Dr. James Hudspeth on Front Lines of COVID-19 Pandemic
Anxiety, determination, and hope
On Friday, April 3, Dr. 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.”
Dr. Hudspeth’s general medical admissions floor houses COVID-19 patients who are too sick to stay home, but not sick enough to require intensive care, and patients undergoing testing for COVID-19.
“We are used to dealing with an underserved population at BMC and dealing with patients who have a great deal of psychosocial stress across the board,” says Dr. Hudspeth. “We try to reassure patients who are afraid because of the disease, and we try to address psychosocial issues concerning things like homelessness and substance abuse. COVID-19 adds another level of complexity because patients can’t go back to a shelter, can’t go back to some treatment programs, and some can’t go back to crowded housing they share with vulnerable family members.”
At the same time, BMC’s healthcare providers are dealing with their own unprecedented levels of stress—much of which, Dr. Hudspeth says, depends on people’s home situations. “For me it’s not so bad,” he says. “I don’t have children and I don’t live with my parents. My wife is a primary care physician who is working in an ILI clinic at BMC. We had a forthright discussion at the beginning of this. We decided that we were both comfortable working with these patients. We accepted that there was some level of risk, and we accepted that if we become infected the probability of either of us having a bad outcome was low. I think for colleagues that have children or older parents at home or have personal medical issues placing them at higher risk, this is a very challenging decision. I’m thankful that at BMC we have enough providers that we can keep people who are at higher risk away from the front lines and use them in other roles to support our efforts.”
For Dr. Hudspeth, however, COVID-19 has curtailed a reliable routine exercise in stress relief. “Ordinarily, when I have a tough day, I just go sit with one of my patients and talk to them for a while,” he says. “That is a very restorative thing, to be reminded that this is a human who I am helping to try to feel better with my work. With this situation, I have to be gowned up, I have to be wearing a mask, and that really detracts from the human connection. It adds a lot more stress to the situation.”
Dr. Hudspeth says he has seen “tremendous progress” in the four weeks since the inevitability of COVID-19 settled on doctors at BMC. “I feel like the people in infectious disease grasped the enormity of what was going to happen,” he says. “Then everyone agreed that this is real and this is happening, and we started to see patients, and since then there has been a very well-organized structure to address this. Operationally, we have reorganized the hospital in very fundamental and important ways.”
Collaboration has been critically important in that regard, Dr. Hudspeth says. “We know the strategy people, and the head of physical therapy, and head of the lab, and this situation is requiring all of us to come up with new operations and new workflows on a daily basis, and to communicate that to our front lines and reinforce them in real time,” he says.
“We’ve built structures,” he adds. “Now the question is whether what we built is going to be resilient enough and strong enough to make it through the next several weeks.”
Thank you for what you do, Dr. Hudspeth!
*The original article can be found here.