I’m not sure what the day will bring. That is energizing and a challenge. That is true for all my days, but especially true now.
Today, the first thing that I received were texts from several patients who were concerned that I hadn’t seen the latest posts on various websites. There was the www.sanantonio.gov/website that showed that the highest number of Covid-19 cases were in the 78209 zip code. That surely would make the former Express-News columnist, Rodney Stinson, happy. He was always lampooning the denizens of this zip code and coined the phrase, “09ers”. There must be something salacious to explain that. In reality, it is probably far more mundane. The reason there are more positive tests is that there were more tests. We don’t know the total number of tests to know if there is a higher percentage of patients infected than in other localities. Patients in this zip code may have more access to testing. The other possibility is that patients in that area of town may have less understanding of social distancing than other zip codes, although I find that highly unlikely.
I went to the hospital Saturday morning to see a patient who had had a stroke. With all the hoopla over corona viruses, people forget that people have other medical emergencies like strokes and heart attacks. The hospital atmosphere had changed in the last week. I entered in the physicians entrance with my badge, but I noticed that the public entrance was guarded by two individuals at each entrance. There purpose was to make sure that those entering were:
A: not infectious
B: needed to be there
What we learned in the SARS outbreak of almost two decades ago was that there were two waves of infection. The first was those that were infected and the second was from their visitors who brought infections into the hospital. To avoid that, hospital visitors today are severely restricted. As of a week ago, visitors to Baptist and Methodist hospitals have been banned except for certain exceptions. My patient was knowledgeable of what his diagnosis was and what his treatment was to be, but was reluctant to move forward with going to rehab because he wouldn’t be able to have visitors from his family.
I had a patient with an advanced neuro degenerative disease who died several days ago. He had recurrent aspiration pneumonia, was intubated and on a ventilator. His family was devastated that they couldn’t be with him in the hospital until discussions were underway about removing him from life support. They were finally able to be with him when he was removed from the ventilator and subsequently died, but the whole process was very traumatic to the family. It would have been terrible under normal circumstances, but was that much worse since they couldn’t be with him until he was near death.
So when you lament your ability to go about your normal daily routine, just think of those who are hospitalized and are unable to be visited by their loved ones for fear of the transmission of disease. They are doubly afflicted, first from their illness and second from their isolation.