When Koosh Desai finished his internal-medicine residency in 2019, he was happy to get offered a job at Phoebe Putney Memorial Hospital in Albany. The small, friendly community, not far from where he grew up in Columbus, seemed like an ideal place to start his career as a doctor. He could see a wide range of patients and practice a holistic approach to medicine, while also working for the Medical College of Georgia. He couldn’t have expected that, six months in, a global pandemic would ravage this corner of rural Georgia.
“The first couple of patients, we didn’t know what they had. In early March, the idea that there was community spread of coronavirus happening in Albany was shocking,” says Desai, 30, a graduate of Medical College of Georgia in Augusta. “My first day taking care of COVID patients, I had two people who went from okay to being on a ventilator. That was the moment when I realized this is not like anything I’m used to.”
Within less than two months, all ICU beds were full with COVID patients. Phoebe Putney had to create several additional units to handle the volume, and Desai felt overwhelmed by the number of patients who needed his attention.
“Going from residency, where you’re supervised, to suddenly being on your own is already a learning curve,” he says. “The pandemic has just added another layer of stress on top of that.”
At other hospitals, new doctors were facing nearly empty waiting rooms. Stephen Jackson, an emergency medicine physician, also finished his residency in 2019 after graduating from Medical College of Georgia three years earlier. At Wellstar’s Atlanta Medical Center South in East Point, where he works, the normal stream of heart attacks, strokes, accidents, and broken bones slowed markedly in the wake of coronavirus.
“Normally, we might see a stroke every week and a heart attack once a month,” says Jackson, 31. “I don’t know if they’re dying at home or what’s happened. I’m used to seeing 25 to 30 patients in a 10-hour shift. Now, it’s like eight patients, and they’re mostly there because of COVID. Our typical caseload has dramatically decreased.”
Jackson is paid based on the number of patients he sees rather than a set salary and has had his pay cut by more than 30 percent. “People think doctors are making boatloads of money just because we’re in a healthcare crisis. But a lot of practices are really suffering.” He and his wife had hoped to pay off his medical-school loans within five years, but, “now, I’m thinking it’s going to be more like 10.”
“Out of the frying pan and into the fire,” is how Peyton Hanson views his looming transition from medical-school student to practicing doctor. Hanson, 26, officially earned his MD from Emory School of Medicine on May 8. This summer, he’ll pack his things into a U-Haul and begin the long drive to Boston to start his residency in internal medicine at Massachusetts General Hospital.
Under normal circumstances, Hanson would be celebrating his graduation and residency match with friends and family: Mass General is a prestigious, sought-after training program for doctors. Instead, since Emory closed its campus in mid-March, Hanson has been staying with his parents on Lake Martin in Alabama, wrapping up his schoolwork and helping out at his family’s hand-sanitizer distribution business.
Boston has been hard-hit by coronavirus, with more than 17,000 cases in Suffolk County so far. Hanson says this could alter his training on conditions other than COVID-19, depending on the case mix when he starts.
“I wasn’t thinking about specializing in infectious diseases, but that’s what my training will be now. During residency, you’re supposed to have two- to four-week blocks of electives, like in cardiology or endocrinology, often in an outpatient setting, so you get a feel for that subspecialty. A lot of that was upended when places temporarily stopped holding outpatient clinics.”
Caroline Coleman, who also graduated from Emory School of Medicine this spring, is starting her residency in internal medicine, which rotates between four area hospitals: Grady, Emory University Hospital, Emory Midtown, and the VA. She knows that a lot has been asked of residents during the pandemic, and she’s nervous about donning a white coat for the first time as some experts are predicting a second wave of cases.
“The way I was describing it to a friend is that it feels like we’re at summer camp getting ready to go off the diving board. But as you get close to the front of the line, someone puts a big X over the normal diving board and they point you to the Olympic-sized board instead,” she says. “It’s like, yeah, I know how to dive, but it’s really scary. It’s definitely going to be an extra challenge learning the ropes at the same time that this simmering anxiety is going on in the background.”
She also anticipates that she might have to self-quarantine away from her parents at some point. Still, Coleman, 25, is proud to be joining the ranks of a profession whose members are being hailed as heroes.
“There’s this sense that we’re all in it together. It’s like, Put me in, Coach. Seeing the yard signs and the cheers that happen at shift changes; that kind of stuff gives me chills.”
For Alex Galloway, the “hero” label is intimidating. Galloway, 27, just finished his first year of residency in internal medicine at Emory and works at the same four Atlanta hospitals as Coleman. He himself got sick with COVID-19 back in March and has since recovered.
He says there’s no way to know where he was exposed to the virus, adding, “Healthcare workers face unknown risks every day. I chose to do medicine because I wanted to care for others in spite of the risks.” While he appreciates community support, he admits, “I often feel inadequate in the face of these challenging times. I have come to appreciate the sacrifices of so many, including food services, housekeeping, security, and others who keep the hospital going.”
Ashlee-Marie Jones, 27, graduated from Morehouse School of Medicine in May and will soon start her residency in obstetrics and gynecology at Wellstar Kennestone in Marietta. She points out that the state’s dismal maternal mortality rate could worsen if more pregnant patients miss out on prenatal and postnatal care because of COVID.
“Some women are already coming in for their first prenatal visit at 30-plus weeks of pregnancy,” says Jones. “Being pregnant is already an immunocompromised state. It’s really a double-edged sword, and there are a lot of steps where things can go wrong.”
Jones, who says her medical-school textbooks had “one paragraph” about coronaviruses, adds that the pandemic may present an opportunity to learn more about infectious diseases in pregnant women. Still, the many unknowns about how the virus impacts expectant mothers and babies are daunting.
“Instead of just worrying about my ability to take care of my patients, I’m also worried that I’ll somehow mess up a disinfecting procedure or get exposed myself,” says Jones. “I also have a daughter who is only three years old. It’s going to be hard coming home from the hospital and not being able to give her a hug.”
This article appears in our July 2020 issue.