The Doctor Who Helps Colleagues Deal with the “Dull, Dark Dread” of COVID-19
Dr. Christopher Goodwin is one of the people you call at Temple University Hospital when you are an employee and think you’re sick with COVID-19.
He is in the basement of Rock Pavilion, one of the team in charge of occupational health. Emails and phone calls come in all day long from nurses and doctors and frontline workers and staff throughout the hospital, not to mention cops and bus drivers and other frontline workers with whom the hospital has a contract. When employees are frightened about exposure, when they get headaches and fevers and coughs, when they wonder what to do, they contact him.
Dr. Goodwin’s mission is twofold and often seemingly in conflict – on one hand, take care of Temple workers, protect them and keep them safe; and on the other, maintain an adequate workforce to keep the hospital up and running and saving patient lives.
“It’s an impossible position to be in,” he said. “We want to be compassionate to docs and nurses who are having symptoms, but we also want to say suit up we need you on the front line.” He added that “an overwhelming majority of doctors and nurses want to get back to help their teammates. It’s awe-inspiring.”
He has seen every variation of response by employees, and in his view all are completely understandable.
“We get people who say, `I just want to go back to work. My team is short,’ and you know they shouldn’t, to people who aren’t sick at all but are just terrified, to people who are resentful and mad and feel Temple doesn’t want to take care of them,” even though he knows leadership is doing all it can with the resources it has to protect patients and staff.
He also sees up close how “this disease divides right down class lines. The ones who are most vulnerable don’t have the privilege of working from home.” He says many staffers who get sick are still riding subways and buses. “Many live with frail elderly parents and their job at Temple is their lifeline for themselves and others. We’re asking them to fight an enemy that we don’t well understand and really don’t have the body armor for and get back in the trenches. It’s just nuts.”
Dr. Goodwin says when employees exhibit symptoms they are tested, but “the test is so far from perfect.” He tells them, “We're going to treat you and not the test result. What are your symptoms? How are you feeling? Your test is negative but you lost your sense of taste and smell and feel like you’ve been hit by a truck? We’re going to believe it’s COVID.”
He said those with symptoms are told to go home and quarantine, but often are back within seven days on average. “The majority we test are having a mild course,” he said. “Of all these workers, most are able to get back to work within a week.”
He gets all manner of problems in his office. One doctor who was worried about getting sick because of exposure to COVID patients also was accidentally stuck by a needle, and worried about other possible consequences like HIV or hepatitis.
“Anything I can do to relieve your psychic burden,” he tells employees, “I’m here to walk with you every step as best you can.”
Dr. Goodwin said his office has benefited from a huge influx of doctors from family medicine, internal medicine, sports medicine and psychiatry – a dozen clinicians overall -- to help field all the calls and emails.
He said he begins every day as a messenger, calling households with test results, and on the other end of the phone he can hear the full range of human emotions, from euphoria and relief to what he described as fear and a “dull, dark dread.”
Dr. Goodwin says he knows that North Philadelphians are in the best possible hands at Temple, and says he is grateful for every minute he can serve. He said he also feels he is right where he is supposed to be, doing his part, and he believes that doctors as a profession feel a renewed sense of purpose and mission.
He also notes the terrible disconnect of sheltering during a pandemic. He lives in the city’s Fairmount neighborhood. “The mornings are exquisitely quiet and we can hear birds for blocks and there are no cars and the sky is blue and yet there is this horror just a few blocks away.”
Dr. Goodwin writes verse as a means to process his own emotions and feelings during the pandemic. Below is a poem about his scooter ride up Broad Street every morning to the hospital, a poem he titled “COVID Commute”:
I beg for empty streets.
Now traverse in tears alone.
Half the time to travel.
I have to get there.
I ride each morning
I go to the fever house.
Red lights, empty intersections
Make my chest tight, heart race.
Arrival feels too late.
To a basement office
Hole in the wall.
To man the phone.
Air traffic control -
Who to quarantine,
Who to send back to the beast.
To field the fears
Of my colleagues,
The Cleaners, Nurses,
The Doctors, Cooks
The Pharmacists, Phlebotomists.
The Respiratory Therapists.
Quarantine, test, wait. Hope.
Guilty of feeling guilty
For doing so little.
Thanked again and again
For reaching, listening, embracing through the line.
Feels so small. So huge.
That swab at the back of the nose.
Some positive, most negative,
—a few false negative—
Almost all I talk to,
Make it through the ten day storm.
But “almost” means
There are the calls -
The shortness of breath
That catches my breath.
Severe aches and fever,
Fatigue. I’m so scared, Doc.
Panting on the end of the line.
The streets aren’t empty enough.
I beg for empty streets.
Michael Vitez, winner of the 1997 Pulitzer Prize for Explanatory Journalism at The Philadelphia Inquirer, is the director of narrative medicine at the Lewis Katz School of Medicine at Temple University. Michael.firstname.lastname@example.org