Unmasking Rehabilitation Medicine During COVID
In mid-April, I was almost done with my first year of medical school, studying the intricacies of neuroanatomy. With my attention focused on the descending and ascending pathways to sense pain, pressure, and touch, I was suddenly awoken to the painful reality of the pandemic. My dad called and told me that Grandma had COVID, and although she was initially stable, her oxygenation rapidly deteriorated and was intubated. During the next two weeks, Grandma was in a state of limbo. I felt helpless being so far away, and if that wasn’t enough, a couple days later, my dad tested positive for the virus and his health began to decline as well. Miraculously, Grandma started to improve; though she was still very weak, she moved to a rehabilitation hospital around the same time that my dad started to regain his strength. The rehab doctors and therapists helped Grandma recover physically and cognitively, and finally after six weeks in the hospital, she made it home.
After reflecting on Grandma’s experience with COVID, I wanted to learn more about the perspective of rehab providers working with COVID patients like her, and to give them a platform to tell their stories. I spent the summer interviewing physicians, therapists, psychologists, and researchers in the field of rehab medicine and wrote profiles of each of them. The dedication and courage of the individuals I met were breathtaking. Each story was so powerful, and illuminated the blunt realities of the pandemic along with the moments that inspired them to keep going.
Dr. Angela Riccobono, a rehab psychologist at Mount Sinai in New York, discussed how the extra PPE sometimes posed a challenge, but she was able to adapt. She said, “In the healing of people, it’s whether they think you care, and even if you’re wearing a mask they can still sense [that].” She also reflected, “As helpless as other people felt, I had the opportunity to be helpful, and that was a gift to be able to give to other people during this time.” Similarly, Dr. Nadia Zaman, a physiatrist and sports medicine fellow at Mount Sinai reflected that, “Your fears get put aside when you deal with the fears of patients, when you sit down with the patient, their fears always trump yours.”
Dr. Jacob Rohrs, a PM&R resident physician at Temple University Hospital, shared how his grandmother passed away from COVID after the virus spread in her nursing home. He said how afterwards, it was particularly difficult to have a funeral or celebrate her life because of social distancing. Working on the frontlines and not being able to see family or friends was incredibly challenging. For Stefanie Haft, a speech language pathologist at Mount Sinai, she said, “It was pretty isolating at the beginning. My co-workers really became the only people I interacted with in person. We became a tighter group.”
Looking to the future, Dr. Miguel Escalon, the director of critical care rehab at Mount Sinai, believes that PM&R will become increasingly important for managing the COVID aftermath. He noted, “We will have a lot to say about what happens over the next few years. How do we follow patients after acute rehab, and how do we make sure that a year from now they’re back at work, a year from now they’re not having nightmares about having been in the ICU?”
Through this project, I learned about the diversity of rehab providers, the wonderful culture of PM&R, and the impact that COVID had on both their work and personal lives. It was a valuable experience not only for myself, but also for the rehab clinicians, who found it meaningful to share their stories. I also asked each of the clinicians to send me a photo of them during COVID, and from their images I made acrylic paintings. Painting their portraits enriched my appreciation of the people I interviewed and I enjoyed being able to capture their unique qualities.
This project also helped me on a personal level to process the severe illness of my grandmother, and when she was feeling better by the end of the summer, I interviewed her as well. Thinking about her illness, Grandma said, “I’m trying to think of it as something unfortunate that happened to me, that it was a setback. I’m hoping to live through this and go on with my life.”
R. Mayeda is a second year MD candidate at the Lewis Katz School of Medicine at Temple University in Philadelphia, Pennsylvania.