Coping with COVID: Sandra’s Story

As healthcare providers, the COVID era has forced us to shift our paradigm, changing from in-person clinical evaluations to telehealth visits and adapting surgical protocols.  We have become creative in all aspects of patient care, while remembering the oath that we took at the beginning of our professional journey: “Primum Non Nocere (first do no harm).”  These words replay in my mind, as I try to navigate a fractured system.  How do I perform high risk aerosol generating procedures and provide the best care, without putting the operating room staff and my own family at risk?

Moral injury is essentially the cause of harm to an individual’s moral conscience.  This results from betraying one’s personal moral code, which can possibly lead to profound internal suffering.  More commonly, moral injury is associated with military veterans; however it may also include teachers, health care professionals and caregivers. On a daily basis, as I confront the inadequacies in the health care system, which the COVID 19 pandemic has exposed; I struggle morally, as a variety of thoughts race through my mind: 

-The insufficient COVID Tests… I know that 50% of positive patients are asymptomatic.

-The limited supply of PPE… I know that N95 masks may not adequately protect against COVID in high risk procedures.

-The exposure of health care professionals returning to work after insufficient periods of quarantine… I know there isn’t subsequent serial surveillance testing of these personnel.

-As patient X’s laryngeal cancer is progressing and patient Y’s airway obstruction is worsening…

-And my little ones at home with asthma...Will I bring the virus home to them?

Now, more than ever, as physicians, our responsibility is not solely our diagnostic and treatment capabilities, but also our ability to advocate for our patients and our staff.  In this time, as clinicians, we are faced with numerous obstacles that are seemingly unfathomable in the wealthiest country in the world.  Yet, several of my colleagues, like me, are in the throes of both a tangible and a moral battle.  Whether heading out to work or coming home to loved ones, the uncompromising battle against this invisible, deadly pathogen will continue to wreak havoc on us all: physically, emotionally, and mentally.  

Dr. Sandra Stinnett is the Director of Laryngology at UT Health Science Center in Memphis, TN. Follow her on Instagram @thevoiceboxdoctor