Northwestern doctors upend family life to fight at frontlines, NM builds capacity for peak


Daily file photo by Colin Boyle

Northwestern Memorial Hospital. Many of Northwestern Medicine’s healthcare workers — technicians, nurse practitioners, physicians — have seen their personal and work lives upended by the pandemic in different ways.

Amy Li, In Focus Editor

After a shift in the emergency room at Northwestern Memorial Hospital, resident Vidya Eswaran makes sure that someone else watches her while she removes her protective equipment. That’s the time when ER workers are most likely to get infected, she said. Because her apartment doesn’t have an in-unit washing machine, she said she tries to change her clothes at the hospital to keep her home as germ-free as possible.

In the face of long hours working against a global pandemic, other healthcare workers with spouses and children are taking more extreme precautions — entirely changing what home looks like to protect their loved ones from a possible infection.

Nathan Trueger, an ER physician at Northwestern Memorial, a subsidiary of Northwestern Medicine, said his wife and daughter have moved in with his sister-in-law two miles away from home.

“It’s hard in a lot of ways, but the chances of me bringing something home and getting them sick are much lower,” Trueger said. “But it’s tough.”

Many of Northwestern Medicine’s healthcare workers — technicians, nurse practitioners, physicians — have seen their personal and work lives upended by the pandemic in different ways. Eswaran and Trueger, who both work in emergency medicine, have already witnessed a surge in coronavirus cases and anticipate more difficult times ahead.

“It’s this calm before the storm,” Trueger said. “We haven’t hit peak yet. We’re building up capacity. We’re certainly not overwhelmed — but it’s also this sense of watching a hurricane that you’re pretty sure is going to make land and hoping we’re prepared enough. But we just have no idea.”

During the initial weeks of the outbreak in Illinois, Trueger noted, the emergency department witnessed a lot of uncertainty in its response to the virus — not only in terms of the treatment of the disease, but also in terms of logistics such as where COVID-positive patients should stay and how to determine which patients needed testing.

Trueger said the first coronavirus patient he saw had straightforward gastrointestinal symptoms with minimal respiratory problems, but at the time, the ER team knew less about the virus and its effects. He said many doctors have had similar experiences in seeing the spread of COVID-19.

“One (story) that all the doctors are sharing is how many times a patient gets a CT scan and we expect it to be something like appendicitis, and the lower section of the CT scan shows that ‘ground glass’ appearance you see in COVID,” Trueger said. “Or the number of patients that come in with something like an ankle sprain, and three hours later they have a fever and turns out they have COVID.”

Northwestern Memorial’s emergency department, however, has witnessed an decrease in overall ER patients, which can be attributed to a variety of changes to people’s everyday lives.

People are less prone to dangerous accidents while following social-distancing guidelines and statewide stay-at-home orders, Eswaran said. However, both Eswaran and Trueger are more concerned that people who may need emergency medical attention are unwilling to come into the hospital out of fear they might contract coronavirus.

Northwestern Memorial, like other hospitals across the country, has canceled or delayed elective procedures and routine outpatient clinic visits to divert resources to COVID-19 treatment and prepare for a potential influx of coronavirus patients.

Northwestern Medicine cardiology fellow Baljash Cheema’s workflow has been dramatically reduced for the time being as he waits on call to attend to coronavirus patients. While he said he hasn’t had this much time off since his college summers, he is concerned about the second wave of medical attention that’s been put on the back burner because of the coronavirus.

“We don’t have a lot of patients coming into the hospital having heart attacks or heart failures, which is one of the most common reasons for hospital admissions anywhere in the country,” Cheema said. “It can’t be because people’s hearts are just suddenly working great. I’m anticipating a lot of hospitalizations for people that are sick at home right now who have not sought the care they need. That is going to come like a crash, for sure.”

Aparna Chatterjee, a psychiatry fellow at Northwestern Medicine who works in outpatient clinics with women during pregnancy and postpartum, said she is concerned that managing some very ill patients through outpatient telemedicine programs means they are not receiving the necessary support and care.

Chatterjee and Cheema are engaged but delayed their wedding, which was scheduled to take place in June. While Chatterjee said she’s been lucky to not have to worry about her fiance’s safety, she joked that she’s “definitely not used to having him home this much at all.”

Aderonke Pederson is a mother on top of being a psychiatrist at Northwestern Medicine and works to keep a balance between tending to her patients and homeschooling her children.

“Life is still happening in all those other domains and personally, it’s definitely overwhelming,” Pederson said. “But like what I tell my patients, it’s the matter of figuring out what you’re in control of and what you’re not in control of. If, on one day, I didn’t get through all the homeschooling tasks I’m not going to beat myself up for it.”

Even though projections indicate Illinois cases will peak within the next two weeks, Northwestern healthcare providers are confident that the curve is flattening and cautiously optimistic that extreme measures have been effective. Still, they urged citizens to continue to stay indoors and practice social distancing to avoid undoing all of the progress that’s been made thus far.

“Just because things are doing well now doesn’t mean all the extreme measures we’ve been taking weren’t necessary,” Trueger said. “It’s like vaccines — the fact that I didn’t get measles or mumps doesn’t mean that I didn’t need to get the vaccine.”

Trueger said because there are still no treatments that have proven effective against the virus and no vaccine has been developed yet, there is “no question” that the situation will worsen dramatically if the rules are relaxed.

Eswaran said some patients have entered the hospital with oxygen levels lower than she’d ever seen. Eswaran said for her, the most rewarding moments have been seeing those patients, “the sickest of the sick” who had to be hooked up to a ventilator, discharged from the hospital with no more difficulties breathing on their own.

“A lot of people are dying. While that’s true, it’s really nice and reassuring to see that people do actually get better,” Eswaran said. “It’s those cases that’s helping everyone in the healthcare field move forward and know that what we’re doing is not completely futile and hopeless.”

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