When Risks Become Very Real

What your doctor is reading on Medscape.com:

APRIL 14, 2020 — Because I travel so much, I cherish my weekends at home. I put work aside, for the most part, and spend time with my family. Sundays are the highlight: I often plan a nice supper and we eat in our formal dining room, a space typically reserved for large family parties.-

COVID-19 has made these weekends more special. I know that each time I go to work, I risk exposing myself to an asymptomatic carrier—a fellow oncologist, a nurse, or a patient. I can put this stress away when I am at home for the weekend.

This past weekend, I received an email from a colleague embedded as an oncology hospitalist; she recently attended the code of a COVID-19–positive patient. In that moment, the risks she faced became very real.

In her note, she reiterated many of the same COVID-19 fears that I have written about in this diary: concern for her own safety as well as that of her family and her husband, also a doctor. She wondered what options she had to mitigate her risk. I saw just how much she had not “signed up for” when she took the position.

I realized then that none of us did.

At no point in my career did I think that treating people with cancer would involve worrying about my own safety—not that I’d get cancer, of course, but that they might pass on a potentially deadly virus. Who could have imagined that one day I’d practice with a mask on my face, unable to hold my patient’s hand?

I could have told my colleague that her role required her to attend as scheduled, that COVID-19 should not be treated any differently from influenza. That yes, as a physician she needs to do her job.

But I know from my own anxieties that this is not a reasonable response. Where she is a mother, I am a father—our concerns are the same. I was proud to see my team pull together to mitigate the risks of our group’s hospitalists; when the surge schedule activates on Tuesday, the consult attending—one of the outpatient doctors—will care for those with cancer and COVID-19. We have acted as a group to maintain our inpatient ward free of COVID-19.

I hope to God we are prepared.

Don S. Dizon, MD, is an oncologist who specializes in women’s cancers. He is the director of women’s cancers at Lifespan Cancer Institute and director of medical oncology at Rhode Island Hospital.