Few doctors ever spend their first weeks in such an environment. For one thing, in April at Bellevue Hospital, where Mayer and Ulloa now work, every patient on their floors had COVID-19. For another, there are no daily conferences to talk through cases, no running in or out of a patient’s room if they forget something. By design, none of these new doctors is working in the ICU or assisting in the room with “super-spreader events,” such as
resuscitations or insertions of ventilators. But even so, their
patients are sick, and the work is vastly different from before.
As a medical student, Mayer enjoyed what she thought of as her afternoon “social” rounds—talking with patients about their lives and families. “You always learn something useful for their medical care,” she says. Visits like that don’t happen now. Before going into a patient’s room, she dons an N95 mask, a face shield, a gown and gloves. There is a newfound cognizance of how many times someone has been in a patient’s room and a collaborative effort to minimize those numbers. In their first weeks at Bellevue, Mayer and Ulloa worked with nurses to do more procedures than usual each time they went into a room, so someone else didn’t have to go in a few minutes later.
Every day, they try to make a connection with each of the four to seven patients they are in charge of. Even all geared up, her face practically hidden, Ulloa talks football with her patients; the week we spoke, the talk was of Rob Gronkowski’s trade from the Patriots to the Buccaneers to play with Tom Brady. “It’s a way of bringing some normalcy to this abnormal time,” she says. (It’s hard not to think that Gronk, football’s everyman, would enjoy that idea.)
After every patient interaction, Mayer and Ulloa spend two or three minutes “doffing” their PPE. First, the gown is torn off and rolled up inside out. The gloves are stripped off in a specified way, wrapped in the gown and thrown away. Then hands are washed or sanitized. Once the
doctor is outside the room, the face shield is removed and wiped down on both sides. Mayer’s was constructed for her by NYU medical students, and she and others put them on upside down to dry, like the hat of “a weird pope.” Back in the on-call room, they carefully remove their masks, which they’ll reuse, and place them in paper bags with their names on them.
The precautions continue at home. Ulloa puts her shoes, badge, bike helmet and backpack into a cardboard box by the front door of the apartment she shares with her husband. She removes her scrubs and carries them with her directly to the shower. Her apartment has no washing machine, and she doesn’t want to risk exposing anyone to the virus by taking her scrubs to a laundromat or sending them out, so she washes them in the shower with her and hangs them to dry.