Stars who I have barely noticed and rarely thanked.

It isn’t how many people this virus killed or may yet kill that affected me. This is forced perspective by the daily stories from people I know who are family practitioners, internists, cardiologists, intensivists and the many physicians I have never met who share their nightmares on a daily basis in various groups. They know that more than 60 Italian physicians have died and at least as many Chinese doctors as well. Cheated of protection by every government, state, local, and federal, they still march daily to their trenches and risk everything, everyday. I have some 60 family members who are physicians and many of them are on that front line.

We learn in a gruesome way, mostly from our failures and not our successes. In 1988 my first two patient on my medicine rotation as a medical student were from Haiti. They had a horrible wasting disease and a pneumonia we couldn’t treat. They both died on my very first day on the wards and we did CPR on each of them for an hour. I used a mask to provide breaths for them not because I planned on it, but because it was on the wall behind their bed. We had had a 30 minute lecture on HIV but I didn’t know it when I saw it like I do now. The horror I felt when I realized what they had and the risk of transmission lasted a few years and through multiple blood tests. Now imagine that the air is laced with HIV floating on drafts of air, just waiting for you to inhale it. The horror I felt is everyday in every Covid ward for every CNA, nurse and doctor.

I have never walked towards my doom and have always felt that I could change my fate for the better. Today I saw a post from a colleague inundated with Covid patients who said he felt there was no avoiding contracting the disease. Between lack of equipment and daily exposure, he was just waiting to turn positive and develop symptoms. This disease doesn’t just damage the lungs or heart or kidney. It kills the spirit because we can’t cure it or fight it. Time will change that if my colleagues are still here to know the difference. I am awestruck by their strength and perseverance, and I weep for their lost colleagues and their mental anguish.

To all of my colleagues who stand between my family and this disease, I honor you, I pray for you, and I will always remember what you did that I could not. We will never forget.