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In the Biodome

In the Biodome

As a pulmonary and critical-care medicine fellow, I care for patients with a broad variety of respiratory ailments. But little did I know, as I examined my patient Mr. Smith in the outpatient pulmonary clinic this past winter, that I’d see him again only months later as my first patient with COVID-19.

Mr. Smith was tough as nails. A stoic retired steelworker and former smoker, he suffered from significant emphysema, but was inclined–by nature and

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This Is Why

February 2016
Tierra Nueva, Dominican Republic
I’m in the last of five days caring for patients at rural clinics in western DR, along the Haitian frontier.
Tierra Nueva, miles from anywhere, is a collection of clapboard shanties and shacks scattered along a dusty, unpaved road that dead-ends at the border. People survive here by coaxing vegetables out of the earth via scratch farming. The lucky ones have a goat and maybe some hens.
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Burned Out

Burned Out

It’s been five months since I left my position as a psychiatrist and medical director, and like everyone, I’m wrestling with questions about how COVID-19 has changed our lives, maybe forever. As I read the news and hear from my former colleagues, who’ve had to quickly ramp up to deliver telepsychiatry, I feel a mixture of emotions: fear and concern for my former patients; guilt that I’ve left my colleagues behind to fight on without

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Inside the Respiratory Tent

Inside the Respiratory Tent

Spring comes slowly to New England. When I leave the house in the mornings at the end of April, I pull my fleece jacket tighter around me on my way to the car. My preteen daughter’s dark eyes and solemn mouth watch from the second-floor window as I pull away.
In the “don and doff” station at the respiratory tent in the hospital parking lot, I put on a gown and gloves, then take one

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The Last Pandemic

The Last Pandemic

7:00 on a Sunday evening.

It is day 30+ of New York City’s COVID-19 pandemic. Fire trucks and flashing lights fill the street fronting the hospital emergency department where I’m a physician. The scene erupts into applause and sirens. We doctors, nurses, physician assistants, techs, housekeepers and clerks wave back and flash our individual cardboard letters spelling “Thank You!” It is so good to be outside and, for a few minutes, unafraid. Inside, our

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Unmute

Unmute

His name announces itself as a banner across my ringing phone. We share the same last name.
I hit Mute, buying time while I do the math: Answer his call now and stave off three missed calls and two long-winded voicemails, with him clearing his throat in the background; or take the call, along with God knows what kinds of trauma he’ll inflict on me. I have avoided calling him lately. Subconsciously, I know this

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A COVID State of Mind

I’m a fourth-year psychiatry resident in the final months of training, and I have signed on to continue as an attending physician at my hospital.

In mid-March, my team was consulted on a patient in the ICU. She was one of the first identified COVID-19 cases in Michigan, and our hospital’s first such patient.

The patient was being treated with psychotropic medications, and one of them was decreasing the effectiveness of an antiviral

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Stumbar IMG 8399

Love in the Time of COVID-19

COVID-19 changes everything–even, or especially, love. It demands that we love differently, and in new ways. For me, this is what #loveinthetimeofcovid19 looks like.

My husband, Lunan, and I are both doctors. Lunan, a urologist, is completing his final year of training in New York City, and I am a family-physician educator at a medical school in Miami.

We are living separately this year–one of the many sacrifices we’ve made in pursuing our medical training

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Put to the Test

Put to the Test

I’m a primary-care doctor in Washington state. I was recently confronted with a ticklish and painful situation.
Here are the facts and the sequence of events:
On a recent Wednesday morning, I saw a forty-five-year-old woman in my office for an earache. She told me that a member of her church had been diagnosed with coronavirus, and that many schools in the area were being closed because of possible exposure. Later that day I started

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Greetings and Salutations

Greetings and Salutations

I have seen tribesmen in the West African country of Mali meet each other on a narrow dirt path and stop to spend several minutes chanting highly scripted greetings. When they part, shortly afterwards, there is an equally elaborate farewell.

As a psychiatrist and medical educator, I’ve seen my colleagues carrying out a parallel ritual: Two doctors hurriedly passing each other in a hospital hallway and cheerily but tersely saying, “How are you?”–neither

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Desperate Measures

Desperate Measures

In my very first job as a doctor, working in a London hospital in the 1980s, I always took a ridiculously detailed past medical history for every patient I saw. I started to notice how many elderly women had had septicemia, a life-threatening infection in which enormous amounts of bacteria enter the bloodstream.

The neighborhood surrounding the hospital had once been the worst slum in London, and it didn’t take me long to guess

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A Flower in Winter

A Flower in Winter

It’s winter of 1993. A cold, snowy day. Windy. A blizzard. The phone rings.

I’m not on call for my patients today–except for one. Daisy has been in my care since the early 1970s, and given the risk that she may suffer a serious downturn, I’ve instructed her nursing home to call me whenever necessary.

This is that call. Daisy, my dear lady, the old artist, is dying.
Throughout her nine decades of

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