Many struggle with COVID-19 without ever being infected.
Think of how worrisome this epidemic is to rational folks sheltering in comfort at home. Now, consider the mentally ill, the disturbed patients treated at a place like Mount Sinai Hospital — the psychotic and bi-polar, schizophrenic and depressed. Like your world, their worlds, too, are turned upside down, though they often have far less ability to cope with events that even the most stable person can have trouble processing.
“We are seeing more patients experiencing more ill effects of emotional distress,” said Dr. Paul Berkowitz, chairman of the department of psychiatry and behavioral health at Sinai.
“Not just from fears and concerns associated with the virus, but social distancing and isolation. People are having less and less contact and are more overwhelmed. Perhaps they’ll not be checking in with family members, perhaps [they’ll be] coming off medication, relapsing on drugs or alcohol if that has been a problem. All of these make for ... more people coming in for psychiatric symptom exacerbation. We’ve seen that already at Holy Cross and Mount Sinai behavioral units.”
Staff also must make sure their own stress and anxiety doesn’t overwhelm them.
“I’ve been a disaster nurse for 25 years. I never thought I’d see this,” said Michele Mazurek, chief nursing officer for Sinai Health Systems. “We’re seeing hardened nurses having a rough time.”
Early on, a doctor at Sinai contracted COVID-19. That rattled everyone.
“When we had a caregiver test positive, it caused a lot of concern,” said nurse Adam Garrison. “It really brought the reality to the caregivers. It was an eye-opener: ‘This can happen to me.’”
For some, a certain resignation has set in.
“We’re going to be exposed, if we’re not already,” said trauma tech Gabrielle DuFour. “Unfortunately, that’s just the way things are going. Fortunately, my immediate family is not in Chicago ... ”
If they are exposed — there are not enough tests for medical personnel to find out, and there isn’t really much point, since they can get infected the day after being tested — then they have to worry about spreading the disease both inside and outside the hospital.
“I feel I am a walking vector for passing on this virus,” said DuFour. “After work I go to Trader Joe’s. I get off work at 7 a.m It opens at 8 a.m., and I’m there, doing my thing. Doing my best to stay six feet away. But I am essentially spreading this around without trying to spread this around. Something I’m thinking about a lot.”
And something you might think about too. That person you are getting too close to at the supermarket could be a trauma tech coming off a 12-hour shift. Sure, they leave their scrubs at the hospital and shower, usually. But still ...
After all the hands-on work with COVID-19 patients, Mount Sinai’s staff goes home to watch the same news as everyone else of us.
“I wish I could go to New York and help them, but we have to reserve what we have for what is coming to Chicago.” said Mazurek.
And come it will. No one knows when the worst will hit, or for how long.
“It’s scary not knowing how long this will last and will we have enough at the end,” said emergency department director Raquel Prendkowski. “We’re so scared ourselves. I worry. I’m a healthy young adult, but if I get it, I’ll probably be OK. I will probably have mild symptoms. But I can’t go home to my kids and kiss them. I can’t go to my mom and dad and hug them, or have Sunday family dinners.”
She can’t go home to her kids because they’re gone to live in northern Michigan. Many hospital staffers are living apart from their families, concerned about infecting them.
That doesn’t mean the people they care about are out of harm’s way. Just the opposite. At a place like Mount Sinai, it often isn’t strangers coming in. They’re members of the community whom doctors and nurses have gotten to know over the years, sharing their joys (beating back cancer) and heartbreak (the death of a child).
“Our patients have a lot of co-morbidities,” said nurse Kimberly Lipetzky, using a term for underlying medical conditions. “They’re often from a lower socio-economic background. They might have difficulties managing those diseases. They’re at risk of declining rapidly. Our patient population is not the ‘worried well.’ I love our community, I really do. We do so much work with them, trying to get them stable. It’s such a challenge, given the nature of their lives.”
Working in North Lawndale, a low-income community with increased crime, can feel like your back is against the wall on a good day. Then this new coronavirus shows up.
“It moves so fast,” Lipetzky continued. “I had a cancer patient intubated, test positive for corona. I don’t know how she’s going to do. I don’t have a good feeling about it. It feels personal in a way. It makes me so mad. You want people to get better, to live their best life, then here comes this tidal wave and knocks all that out.”
Sometimes it just gets to you.
“Everyone is stressed right now,” said Prendkowski. “We try to take a step back. When someone else is overwhelmed, someone else will step in. What we do in this line of work is always a stressful situation. With COVID-19 concerns on top of it, that’s much more. I’ve seen the some of the strongest of the strong really having a hard time and breaking down. But all of them have snapped back.”
There isn’t much choice.
“There’s a lot of fear,’ said Prendkowski. “What’ll we do if we get sick? We’re constantly building plans, recruiting people, making sure all hands on deck right now.”
Fear is overcome as problems are coped with. Retirees have come back to help; cleaning staff have pitched in at peak moments, assisting with non-medical tasks.
“Now we’re getting hang of it,” Prendkowski said. “Dress rehearsal is over, this is the full game time, the full go and we’re going to get through this.”
The bond between caregiver and patient is even stronger.
“We’re scared. They’re scared,” said Prendkowski. “But we are here and we’re going to take care of them when they need us. What’s important is, we’re here and we’re not going anywhere.”
“This is the moment why physicians take their oath,” said Dr. Sunita Mohapatra, head of infectious disease at Mount Sinai. “To care for people, do their best.”
“We’re living in a moment in history,” said Garrison.
“This is my home. This is where I want to serve the people,” he added. “It’s a time of hardship, but we will persist through this. We will prevail.”
This is the last of a three-part series. To read the Wednesday and Thursday columns, go to suntimes.com/authors/neil-steinberg