A Colorectal Surgeon in the Time of Coronavirus

Summary

A colorectal surgeon shares their personal experience working during the COVID-19 pandemic, including falling ill with suspected coronavirus and adapting to new roles in the emergency room.

Abstract

The author, a colorectal surgeon, describes the impact of the coronavirus pandemic on their professional life. Initially, they were building their practice, treating a range of conditions from cancer to constipation. However, the pandemic led to the closure of their offices and the cancellation of elective surgeries, significantly altering their daily work. After contracting a suspected case of COVID-19, the surgeon was quarantined without the possibility of testing. Despite ongoing concerns about their health and virus transmission, they were called back to work in the emergency room, performing tasks outside their specialty, such as transporting patients and managing ventilators. The surgeon reflects on the personal and professional challenges faced during this time, including the emotional toll on healthcare workers and patients alike, and remains hopeful for the future as hospitals plan to resume normal operations with new safety protocols.

Opinions

The surgeon is concerned about the broader impact of the pandemic, noting the struggles of others in the city.
They express frustration at not being able to get tested for COVID-19 despite having symptoms.
There is a sense of duty and willingness to help in any capacity needed, even if it means performing tasks outside their surgical expertise.
The surgeon questions the adequacy of the 7-day quarantine period for healthcare workers with suspected COVID-19.
They believe that the pandemic has forced healthcare professionals to find strength and adaptability, leading to personal growth and a more evolved approach to patient care.

It’s not all sh*ts and giggles.

I have been asked a lot lately, “What do you think about what’s going on?” And, frankly, I have a lot of opinions about what’s going on, as well as a lot of information to share. But I also have a lot of people wondering what how exactly I have been doing in this crisis. So this will answer a little bit of both.

I am a Colon and Rectal surgeon, sometimes abbreviated Colorectal surgeon. Having been in training for over ten years, I recently started my new position as a faculty member at a large academic hospital, treating patients and teaching the next generation of surgeons, my two favorite things. I had started building my practice, which essentially means gathering patients and getting your name out there, so that other doctors know to send their patients to you when they have problems. These problems include: colon or rectal cancer, diverticulitis, inflammatory bowel diseases such as Crohn’s and ulcerative colitis, hemorrhoids, anal fistulas, fissures, anal warts, anal cancer, and then I treat things like small bowel tumors and chronic constipation, fecal incontinence, and rectal prolapse. The list is quite extensive and encompasses both benign and malignant colon, anal and rectal diseases (and some small intestine as well!) Not to mention, I am a board-certified general surgeon so I can treat gallbladder problems, skin tumors, and appendicitis (my favorite!) though I don’t do as much of that stuff these days.

So I was revved and ready to go, hitting my stride, operating, and then Coronavirus put us all on pause. Overnight, my offices closed and I could not longer see new patients. A few days after that, elective (non-emergency) surgeries were cancelled. Pretty soon, even urgent surgeries were hard to do, as the hospitals became overwhelmed with COVID-19 patients and the beds and ventilators had to be re-assigned to treat them. Frankly, I am not upset about the loss of revenue, especially not when so many other people in my city are doing much, much worse and filing for unemployment. But I was upset that I didn’t get to do what I loved.

Then I got sick. On that last Friday before the city was shut down, I had rounded on one of my patients in the hospital, which at that time, had three patients under investigation for COVID-19. I think they must’ve had it, because two weeks later, I was sitting on the couch when suddenly I had terrible body aches in my back, neck and hips, the likes of which I’ve never had before, and never hope to have again. Overnight, I developed a fever, a sore throat, and the next morning, a cough. I notified the hospital but was told that even though these were classic COVID-19 symptoms, I could not get tested (this was at the end of March, I have another post about that). I sat at home for two weeks, intermittently relapsing into coughs or muscle aches, completely fatigued. Then I got a call from my department saying that I would be deployed to another hospital to help out in the emergency room. I wasn’t quite ready to go back to work, but I was also eager to help in the fight, despite not knowing my COVID status, and, this part felt socially irresponsible to me, not knowing truly how long I could shed the virus even after the illness. I have gathered the stories of about ten other healthcare workers who have similar stories and could not get tested. But we were told that 7 days after symptoms should be fine, so into the trenches I went.

As far as my surgical skills go, they were not really needed in the emergency room, except for placing the occasional central line (a long IV is how I explain it to patients). Good thing that medical training is medical training, and I was still able to help by checking labs, reviewing x-rays, and seeing patients who were sick. The most helpful thing I did, though, was do the job that no one else would, which is help transport patients. Between me and my team, we physically pushed the patients in their stretchers up to their rooms, several times a night. It seems like a crazy thing for a surgeon to be doing, but, there it is. I wanted to help, so I did what had to be done.

I’ve since helped in a couple of emergency rooms, managing ventilators, drawing arterial blood so that we can check the patients’ oxygenation. The most helpful thing, though, was that I went into the rooms when other people couldn’t, or wouldn’t. Bolstered, perhaps, by a false sense of security that I perhaps had some immunity (though as of now, my antibody status is unknown, because my test is still pending). But I talked to a 90 year old Tibetan patient and her son, who was worried sick about her. I spoke to the wife of a man who came to the ER alone. He works in the city but they live in Pennsylvania. I helped patients get up to go to the bathroom.

There is an end in sight. Our predictions were 4–6 weeks and that seems about right. Our hospitals are developing plans to slowly start surgeries and office visits again, maintaining social/physical distancing guidelines in the reception areas and strict PPE protocols in the hospitals. I really think that we will come out of this as better, more evolved individuals, because we all had to dig a little deeper within ourselves to keep on going through this difficult time.