Family Physician Hunkers Down to Fight COVID 19

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My name is Stephanie Segal and I’m a Family Medicine physician at Kaiser. Denver, CO

First *confirmed* case of COVID-19 in Denver area was Thursday 3/5. 

Over the next week, cases increased every day. We put clinical teams in place to react to positive “screening questions”, but watching things escalate in Italy a couple of my co-workers and I wondered if it was enough. I started stripping down in the guest bathroom as I walked into the house and taking a scalding hot shower every day after work.

Monday 3/16 I moved out of the house. The day before I made my big Irish meal a couple of days ahead of time, knowing I wouldn’t be home on St Patty’s Day.

Monday morning at work, we started mobilizing. In one week we are switching to 2/3 virtual care, 1/3 face to face care. We have a plan to have COVID testing/suspects in a few specific locations, “clean” clinic sites for other health issues. We’re bringing in military tents to set up testing centers. I feel like we’re mobilizing for battle, and we’re actually using military terms like “deployment.” Urgent care docs will be “deployed” to hospitals. They’re begging family docs to sign up for urgent care shifts. 

I told my kids I’d be gone a couple of weeks to start, but I knew it would be longer. I told them all yesterday I’d probably be gone for months. Thank God I can video chat with them every day. We had a “virtual movie night” yesterday and I amused myself by trying to get our audios in synch. 

We also had a serious chat about what they need to do to keep the household going.

My husband and I are updating wills.

My emotions are all over the place. 

Intense exhilaration of being on the front lines.  
Sadness of being away from my kids.
Liberation from all the stupid bullshit I usually worry about.
Fear. I am the opposite of a germaphobe but I’m really f”**ing scared of this one.
Disbelief that people are still going out to restaurants.
Anger for the families in the neighborhood not listening, letting their kids play close together.
Regret that I have not spoken out more forcefully the past week.
Proud that I can do something to help.
Humbled by the kind words from patients, calling me a hero.

Keeping busy is my go-to reaction in stressful situations. 
I’m trying to grow from this and schedule time outs for myself.
I could sit on my computer and do virtual care 24/7, the need is so great.
I could sign up for double Urgent Care shifts. I actually am signing up for extra, because we are keeping doctors over age 60 and with other high-risk factors on 100% virtual care.

So I’m trying to schedule myself SELF CARE blocks and yesterday I actually did it! I called my oldest and gave him a “man up” pep talk. I went for a walk. I closed my computer and stayed off my phone (mostly) for 3 solid hours.

The phrase I keep using is “the bomb is ticking.”

I hear it in every sniffle.

I hear it louder every time there is a new positive.

I hear it in every teacher calling because a student’s teacher tested positive…I hear those silent carriers.

I hear it leaping from the pages if every dystopian virus novel I read as a teenager.

By the time you share this, the bomb may have detonated here.

Thank you, Dr. Segal, first and foremost for the incredible sacrifice you’re making to care for patients and help during this time. Your work is heroic. Stay safe and keep us posted. We are proud of you and very much appreciate all you’re doing.

Heather

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7 Comments

  1. Jane Zendarski on March 21, 2020 at 3:05 am

    Wow! A powerful post. Amazing woman, Dr. Segal. I am afraid. I wish I was as brave as her. What concern for older physicians like myself, to put them only in video/telephone visits.

  2. Lynette Charity MD on March 23, 2020 at 1:59 am

    Dr. Segal, first and foremost, thank you! I applaud your ability to be in the fray, but also take time for your self-care. I am retired and over 60 and watching all of this from home. I can’t image the emotional trauma this is producing within you. Well, actually, from your post, I can. My son works for Google and is on “lockdown” in Mountain View, CA. I video chat with him everyday. Like you, it gives me some semblance of “normalcy” in the present abnormal world. That is all we can do right now. And you are doing all you can do right now which includes taking personal time to recharge. Thanks for the idea of “virtual movie night”. I’ll have to ask my son how to do that.

    Please keep us up to date on what’s happening on the front lines, but also do not take on more than your physical and mental state can handle. We need you for the future of healthcare. You are dedicated! You are strong! You are wonderful!. Stay safe.

    • Heather Fork on March 23, 2020 at 2:29 am

      Thank you both, Dr. Charity and Dr. Zendarski, for your super supportive comments for Dr. Segal! I agree 100%. It takes a lot of courage to risk your life to care for others. We’re wired to run from danger, but she is answering the call to serve. This is the work of heros and heroines and I really hope, Dr. Segal, that you are feeling the appreciation and support of others. You deserve it. I agree with what Dr. Charity wrote, to make sure to take care of yourself and stay as safe as possible. Your health and life matter. I hope that this COVID crisis, with its great demands on healthcare workers, leads to a return of the respect for physicians and others who give so much to care for patients. There has been a disheartening decline in how we treat those who sacrifice so much to care for us that it is no wonder many doctors feel relieved to not be on the front lines. There would be more physicians feeling like Dr. Segal, I believe, if physicians were given more respect and autonomy. Physicians are willing to work long, hard hours, and give up many things to do what they trained to do, but many feel betrayed by the very system that acutely needs them. Thank you Dr. Segal for answering the call. You are making a difference.

  3. The All England Practice on March 24, 2020 at 5:14 am

    WOW! This is very impressive and very helpful.

    • Heather Fork on March 24, 2020 at 1:33 pm

      Thank you very much for reading and commenting!

  4. Aaron Segal on March 25, 2020 at 5:26 pm

    That’s my wife.
    She’s a badass. In so many ways.

    • Heather Fork on March 25, 2020 at 5:58 pm

      Hi Aaron!! Proud of you and her.

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