Five Stories from the Front Lines

Since late February, once it became clear that Boston would not escape the ravages of the COVID-19 pandemic, the city’s hospitals have been preparing for the greatest patient surge in their history. Planned surgeries were canceled, workflows redesigned, doctors reassigned, and special clinics erected.

At Boston Medical Center (BMC), the city’s safety net hospital serving the most underserved, vulnerable patient populations, and home to one of the country’s busiest emergency departments, doctors, nurses, physician assistants, and other staff are running both a sprint and a marathon. It is an all-hands-on-deck moment to help rescue a tidal wave of patients from a novel disease they know little about—and whose transmission can put their lives and their loved ones’ lives at risk.

In barely two months, in addition to admitting more than 180 patients with confirmed or possible cases of coronavirus, BMC has more than 100 employees who have tested positive for the disease. And the presumption is that it’s going to get worse before it gets better.

BU Today talked with five BMC physicians—who also hold faculty positions at the Boston University School of Medicine—about working on the front lines, their efforts, fears, and frustrations, as well as their reasons for hope.

From chaos, progress
Evan Berg

The emergency department at Boston Medical Center is a place where doctors and nurses are ordinarily unfazed by patient surges and where the staff take pride in their ability to handle any injury or infection—or even mass casualty event—the city can throw at them. But COVID-19, says Evan Berg, an attending emergency room physician for 16 years and vice chair of clinical operations for the emergency department, is something entirely different.

 


Service and sacrifice
Kristen Goodell

At the end of a recent three-mile run with her teenage daughter and son, Kristen Goodell raised her hand for a congratulatory high five. Then she lowered it. That familiar gesture, she remembered, was no longer permitted. In the new normal, Goodell, associate dean for admissions and an assistant professor of family medicine at Boston University’s School of Medicine, cannot touch her children. And her children cannot touch her.

 


Anxiety, determination, and hope
James Hudspeth

On Friday, April 3, James Hudspeth admitted three patients to Boston Medical Center. “I would not have told you at the end of that shift I was worried about any of those patients going to the ICU,” says Hudspeth, who oversees the hospital’s COVID-19 response inpatient floor. “But at the end of 24 hours, two of those patients were in the ICU. As an experienced doctor, that is very disconcerting. I’ve been doing this for 14 years, and I have a very good sense of a patient with pneumonia, who looks good and who looks bad, and what kind of patient I need to worry about. COVID-19 upends all that.”


Stemming collateral damage
Sarah Kimball

For Sarah Kimball, a primary care doctor and codirector of Boston Medical Center’s Immigrant & Refugee Health Center (IRHC), life has changed with two sudden shifts. First, three weeks ago, the IRHC halted in-person visits and moved all communications to telephones. The risk of infection from COVID-19 had made person-to-person contact far too risky. One week later, Kimball accepted an invitation to codirect BMC’s newly launched influenza-like illness (ILI) clinic, which operates in the Shapiro Building.


Greater distance, stronger bonds
Michael Ieong

Michael Ieong, medical director for the Boston Medical Center’s intensive care units and assistant professor of pulmonary, allergy, sleep, and critical care medicine at Boston University’s School of Medicine, is accustomed to 12-hour days. But before the ICU filled with COVID-19 patients, his 12-hour days were spent coordinating disciplines and workflows, and as he puts it, “making sure everything works well.” He did rounds, did some teaching, and like other ICU doctors, responded to situations with the confidence that he was applying evidence-based best practices.

This BU Today story was written by Art Jahnke.