As we move beyond the three-month shelter-in-place mark, physicians can reflect on the ups and downs they have experienced during this unique global crisis. Dr. Samiraly Moosa, a second-year resident at Norwegian American Hospital on the west side of Chicago, along with 17 other residents, rolls up his sleeves every morning ready to face the uncertainties of the day.
Dr. Moosa describes the most difficult part of his work as navigating the knowns and unknowns of an “optimal” COVID-19 treatment plan. “What works for one patient doesn’t always work for another patient. If we take two individuals with similar health scores and no comorbid conditions, with all other variables held constant, both individuals could react very differently to the virus or the same treatment plan,” he said.
For students and physicians actively providing health care services, it is imperative to constantly read and study new cases, new research, and familiarize themselves with medical best practices. Common ailments have researched back treatment plans and physicians can reference documented cases for use in their plans. However, no such road map was available to physicians at the onset of the COVID-19 pandemic.
“The biggest problem I was struggling with is that there aren’t specific guidelines for how to address the disease caused by COVID-19 and we’re learning on the fly. I’m constantly modifying my approach. Some things work and some things don’t, and it’s emotionally taxing.” Dr. Moosa said.
Describing the on-going struggle with the guilt that comes from having to make tough decisions, especially when guidance can change so quickly, Dr. Moosa gives an example: he and other physicians around the country began prescribing hydroxychloroquine after the FDA approved it for emergency use for COVID-19 treatment. “After research came out that the drug was probably doing more harm than good, I went home and thought, what did I do? Because as a physician we’ve all taken the oath to first do no harm.”
As an Ismaili Muslim and a practicing physician, Dr. Moosa reconciles the guilt of not obtaining desired optimal results by continuing to do his best and perform thorough due diligence for each diagnosis.
“As an individual who practices medicine but also believes in a higher power, these past few months have been incredibly humbling. Science, research, medicine, it all has limits. Every day we can do our best, but when dealing with a disease that continues to morph, a disease that is still somewhat of a mystery to us, at the end of the day, I believe there is immense strength in prayer and community. Prayer for guidance, prayer for strength, prayer for loved ones. I don’t want people to think that prayers don’t work and that science is the ultimate answer.”
Norwegian American Hospital is a safety net medical facility, which provides healthcare to individuals regardless of their insurance status. Patients can require one-on-one time to understand the changing and expanding safety guidelines related to COVID-19 and navigating the healthcare landscape in general. Dr. Moosa identified this need and created an email account that he circulates to the patients he treats. This account allows him to respond to questions in a way that can easily be internalized by his patients. He encourages his patients to provide the email account to those who have barriers to medical care access and may benefit from someone providing reliable health information.
Dr. Moosa says the most frequent question in his inbox is how his patients can reliably know when to come into the emergency room.
“If they are self-quarantining at home and they’re sick, they don’t know if they have COVID. If they do not have COVID, they don’t want to run the risk of potentially getting it by coming to the ER. People are having a hard time figuring out when they should actually come to the hospital.”
As cities begin to lift the shelter-in-place regulations, Dr. Moosa recommends individuals take ownership of their health.
“The only advice I would give is that everyone has to try their best to take care of their health. The onus is on them to protect themselves. Wear a mask, wash your hands, practice good hygiene, and be socially distant! Perhaps don’t have extended family over at your house when shelter-in-place lifts. Before making any health decisions, do a cost-benefit analysis, speak to your provider, anything you take will have a side-effect.”
