January 5th, 2022
I feel slightly more tired today and there’s this burning sensation in my lower throat.
I don’t really have a sore throat though. It’s probably nothing. Maybe I should see how I feel tomorrow morning. I’m working from home today anyways.
Hmmm, that burning sensation doesn’t seem to be getting better. Maybe it’s getting a little worse. Maybe my nose is starting to run just slightly. Maybe I just had some reflux in the middle of the night. Let me try some Tums.
“Well, that didn’t work…”
Ugh, maybe I should go get COVID tested.
I have 10 patients on my morning schedule and don’t want to cancel them for just mild symptoms or possibly no symptoms if I’m Covid negative. I’m not really even certain that I’m starting to feel sick. It still doesn’t even feel like a sore throat, which is usually my first symptom along with congestion.
Maybe I should just go to our smaller hospital’s ER because I know the COVID PCR will come back in an hour and then I can still see my patients in the morning if I’m negative.
“Phew, I’m COVID negative.”
As I work through my morning clinic I start to feel worse.
What if I got tested too early? That can happen.
I barely had any symptoms yesterday and now I actually have a runny nose, a cough, and a sore throat. Maybe I should get tested again.
“I really hope I’m negative.”
I’m supposed to work nights starting in two days and I really don’t want to have to pull one of my friends to cover nights for me.
I spit in a tube at clinic. They tell me it could take 72 hours to get results back.
I really, really hope I’m negative. I don’t want to do this to my friend.
The day progresses. I’m feeling worse and I’m certain tomorrow is just going to be worse before I slowly turn a corner. 99% of me really wants to be negative so then I can work Saturday night and my friend doesn’t have to cover. But there’s this tiny part of me of me that thinks sure would be nice to be COVID positive. Then the CDC says I have to quarantine for 5 days and I will actually get a chance to recover. Whether or not I’m COVID positive my immune system is not going to do well starting nights.
I know this pattern too well.
Before COVID, there’s no way I would take a sick day unless I was feeling like I was dying. At one point during residency on a tough rotation which starts at 5am, I worked Christmas Eve super snotty and with periodic subjective fevers and chills because there was no way I was letting my friend get pulled in to cover for me unless I felt like I was dying. I continued to work 13-14hr shifts for the next few days and thus it took weeks longer to recover because I didn’t give my body any time to rest.
What about that other time that we were called upon to volunteer to cover the MICU? I catch a cold a few days before my shift. COVID Negative so I guess I can work. My symptoms are fairly mild but I’m sure the 6:00 am to 6:00 pm shift isn’t going to make that better. But there’s no way one of my friends is getting pulled to help cover for me for a shift that I volunteered for. So I work and get worse and worse throughout the day. Well, I expected this.
Back to the present. I sit here and wait for my test to come back still really hoping it’s negative. Knowing that it’s most likely going to be negative since I tested negative yesterday but there is a chance that I tested too early. Knowing that I will go to work sick unless I actually feel like I’m dying. Knowing that since I’m starting nights for 2 weeks, there’s fat chance that my body is going to recover and my immune system is actually going to work well during this time. But hey, at least my friend isn’t going to get pulled in to cover for me.
There is that small chance that it may be positive. If it is, great—I will feel terrible because my friend will have to cover for me working 14 hr nights while I quarantine.
But hey, I guess my immune system will get some time to recover and that’s a small positive.
I wanted to share my thought process to highlight a flaw in our healthcare system. This experience is not uncommon for residents not just in my program but in almost all residency programs. I think this experience also expands to outside the residency system. Most doctors I know will work when they’re sick unless they are about to be hospitalized. Or unless they have are COVID positive or have a COVID test pending. Despite the many times we counsel our patients that most viral illnesses can take a week to two weeks to recover and you need to let your body rest and give it some time. What hypocrites we are.
Is there a small positive of being COVID positive? To be forced to quarantine for at least 5 days? To be forced to take time to recover? To actually be able to let our immune system work? To rest and recover like we know our body needs to? You tell me. Regardless, the guilt of having your friends get pulled from their very little free time to cover for you is still there.
I think this calls for a change in the system. Could someone qualified outside of my friends (co-residents who have been worked to the bone and deserve the very little time they get off) get called in? Could someone else get paid overtime to cover if I’m sick? Should wellness funds be used to support this instead of buying us thermoses or soup mugs? One of the arguments I hear is that faculty are often so far removed from the residency training that they don’t know how to cover if they’re called in.
So does it have to be faculty?
I know when nurses or techs call in sick, there is often a resource pool from which someone is called in to cover for the sick person and it doesn’t jeopardize the sick person’s friends/colleagues.
Hah, one of our sister residency programs calls their sick coverage Jeopardy. I wonder why?
I think we have so many options besides calling in overworked residents who are often getting paid minimum wage for the hours they are working. What do you think?
Likely Covid Negative, MD
Family Medicine Resident
Today’s Vital Signs rumination on COVID-19’s impact on healthcare has been contributed by a resident who prefers to remain anonymous.