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Residents’ ForumFull Access

Redeployment to COVID-19 Care Is Like Treading Water but Deeply Gratifying

Published Online:https://doi.org/10.1176/appi.pn.2020.5a36

Abstract

Photo: Ruth McCann, M.D.

As a third-year psychiatry resident in New York, I’ve been redeployed to care for COVID-19 patients in our hospital. For now, I’m working in a medical intensive care unit (ICU), functioning in the role of an intern. I am, truly, more than happy to do this.

The word “redeployment” feels odd, though. Was I ever “deployed” to begin with? I’ve never thought of doctors as soldiers. But if we’re now at war, it feels tricky—if not impossible—to say what or who the enemy is and what winning or losing might look like.

After the shelter-in-place orders began, I spent two weeks doing remote visits with my outpatients by phone and Zoom. Ambulance sirens were almost constant. I felt guilty being at home and safe when I might reasonably be able to help in the hospital. So I volunteered for so-called redeployment, and my clinic director very kindly offered to cover my outpatients.

After a few days of waiting, I was sent to work in a surgical ICU that had been converted into a COVID ICU. In fact, almost every available space in our hospital is now functioning as an ICU, including most of the operating rooms.

Seven of my co-residents have also been redeployed to medical wards or ICU settings, and others are manning a new palliative care team. Still others have volunteered and are awaiting assignments. Thankfully, our intern years involved rotations in internal medicine (wards and ICU), neurology, and emergency medicine, so we arrived not entirely unprepared.

So far, I’ve been working overnight shifts alongside many others who’ve been redeployed, including residents and fellows from anesthesia, surgery, orthopedics, and pediatrics. Our current supervisors are extremely competent cardiologists who’ve stepped up to run the ICU in which I am working.

I’m essentially an intern again. I follow up lab results and order X-rays. I help nurses turn patients in bed. I call families and consults. I write admission notes, transfer notes, and death notes (of which there’ve been a heartbreaking number). In essence, I provide basic, hands-on assistance to my supervisors and the outstanding ICU nurses. And I do have an N95 that I use and reuse.

The hospital—my home institution since medical school—is eerily tense and often quiet. Medical students have been sent home, and visitors are no longer allowed.

It has admittedly been an adjustment to go from being a competent third-year psychiatry resident to being—again—an intern treading water. I am, in this new setting, not particularly special or talented or authoritative. No one looks to me for any kind of answer. I do what I can and what I’m asked. The experience is somewhat similar to how it felt to stay at home and isolated from the people I love—difficult but not unique. We’re all doing it; we’re all in this together.

There are, I know, grave ethical, political, and social questions to be asked right now. People everywhere are suffering and dying. Our medical system is broken and breaking further. Many health care workers across the country are not being adequately protected, supported, or compensated during this crisis.

But to push myself from today into tomorrow, I’ve sometimes avoided thinking about the forest. I’ve relied, instead, on the solidity of various trees. I wish, for example, that I could adequately express to you the joy I felt the other night as I watched my attending care for patients on our unit. She flew, seemingly tireless, from room to room, putting out fire after fire, changing ventilator settings, running codes, calling families, and answering every question the nurses and I came to her with. She was dedicated, kind, and indefatigable. I wished the patients’ families could see her, ministering so beautifully and intently to their loved ones.

There’s been a nightly 7 p.m. “Clap for Carers” in Manhattan, and I’ll admit that I sometimes ignore it, because it hurts to think about what’s happening. But yesterday, when the clapping started, I went to the window and joined in. I clapped for that particular attending and for the work I’d seen her do—something like war, maybe, but more like love. ■

Ruth McCann, M.D., is a PGY-3 psychiatry resident at Columbia University Irving Medical Center/New York State Psychiatric Institute.